The Association Between Dietary Antioxidant Micronutrients and Cardiovascular Disease in Adults in the United States: A Cross-Sectional Study

Abstract

Background: Antioxidant micronutrients represent an important therapeutic option for the treatment of oxidative stress-associated cardiovascular diseases (CVDs). However, few studies have evaluated the relationship between the levels of multiple dietary antioxidants and CVDs.Objective: The study therefore aimed to evaluate associations between dietary antioxidants and total and specific CVDs among a nationally representative sample of adults in the US.Design: In total, 39,757 adults (>20 years) were included in this cross-sectional study from the 2005–2018 National Health and Nutrition Examination Survey. We analyzed dietary recall of 11 antioxidant micronutrients in this population. Multivariate logistic and weighted quantile sum (WQS) regression were both applied to examine the relationships between these antioxidants, alone and in combination, with the prevalence of all CVDs and specific CVDs. The linearity of these correlations was also explored using restricted cubic spline (RCS) regression.Results: Multivariate logistic models showed that, compared with the lowest quartile, the levels of 11 antioxidants in the highest quartile were independently associated with decreased total CVD (all P < 0.05). The WQS index showed that, when considered together, the 11 micronutrients were negatively correlated with total CVD (P < 0.001) and five specific CVDs (all P < 0.05), and selenium had the strongest association (weight = 0.219) with total CVD. Moreover, the RCS model demonstrated that iron, zinc and copper were all negatively and non-linearly correlated with total CVD, while the eight other micronutrients had non-significant, linear, negative relationships with total CVD (P for non-linearity >0.05). A piecewise binary logistic regression analysis showed that the inflection points in the relationships between CVD and iron, zinc and copper were 7.71, 6.61, and 0.74 mg/day, respectively.Conclusions: Our findings suggested that high levels of combined dietary antioxidant micronutrients are associated with decreased prevalence of CVDs, and that selenium has the greatest contribution to this association.

Association of habitually low intake of dietary selenium with new-onset stroke: A retrospective cohort study (2004–2015 China Health and Nutrition Survey)

“…Studies have shown that selenium-rich Brazil nuts can improve oxidative stress by regulating GPx activity and the expression of Nrf2-related genes ( 65 ). In addition, selenium is a component of dietary antioxidants and increasing dietary antioxidant intake may not only reduce the risk of stroke but also improve the prognosis of stroke patients ( 66 , 67 ). Although many studies have demonstrated the beneficial effects of selenium on stroke, a balanced diet (containing fruits, vegetables, legumes, whole grain cereals, nuts and seeds) naturally rich in antioxidant foods such as selenium may be a safer approach until the mechanistic effects of selenium and antioxidant supplement use on stroke are elucidated ( 68 ).…”

Dietary copper intake and risk of myocardial infarction in US adults: A propensity score-matched analysis

“…Our findings were consistent with those of Kodali et al ( 1 ): Copper might reduce the risk of ischemic heart disease. Yin et al ( 45 ) showed that high levels of antioxidant micronutrients in the diet were correlated with reduced cardiovascular disease morbidity; levels of iron, zinc, and copper were inversely and non-linearly correlated with cardiovascular diseases. Therefore, trace minerals might have the ability to prevent cardiovascular disease.…”

Selenium Status and Its Antioxidant Role in Metabolic Diseases

“…In addition, considering the crucial role of Se in the cellular antioxidant defense system, therapeutic strategies involving Se supplementation for the treatment of certain diseases have been underway for many years [77,78]. Recently, this practice has achieved promising results in the prevention and treatment of metabolic diseases, including CHD, HT, NAFLD, and T2DM [6,[79][80][81][82].…”