Abstract
Abstract:Background: Numerous studies have revealed the protective role of dietary antioxidants against hypertension and diabetes. In the current systematic review and meta-analysis, we evaluated the possible role of dietary total antioxidant capacity (TAC) against metabolic parameters in the adult population. Methods: A literature search of authentic electronic resources including PubMed, Scopus, Web of Sciences, and Cochrane had been performed to retrieve the qualified observational studies that reported the mean plus/minus the SD for the parameter in subjects of the highest versus lowest dietary TAC categories up to July 2020. Results: Totally, the number of included studies was 13 for fasting blood sugar (FBS), 12 for systolic blood pressure (SBP), and 12 for diastolic blood pressure (DBP), with the participants’ number of 26349. The results of the current study showed that being at highest category of TAC significantly reduces serum FBS (WMD: −2.381; CI: −3.445, −1.316; P<0.001), SBP (WMD: −1.080; CI: −1.458, −0.701; P<0.001) and DBP (WMD: −0.854; CI: −1.655, −0.052; P<0.001), while no significant difference in the serum insulin, HOMA-IR values, prevalence of type 2 diabetes (T2DM) (P=0.37) and hypertension (HTN) (P=0.09) was observed. Subgroup analysis revealed the geographical location, dietary assessment tool, sample size, and gender as possible sources of heterogeneity. Conclusion: Higher intake of dietary TAC was associated with reduced SBP, DBP, and FBS in the current observational studies of this meta-analysis. These findings further confirm the clinical importance of dietary antioxidants in the prevention of different metabolic disorders.
References
1 . Spectrophotometric assays for total antioxidant capacity (TAC) in dog serum: an update. BMC Vet Res. 2016;12(1):1–7.
2 . Dietary total antioxidant capacity and obesity in children and adolescents. Int J Food Sci Nutr. 2010;61(7):713–21.
3 . Dietary total antioxidant capacity: a novel indicator of diet quality in healthy young adults. J Am Coll Nutr. 2009;28(6):648–56.
4 . Redox molecules and cancer prevention: the importance of understanding the role of the antioxidant network. Nutr Cancer. 2006;56(2):232–40.
5 . Both lipid and protein intakes stimulate increased generation of reactive oxygen species by polymorphonuclear leukocytes and mononuclear cells. Am J Clin Nutr. 2002;75(4):767–72.
6 . Glucose challenge stimulates reactive oxygen species (ROS) generation by leucocytes. J Clin Endocrinol Metab. 2000;85(8):2970–3.
7 Dietary total antioxidant capacity and dietary polyphenol intake and prevalence of metabolic syndrome in polish adults: a nationwide study. Oxid Med Cell Longev. 2018;2018:7487816.
8 . Dietary total antioxidant capacity is negatively associated with some metabolic syndrome features in healthy young adults. Nutrition. 2010;26(5):534–41.
9 . Higher dietary total antioxidant capacity is inversely related to pre-diabetes: a case-control study. Nutrition. 2018;46:20–5.
10 Dietary non-enzymatic antioxidant capacity and the risk of myocardial infarction: a case-control study in Italy. Nutr Metab Cardiovasc Dis. 2014;24(11):1246–51.
11 Total antioxidant capacity from diet and risk of myocardial infarction: a prospective cohort of women. Am J Med. 2019;125(10):974–80.
12 , Dietary total antioxidant capacity (TAC) among candidates for coronary artery bypass grafting (CABG) surgery: Emphasis to possible beneficial role of TAC on serum vitamin D. PLoS One. 2018;13(12).
13 . High dietary total antioxidant capacity is associated with a reduced risk of hypertension in French women. Nutr J. 2019;18(1):31–41.
14 Dietary antioxidant capacity and risk of type 2 diabetes mellitus, pre-diabetes and insulin resistance: the Rotterdam Study. Eur J Epidemiol. 2019;34(9):853–61.
15 . Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603–5.
16 . Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539–58.
17 . Total and individual antioxidant intake and endometrial cancer risk: Results from a population-based case-control study in New Jersey. Cancer Causes Control. 2012;23(6):887–95.
18 . Association between dietary total antioxidant capacity and hepatocellular ballooning in nonalcoholic steatohepatitis: a cross-sectional study. Eur J Nutr. 2018;58(6):2263–70. https://doi.org/10.1007/s00394-018-1776-0.
19 . Dietary total antioxidant capacity is inversely associated with all-cause and cardiovascular disease death of US adults. Eur J Nutr. 2018;57(7):2469–76.
20 . Greater total antioxidant capacity from diet and supplements is associated with a less atherogenic blood profile in U.S. Adults. Nutrients. 2016;8(1):15–29.
21 Dietary total antioxidant capacity is inversely associated with prostate cancer aggressiveness in a population-based study. Nutr Cancer. 2016;68(2):214–24.
22 Development of a comprehensive dietary antioxidant index and application to lung cancer risk in a cohort of male smokers. Am J Epidemiol. 2004;160(1):68–76.
23 . Dietary total antioxidant capacity and incidence of chronic kidney disease in subjects with dysglycemia: Tehran Lipid and Glucose Study. Eur J Nutr. 2018;57(7):2377–85.
24 . Dietary total antioxidant capacity and the occurrence of metabolic syndrome and its components after a 3-year follow-up in adults: Tehran Lipid and Glucose Study. Nutr Metab. 2012;9(1):70–9.
25 Postoperative atrial fibrillation and total dietary antioxidant capacity in patients undergoing cardiac surgery: the Polyphemus Observational Study. J Thorac Cardiovasc Surg. 2015;149(4):1175–82.
26 Total antioxidant capacity of the diet and major neurologic outcomes in older adults. Neurology. 2013;80(10):904–10.
27 . Total antioxidant capacity of diet in relation to cognitive function and decline. Am J Clin Nutr. 2010;92(5):1157–64.
28 Interplay of glycemic index, glycemic load, and dietary antioxidant capacity with insulin resistance in subjects with a cardiometabolic risk profile. Int J Mol Sci. 2018;19(11):3662–74.
29 Association of total dietary antioxidant capacity with oxidative stress and metabolic markers among patients with metabolic syndrome. J Nutr Health. 2017;50(3):246–56.
30 Dietary total antioxidant capacity and mortality in the PREDIMED study. Eur J Nutr. 2016;55(1):227–36.
31 Dietary total antioxidant capacity is inversely related to central adiposity as well as to metabolic and oxidative stress markers in healthy young adults. Nutr Metab. 2011;8(1):59–67.
32 Are dietary antioxidant intake indices correlated to oxidative stress and inflammatory marker Levels? Antioxid Redox Sign. 2015;22(11):951–9.
33 Dietary antioxidant capacity and risk of type 2 diabetes in the large prospective E3N-EPIC cohort. Diabetologia. 2018;61(2):308–16.
34 . Dietary antioxidant intake decreases carotid intima media thickness in women but not in men: A cross-sectional assessment in the Kardiovize study. Free Radic Biol Med. 2019;131:274–81.
35 . Total antioxidant capacity of diet and risk of heart failure: a population-based prospective cohort of women. Am J Med. 2013;126(6):494–500.
36 . Total antioxidant capacity of the diet and risk of age-related cataract: a population-based prospective cohort of women. JAMA Ophthalmol. 2014;132(3):247–52.
37 . The association between total antioxidant capacity and resting metabolic rate (RMR)/respiratory quotient (RQ) in overweight and obese woman. Diabetes Metab Syndr. 2019;13(4):2763–7.
38 . Dietary total antioxidant capacity is associated with diet and plasma antioxidant status in healthy young adults. J Acad Nutr Diet. 2012;112(10):1626–35.
39 Dietary non-enzymatic antioxidant capacity and the risk of myocardial infarction: the Swedish National March Cohort. Int J Epidemiol. 2018;47(6):1947–55.
40 . Quercetin, a flavonoid antioxidant, prevents and protects streptozotocin-induced oxidative stress and b-cell damage in rat pancreas. Pharmacol Res. 2005;51:117–23.
41 . Free radicals, antioxidants in disease and health. Int J Biomed Sci. 2008;4:89–96.
42 . Natural antioxidants and hypertension: promise and challenges. Cardiovasc Ther. 2010;28(4):e20–e32.
43 . Hormone replacement therapy causes a respiratory alkalosis in normal postmenopausal women. J Clin Endocrinol Metabol. 1999;84(6):1997–2001.
44 . Mechanisms of sex differences in hypertension, in Molecular Mechanisms in Hypertension. CRC Press. 2006;422–9.
45 . Anti-inflammatory activity of extracts from fruits, herbs and spices. Food Chem. 2010;122(4):987–96.
46 . Dietary assessment methods in epidemiologic studies. Epidemiol Health. 2014;36:1–8.
47 . Diversity of dietary patterns observed in the European Prospective Investigation into Cancer and Nutrition (EPIC) project. Public Health Nutr. 2002;5:1311–28.
48 Dietary polyphenol intake, but not the dietary total antioxidant capacity, is inversely related to cardiovascular disease in postmenopausal polish women: results of WOBASZ and WOBASZ II studies. Oxid Med Cell Longev. 2017;2017.
49 Dietary antioxidant capacity and risk for stroke in a prospective cohort study of Swedish men and women. Nutrition. 2017;33:234–9.
50 Dietary antioxidant capacity and all-cause and cause-specific mortality in the E3N/EPIC cohort study. Eur J Nutr. 2017;56(3):1233–43.
51 . Dietary total antioxidant capacity (TAC) significantly reduces the risk of site-specific cancers. an updated systematic review and meta-analysis. Nutr Cancer. 2020;1–19.