Abstract
Abstract.Background: In the present meta-analysis, we aimed to summarize the relationship between dietary total antioxidant capacity (TAC), general and central obesity indices and lipid profile in adult population. Methods: The electronic databases of Web of Sciences, PubMed, Scopus and Cochrane library were searched for relevant studies from inception to October 2019. The effect size was indicated as weighted mean difference (WMD) and 95% confidence intervals (CI) by using random effects model. The I2 index and Cochran’s Q-test were used for evaluating heterogeneity. Results: From 2,469 studies identified, thirty-four studies (nineteen cross-sectional studies, thirteen cohort studies, two case-control studies) were included in the meta-analysis. According to our results, higher categories of TAC were associated with significantly lower serum triglyceride concentartions (TG; WMD: −7.58; CI: −11.42, −3.75; P < 0.001) and waist circumference (WC; WMD: −1.17; 95% CI: −1.47, −0.87; P < 0.001); while no significant change in body mass index (BMI; WMD: −0.17; 95% CI: −0.35, 0.01; P = 0.12), high density lipoprotein cholesterol (HDL-C; WMD: 0.61; 95% CI: −0.16, 1.40; P = 0.12), low density lipoprotein cholesterol (LDL-C; WMD: 1.34; 95% CI: −0.61, 3.30; P = 0.17) and total cholesterol (TC; WMD: 1.19; 95% CI: −1.46, 3.855; P = 0.37) was reported. Conclusion: Higher dietary TAC was related to reduced prevalence of central obesity, reduced WC and TG concentrations in the current meta-analysis. Moreover, subgroup analysis showed that TAC measurement index, geographical area, dietary assessment tool, health status and gender were potential sources of heterogeneity.
References
1 . Obesity and overweight. 2018. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
2 . A systematic review of diet quality indices in relation to obesity. Br J Nutr. 2017;117(8):1055–65.
3 Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766–81.
4 . Total serum antioxidant capacity in healthy normal weight and asymptomatic overweight adults. Exp Clin Endocrinol Diabetes. 2017;125(7):470–7.
5 Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest. 2017;114(12):1752–61.
6 Obesity and systemic oxidative stress: Clinical correlates of oxidative stress in the Framingham Study. Arterioscler Thromb Vasc Biol. 2003;23(3):434–9.
7 . The implication of obesity and central fat on markers of chronic inflammation: The ATTICA study. Atherosclerosis. 2005;183(2):308–15.
8 Recent advances in the relationship between obesity, inflammation, and insulin resistance. Eur Cytokine Netw. 2006;17(1):4–12.
9 . Epidemiology of diabetes. Br J Clin Pharmacol. 2004;44(4):397–405.
10 Oxidative stress in obesity: A critical component in human diseases. Int J Mol Sci. 2015;16(1):378–400.
11 Effects of a Mediterranean-style diet on cardiovascular risk factors: A randomized trial. Ann Intern Med. 2006;145(1):1–11.
12 . A legume-based hypocaloric diet reduces proinflammatory status and improves metabolic features in overweight/obese subjects. Eur J Nutr. 2011;50(1):61–9.
13 . Effects of grapefruit, grapefruit juice and water preloads on energy balance, weight loss, body composition, and cardiometabolic risk in free-living obese adults. Nutr Metab (Lond). 2011;8(1):8.
14 . 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.
15 . Dietary antioxidant capacity is associated with improved serum antioxidant status and decreased serum C-reactive protein and plasma homocysteine concentrations. Eur J Nutr. 2013;52(8):1901–11.
16 Effects and mechanisms of fruit and vegetable juices on cardiovascular diseases. Int J Mol Sci. 2017;18(3):555.
17 . Spectrophotometric assays for total antioxidant capacity (TAC) in dog serum: An update. BMC Vet Res. 2016;12(1):166.
18 . Dietary total antioxidant capacity and obesity in children and adolescents. Int J Food Sci Nutr. 2010;61(7):713–21.
19 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.
20 . Dietary total antioxidant capacity: A novel indicator of diet quality in healthy young adults. J Am Coll Nutr. 2009;28(6):648–56.
21 . 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.
22 . Glucose challenge stimulates reactive oxygen species (ROS) generation by leucocytes. J Clin Endocrinol Metab. 2000;85(8):2970–3.
23 . Redox molecules and cancer prevention: The importance of understanding the role of the antioxidant network. Nutr Cancer. 2006;56(2):232–40.
24 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.
25 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 (Lond). 2011;8(1):59.
26 . Dietary total antioxidant capacity is negatively associated with some metabolic syndrome features in healthy young adults. Nutrition. 2010;26(5):534–41.
27 Dietary total antioxidant capacity and dietary polyphenol intake and prevalence of metabolic syndrome in Polish adults: A nationwide study. Oxid Med Cell Longev. 2018;2018:1–10.
28 . Dietary total antioxidant capacity significantly interacts with 6–P21 rs2010963 gene polymorphisms in terms of cardio-metabolic risk factors in patients with metabolic syndrome. BMC Res Notes. 2020;13(1):1–8.
29 . Higher dietary total antioxidant capacity is inversely related to prediabetes: A case-control study. Nutrition. 2018;46:20–5.
30 . 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.
31 . 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):e0208806.
32 Total antioxidant capacity from diet and risk of myocardial infarction: A prospective cohort of women. Am J Med. 2012;125(10):974–80.
33 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.
34 . Total antioxidant capacity of diet in relation to cognitive function and decline. Am J Clin Nutr. 2010;92(5):1157–64.
35 . 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 (Lond). 2012;9(1):70.
36 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.
37 . 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.
38 Dietary flavonoid, lignan and antioxidant capacity and risk of hepatocellular carcinoma in the European prospective investigation into cancer and nutrition study. Int J Cancer. 2013;133(10):2429–43.
39 . Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Ann Intern Med. 2009;151(4):264–9.
40 . 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.
41 . Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58.
42 Dietary total antioxidant capacity is inversely related to menopausal symptoms: A cross-sectional study among Iranian postmenopausal women. Nutrition. 2018;55:161–7.
43 . 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.
44 Dietary antioxidant capacity and all-cause and cause-specific mortality in the E3 N/EPIC cohort study. Eur J Nutr. 2017;56(3):1233–43.
45 Dietary antioxidant capacity and risk for stroke in a prospective cohort study of Swedish men and women. Nutrition. 2017;33:234–9.
46 . Association between dietary total antioxidant capacity and hepatocellular ballooning in nonalcoholic steatohepatitis: A cross-sectional study. Eur J Nutr. 2019;58(6):2263–70.
47 Total antioxidant capacity of the diet and major neurologic outcomes in older adults. Neurology. 2013;80(10):904–10.
48 Dietary non-enzymatic antioxidant capacity and the risk of myocardial infarction: The Swedish National March Cohort. Int J Epidemiol. 2018;47(6):1947–55.
49 Dietary total antioxidant capacity and mortality in the PREDIMED study. Eur J Nutr. 2016;55(1):227–36.
50 . Dietary total antioxidant capacity and the risk of breast cancer: A case-control study. East Mediterr Health J. 2015;21(8):564–71.
51 Dietary non-enzymatic antioxidant capacity and DNA damage in a working population. Nutrition. 2018;47:63–8.
52 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.
53 . 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.
54 . High dietary total antioxidant capacity is associated with a reduced risk of hypertension in French women. Nutr J. 2019;18(1):31.
55 . Dietary antioxidants and risk of Parkinson's disease in two population-based cohorts. Mov Disord. 2017;32(11):1631–6.
56 . 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.
57 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.
58 . 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.
59 Are dietary antioxidant intake indices correlated to oxidative stress and inflammatory marker levels? Antioxid Redox Signal. 2015;22(11):951–9.
60 Dietary antioxidant capacity and risk of type 2 diabetes in the large prospective E3 N-EPIC cohort. Diabetologia. 2018;61(2):308–16.
61 . 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.
62 . Obesity: Overview of prevalence, etiology, and treatment. Phys Ther. 2003;83(3):276–88.
63 The implication of obesity on total antioxidant capacity in apparently healthy men and women: The ATTICA study. Nutr Metab Cardiovasc Dis. 2007;17(8):590–7.
64 . Dietary pattern, dietary total antioxidant capacity, and dyslipidemia in Korean adults. Nutr J. 2019;18(1):37.
65 . Antioxidants and cardiovascular disease: A review. J Am Coll Nutr. 1993;12(4):426–32.
66 . Effect of antioxidant capacity on blood lipid metabolism and lipoprotein lipase activity of rats fed a high-fat diet. Nutrition. 2006;22(11–12):1185–91.
67 . Influence of dietary ginger (Zingiber officinales Rosc) on antioxidant defense system in rat: Comparison with ascorbic acid. Indian J Exp Biol. 2000;38(6):604–6.
68 Effects of grape antioxidant dietary fiber in cardiovascular disease risk factors. Nutrition. 2008;24(7–8):646–53.
69 . Effect of chokeberry juice consumption on antioxidant capacity, lipids profile and endothelial function in healthy people: A pilot study. Czech J Food Sci. 2016;34(1):39–46.
70 Simple method for determining human serum 2,2-diphenyl-1-picryl-hydrazyl (DPPH) radical scavenging activity - Possible application in clinical studies on dietary antioxidants. Clin Chem Lab Med. 2008;46(3):342–9.
71 Influence of chokeberry juice on arterial blood pressure and lipid parameters in men with mild hypercholesterolemia. Pharmacol Rep. 2007;59(Suppl 1):177–82.
72 Polyphenol-rich cranberry juice has a neutral effect on endothelial function but decreases the fraction of osteocalcin-expressing endothelial progenitor cells. Eur J Nutr. 2013;52(1):289–96.
73 . The anti-obesity effect of quercetin is mediated by the AMPK and MAPK signaling pathways. Biochem Biophys Res Commun. 2008;373(4):545–9.
74 Vegetables containing phytochemicals with potential anti-obesity properties: A review. Food Res Int. 2013;52(1):323–33.
75 AICAR inhibits adipocyte differentiation in 3T3L1 and restores metabolic alterations in diet-induced obesity mice model. Nutr Metab (Lond). 2006;3(1):31.
76 . AMPK activation regulates apoptosis, adipogenesis, and lipolysis by eIF2α in adipocytes. Biochem Biophys Res Commun. 2006;340(1):43–7.
77 . AMPK in health and disease. Physiol Rev. 2009;89(3):1025–78.
78 . MEK inhibition enhances paclitaxel-induced tumor apoptosis. J Biol Chem. 2000;275(50):38953–6.
79 . Functional in vivo interactions between JNK1 and JNK2 isoforms in obesity and insulin resistance. Proceedings of the National Academy of Sciences. 2006;103(28):10741–6.
80 . Effects of dietary fibers on disturbances clustered in the metabolic syndrome. J Nutr Biochem. 2008;19(2):71–84.
81 . Butyrate inhibits cytokine-induced VCAM-1 and ICAM-1 expression in cultured endothelial cells: The role of NF-kappaB and PPARalpha. J Nutr Biochem. 2004;15(4):220–8.
82 . Effects of isolated soluble fiber supplementation on body weight, glycemia, and insulinemia in adults with overweight and obesity: A systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2017;106(6):1514–28.
83 . Maternal antioxidant supplementation prevents adiposity in the Offspring of Western Diet-Fed Rats. Diabetes. 2010;59(12):3058–65.
84 . Reactive oxygen species facilitate adipocyte differentiation by accelerating mitotic clonal expansion. J Biol Chem. 2009;284(16):10601–9.
85 Inflammation, oxidative stress, and obesity. Int J Mol Sci. 2011;12(5):3117–32.
86 . Green tea as inhibitor of the intestinal absorption of lipids: Potential mechanism for its lipid-lowering effect. J Nutr Biochem. 2007;18(3):179–83.
87 . (-) Epigallocatechin gallate suppresses the differentiation of 3T3-L1 preadipocytes through transcription factors FoxO1 and SREBP1c. Cytotechnology. 2010;62(3):245–55.
88 Lemon polyphenols suppress diet-induced obesity by up-regulation of mRNA levels of the enzymes involved in beta-oxidation in mouse white adipose tissue. J Clin Biochem Nutr. 2008;43(3):201–9.
89 . Induction of cell apoptosis in 3T3-L1 pre-adipocytes by flavonoids is associated with their antioxidant activity. Mol Nutr Food Res. 2006;50(11):1072–9.
90 . Ferric reducing antioxidant potential (FRAP) of antioxidants using reaction flow chromatography. Anal Chim Acta. 2017;967:93–101.
91 Dietary total antioxidant capacity from different assays in relation to serum C-reactive protein among young Japanese women. Nutr J. 2012;11(1):91.
92 A systematic screening of total antioxidants in dietary plants. J Nutr. 2002;132(3):461–71.
93 . Relative validity of food intake estimates using a food frequency questionnaire is associated with sex, age, and other personal characteristics. J Nutr. 2006;136(2):459–65.
94 . Gender differences in food choice: The contribution of health beliefs and dieting. Ann Behav Med. 2004;27(2):107–16.
95 . Association of dietary total antioxidant capacity to anthropometry in healthy women: A cross-sectional study. Nutrition. 2020;69:110577.
96 Effect of body condition, body weight and adiposity on inflammatory cytokine responses in old horses. Vet Immunol Immunopathol. 2009;127(3–4):286–94.
97 . Anti-inflammatory activity of extracts from fruits, herbs and spices. Food Chem. 2010;122(4):987–96.
98 Diversity of dietary patterns observed in the European Prospective Investigation into Cancer and Nutrition (EPIC) project. Public Health Nutr. 2002;5(6b):1311–28.