Higher Composite Dietary Antioxidant Index Reduces Risk of Diabetes for Women

Intake of vitamin C was negativity associated with diabetes prevalence and Composite Dietary Antioxidant Index (CDAI) reduced the risk of diabetes for those women, according to results of a study published in Frontiers in Nutrition.¹

Diabetes, Vitamin, Vitamin C | Image Credit: © Chinnapong | stock.adobe.com

Investigators aimed to determine the association between dietary and antioxidant levels and diabetes for adults in the National Health and Nutrition Examination Survey (NHANES) database and explored the association between CDAI and diabetes. According to the study authors, previous data have shown that high CDAI was associated with a reduction in prevalence for chronic kidney disease and chronic obstructive pulmonary disease, but the association between CDAI and diabetes has limited data.¹

In a 2023 study, investigators found that CDAI was negatively associated with diabetes, independent of other traditional risk factors such as cardiovascular diseases. The investigators used data from a total of 11,956 individuals from NHANES and used the CDAI to calculate the intake of 6 dietary antioxidants.²

Between 2011 and 2018, 7982 individuals were eligible from the study with NHANES data, according to the study authors. Information on dietary intake was obtained during 2 24-hour dietary recall interviews, according to the investigators. The first interview was conducted in person at a mobile examination center, and the second was conducted by phone 3 to 10 days later. The CDAI was calculated from the mean dietary intake of vitamin A, vitamin C, vitamin E, zinc, selenium, and carotenoids.¹

Of the individuals included, 48.5% were male, 1607 of whom were diabetic and 66,375 were non-diabetic. The non-diabetic group had lower age, body mass index, glucose, and hemoglobin A1C levels, but high daily alcohol consumption, total daily energy intake, and higher CDAI scores compared with the diabetic group.¹

Investigators found that vitamin A intake at the higher quartiles was associated with an increased risk of diabetes, whereas zinc had the opposite effect with higher quartiles resulting in a decreased risk of diabetes. The findings were not statistically significant for zinc, but the investigators still noted the effect. Furthermore, the investigators noted an overall reduction in the risk of developing diabetes with an increasing vitamin C intake.¹

As for CDAI, higher levels were associated with lower risk when the CDAI was treated as a continuous variable. The study authors stated that both model 1 and model 2 were statistically significant, with the higher quartiles showing consistent results and supporting the lowering risk. Of note, the association was not significant in model 3, demonstrating no significant evidence of a non-linear relationship. For the subgroup analysis, the association between CDAI and diabetes was more significant in females, and there was a notable interaction between the 2 for the age covariate, according to the study investigators.¹

The investigators acknowledged the other study’s findings, stating that those results were not entirely consistent with the current study, which showed a strong correlation between CDAI and diabetes for adult women. They also acknowledged that the current data used did not include information on dietary manganese, which could have affected the results.¹

REFERENCES

1. Zhou L, Xu X, Li Y, Zhang S, Xie H. Association between dietary antioxidant levels and diabetes: a cross-sectional study. Front Nutr. 2024;11:1478815. Published 2024 Oct 23. doi:10.3389/fnut.2024.1478815

2. Chen X, Lu H, Chen Y, Sang H, Tang Y, Zhao Y. Composite dietary antioxidant index was negatively associated with the prevalence of diabetes independent of cardiovascular diseases. Diabetol Metab Syndr. 2023;15(1):183. Published 2023 Sep 8. doi:10.1186/s13098-023-01150-6