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Association of the composite dietary antioxidant index with bone mineral density in the United States general population: data from NHANES 2005–2010

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Journal of Bone and Mineral Metabolism Aims and scope Submit manuscript

Abstract

Introduction

There is evidence that individual antioxidants may increase bone mineral density (BMD) in patients with low BMD. However, the association between overall dietary antioxidant intake and BMD is unclear. The objective of this study was to examine how overall dietary antioxidant intake is related to BMD.

Materials and methods

A total of 14,069 people participated in the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2010. Dietary Antioxidant Index (DAI) was calculated from the intake of vitamins A, C, E, zinc, selenium, and magnesium, which indicates a nutritional tool to assess the overall antioxidant properties of the diet. The correlation between the Composite Dietary Antioxidant Index (CDAI) and BMD was examined using multivariate logistic regression models. In addition to fitting smoothing curves, we fitted generalized additive models as well. Furthermore, to ensure data stability and avoid confounding factors, subgroup analysis was also conducted on gender and body mass index (BMI).

Results

A significant association was demonstrated by the study between CDAI and total spine BMD (β = 0.001, 95% CI 0–0.001, P = 0.00039). And just like that, CDAI was positively correlated with femoral neck (β = 0.003, 95% CI 0.003–0.004, P < 0.00001) and trochanter (β = 0.004, 95% CI 0.003–0.004, P < 0.00001). In the gender subgroup analysis, CDAI maintained a strong positive correlation with femoral neck and trochanter BMD in males and females. Nevertheless, the link with total spine BMD was only observed in males. In addition, in the subgroup analysis stratified by BMI, CDAI showed a significantly positive relation to BMD of the femoral neck and trochanter in each group. However, the significant relationship between CDAI and BMD of the total spine was only maintained when BMI was above 30 kg/m2.

Conclusion

This study found that CDAI correlated positively with femoral neck, trochanter, and total spine BMD. This suggests that intake of a diet rich in antioxidants can reduce the risk of low bone mass and osteoporosis.

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Data availability

The survey data were publicly available on the internet for data users and researchers throughout the world http://www.cdc.gov/nchs/nhanes/.

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Acknowledgements

We thanked the staff and the participants of the NHANES study for their valuable contributions.

Funding

This work was supported by the Elderly Health Research Project of Jiangsu Commission of Health (LKZ2022008), the Natural Science Foundation of Nanjing University Of Chinese Medicine (XZR2021060), and the Foundation of The Second Affiliated Hospital of Nanjing University of Chinese Medicine (SEZ202003).

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Author notes

  1. Huawei Han and Shuai Chen have equally contributed to this work.

Authors and Affiliations

  1. Department of Orthopedics, The Second Affiliated Hospital of Nanjing University of Chinese Medicine, No.23, Nanhu Road, Jianye District, Nanjing, 210017, Jiangsu, People’s Republic of China

    Huawei Han, Shuai Chen, Jie Jin, Xianghui Li & Zhiwei Li

  2. Department of Gynecology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China

    Xinzhe Wang

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  1. Huawei Han
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Contributions

SC and JJ collected data. XW and XL organized the study and performed the statistical analysis. HH and ZL drafted the manuscript, to which all authors contributed, and approved the final version for publication.

Corresponding authors

Correspondence to Xianghui Li or Zhiwei Li.

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Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All analyses were based on data of the National Health and Nutrition Examination Survey (NHANES). The study was approved by the ethics review board of the National Center for Health Statistics. The detailed information is located on the NHANES website. Written informed consent was obtained from each participant before their inclusion in the NHANES database. Detailed information on the ethics application and written informed consent are provided on the NHANES website.

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Han, H., Chen, S., Wang, X. et al. Association of the composite dietary antioxidant index with bone mineral density in the United States general population: data from NHANES 2005–2010. J Bone Miner Metab 41, 631–641 (2023). https://doi.org/10.1007/s00774-023-01438-7

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  • DOI: https://doi.org/10.1007/s00774-023-01438-7

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