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Dietary total antioxidant capacity and mortality from all causes, cardiovascular disease and cancer: a systematic review and dose–response meta-analysis of prospective cohort studies

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Abstract

Purpose

No conclusive information is available about the association between dietary total antioxidant capacity (DTAC) and risk of mortality. Current meta-analysis of prospective cohort studies was done to summarize available findings on the association between DTAC and risk of death from all-cause, cancer and cardiovascular diseases (CVDs).

Methods

Online databases were searched to detect relevant publications up to January 2018, using relevant keywords. To pool data, either fixed-effects or random-effects model was used. Furthermore, linear and non-linear dose–response analyses were also done.

Results

In total, five prospective studies were included in the current systematic review and meta-analysis. In a follow-up period of 4.3–16.5 years, there were 38,449 deaths from all-cause, 4470 from cancer and 2841 from CVDs among 226,297 individuals. A significant inverse association was found between DTAC and all-cause mortality (combined effect size: 0.62, 95% CI 0.60–0.64). Such finding was also seen for cancer (combined effect size: 0.81, 95% CI 0.75–0.88) and CVD (combined effect size: 0.71, 95% CI 0.63–0.82) mortality. Findings from linear dose–response meta-analysis revealed that a 5 mmol/day increment in DTAC based on ferric reducing antioxidant power (FRAP) and oxygen radical absorbance capacity (ORAC) was associated with 7% and 15% lower risk of all-cause mortality, respectively. Based on findings from non-linear dose–response meta-analysis, a significant reduction in risk of all-cause mortality was seen when increasing FRAP from 2 to 12 mmol/day (P-nonlinearity = 0.002) and ORAC from 5 to 11 mmol/day (P-nonlinearity < 0.001).

Conclusions

Adherence to diet with high total antioxidant capacity was associated with decreased risk of death from all-cause, cancer and CVDs.

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Abbreviations

DTAC:

Dietary total antioxidant capacity

FRAP:

Ferric reducing antioxidant power

TRAP:

Total radical trapping antioxidant parameter

TEAC:

Trolox equivalence antioxidant capacity

ORAC:

Oxygen radical absorbance capacity

OR:

Odds ratio

RR:

Relative risk

HR:

Hazard ratio

FFQ:

Food frequency questionnaire

CVD:

Cardiovascular disease

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Acknowledgements

This study was supported jointly by Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran, and Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.

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Authors and Affiliations

  1. School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

    Mohammad Parohan & Javad Anjom-Shoae

  2. Department of Operating Room Technology, School of Paramedicine, Qom University of Medical Sciences, Qom, Iran

    Morteza Nasiri

  3. Department of Surgical Technology, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran

    Morteza Nasiri

  4. Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mahmoud Khodadost

  5. Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

    Mahmoud Khodadost

  6. Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran

    Seyed Reza Khatibi

  7. Gerash University of Medical Sciences, Gerash, Iran

    Omid Sadeghi

  8. Students’ Scientific Research Center, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran

    Omid Sadeghi

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MN, JAS, MP, SRK and MK contributed to conception, design, statistical analyses, data interpretation and manuscript drafting. OS and MP contributed to data analysis, data interpretation and manuscript drafting. All authors approved the final manuscript for submission.

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Correspondence to Omid Sadeghi.

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Parohan, M., Anjom-Shoae, J., Nasiri, M. et al. Dietary total antioxidant capacity and mortality from all causes, cardiovascular disease and cancer: a systematic review and dose–response meta-analysis of prospective cohort studies. Eur J Nutr 58, 2175–2189 (2019). https://doi.org/10.1007/s00394-019-01922-9

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