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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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).
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.
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).
Adherence to diet with high total antioxidant capacity was associated with decreased risk of death from all-cause, cancer and CVDs.
KeywordsAntioxidants Mortality Meta-analysis Dose–response Cancer Cardiovascular
Dietary total antioxidant capacity
Ferric reducing antioxidant power
Total radical trapping antioxidant parameter
Trolox equivalence antioxidant capacity
Oxygen radical absorbance capacity
Food frequency questionnaire
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.
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.
Compliance with ethical standards
Conflict of interest
The author declares that there is no conflict of interest.
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