Dietary Total Antioxidant Capacity-A New Indicator of Healthy Diet Quality in Cardiovascular Diseases: A Polish Cross-Sectional Study

Abstract

This study aimed to assess the relationship between the dietary total antioxidant capacity (DTAC) and the occurrence of cardiovascular diseases (CVDs), as well as healthy diet quality, in a representative sample (n = 5690) of the whole Polish adult population (WOBASZ II study). Daily food consumption was estimated by the single 24 h dietary recall method. Antioxidant vitamins (C, E, and β-carotene) and minerals (Zn, Fe, Mn, and Cu) from the diet and supplements were calculated using 5D Diet software, and dietary total polyphenol intake (DTPI) was determined using the Phenol-Explorer database and our database. Total diet quality was measured by the Healthy Diet Indicator (HDI) based on World Health Organization (WHO) recommendations for the prevention of CVD. DTAC was calculated using the data on food consumption and the antioxidant potential of foods measured by the FRAP (ferric ion reducing antioxidant potential) method. It was shown that higher DTAC was associated with a higher intake of polyphenols, antioxidant vitamins, and minerals. Moreover, a higher quartile of DTAC was associated with a reduced odds ratio for cardiovascular diseases in a Polish population, as well as with a higher HDI. Therefore, dietary recommendations for the prevention and therapy of CVDs should take into account a high DTAC. DTAC, measured by the FRAP method, can be considered an indicator of healthy diet quality.

Keywords: FRAP; cardiovascular disease; dietary total antioxidant capacity; population.

Figure 1

Distribution of HDI score (HDI ≥ 5 vs. HDI ≤ 4) and average HDI score (95% CI) by quartiles of DTAC. Mean HDI adjusted for age in men and women and additionally for sex in the total group. p_t—p-value for trend test; p₁₂, p₁₃, and p₁₄—p-values for comparisons with reference quartile Q1. DTAC—dietary total antioxidant capacity; HDI—Healthy Diet Indicator. Difference between average HDI was tested using a general linear model with Tukey–Kramer adjustment for multiple comparisons, while the distribution of HDI was tested by Cochran–Armitage test for trend.