Association of composite dietary antioxidant index with circadian syndrome: evidence from NHANES

Abstract

Background: The Circadian Syndrome (CircS) has been linked to various chronic diseases. However, the relationship between composite dietary antioxidant index (CDAI) and CircS has remained unexplored. This study aimed to investigate the potential association between CDAI and CircS.

Methods: Cross-sectional analyses were based on the National Health and Nutrition Examination Survey (NHANES) 2005-2018. Dietary consumption was assessed via the 24-h diet recall method and CDAI was computed following a validated approach involving six antioxidants. CircS was defined based on metabolic syndrome components, supplemented by short sleep duration and depressive symptoms. The relationship between CDAI and CircS was examined using weighted multivariable logistic regression and subgroup analyses. Additionally, restricted cubic spline (RCS) regression was employed to investigate potential nonlinear correlations.

Results: Among 11,048 subjects included (mean age 47.57 years), 2,733 (weighted prevalence = 22.13%) were reported to have CircS. Logistic regression revealed that the highest quartile of CDAI was inversely associated with the risk of CircS {odds ratio (OR) [95% CI = 0.69 (0.55-0.87)]} and the risk of depression [OR = 0.59 (0.48-0.72)], short sleep duration [OR = 0.54 (0.41-0.70)], elevated fasting glucose [OR = 0.80 (0.65-0.98)], elevated triglycerides (TG) [OR = 0.74 (0.59-0.92)], elevated waist circumference [OR = 0.65, (0.52-0.80)] and reduced high-density lipoprotein cholesterol (HDL-C) [OR = 0.75 (0.61-0.92)], respectively. A dose-response gradient in odds of CircS components was noted as CDAI levels increased, particularly with depression and short sleep duration. RCS showed a non-linear relationship between CDAI and CircS, with a U-shaped correlation found between Zinc and CircS (inflection point 12.63). Subgroup analysis showed BMI modified the inverse association between CDAI and CircS (p for interaction = 0.003).

Conclusion: This study revealed a non-linear and negative association between CDAI and CircS risk, with a U-shaped correlation observed between Zinc and CircS. Obese individuals might not benefit from excessively high CDAI. The results suggest that a higher CDAI score was correlated with a decreased risk of CircS.

Keywords: NHANES; circadian syndrome; composite dietary antioxidant index; cross-sectional study; dietary antioxidant; restricted cubic spline.

Figure 1

Flowchart of the study design.

Figure 2

Association of CDAI with Circs and its components. Associations of CDAI with (A) Circadian Syndrome, (B) elevated glucose, (C) elevated TG, (D) elevated BP, (E) elevated WC, (F) reduced HDL-C, (G) depression, and (H) Short sleep duration. CDAI, Composite dietary antioxidant index; Circs, Circadian Syndrome. *Statistically significant findings. Adjusted for age, sex, race, poverty income ratio, educational level, energy intake, cholesterol intake, smoke status, and alcohol consumption.

Figure 3

The RCS curve of the association of CDAI with CircS and its components among all the study participants. (A) The RCS curve of the association between CDAI and CircS; (B) The RCS curve of the association between CDAI and elevated glucose; (C) The RCS curve of the association between CDAI and elevated TG; (D) The RCS curve of the association between CDAI and elevated BP; (E) The RCS curve of the association between CDAI and elevated WC; (F) The RCS curve of the association between CDAI and reduced HDL-C; (G) The RCS curve of the association between CDAI and depression. (H) The RCS curve of the association between CDAI and short sleep duration. RCS regression was adjusted for age, sex, race, PIR, educational level, energy intake, cholesterol intake, smoke status, and alcohol consumption. RCS, restricted cubic spline; CDAI, composite dietary antioxidant index; CircS, circadian syndrome; TG, triglycerides; BP, blood pressure; WC, waist circumference; HDL-C, High density lipoprotein-cholesterol, PIR, poverty income ratio.

Figure 4

Forest plot of logistic regression analyses of the association between CDAI components and Circs. (A) The logistic regression analyses of the association between Vitamin A and Circs; (B) The logistic regression analyses of the association between Vitamin C and Circs; (C) The logistic regression analyses of the association between Vitamin E and Circs; (D) The logistic regression analyses of the association between Zinc and Circs; (E) The logistic regression analyses of the association between Selenium and Circs; (F) The logistic regression analyses of the association between Carotenoid and Circs. Adjusted for age, sex, race, PIR, educational level, energy intake, cholesterol intake, smoke status, and alcohol consumption. CDAI, composite dietary antioxidant index; CircS, circadian syndrome; PIR, poverty income ratio.

Figure 5

The RCS curves of the association between CDAI components and CircS among all the study participants. (A) The RCS curve of the association between Vitamin A and circadian syndrome; (B) The RCS curve of the association between Vitamin C and circadian syndrome; (C) The RCS curve of the association between Vitamin E and circadian syndrome; (D) The RCS curve of the association between zinc and circadian syndrome; (E) The RCS curve of the association between selenium and circadian syndrome; (F) The RCS curve of the association between carotenoid and circadian syndrome. RCS regression was adjusted for age, sex, race, PIR, educational level, energy intake, cholesterol intake, smoke status, and alcohol consumption. RCS, restricted cubic spline; CDAI, composite dietary antioxidant index; CircS, circadian syndrome; PIR, poverty income ratio.

Figure 6

Subgroups RCS analyses for the association between CDAI and circadian syndrome stratified by (A) age (<40, 40–59, and ≥ 60), (B) sex (male and female), (C) race (others; NH-Black, and NH-White), and (D) BMI (<30.0, and ≥ 30.0). RCS regression was adjusted for age, sex, race, PIR, educational level, energy intake, cholesterol intake, smoke status, and alcohol consumption. RCS, restricted cubic spline; CDAI, composite dietary antioxidant index. CircS, circadian syndrome, PIR, poverty income ratio.