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Dietary Antioxidants, Circulating Antioxidant Concentrations, Total Antioxidant Capacity, and Risk of All-Cause Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Observational Studies
Open accessAbstract
The associations of various dietary or circulating antioxidants with the risk of all-cause mortality in the general population have not been established yet. A systematic search was performed in PubMed and Scopus, from their inception up to October 2017. Prospective observational studies reporting risk estimates of all-cause mortality in relation to dietary intake and/or circulating concentrations of antioxidants were included. Random-effects meta-analyses were conducted. Forty-one prospective observational studies (total n = 507,251) involving 73,965 cases of all-cause mortality were included. The RRs of all-cause mortality for the highest compared with the lowest category of circulating antioxidant concentrations were as follows: total carotenes, 0.60 (95% CI: 0.46, 0.74); vitamin C, 0.61 (95% CI: 0.53, 0.69); selenium, 0.62 (95% CI: 0.45, 0.79); β-carotene, 0.63 (95% CI: 0.57, 0.70); α-carotene, 0.68 (95% CI: 0.58, 0.78); total carotenoids, 0.68 (95% CI: 0.56, 0.80); lycopene, 0.75 (95% CI: 0.54, 0.97); and α-tocopherol, 0.84 (95% CI: 0.77, 0.91). The RRs for dietary intakes were: total carotenoids, 0.76 (95% CI: 0.66, 0.85); total antioxidant capacity, 0.77 (95% CI: 0.73, 0.81); selenium, 0.79 (95% CI: 0.73, 0.85); α-carotene, 0.79 (95% CI: 0.63, 0.94); β-carotene, 0.82 (95% CI: 0.77, 0.86); vitamin C, 0.88 (95% CI: 0.83, 0.94); and total carotenes, 0.89 (95% CI: 0.81, 0.97). A nonsignificant inverse association was found for dietary zinc, zeaxanthin, lutein, and vitamin E. The nonlinear dose-response meta-analyses demonstrated a linear inverse association in the analyses of dietary β-carotene and total antioxidant capacity, as well as in the analyses of circulating α-carotene, β-carotene, selenium, vitamin C, and total carotenoids. The association appeared to be U-shaped in the analyses of serum lycopene and dietary vitamin C. The present study indicates that adherence to a diet with high antioxidant properties may reduce the risk of all-cause mortality. Our results confirm current recommendations that promote higher intake of antioxidant-rich foods such as fruit and vegetables.
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“Higher dietary intake of vitamin E, as measured by serum alpha tocopherol levels, was associated with reduced mortality from several chronic conditions (cardiovascular diseases, stroke, cancer)”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [366]
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“Meta-analyses have also suggested that adhering to a diet high in antioxidant properties may reduce the risk of all-cause mortality [28].”
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“[39,40] We utilized a fi xed effects model to merge the subgroup-speci fi c estimates from each study and included the combined effect estimates in the meta-analysis when individual effect sizes were reported for different subgroups, such as gender.”
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Dietary patterns and type 2 diabetes—relationship to metabolic syndrome and inflammation
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Comparing lycopene's impact on mortality in adults with or without obesity
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“Studies have shown that antioxidants prevent cell injury from free radicals and might be beneficial in reducing risks of various diseases including cardiovascular diseases, cancer, Alzheimer’s disease and renal diseases (Aune et al. 2018; Jayedi et al. 2018).”
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“Additionally, a meta-analysis of 41 prospective observational studies concluded that adherence to an antioxidant-rich diet may reduce all-cause mortality risk [32].”
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“However, epidemiologic evidence indicates that the consumption of antioxidant-rich foods, such as vegetables, fruits, whole grains, legumes, nuts, and spices [11], may reduce the risk of all-cause mortality [12, 13].”
BackgroundResultInfluentialRocha, A. C. L., Bortoletto, M. C. D. C., da Costa, A. C., Oyafuso, L. K. M., Sañudo, A., & Tomita, L. Y. (2021) · Nutrition and Health · doi:10.1177/02601060211014127 · Cited by 3
“However, dietary lycopene has elsewhere been associated with a 28% lower risk of all-cause mortality (Jayedi et al., 2018).”
Background
Metadata
- Authors
- Jayedi, A., Rashidy-Pour, A., Parohan, M., Zargar, M. S., & Shab-Bidar, S.
- Affiliations
- Tehran University of Medical Sciences (IR)
- Semnan University of Medical Sciences (IR)
- Venue
- Advances in Nutrition
- Publisher
- Elsevier BV
- Published
- 2018-11
- Volume
- 9
- Issue
- 6
- Pages
- 701-716
- ISSN
- 2156-5376 (ISSN-L)
- 2161-8313
- PMC
- PMC6247336
- OpenAlex
- W2891504254
- Cited by
- 137
- References
- 161
- Citations by year
- 2026: 9 · 2025: 19 · 2024: 14 · 2023: 27 · 2022: 22 · 2021: 25 · 2020: 13 · 2019: 7 · 2018: 1
- FWCI
- 1.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Advances in Nutrition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Biochemistry (medical) › Antioxidant Activity and Oxidative Stress
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Biochemistry (medical) › Phytochemicals and Antioxidant Activities
- Keywords
- dietary antioxidants, total antioxidant capacity, all-cause mortality, carotenoids, vitamin C, selenium, lycopene, alpha-tocopherol, beta-carotene, alpha-carotene, dose-response relationship, mortality risk reduction, dietary intake, cardiovascular risk, neurodegenerative disease risk
- MeSH terms
- Lycopene, Antioxidants, Ascorbic Acid, Carotenoids, Cause of Death, Diet, Female, Humans, Male, Prospective Studies, Risk Factors, Selenium, Nonlinear Dynamics, alpha-Tocopherol, Observational Studies as Topic
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