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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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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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