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Background/Aim <p>Metabolic syndrome (MetS) increases the risk of type 2 diabetes and cardiovascular diseases, with oxidative stress playing an important role in its development. This study aimed to examine the association between the Composite Dietary Antioxidant Index (CDAI), a measure of total dietary antioxidant intake, and the risk of MetS in Iranian adults.</p> Methods <p>This prospective cohort study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) and included 4,628 adults (&gt; 18 years) with complete dietary assessment data from the third TLGS examination and newly enrolled participants from the fourth examination. Dietary intake was assessed using a validated 168-item food frequency questionnaire, and the CDAI was calculated based on six components: vitamins A, C, and E, manganese, selenium, and zinc. MetS was defined according to the Joint Interim Statement criteria. Multivariable-adjusted Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for MetS.</p> Results <p>The mean age and body mass index (BMI) of participants (40.4% men) were 36.1 ± 12.8 years and 25.5 ± 4.28&#xa0;kg/m², respectively. The median (25th–75th interquartile range) CDAI score was − 0.63 (− 2.70 to 1.88). During a mean follow-up of 9.3 ± 4.2 years, 1,650 (35.7%) incident cases of MetS were identified. After adjustment for age, sex, smoking status, physical activity, and energy intake, a lower risk of MetS was observed across quartiles of CDAI (HR = 0.74; 95% CI: 0.59–0.93; <i>P</i> for trend = 0.013). Further adjustment for all potential confounders strengthened this association, with a 36% lower risk of MetS across CDAI quartiles (HR = 0.64; 95% CI: 0.51–0.80; <i>P</i> for trend &lt; 0.001).</p> Conclusions <p>In this cohort of Iranian adults, higher CDAI scores were associated with a lower risk of MetS, providing the first evidence of this association in the Iranian population.</p>

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The composite dietary antioxidant index and metabolic syndrome in an Iranian adult population: a prospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月21日

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  • Hossein Farhadnejad,
  • Hamid Ahmadirad,
  • Zahra Dianati,
  • Mitra Kazemi Jahromi,
  • Niloufar Saber,
  • Farshad Teymoori,
  • Parvin Mirmiran,
  • Fereidoun Azizi

摘要

Background/Aim

Metabolic syndrome (MetS) increases the risk of type 2 diabetes and cardiovascular diseases, with oxidative stress playing an important role in its development. This study aimed to examine the association between the Composite Dietary Antioxidant Index (CDAI), a measure of total dietary antioxidant intake, and the risk of MetS in Iranian adults.

Methods

This prospective cohort study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) and included 4,628 adults (> 18 years) with complete dietary assessment data from the third TLGS examination and newly enrolled participants from the fourth examination. Dietary intake was assessed using a validated 168-item food frequency questionnaire, and the CDAI was calculated based on six components: vitamins A, C, and E, manganese, selenium, and zinc. MetS was defined according to the Joint Interim Statement criteria. Multivariable-adjusted Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for MetS.

Results

The mean age and body mass index (BMI) of participants (40.4% men) were 36.1 ± 12.8 years and 25.5 ± 4.28 kg/m², respectively. The median (25th–75th interquartile range) CDAI score was − 0.63 (− 2.70 to 1.88). During a mean follow-up of 9.3 ± 4.2 years, 1,650 (35.7%) incident cases of MetS were identified. After adjustment for age, sex, smoking status, physical activity, and energy intake, a lower risk of MetS was observed across quartiles of CDAI (HR = 0.74; 95% CI: 0.59–0.93; P for trend = 0.013). Further adjustment for all potential confounders strengthened this association, with a 36% lower risk of MetS across CDAI quartiles (HR = 0.64; 95% CI: 0.51–0.80; P for trend < 0.001).

Conclusions

In this cohort of Iranian adults, higher CDAI scores were associated with a lower risk of MetS, providing the first evidence of this association in the Iranian population.