Examining the Relationship Between a High Antioxidant Diet, Lifestyle Habits, and Diabetic Retinopathy: Insights from NHANES Cross-Sectional Study

A recent study conducted by the National Center for Health Statistics (NCHS) has shed light on the relationship between oxidative balance score (OBS) and diabetic retinopathy (DR) in the United States. The study, which utilized data from the National Health and Nutrition Examination Survey (NHANES), aimed to evaluate the antioxidant capacity of individuals and its impact on the development of DR.

The research incorporated data from two NHANES study cycles in 2007–2008 and 2011–2012, enrolling a total of 19,905 participants. After applying eligibility criteria, the study focused on 1287 qualified participants. The study protocols adhered to ethical guidelines and received approval from the NCHS research ethics review board, with written informed consent obtained from all participants.

OBS is a measure of antioxidant capacity and consists of dietary OBS and lifestyle OBS components. Dietary OBS includes 16 nutrients such as dietary fiber, vitamins, and minerals, while lifestyle OBS includes factors like alcohol consumption, smoking, body mass index, and physical activity. Higher OBS scores indicate greater antioxidant capacity. The study also utilized the combined dietary antioxidant index (CDAI) to measure dietary antioxidant intake.

The study defined type 2 diabetes using criteria from the American Diabetes Association (ADA) and NHANES studies, including fasting plasma glucose levels and hemoglobin A1C percentages. DR was reported as a binary outcome confirmed by a physician.

To analyze the association between OBS, CDAI, and DR, the researchers conducted logistic regression analysis and fitted smooth curves using restricted cubic splines. They also performed stratified analysis and interaction tests to explore potential relationships.

The study also considered various covariates such as age, gender, race, household income, education level, and clinical measures like blood lipids and HbA1c levels. Statistical analysis was conducted using Python and R software, with a significance level set at P < 0.05. The findings of the study revealed interesting insights into the relationship between antioxidant capacity and DR. The results showed a significant association between OBS, CDAI, and the risk of developing DR, even after adjusting for potential confounders. The researchers observed a potential nonlinear relationship between OBS, CDAI, and DR, indicating that the impact of antioxidant capacity on DR risk may vary across different levels. Overall, the study highlights the importance of antioxidant intake and lifestyle factors in the development of DR among individuals with type 2 diabetes. By understanding the role of oxidative balance in disease progression, healthcare professionals can better tailor interventions to prevent or manage DR in at-risk populations. The research design and methodologies were approved by the NCHS Ethics Review Board, with all participants providing written consent. The study was exempt from institutional oversight as it involved secondary data analysis from NHANES. The findings of this study contribute valuable insights to the field of epidemiology and may inform future research on the prevention and management of DR in diabetic populations.