Antioxidant Diets and Lifestyles Could Mitigate the Risk of Sarcopenia with Low Muscle Mass in Women: A Retrospective Study

<b>Background:</b> Sarcopenia is characterized by a loss of muscle mass, strength, and function. At present, there are no effective methods available for prevention or treatment. Oxidative Balance Score (OBS) has been shown to be significantly correlated with a decreased risk of sarcopenia. Nevertheless, gender-specific studies still exhibit certain limitations. <b>Methods:</b> Individuals who completed dual-energy X-ray absorptiometry and the diet and lifestyle questionnaires from the National Health and Nutrition Examination Survey were enrolled. OBSs were calculated according to dietary or lifestyle variables and physical activity. Sarcopenia with low muscle mass (SLM) was identified based on the ratio of appendicular skeletal muscle mass to body mass index. A logistic regression analysis investigated the association between OBS and the risk of SLM in different gender groups. Kaplan-Meier survival and subgroup analyses and Cox regression analyses were used to explore the relationship between OBS and mortality in individuals with SLM in each gender subgroup. <b>Results:</b> The level of OBS in the SLM group was lower (20.40 vs. 17.07, <i>p</i> < 0.05). A multivariate logistic regression analysis showed that the OR between individual dietary nutrients and lifestyle and the risk of SLM exhibition was gender-specific. Stratified analyses revealed that total OBS, as well as diet and lifestyle OBS were negatively associated with the risk of SLM within each gender subgroup (all <i>p</i> < 0.05, all trends <i>p</i> < 0.05). Furthermore, a restriction cubic spline regression analysis showed that diet and lifestyle OBSs were negatively correlated with the risk of SLM in females (nonlinear <i>p</i> = 0.0469, nonlinear <i>p =</i> 0.0254). The KM curve showed that OBS was not significantly associated with all-cause mortality in the male and female subgroups (female, <i>p =</i> 0.064, male, <i>p =</i> 0.53). <b>Conclusions:</b> This study establishes a significant negative correlation between OBS and the risk of SLM, particularly among females. Consequently, adopting an antioxidant diet and lifestyle may prove to be more advantageous for females.