Association between comprehensive dietary antioxidant index and stroke: mediating role of oxidative stress

Consuming a diet high in antioxidants can help lower the risk of stroke. Although the association between the comprehensive dietary antioxidant index (CDAI) and stroke has not been extensively researched, it is a useful tool for evaluating the antioxidant capacity of the diet. To look at any possible processes that may be at play in the association between stroke risk and CDAI. The National Health and Nutrition Examination Survey (NHANES) database, which collected data on stroke patients between 2003 and 2018, was utilized. The study involved three independent variables: CDAI, stroke, serum albumin, and gamma-glutamyltransferase (GGT) as mediating factors. The association between CDAI and stroke was examined using logistic regression models, and the non-linear relationship between the two was investigated using restricted cubic splines (RCS). Furthermore, the possible mediating function of serum albumin and GGT in the connection between CDAI and stroke was examined by the use of mediation analysis. Spearman correlation coefficients were used to evaluate the relationship between the stroke risk and the CDAI component parts. 31,313 non-stroke participants and 1,215 stroke patients were included in this research. The data revealed a negative connection between CDAI and stroke (OR: 0.96, 95% CI: 0.93-0.99, <i>p</i><0.01) after controlling for all confounding factors. A 38% reduction in the risk of stroke was linked to the highest quartile level of CDAI (OR: 0.62, 95% CI: 0.48-0.80, <i>p</i><0.001). A non-linear negative connection (P-non-linear = 0.0346) between CDAI and stroke was revealed using RCS analysis. Significant mediation effects on the link between CDAI and stroke are attributed to serum albumin (10.98%; <i>p</i><0.001) and GGT (0.33%; <i>p</i><0.024), respectively. The Spearman correlation coefficient results showed that vitamin A (r = 0.76) and vitamin E (r = 0.75) in CDAI were most strongly correlated with stroke, while carotenoids reduce the risk of stroke by mediating serum albumin (Proportion of mediation = 25.16%). There was a negative correlation found between CDAI and stroke risk. It could be advantageous to consume more vitamin A and E to help avoid cardiovascular illnesses.