Higher Dietary Antioxidants Linked to Lower Mortality in adults with High-Cholesterol: Study

In this study, researchers analyzed data from 25,383 adults with hyperlipidemia who were enrolled in the 2001-2018 NHANES. The weighted Cox proportional hazards model, Kaplan-Meier survival curves, subgroup analyses, and sensitivity tests were conducted to evaluate all-cause, CVD, and cancer mortality. They divided the participants into quartiles (Q1-Q4) based on CDAI levels, with comparisons between the lowest and highest antioxidant intake groups. The potential inflammatory pathways of influence on mortality risk were mediated by key inflammation-related biomarkers: leucocytes, neutrophils, monocytes, lymphocytes, and SIRI.

Results

• During follow-up, 3,810 all-cause deaths, 1,218 CVD deaths, and 883 cancer deaths were recorded.

• The fully adjusted analysis showed that compared with the lowest quartile (Q1), individuals in the highest CDAI quartile (Q4) had a significantly decreased risk of all-cause mortality (HR 0.79, 95% CI 0.68–0.91, P = 0.001), CVD mortality (HR 0.73, 95% CI 0.55–0.96, P = 0.026), and cancer mortality (HR 0.72, 95% CI 0.55–0.93, P = 0.011).

• Of all antioxidants, vitamin E intake had the most potent protective effect. These findings were consistent throughout subgroup analyses, including age, sex, BMI, smoking status, and comorbidity profiles, and the consistency of the findings was further supported by various sensitivity analyses confirming stability.

Higher Composite Dietary Antioxidant Index levels, especially driven by vitamin E intake, were independently associated with significant reductions in all-cause and cardiovascular and cancer mortalities in adults with hyperlipidemia. According to the findings, inflammation partially mediated such associations, thereby pointing to a small but significant biological pathway that links antioxidant intake with survival.

Reference:

Liang, Y., Shi, C. Composite dietary antioxidant index is inversely associated with all-cause, cardiovascular and cancer mortality in adults with hyperlipidemia. Sci Rep 15, 39933 (2025). https://doi.org/10.1038/s41598-025-23753-x