The relationship between oxidative balance score, depression, and survival among adult cancer survivors in the United States

BackgroundDepression and oxidative balance score (OBS) are linked to disease risk, yet their combined effects on cancer survival remain unclear. This study assessed OBS, depression, and mortality in cancer survivors.MethodsUtilizing a prospective, population-based cohort design, this analysis enroll...

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Main Authors: Qu Zhang, Yemei Wu, Qianyu Fan, Wenxi Zhou, Min Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Nutrition
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Online Access:https://www.frontiersin.org/articles/10.3389/fnut.2025.1622588/full
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author Qu Zhang
Qu Zhang
Yemei Wu
Qianyu Fan
Wenxi Zhou
Wenxi Zhou
Min Liu
author_facet Qu Zhang
Qu Zhang
Yemei Wu
Qianyu Fan
Wenxi Zhou
Wenxi Zhou
Min Liu
author_sort Qu Zhang
collection DOAJ
description BackgroundDepression and oxidative balance score (OBS) are linked to disease risk, yet their combined effects on cancer survival remain unclear. This study assessed OBS, depression, and mortality in cancer survivors.MethodsUtilizing a prospective, population-based cohort design, this analysis enrolled 1,455 adult cancer survivors (age ≥20 years) through the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. The OBS was related to diet and exercise, and depression was self-reported. Depressive symptomatology was measured using the established Patient Health Questionnaire-9 (PHQ-9) self-report questionnaire. Depression was defined as a total PHQ-9 score > 4, indicating the presence of depressive symptoms. A score ≤ 4 was considered to indicate no depression. Mortality outcomes (all-cause, cancer-specific, non-cancer) were tracked via the National Death Index through 2019. Cox models adjusted for demographics, socioeconomic status, and comorbidities.ResultsOver 80–90 months, 329 deaths occurred (102 cancer-related). Higher OBS predicted reduced mortality (per-unit HR = 0.94, 95% CI: 0.90–0.98). In OBS tertiles, Tertile 3 vs. Tertile 1 showed HR = 0.30 (95% CI: 0.14–0.63) for cancer mortality. Depression alone had no mortality association (HR = 1.24, 95% CI: 0.49–3.18). However, within the highest OBS tertile, depressed patients exhibited lower cancer mortality (HR = 0.18, 95% CI: 0.05–0.71) versus non-depressed counterparts.ConclusionElevated OBS is protective in cancer survivors. Depression may paradoxically reduce mortality risk in high-OBS subgroups, suggesting nutrition-psychology interactions.
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spelling doaj-art-ee1b30bb1b0a415894ed8055ceb9fa0e2025-08-20T03:13:11ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-07-011210.3389/fnut.2025.16225881622588The relationship between oxidative balance score, depression, and survival among adult cancer survivors in the United StatesQu Zhang0Qu Zhang1Yemei Wu2Qianyu Fan3Wenxi Zhou4Wenxi Zhou5Min Liu6Department of Radiation Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, ChinaDepartment of Radiotherapy Center, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Thoracic Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaNational Key Clinical Specialty Discipline Construction Program, Hubei Provincial Clinical Research Center for Breast Cancer, Wuhan Clinical Research Center for Breast Cancer, Breast Cancer Center, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Radiation Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, ChinaBackgroundDepression and oxidative balance score (OBS) are linked to disease risk, yet their combined effects on cancer survival remain unclear. This study assessed OBS, depression, and mortality in cancer survivors.MethodsUtilizing a prospective, population-based cohort design, this analysis enrolled 1,455 adult cancer survivors (age ≥20 years) through the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. The OBS was related to diet and exercise, and depression was self-reported. Depressive symptomatology was measured using the established Patient Health Questionnaire-9 (PHQ-9) self-report questionnaire. Depression was defined as a total PHQ-9 score > 4, indicating the presence of depressive symptoms. A score ≤ 4 was considered to indicate no depression. Mortality outcomes (all-cause, cancer-specific, non-cancer) were tracked via the National Death Index through 2019. Cox models adjusted for demographics, socioeconomic status, and comorbidities.ResultsOver 80–90 months, 329 deaths occurred (102 cancer-related). Higher OBS predicted reduced mortality (per-unit HR = 0.94, 95% CI: 0.90–0.98). In OBS tertiles, Tertile 3 vs. Tertile 1 showed HR = 0.30 (95% CI: 0.14–0.63) for cancer mortality. Depression alone had no mortality association (HR = 1.24, 95% CI: 0.49–3.18). However, within the highest OBS tertile, depressed patients exhibited lower cancer mortality (HR = 0.18, 95% CI: 0.05–0.71) versus non-depressed counterparts.ConclusionElevated OBS is protective in cancer survivors. Depression may paradoxically reduce mortality risk in high-OBS subgroups, suggesting nutrition-psychology interactions.https://www.frontiersin.org/articles/10.3389/fnut.2025.1622588/fulloxidative balance scoredepressioncancer survivorsmortalityNHANES
spellingShingle Qu Zhang
Qu Zhang
Yemei Wu
Qianyu Fan
Wenxi Zhou
Wenxi Zhou
Min Liu
The relationship between oxidative balance score, depression, and survival among adult cancer survivors in the United States
Frontiers in Nutrition
oxidative balance score
depression
cancer survivors
mortality
NHANES
title The relationship between oxidative balance score, depression, and survival among adult cancer survivors in the United States
title_full The relationship between oxidative balance score, depression, and survival among adult cancer survivors in the United States
title_fullStr The relationship between oxidative balance score, depression, and survival among adult cancer survivors in the United States
title_full_unstemmed The relationship between oxidative balance score, depression, and survival among adult cancer survivors in the United States
title_short The relationship between oxidative balance score, depression, and survival among adult cancer survivors in the United States
title_sort relationship between oxidative balance score depression and survival among adult cancer survivors in the united states
topic oxidative balance score
depression
cancer survivors
mortality
NHANES
url https://www.frontiersin.org/articles/10.3389/fnut.2025.1622588/full
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