Composite dietary antioxidant index and lung cancer risk: insights from the UK biobank

Abstract Background Previous studies provided inconsistent results on the effects of antioxidant intake on lung cancer prevention. This study aimed to investigate the association between the composite dietary antioxidant index (CDAI), which calculated the dietary intake of manganese, selenium, zinc,...

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Main Authors: Yi Feng, Xiuxia Fu, Bo Cheng, Peiling Chen, Zixun Wang, Juan He, Xiangyuan Zheng, Xinyi Wu, Xin Bi, Minyu Dong, Jianxing He, Wenhua Liang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23720-1
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author Yi Feng
Xiuxia Fu
Bo Cheng
Peiling Chen
Zixun Wang
Juan He
Xiangyuan Zheng
Xinyi Wu
Xin Bi
Minyu Dong
Jianxing He
Wenhua Liang
author_facet Yi Feng
Xiuxia Fu
Bo Cheng
Peiling Chen
Zixun Wang
Juan He
Xiangyuan Zheng
Xinyi Wu
Xin Bi
Minyu Dong
Jianxing He
Wenhua Liang
author_sort Yi Feng
collection DOAJ
description Abstract Background Previous studies provided inconsistent results on the effects of antioxidant intake on lung cancer prevention. This study aimed to investigate the association between the composite dietary antioxidant index (CDAI), which calculated the dietary intake of manganese, selenium, zinc, vitamins A, C and E, and the risk of lung cancer. Methods Using prospective data from the UK Biobank, this study employed Cox proportional hazards regression models to evaluate the relationship between CDAI and lung cancer risk, and restricted cubic spline analyses were used to explore potential nonlinear associations. Multiplicative and additive interaction analyses were conducted to assess the joint effects of CDAI and smoking status on lung cancer risk. Results Among 201,316 participants over a median follow-up of 11.8 years, 1,229 new cases of lung cancer were identified. Multivariate analysis showed that participants in the highest quartile of CDAI had a significantly lower risk of lung cancer (HR: 0.70; 95% CI: 0.57–0.86; P < 0.001), compared with those in the lowest quartile. An interaction effect between CDAI and smoking status was noted (P = 0.001). Among former smokers, the hazard ratio was 4.58 (95% CI: 3.36–6.25; P = 8.42 × 10⁻22) in the lowest CDAI quartile and decreased to 2.60 (95% CI: 1.83–3.70; P = 1.10 × 10⁻⁷) in the highest quartile, compared to never smokers in the lowest CDAI quartile. Conclusion This study revealed a significant link between increased dietary antioxidant intake and a reduced risk of lung cancer, particularly in former smokers.
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spelling doaj-art-f7ad3506edd7429aae700b042a38e0332025-08-20T03:46:24ZengBMCBMC Public Health1471-24582025-07-0125111210.1186/s12889-025-23720-1Composite dietary antioxidant index and lung cancer risk: insights from the UK biobankYi Feng0Xiuxia Fu1Bo Cheng2Peiling Chen3Zixun Wang4Juan He5Xiangyuan Zheng6Xinyi Wu7Xin Bi8Minyu Dong9Jianxing He10Wenhua Liang11Department of Thoracic Surgery and Oncology, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical UniversityDepartment of Thoracic Surgery and Oncology, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical UniversityDepartment of Thoracic Surgery and Oncology, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical UniversityDepartment of Thoracic Surgery and Oncology, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical UniversityDepartment of Thoracic Surgery and Oncology, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical UniversityDepartment of Thoracic Surgery and Oncology, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical UniversityDepartment of Thoracic Surgery and Oncology, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical UniversityDepartment of Thoracic Surgery and Oncology, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical UniversityDepartment of Thoracic Surgery and Oncology, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Guangzhou Medical UniversityDepartment of Thoracic Surgery and Oncology, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical UniversityDepartment of Thoracic Surgery and Oncology, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical UniversityAbstract Background Previous studies provided inconsistent results on the effects of antioxidant intake on lung cancer prevention. This study aimed to investigate the association between the composite dietary antioxidant index (CDAI), which calculated the dietary intake of manganese, selenium, zinc, vitamins A, C and E, and the risk of lung cancer. Methods Using prospective data from the UK Biobank, this study employed Cox proportional hazards regression models to evaluate the relationship between CDAI and lung cancer risk, and restricted cubic spline analyses were used to explore potential nonlinear associations. Multiplicative and additive interaction analyses were conducted to assess the joint effects of CDAI and smoking status on lung cancer risk. Results Among 201,316 participants over a median follow-up of 11.8 years, 1,229 new cases of lung cancer were identified. Multivariate analysis showed that participants in the highest quartile of CDAI had a significantly lower risk of lung cancer (HR: 0.70; 95% CI: 0.57–0.86; P < 0.001), compared with those in the lowest quartile. An interaction effect between CDAI and smoking status was noted (P = 0.001). Among former smokers, the hazard ratio was 4.58 (95% CI: 3.36–6.25; P = 8.42 × 10⁻22) in the lowest CDAI quartile and decreased to 2.60 (95% CI: 1.83–3.70; P = 1.10 × 10⁻⁷) in the highest quartile, compared to never smokers in the lowest CDAI quartile. Conclusion This study revealed a significant link between increased dietary antioxidant intake and a reduced risk of lung cancer, particularly in former smokers.https://doi.org/10.1186/s12889-025-23720-1Composite Dietary Antioxidant Index (CDAI)Lung cancerSmokingUK Biobank
spellingShingle Yi Feng
Xiuxia Fu
Bo Cheng
Peiling Chen
Zixun Wang
Juan He
Xiangyuan Zheng
Xinyi Wu
Xin Bi
Minyu Dong
Jianxing He
Wenhua Liang
Composite dietary antioxidant index and lung cancer risk: insights from the UK biobank
BMC Public Health
Composite Dietary Antioxidant Index (CDAI)
Lung cancer
Smoking
UK Biobank
title Composite dietary antioxidant index and lung cancer risk: insights from the UK biobank
title_full Composite dietary antioxidant index and lung cancer risk: insights from the UK biobank
title_fullStr Composite dietary antioxidant index and lung cancer risk: insights from the UK biobank
title_full_unstemmed Composite dietary antioxidant index and lung cancer risk: insights from the UK biobank
title_short Composite dietary antioxidant index and lung cancer risk: insights from the UK biobank
title_sort composite dietary antioxidant index and lung cancer risk insights from the uk biobank
topic Composite Dietary Antioxidant Index (CDAI)
Lung cancer
Smoking
UK Biobank
url https://doi.org/10.1186/s12889-025-23720-1
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