Association of Dietary Fiber, Composite Dietary Antioxidant Index and Risk of Death in Tumor Survivors: National Health and Nutrition Examination Survey 2001–2018

Background: Dietary fiber is a functional substance with strong antioxidant activity that plays an important role in human health. Dietary fiber has been shown to reduce the risks of many types of cancers, but whether it can reduce the risk of death in cancer survivors remains undetermined. Methods: This study included the dietary data of cancer survivors who participated in the National Health and Nutrition Examination Surveys from 2001 to 2018. Firstly, the relationship between fiber intake and composite dietary antioxidant index (CDAI) was explored by weighted multiple regression and smooth curve. Subsequently, multivariable Cox proportional hazards regression models were used to explore the effects of dietary fiber intake and CDAI level on the risks of all-cause, tumor, and cardiovascular death among cancer survivors. Results: A total of 2077 participants were included in the study, representing approximately 11,854,509 cancer survivors in the United States. The dietary fiber intake of tumor survivors had a nonlinear positive relationship with CDAI levels (β = 0.24, 95% CI: 0.08–0.40, p = 0.004). Multivariable Cox proportional hazards regression models showed that high dietary fiber intake and CDAI levels were associated with reduced risks of all-cause and tumor death in tumor survivors, but were not associated with the risk of cardiovascular death. Conclusion: An increased dietary fiber intake can enhance the body’s antioxidant capacity. A higher dietary fiber intake and CDAI level may reduce the risk of all-cause and tumor death in tumor survivors.

[1]  Jian Zhang,et al.  Independent and joint associations of dietary antioxidant intake with risk of post-stroke depression and all-cause mortality. , 2022, Journal of affective disorders.

[2]  Z. Yi,et al.  Association of the Composite dietary antioxidant index with all-cause and cardiovascular mortality: A prospective cohort study , 2022, Frontiers in Cardiovascular Medicine.

[3]  A. Jemal,et al.  Cancer treatment and survivorship statistics, 2022 , 2022, CA: a cancer journal for clinicians.

[4]  Jian-Min Yuan,et al.  Composite dietary antioxidant index and the risk of colorectal cancer: Findings from the Singapore Chinese Health Study , 2022, International journal of cancer.

[5]  Jared C Malke,et al.  Dietary fiber and probiotics influence the gut microbiome and melanoma immunotherapy response , 2021, Science.

[6]  E. Huang,et al.  2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2022. , 2021, Diabetes care.

[7]  R. Rodrigues,et al.  Microbiota triggers STING-type I IFN-dependent monocyte reprogramming of the tumor microenvironment , 2021, Cell.

[8]  F. Bray,et al.  The ever‐increasing importance of cancer as a leading cause of premature death worldwide , 2021, Cancer.

[9]  C. Mackay,et al.  Gut microbial metabolites facilitate anticancer therapy efficacy by modulating cytotoxic CD8+ T cell immunity. , 2021, Cell metabolism.

[10]  Yu-qin Mao,et al.  Pectin supplement significantly enhanced the anti-PD-1 efficacy in tumor-bearing mice humanized with gut microbiota from patients with colorectal cancer , 2021, Theranostics.

[11]  A. Jemal,et al.  Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries , 2021, CA: a cancer journal for clinicians.

[12]  A. Hichami,et al.  Antioxidant and Anti-Inflammatory Potential of Polyphenols Contained in Mediterranean Diet in Obesity: Molecular Mechanisms , 2021, Molecules.

[13]  S. O'keefe,et al.  Dietary fat, bile acid metabolism and colorectal cancer. , 2020, Seminars in cancer biology.

[14]  S. Nie,et al.  Composition of bound polyphenols from carrot dietary fiber and its in vivo and in vitro antioxidant activity. , 2020, Food chemistry.

[15]  R. Malekzadeh,et al.  Meat intake and risk of gastric cancer in the Stomach cancer Pooling (StoP) project , 2020, International journal of cancer.

[16]  I. Harris,et al.  The Complex Interplay between Antioxidants and ROS in Cancer. , 2020, Trends in cell biology.

[17]  Xinglian Xu,et al.  Processed meat protein promoted inflammation and hepatic lipogenesis by upregulating Nrf2/Keap1 signaling pathway in Glrx-deficient mice. , 2019, Journal of agricultural and food chemistry.

[18]  A. Jayedi,et al.  Adherence to the Mediterranean Diet in Relation to All-Cause Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. , 2019, Advances in nutrition.

[19]  L. T. Te Morenga,et al.  Carbohydrate quality and human health: a series of systematic reviews and meta-analyses , 2019, The Lancet.

[20]  C. la Vecchia,et al.  Mediterranean diet and its components in relation to all-cause mortality: meta-analysis , 2018, British Journal of Nutrition.

[21]  R. Gyurko,et al.  Association between time since quitting smoking and periodontitis in former smokers in the National Health and Nutrition Examination Surveys (NHANES) 2009 to 2012 , 2018, Journal of periodontology.

[22]  H. Hao,et al.  Butyrate Suppresses the Proliferation of Colorectal Cancer Cells via Targeting Pyruvate Kinase M2 and Metabolic Reprogramming * , 2018, Molecular & Cellular Proteomics.

[23]  Kanthi Athreya,et al.  Antioxidants in the Treatment of Cancer , 2017, Nutrition and cancer.

[24]  Joshua Nickerson,et al.  Dietary saturated fat and monounsaturated fat have reversible effects on brain function and the secretion of pro-inflammatory cytokines in young women. , 2016, Metabolism: clinical and experimental.

[25]  T. Preston,et al.  Formation of short chain fatty acids by the gut microbiota and their impact on human metabolism , 2016, Gut microbes.

[26]  J. Dwyer,et al.  Update on NHANES Dietary Data: Focus on Collection, Release, Analytical Considerations, and Uses to Inform Public Policy , 2016, Advances in nutrition.

[27]  X. Shu,et al.  Are dietary antioxidant intake indices correlated to oxidative stress and inflammatory marker levels? , 2015, Antioxidants & redox signaling.

[28]  R. Medzhitov,et al.  The microbial metabolite butyrate regulates intestinal macrophage function via histone deacetylase inhibition , 2014, Proceedings of the National Academy of Sciences.

[29]  V. Fuchs-Tarlovsky,et al.  Antioxidant supplementation has a positive effect on oxidative stress and hematological toxicity during oncology treatment in cervical cancer patients , 2013, Supportive Care in Cancer.

[30]  P. Dolara,et al.  Antioxidant vitamins and mineral supplementation, life span expansion and cancer incidence: a critical commentary , 2012, European Journal of Nutrition.

[31]  R. Lau,et al.  Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies , 2011, BMJ : British Medical Journal.

[32]  F. Saura-Calixto.  Dietary fiber as a carrier of dietary antioxidants: an essential physiological function. , 2011, Journal of agricultural and food chemistry.

[33]  Jesús Fernando Ayala-Zavala,et al.  The Role of Dietary Fiber in the Bioaccessibility and Bioavailability of Fruit and Vegetable Antioxidants , 2011, Journal of food science.

[34]  J. Lattimer,et al.  Effects of Dietary Fiber and Its Components on Metabolic Health , 2010, Nutrients.

[35]  L. Sperling,et al.  Hypervitaminosis A altering the lipid profile in a hypercholesterolemic patient. , 2009, Journal of clinical lipidology.

[36]  Z. Li,et al.  Development of a comprehensive dietary antioxidant index and application to lung cancer risk in a cohort of male smokers. , 2004, American journal of epidemiology.

[37]  R. Buddington,et al.  Dietary oligofructose and inulin protect mice from enteric and systemic pathogens and tumor inducers. , 2002, The Journal of nutrition.

[38]  D. Jacobs,et al.  Whole-grain intake and cancer: an expanded review and meta-analysis. , 1998, Nutrition and cancer.

[39]  J. Palmgren,et al.  Alpha-Tocopherol and beta-carotene supplements and lung cancer incidence in the alpha-tocopherol, beta-carotene cancer prevention study: effects of base-line characteristics and study compliance. , 1996, Journal of the National Cancer Institute.

[40]  J. Meyerhardt,et al.  Fiber Intake and Survival After Colorectal Cancer Diagnosis , 2018, JAMA oncology.