Validation of Dietary Antioxidant Index (DAI) and investigating the relationship between DAI and the odds of gastric can

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RESEARCH

Validation of Dietary Antioxidant Index (DAI) and investigating the relationship between DAI and the odds of gastric cancer Farhad Vahid1, Diana Rahmani1 and Seyed Hossein Davoodi2,3* 

Abstract  Background:  Gastric cancer (GC) incidence and mortality are rapidly growing worldwide. It is estimated that more than 1,000,000 new cases are diagnosed each year, and more than 78,000 people lose their lives due to GC. The association between dietary antioxidants and GC has been shown in some studies. However, because of the discrepancy between the findings and the lack of a valid indicator, it seems necessary to design and validate the Dietary Antioxidant Index (DAI) to examine the diet’s total antioxidant content. The present study aimed to survey the validity of DAI and its association with the odds of GC. Methods:  In this hospital-based case–control study, 82 patients with GC and 95 healthy controls were examined. We used a 168-item food frequency questioner to assess dietary intakes. The DAI was calculated based on the intake of vitamin A, C, E, and selenium, manganese, and zinc. We standardized each of the six vitamins and minerals by subtracting the global mean and dividing by the global standard deviation to calculate DAI. We then calculated the DAI by summing up the standardized intakes of these vitamins and minerals of the individuals with equal weight. Results:  We observed a significant correlation between DAI and total antioxidant capacity (TAC) after controlling for age, body mass index (BMI), energy intake, smoking and fasting blood sugar, education, total fat intake, helicobacter pylori infection, total cholesterol, and saturated fatty acid (SFA) intakes. Results obtained from modeling DAI as a continuous variable in relation to GC showed a negative association after adjustment for age and in the multivariable analysis (OR = 0.64, CI = 0.43–0.95). Conclusion:  DAI is a valid indicator of dietary antioxidants assessments, and it can be used as a predictor of antioxidant status due to its correlation with serum antioxidant levels. The results showed that dietary antioxidants have a significant relationship with GC, which indicates the importance of antioxidants in this cancer’s etiology. Keywords:  Gastric cancer, Dietary Antioxidant Index (DAI), Total antioxidant capacity (TAC), Malondialdehyde (MDA), Food Frequency Questionnaire (FFQ) Introduction Gastric Cancer (GC) is one of the most common and pernicious malignancies globally [1]. It is estimated that each year more than 1,033,701  new cases of GC *Correspondence: [email protected] 3 Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Full list of author information is available at the end of the article

are diagnosed, and more than 782,685 people lose their lives due to GC [2]. GC’s lifetime risk to age 74 remains between 5 and 20% in some parts of Asia [2, 3]. Given that the therapies for GC are limited, and the survival chance is low, prevention can be a very effective strategy to reduce th