Department of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, 610075, Chengdu, P. R. China.
College of Acupuncture and Tuina, Changchun University of Chinese Medicine, 130117, Changchun, Jilin, P.R. China.
BMC Public Health. 2024 Jan 10;24(1):147. doi: 10.1186/s12889-024-17649-0.
Low back pain is the leading cause of productivity loss, imposes a significant economic burden on the patients and society. Oxidative stress is considered a critical factor in the complex pathophysiological process and pathogenic mechanism of low back pain. Adjustment dietary pattern can effectively increase antioxidant biomarkers levels within the body to reduce oxidative stress. The composite dietary antioxidant index (CDAI) serves a reliable scoring system for quantifying the potential dietary antioxidant capacity of daily diets.
We aim to investigate the potential association between CDAI and low back pain, in order to enhance the management of low back pain through dietary guidance.
This study included 17,682 participants from the National Health and Nutrition Examination Survey (NHANES) 1999-2000, 2001-2002, 2003-2004 and 2009-2010. The weighted logistic regression model was used to investigate the association between CDAI and low back pain, while restricted cubic spline (RCS) was employed to examine non-linear trend and cutoffs.
After adjusting for all confounders, the results showed that there was no significant association between CDAI and low back pain. However, individuals in the highest quartile of CDAI exhibited an 11.7% less likelihood of experiencing a low back pain than those in the lowest quartile (OR = 0.883; 95% CI [0.787,0.991], P = 0.034), and the trend test was also significant (P for trend < 0.001). RCS indicated a linear relationship between CDAI and low back pain (P for non-linear = 0.876). Gender subgroup analysis showed that this negative association was significant in the female population (OR = 0.983; 95% CI [0.968, 0.998], P = 0.027), and females in the highest quartile of CDAI were 19.7% less likely to suffer low back pain than those in the lowest quartile (OR = 0.803; 95% CI [0.682,0.945], P = 0.008). Additionally, the changes in zinc (OR = 1.009; 95% CI [1.002, 1.016], P = 0.015) and selenium (OR = 0.379; 95% CI [0.164, 0.875], P = 0.023) per milligram were independently associated with low back pain.
The fully adjusted model showed no significant association between CDAI and low back pain, but it was significant in quartiles. Meanwhile, subgroup analysis by gender revealed a negative association between CDAI and low back pain in the female population. Additionally, the findings of this study also suggested that the antioxidant diets should be studied in a dietary pattern context.
腰痛是导致生产力下降的主要原因，给患者和社会带来了巨大的经济负担。氧化应激被认为是腰痛复杂病理生理过程和发病机制中的一个关键因素。调整饮食模式可以有效地增加体内抗氧化生物标志物的水平，从而减少氧化应激。复合膳食抗氧化指数（CDAI）是一种可靠的评分系统，用于量化日常饮食的潜在膳食抗氧化能力。
本研究旨在探讨 CDAI 与腰痛之间的潜在关联，以便通过饮食指导来加强腰痛的管理。
本研究纳入了 1999-2000 年、2001-2002 年、2003-2004 年和 2009-2010 年全国健康和营养调查（NHANES）中的 17682 名参与者。采用加权 logistic 回归模型来探讨 CDAI 与腰痛之间的关联，同时采用限制性三次样条（RCS）来检验非线性趋势和截断值。
在调整了所有混杂因素后，结果显示 CDAI 与腰痛之间无显著关联。然而，CDAI 最高四分位组的个体发生腰痛的可能性比最低四分位组低 11.7%（OR=0.883；95%CI[0.787,0.991]，P=0.034），且趋势检验具有统计学意义（P趋势<0.001）。RCS 表明 CDAI 与腰痛之间存在线性关系（P非线性=0.876）。性别亚组分析显示，这种负相关在女性人群中具有统计学意义（OR=0.983；95%CI[0.968,0.998]，P=0.027），CDAI 最高四分位组的女性发生腰痛的可能性比最低四分位组低 19.7%（OR=0.803；95%CI[0.682,0.945]，P=0.008）。此外，每毫克锌（OR=1.009；95%CI[1.002,1.016]，P=0.015）和硒（OR=0.379；95%CI[0.164,0.875]，P=0.023）的变化与腰痛独立相关。
完全调整后的模型显示 CDAI 与腰痛之间无显著关联，但在四分位数中具有显著关联。同时，按性别进行的亚组分析显示，CDAI 与女性腰痛之间存在负相关。此外，本研究的结果还表明，应该在饮食模式的背景下研究抗氧化饮食。
