Front Nutr. 2026 May 20;13:1739431. doi: 10.3389/fnut.2026.1739431. eCollection 2026.
ABSTRACT
BACKGROUND: Cardiovascular disease, particularly ischemic heart disease and stroke, remains a major global health burden. Although dietary antioxidants have been linked to cardiovascular health, previous studies have mainly focused on individual nutrients, and evidence regarding the combined effects of multiple antioxidants remains limited. This study aimed to examine the association between the composite dietary antioxidant index and the risks of ischemic heart disease and stroke in the UK Biobank cohort.
METHODS: This prospective cohort study included 66,382 participants from the UK Biobank. Data were derived from the UK Biobank prospective cohort. Cox proportional hazards models were applied to estimate hazard ratios (HRs) for IHD and stroke across quartiles of CDAI. Potential nonlinear associations were evaluated using restricted cubic spline models. In addition, the interaction analyses were conducted to explore the subgroup differences.
RESULTS: A total of 66,382 participants were included in the analysis, with 4,844 cases of IHD and 1,982 cases of stroke documented during a median follow-up of approximately 12.1 years for IHD and 12.4 years for stroke. Individuals with higher CDAI values demonstrated a trend of initially decreasing and then increasing risk of IHD and stroke compared with those in the lowest quartile. Nonlinear analyses revealed an inflection point at -0.30 for IHD and -0.29 for stroke. Below these thresholds, CDAI was inversely associated with disease risk, with hazard ratios (HRs) of 0.89 (95% CI: 0.81-0.97) for IHD and 0.82 (95% CI: 0.72-0.95) for stroke.
CONCLUSION: This large-scale cohort study revealed that elevated CDAI within a specific range was associated with a reduced risk of IHD and stroke. These results underscore the relevance of antioxidant-rich dietary patterns for cardiovascular disease prevention.
PMID:42245558 | PMC:PMC13229849 | DOI:10.3389/fnut.2026.1739431