Association between Oxidative Balance Score and Colorectal Cancer: Insights from NHANES 1999-2018

Previous studies have indicated an association between high antioxidant exposure and colorectal cancer (CRC) risk in elderly populations. However, the relationship between the oxidative balance score (OBS) and CRC risk in the general population remains unclear.

In this study, we used the OBS, which is based on dietary and lifestyle factors, to assess the oxidative stress (OS) status of individuals and to explore the association between OBS and CRC risk in American adults.

Overall, 44,482 participants from the National Health and Nutrition Examination Survey (NHANES 1999-2018) were included in the cross-sectional study, of whom 340 had CRC. OBS, which consists of 20 dietary and lifestyle factors, was the exposure variable. Weighted multivariate logistic regression, subgroup analysis, and restricted cubic spline curves were used to assess the association between OBS and CRC. Sensitivity analyses were conducted to evaluate the robustness of the results.

Multiple logistic regression showed that the CRC risk decreased by 2.0% for each OBS unit added (OR= 0.98, 95%CI: 0.96-1.00, P=0.019). Compared with the lowest OBS reference group (T1), OBS in the highest tertile of OBS (T3) was associated with a reduced CRC risk (OR= 0.58, 95%CI: 0.39-0.84). Similarly, individuals in the highest dietary OBS tertile (T3) had a reduced CRC risk (OR= 0.63, 95%CI: 0.44-0.91), whereas no significant association was observed in lifestyle OBS and CRC.

Higher OBS and dietary OBS were associated with CRC. A healthy lifestyle and antioxidant-rich diet may be useful for preventing CRC.