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Association Between Composite Dietary Antioxidant Index and Asthma-Chronic Obstructive Pulmonary Disease Overlap

Chunli Zeng1,2, Hequn Lyu3,4, Lihong Lou1

  • 1Department of Critical Care Medicine Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine Shanghai China.

Food Science & Nutrition
|July 27, 2026
PubMed

Insights

The composite dietary antioxidant index (CDAI) shows a complex, nonlinear link with asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS). This association varies significantly by gender, age, and BMI.

Area of Science:

  • Respiratory Medicine
  • Nutritional Epidemiology
  • Public Health

Background:

  • Asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS) poses a significant clinical challenge.
  • The role of dietary factors, specifically the composite dietary antioxidant index (CDAI), in ACOS remains under-investigated.

Purpose of the Study:

  • To investigate the association between the composite dietary antioxidant index (CDAI) and asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS).
  • To explore potential nonlinear relationships and identify specific subgroups affected by this association.

Main Methods:

  • Large-scale cohort study utilizing UK Biobank data.
  • Cox proportional hazards models and restricted cubic splines (RCS) for association analysis.
  • Kaplan-Meier methods, subgroup, and sensitivity analyses were performed.

Main Results:

  • Overall, no significant linear association was found between CDAI and ACOS after adjusting for confounders.
  • Restricted cubic spline analysis revealed a significant nonlinear association between CDAI and ACOS.
  • This nonlinear association was predominantly observed in females, individuals aged 60 and above, and those with a BMI below 30.

Conclusions:

  • A nonlinear relationship exists between dietary antioxidant intake, as measured by CDAI, and ACOS risk.
  • The association between CDAI and ACOS is modulated by sex, age, and body mass index.
  • Further research is warranted to elucidate the mechanisms underlying these complex interactions.

Keywords:
ACOSCDAIUK Biobankcohort studynonlinear

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