Hostname: page-component-cb9f654ff-d5ftd Total loading time: 0 Render date: 2025-08-02T23:45:07.907Z Has data issue: false hasContentIssue false
  • English
  • Français

Diet’s total antioxidant capacity and women’s health: systematic review and meta-analysis

Published online by Cambridge University Press:  06 March 2025

Tauane A. Dutra Open the ORCID record for Tauane A. Dutra [Opens in a new window] ,
Marilene B. T. Fragoso Open the ORCID record for Marilene B. T. Fragoso [Opens in a new window] ,
Thiago M. Wanderley Open the ORCID record for Thiago M. Wanderley [Opens in a new window] ,
Alexandra R. Bezerra Open the ORCID record for Alexandra R. Bezerra [Opens in a new window] ,
Nassib B. Bueno Open the ORCID record for Nassib B. Bueno [Opens in a new window]  and
Alane C. M. de Oliveira Open the ORCID record for Alane C. M. de Oliveira [Opens in a new window]
Tauane A. Dutra
Affiliation:
Programa de Pós-Graduação em Nutrição, Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Alagoas, 57.072-970, Brazil
Marilene B. T. Fragoso
Affiliation:
Instituto de Química e Biotecnologia, Universidade Federal de Alagoas, Maceió, Alagoas, 57.072-970, Brazil
Thiago M. Wanderley
Affiliation:
Programa de Pós-Graduação em Nutrição, Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Alagoas, 57.072-970, Brazil
Alexandra R. Bezerra
Affiliation:
Programa de Pós-Graduação em Ciências da Saúde, Instituto de Ciências Biológicas e da Saúde, Universidade Federal de Alagoas, Maceió, Alagoas, 57.072-970, Brazil
Nassib B. Bueno
Affiliation:
Programa de Pós-Graduação em Nutrição, Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Alagoas, 57.072-970, Brazil
Alane C. M. de Oliveira*
Affiliation:
Programa de Pós-Graduação em Nutrição, Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Alagoas, 57.072-970, Brazil
*
Corresponding author: Alane C. M. de Oliveira; Email: alanecabral@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

The primary causes of female mortality often involve diseases related to oxidative stress. Dietary total antioxidant capacity (TAC) evaluates its antioxidant content and potential health effects. This study, registered with PROSPERO (ID: CRD42024427784), explores the association between dietary TAC and women’s health outcomes, including endocrine conditions with gynaecological implications, obstetric outcomes, gynaecological conditions and oncological diseases related to the female reproductive system. We conducted a systematic search in MEDLINE (via PubMed), EMBASE, LILACS and CINAHL for observational studies published up to February 2024 that explored the relationship between dietary TAC and these health conditions. Data were analysed using RevMan 5·4 software. Nineteen studies met the eligibility criteria (sample sizes: 64–3209 women) and examined various conditions, including neoplasms (breast, endometrial and ovarian), bacterial vaginosis, menopause, polycystic ovary syndrome (PCOS), pre-eclampsia (PE), gestational diabetes mellitus (GDM), miscarriage, infertility and inflammation and oxidative stress markers. The meta-analysis identified a significant association between dietary TAC, measured in vitamin C equivalents, and breast cancer, revealing that women with the disease had a lower dietary TAC due to reduced antioxidant intake. Mixed results were found for endometrial cancer, while higher TAC levels were associated with a lower risk of PCOS and infertility. Among postmenopausal women, higher TAC correlated with fewer symptoms such as sleep issues and anxiety. In gestational conditions, higher dietary TAC was linked to a lower risk of miscarriage, GDM and PE. Twelve of the nineteen studies demonstrated significant associations between dietary TAC and the outcomes of interest.

Keywords

Oxidative stressAntioxidantPregnancyPolycystic Ovary SyndromeNeoplasms

Information

Type
Systematic Review and Meta-Analysis
Information
British Journal of Nutrition , Volume 133 , Issue 11 , 14 June 2025 , pp. 1404 - 1417
Check for updates
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

United Nations (UN) (2022) UN Report Calls for Radical Change to Make Cities Safer for Women | UN News. Newsunorg. https://news.un.org/pt/story/2022/10/1804287 (accessed 29 November 2023).Google Scholar
Brazil (1986) Final Report. 8th National Health Conference. Brasília: Ministry of Health.Google Scholar
Brazil (2004) National Policy for Comprehensive Attention to Women’s Health: Principles and Guidelines. Brasília: Ministry of Health.Google Scholar
World Health Organization (WHO) (2009) Women and Health: Today’s Evidence Tomorrow’s Agenda, 1st ed. Geneva, Switzerland: World Health Organization (WHO). Available at: https://screening.iarc.fr/doc/Womenandhealthreport.pdf. Accessed: March 2024.Google Scholar
Chikara, S, Nagaprashantha, LD, Singhal, J, et al. (2018) Oxidative stress and dietary phytochemicals: role in cancer chemoprevention and treatment. Cancer Lett 413, 122–134. https://doi.org/10.1016/j.canlet.2017.11.002 CrossRefGoogle ScholarPubMed
Hajjarzadeh, S, Nikniaz, Z, Mahdavi, R, et al. (2023) The association of dietary total antioxidant capacity with migraine attack frequency in women. Int J Neurosci 134, 965–972. https://doi.org/10.1080/00207454.2023.2175675 CrossRefGoogle ScholarPubMed
Wang, Y, Yang, M, Lee, S-G, et al. (2012) Dietary total antioxidant capacity is associated with diet and plasma antioxidant status in healthy young adults. J Acad Nutr Diet 112, 1626–1635. https://doi.org/10.1016/j.jand.2012.06.007 CrossRefGoogle ScholarPubMed
Daneshzad, E, Tehrani, H, Bellissimo, N, et al. (2020) Dietary total antioxidant capacity and gestational diabetes mellitus: a case-control study. Oxid Med Cell Longev 2020, 5471316. https://doi.org/10.1155/2020/5471316 CrossRefGoogle ScholarPubMed
Abshirini, M, Siassi, F, Koohdani, F, et al. (2018) Dietary total antioxidant capacity is inversely related to menopausal symptoms: a cross-sectional study among Iranian postmenopausal women. Nutrition 55–56, 161–167. https://doi.org/10.1016/j.nut.2018.04.014 CrossRefGoogle ScholarPubMed
Stroup, DF, Berlin, JA, Morton, SC, et al. (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-Analysis of Observational Studies in Epidemiology (MOOSE) group. JAMA 283, 2008–2012. https://doi.org/10.1001/jama.283.15.2008 CrossRefGoogle ScholarPubMed
Aromataris, E, Fernandez, R, Godfrey, CM, et al. (2015) Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach. Int J Evid Based Healthc 13, 132–140.CrossRefGoogle ScholarPubMed
Gifkins, D, Olson, SH, Demissie, K, et al. (2012) Total and individual antioxidant intake and endometrial cancer risk: results from a population-based case-control study in New Jersey. Cancer Causes Control 23, 887–895. https://doi.org/10.1007/s10552-012-9958-1 Google ScholarPubMed
Gifkins, D, Olson, SH, Paddock, L, et al. (2012) Total and individual antioxidant intake and risk of epithelial ovarian cancer. BMC Cancer 12, 211. https://doi.org/10.1186/1471-2407-12-211 Google ScholarPubMed
Jalali, S, Heidari, Z, de Courten, B, et al. (2022) Dietary total antioxidant capacity and odds of breast cancer: a case-control study. Nutr Cancer 75, 302–309. https://doi.org/10.1080/01635581.2022.2110902 CrossRefGoogle ScholarPubMed
Kabodmehri, R, Sadat, F, Alami, F, et al. (2023) Female infertility and Dietary Antioxidant Index (DAI); a case-control study. BMC Womens Health 23, 247. https://doi.org/10.1186/s12905-023-02747-9 CrossRefGoogle ScholarPubMed
Karimi, Z, Bahadoran, Z, Abedini, S, et al. (2015) Dietary total antioxidant capacity and the risk of breast cancer: a case-control study. East Mediterr Health J 21, 564–571. https://doi.org/10.26719/2015.21.8.564 CrossRefGoogle ScholarPubMed
Noormohammadi, M, Eslamian, G, Kazemi, SN, et al. (2022) Is there any association between adherence to the Mediterranean Diet and dietary total antioxidant capacity with bacterial vaginosis? Results from a case-control study. BMC Womens Health 22, 833. https://doi.org/10.1186/s12905-022-01833-8 CrossRefGoogle Scholar
Rossi, M, Tavani, A, Ciociola, V, et al. (2016) Dietary total antioxidant capacity in relation to endometrial cancer risk: a case-control study in Italy. Cancer Causes Control 27, 425–431. https://doi.org/10.1007/s10552-016-0719-4 Google Scholar
Safabakhsh, M, Imani, H & Shab-Bidar, S (2020) Higher dietary total antioxidant capacity is not associated with risk of breast cancer in Iranian women. Breast Cancer 27, 652–661. https://doi.org/10.1007/s12282-020-01059-2 CrossRefGoogle Scholar
Sasanfar, B, Toorang, F, Maleki, F, et al. (2020) Association between dietary total antioxidant capacity and breast cancer: a case-control study in a Middle Eastern country. Public Health Nutr 24, 965–972. https://doi.org/10.1017/s1368980019004397 CrossRefGoogle Scholar
Alkan, SB, Artaç, M, Aksoy, F, et al. (2023) The evaluation of dietary antioxidant capacity, dietary inflammatory index and serum biomarkers in breast cancer: a prospective study. Nutr Cancer 75, 1625–1637. https://doi.org/10.1080/01635581.2023.2227404 CrossRefGoogle ScholarPubMed
Shoaibinobarian, N, Eslamian, G, Noormohammadi, M, et al. (2022) Dietary total antioxidant capacity and risk of polycystic ovary syndrome: a case-control study. Int J Fertil Steril 16, 200–205. https://doi.org/10.22074/ijfs.2021.526579.1107 Google ScholarPubMed
Sheikhi, M, Sharifi-Zahabi, E & Paknahad, Z (2017) Dietary antioxidant capacity and its association with preeclampsia. Clin Nutr Res 6, 47. https://doi.org/10.7762/cnr.2017.6.1.47 CrossRefGoogle ScholarPubMed
Vahid, F, Rahmani, D, Davoodi, SH, et al. (2021) The association among maternal index of nutritional quality, dietary antioxidant index, and odds of miscarriage incidence: case-control study. J Am Coll Nutr 41, 310–317. https://doi.org/10.1080/07315724.2021.1880987 Google ScholarPubMed
Vahid, F, Rahmani, W, Khodabakhshi, A, et al. (2022) Associated between dietary antioxidant index (DAI) and odds of breast cancer and correlation between DAI with pathobiological markers: hospital-based incidence case-control study. J Am Nutr Assoc 42, 386–392. https://doi.org/10.1080/07315724.2022.2056543 Google ScholarPubMed
Han, D, Chung, M & Park, Y (2022) Association of dietary total antioxidant capacity with cancer recurrence and mortality among breast cancer survivors: a prospective cohort study. Nutr Cancer 74, 3253–3262. https://doi.org/10.1080/01635581.2022.2074061 CrossRefGoogle ScholarPubMed
Pantavos, A, Ruiter, R, Feskens, EF, et al. (2014) Total dietary antioxidant capacity, individual antioxidant intake and breast cancer risk: the Rotterdam study. Int J Cancer 136, 2178–2186. https://doi.org/10.1002/ijc.29249 CrossRefGoogle ScholarPubMed
Maugeri, A, Barchitta, M, Magnano San Lio, R, et al. (2021) Antioxidant and inflammatory potential of diet among women at risk of cervical cancer: findings from a cross-sectional study in Italy. Public Health Nutr 25, 1577–1585. https://doi.org/10.1017/s1368980021001944 CrossRefGoogle ScholarPubMed
Abshirini, M, Siassi, F, Koohdani, F, et al. (2019) Dietary total antioxidant capacity is inversely associated with depression, anxiety and some oxidative stress biomarkers in postmenopausal women: a cross-sectional study. Ann Gen Psychiatry 18, 1–9. https://doi.org/10.1186/s12991-019-0228-2 CrossRefGoogle ScholarPubMed
Cagnacci, A, Cannoletta, M, Palma, F, et al. (2015) Relation between oxidative stress and climacteric symptoms in early postmenopausal women. Climacteric 18, 631–636. https://doi.org/10.3109/13697137.2014.999659 CrossRefGoogle ScholarPubMed
Thompson, LU, Boucher, BA, Liu, Z, et al. (2006) Phytoestrogen content of foods consumed in Canada, including isoflavones, lignans, and coumestan. Nutr Cancer 54, 184–201. https://doi.org/10.1207/s15327914nc5402_5 CrossRefGoogle ScholarPubMed
Canivenc-Lavier, M-C & Bennetau-Pelissero, C (2023) Phytoestrogens and health effects. Nutrients 15, 317. https://doi.org/10.3390/nu15020317 CrossRefGoogle ScholarPubMed
Combelles, CM, Gupta, S & Agarwal, A (2009) Could oxidative stress influence the in-vitro maturation of oocytes? Reprod Biomed Online 18, 864–880. https://doi.org/10.1016/s1472-6483(10)60038-7 CrossRefGoogle ScholarPubMed
Noormohammadi, M, Eslamian, G, Malek, S, et al. (2021) The association between fertility diet score and polycystic ovary syndrome: a case-control study. Hlth Care Wom Int 43, 70–84. https://doi.org/10.1080/07399332.2021.1886298 CrossRefGoogle ScholarPubMed
Mandani, M, Badehnoosh, B, Jalali-Mashayekhi, F, et al. (2021) Alpha-lipoic acid supplementation effects on serum values of some oxidative stress biomarkers in women with gestational diabetes. Gynecol Endocrinol 37, 1111–1115. https://doi.org/10.1080/09513590.2021.1963955 CrossRefGoogle ScholarPubMed
Abbasalizad Farhangi, M & Vajdi, M (2020) Dietary Total Antioxidant Capacity (TAC) significantly reduces the risk of site-specific cancers: an updated systematic review and meta-analysis. Nutr Cancer 73, 721–739. https://doi.org/10.1080/01635581.2020.1771385 CrossRefGoogle ScholarPubMed
Parohan, M, Sadeghi, A, Mahdavi, S, et al. (2019) Dietary total antioxidant capacity and risk of cancer: a systematic review and meta-analysis on observational studies. Crit Rev Oncol Hematol 138, 70–86. https://doi.org/10.1016/j.critrevonc.2019.04.003 CrossRefGoogle Scholar
Lopes, AC, Cruz, LV & Rocha Sobrinho, HM (2020) Association between obesity and gastric cancer. Rev Bras Militar Cienc 6. https://doi.org/10.36414/rbmc.v6i14.37 Google Scholar
Phan, MAT, Paterson, J, Bucknall, M, et al. (2017) Interactions between phytochemicals from fruits and vegetables: effects on bioactivities and bioavailability. Crit Rev Food Sci Nutr 58, 1310–1329. https://doi.org/10.1080/10408398.2016.1254595 CrossRefGoogle ScholarPubMed
Supplementary material: File

Dutra et al. supplementary material

Dutra et al. supplementary material
Download Dutra et al. supplementary material(File)
File 20.5 KB