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Antioxidant status and risk of coronary artery disease

Shokoofeh Talebi (School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran)
Zamzam Paknahad (Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran)
Mohammad Hashemi (School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran)
Akbar Hasanzadeh (School of Health, Isfahan University of Medical Sciences, Isfahan, Iran)

Nutrition & Food Science

ISSN: 0034-6659

Article publication date: 12 December 2018

Issue publication date: 12 August 2019




Coronary artery disease (CAD) is developed by an insufficient supply of oxygen-rich blood to the myocardium. Recent studies have shown that increased oxidative stress has implicated in the pathogenesis of coronary atherosclerosis. Anxiety and CAD have a mutual relationship, as the effect of long-lasting anxiety on atherosclerosis and CAD is well known. The purpose of this study is to investigate the relationship between dietary / serum total antioxidant capacity and CAD.


A total of 160 male patients were enrolled in this cross-sectional study. Diagnosis and analysis of angiograms were performed visually by a cardiologist. The subjects were categorized into CAD− (coronary artery obstruction <75 per cent) and CAD+ (coronary artery obstruction ≥ 75 per cent) groups. Anthropometric indices, blood pressure, blood sugar and lipid profile and physical activity (PA) were assessed. Information about anxiety was obtained by Spielberger questionnaire. Dietary total antioxidant capacity (TAC) was obtained by using a semi-quantitative food frequency questionnaire and an oxygen radical absorbance capacity of selected foods.


Mean of dietary TAC was significantly lower in CAD+ than CAD− group (P < 0.001). However, there was not any significant differences about serum TAC (P = 0.28). The mean of body mass index (BMI) (P = 0.04) and triglyceride (TG) level (P = 0.03) and the frequency of smoking (P = 0.03) were significantly higher in the CAD+ than the CAD− group. There was no significant relationship between CAD with apparent (P = 0.33) and hidden anxiety level (P = 0.16). Confounding factors such as smoking and medications were adjusted.

Research limitations/implications

This study had certain limitations. Being a single center cross-sectional design does not permit analysis of causal relationships; the sample size was geographically limited. The authors could not exclude the medication of patients, which could affect the total antioxidant capacity levels. Measurement error in self-reported dietary consumption may results misclassification of exposure.

Practical implications

A diet high in total antioxidant capacity is inversely associated with CAD. Serum TAC does not vary between men with and without CAD when confounders including age, BMI, TG, smoking, SBP, DBP, energy intake, PA, HDL-C, LDL-C, T-C, FBS, family history of CAD, education and anxiety are taken into consideration.

Social implications

High consumption of vegetables and fruits may play a major role in the prevention of CAD.


The study was approved by the ethics committee of Isfahan University of Medical Sciences (No:394888).



Talebi, S., Paknahad, Z., Hashemi, M. and Hasanzadeh, A. (2019), "Antioxidant status and risk of coronary artery disease", Nutrition & Food Science, Vol. 49 No. 4, pp. 700-712.



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