Validation of Dietary Antioxidant Index (DAI) and investigating the relationship between DAI and the odds of gastric cancer

Background Gastric cancer (GC) incidence and mortality are rapidly growing worldwide. It is estimated that more than 1,000,000 new cases are diagnosed each year, and more than 78,000 people lose their lives due to GC. The association between dietary antioxidants and GC has been shown in some studies. However, because of the discrepancy between the findings and the lack of a valid indicator, it seems necessary to design and validate the Dietary Antioxidant Index (DAI) to examine the diet's total antioxidant content. The present study aimed to survey the validity of DAI and its association with the odds of GC. Methods In this hospital-based case-control study, 82 patients with GC and 95 healthy controls were examined. We used a 168-item food frequency questioner to assess dietary intakes. The DAI was calculated based on the intake of vitamin A, C, E, and selenium, manganese, and zinc. We standardized each of the six vitamins and minerals by subtracting the global mean and dividing by the global standard deviation to calculate DAI. We then calculated the DAI by summing up the standardized intakes of these vitamins and minerals of the individuals with equal weight. Results We observed a significant correlation between DAI and total antioxidant capacity (TAC) after controlling for age, body mass index (BMI), energy intake, smoking and fasting blood sugar, education, total fat intake, helicobacter pylori infection, total cholesterol, and saturated fatty acid (SFA) intakes. Results obtained from modeling DAI as a continuous variable in relation to GC showed a negative association after adjustment for age and in the multivariable analysis (OR = 0.64, CI = 0.43-0.95). Conclusion DAI is a valid indicator of dietary antioxidants assessments, and it can be used as a predictor of antioxidant status due to its correlation with serum antioxidant levels. The results showed that dietary antioxidants have a significant relationship with GC, which indicates the importance of antioxidants in this cancer's etiology.