Associations of the Composite Dietary Antioxidant Index with Body Composition, Sarcopenia, and Sarcopenic Obesity Among US Children and Adolescents: Insights from the National Health and Nutrition Examination Survey

Purpose There is ongoing debate regarding the effectiveness of dietary antioxidant intake in reducing oxidative stress to prevent sarcopenia and sarcopenic obesity(SO) in adults. This study aimed to evaluate whether there is an association between the composite dietary antioxidant index(CDAI), sarcopenia, and SO in children and adolescents. Methods This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) of US children and adolescents aged 8–18 years and included surveys conducted from 2001–2006 and 2011–2018. The CDAI was calculated on the basis of dietary recall data collected via questionnaire interviews. Body composition was assessed via dual-energy X-ray absorptiometry (DXA). Results Our analysis included 10,113 children and adolescents, with a mean age of 13.04 ± 3.14 years, and 51.93% were male. Multivariate linear regression analysis revealed that the CDAI does not significantly affect the muscle mass index(MMI) Z score. Nevertheless, a correlation exists between the CDAI and the muscle-to-fat ratio (MFR), and the fat mass index (FMI) Z-score(β = 0.234, 95% CI 0.102–0.366; β=-0.236, 95% CI -0.392 to -0.079 for every 10-unit increase in CDAI). Multivariate logistic regression analysis revealed that the CDAI was inversely associated with sarcopenia alone and with SO. Subgroup analyses revealed associations between the CDAI and sarcopenia in participants who were female, aged < 14 years, and Mexican American. Conclusion Dietary intake of antioxidants may positively influence overall body composition by reducing fat mass and preventing sarcopenia and SO among children and adolescents.