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Strengthening Dietary Antioxidant Capacity in Primary Care: A Low-Cost Strategy to Prevent Metabolic Syndrome and MASLD in Iran
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M Sepehrinia   , A Nikparast , J Mirzay Razzaz , Reza Homayounfar * |
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Abstract: (8 Views) |
Cardiometabolic diseases, including metabolic syndrome and metabolic dysfunction-associated steatotic liver disease, are among the most important preventable public health challenges in Iran. Oxidative stress, chronic inflammation, insulin resistance, and abdominal obesity are shared pathways involved in the development and progression of these conditions. This policy brief is based on a five-year prospective cohort study among Iranian adults and a review of relevant evidence. The study examined the association between the Composite Dietary Antioxidant Index and incident metabolic syndrome among 4,503 adults, and incident metabolic dysfunction-associated steatotic liver disease among 5,988 adults.
The findings showed that a higher Composite Dietary Antioxidant Index score was associated with a lower risk of both outcomes. Participants in the highest quartile of the index had approximately 41% lower risk of developing metabolic syndrome and approximately 40% lower risk of developing metabolic dysfunction-associated steatotic liver disease compared with those in the lowest quartile. Mediation analysis further showed that dietary fiber explained about 46% of the association between the index and metabolic syndrome, while C-reactive protein, as a marker of systemic inflammation, mediated about 48% of the association with metabolic dysfunction-associated steatotic liver disease. These findings suggest that the protective effect of dietary antioxidants is more likely to occur within a healthy, fiber-rich dietary pattern rather than through isolated micronutrient or supplement intake.
Based on these findings, this policy brief recommends integrating a simple assessment of dietary antioxidant quality into primary care, developing nutrition education packages for both the public and healthcare providers, and improving the food environment to increase access to healthy antioxidant-rich foods. These actions may provide a low-cost and feasible strategy to support the prevention of cardiometabolic diseases in Iran. |
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| Keywords: Composite Dietary Antioxidant Index, metabolic syndrome, metabolic dysfunction-associated steatotic liver disease, primary care, nutrition policy |
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Full-Text [PDF 537 kb]
(8 Downloads)
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Article type: Brief Policy |
Subject:
nutrition
Received: 2026/05/25 | Accepted: 2026/01/30 | Published: 2026/06/1
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