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Open AccessReview

A Review of A Priori Defined Oxidative Balance Scores Relative to Their Components and Impact on Health Outcomes

Department of Nutrition and Bromatology, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain
Nutrition and Food Science Doctorate Program (RD 99/2011), University of Granada, 18002 Granada, Spain
Public Health Division of Gipuzkoa, Biodonostia Research Institute, Health Department, 20014 San Sebastian, Spain
CIBER de Epidemiología y Salud Pública, CIBERESP, 28029 Madrid, Spain
Department of Preventive Medicine and Public Health, University of Navarra, 31003 Pamplona, Spain
Medicina Preventiva y Salud Pública, IdiSNA (Instituto de Investigación Sanitaria de Navarra), 31008 Pamplona, Spain
CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain
Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain
CIBER de Oncología, CIBERONC, 28029 Madrid, Spain
Author to whom correspondence should be addressed.
Nutrients 2019, 11(4), 774;
Received: 11 March 2019 / Revised: 28 March 2019 / Accepted: 1 April 2019 / Published: 3 April 2019
(This article belongs to the Special Issue Dietary Antioxidants and Human Health)
Oxidative Balance Scores (OBSs) are tools that have emerged to evaluate the global balance of individuals’ oxidation—reduction status. The aim was to compare OBSs available in the literature regarding their characteristics and associations with chronic diseases in epidemiological studies. Studies that developed OBSs were searched in PubMed until August 2018. A total of 21 OBSs were identified. These OBSs presented different scoring schemes and different types of anti- and pro-oxidant components, including dietary factors (dietary intake and/or nutrient biomarkers), lifestyle factors, and medications. Most OBSs were based on over 10 components, and some included only dietary factors. Few considered weighted components in the score. Only three OBSs were validated as potential surrogates of oxidative balance through inflammation and OS-related biomarkers. Notably, all the OBSs were associated—to a varying degree—with a reduced risk of cardiovascular diseases, chronic kidney disease, colorectal adenomas, and different cancer types (colorectal and breast cancer), as well as with all-cause and cancer-related mortality. For other outcomes, e.g., prostate cancer, contradictory results were reported. In summary, there is a great heterogeneity in the definition of OBSs. Most studies are concordant in supporting that excessive OS reflected by a lower OBS has deleterious effects on health. Unified criteria for defining the proper OBSs, valuable to gauge OS-related aspects of the diet and lifestyle that may lead to adverse health outcomes, are needed. View Full-Text
Keywords: review; oxidative stress; healthy diet; antioxidants; healthy lifestyle review; oxidative stress; healthy diet; antioxidants; healthy lifestyle
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Hernández-Ruiz, Á.; García-Villanova, B.; Guerra-Hernández, E.; Amiano, P.; Ruiz-Canela, M.; Molina-Montes, E. A Review of A Priori Defined Oxidative Balance Scores Relative to Their Components and Impact on Health Outcomes. Nutrients 2019, 11, 774.

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