AUTHOR=Zhang Qu , Wu Yemei , Fan Qianyu , Zhou Wenxi , Liu Min 

TITLE=The relationship between oxidative balance score, depression, and survival among adult cancer survivors in the United States

JOURNAL=Frontiers in Nutrition

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1622588

DOI=10.3389/fnut.2025.1622588

ISSN=2296-861X

ABSTRACT=BackgroundDepression and oxidative balance score (OBS) are linked to disease risk, yet their combined effects on cancer survival remain unclear. This study assessed OBS, depression, and mortality in cancer survivors.MethodsUtilizing a prospective, population-based cohort design, this analysis enrolled 1,455 adult cancer survivors (age ≥20 years) through the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. The OBS was related to diet and exercise, and depression was self-reported. Depressive symptomatology was measured using the established Patient Health Questionnaire-9 (PHQ-9) self-report questionnaire. Depression was defined as a total PHQ-9 score > 4, indicating the presence of depressive symptoms. A score ≤ 4 was considered to indicate no depression. Mortality outcomes (all-cause, cancer-specific, non-cancer) were tracked via the National Death Index through 2019. Cox models adjusted for demographics, socioeconomic status, and comorbidities.ResultsOver 80–90 months, 329 deaths occurred (102 cancer-related). Higher OBS predicted reduced mortality (per-unit HR = 0.94, 95% CI: 0.90–0.98). In OBS tertiles, Tertile 3 vs. Tertile 1 showed HR = 0.30 (95% CI: 0.14–0.63) for cancer mortality. Depression alone had no mortality association (HR = 1.24, 95% CI: 0.49–3.18). However, within the highest OBS tertile, depressed patients exhibited lower cancer mortality (HR = 0.18, 95% CI: 0.05–0.71) versus non-depressed counterparts.ConclusionElevated OBS is protective in cancer survivors. Depression may paradoxically reduce mortality risk in high-OBS subgroups, suggesting nutrition-psychology interactions.