GENERAL COMMENTARY article
Front. Nutr.
Sec. Clinical Nutrition
Commentary: Association between composite dietary antioxidant index and increased urinary albumin excretion: a population-based study
Provisionally accepted
- 1Xiang'an Hospital, Xiamen University, Xiamen, China
- 2Yangzhou University Medical College, Yangzhou, China
- 3Taikang Xianlin Drum Tower Hospital, Nanjing, China
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In their recent article published in Frontiers in Nutrition, Li et al. explored the association between the Composite Dietary Antioxidant Index (CDAI) and urinary albumin excretion using NHANES 2007-2018 data. While the topic is highly relevant, we would like to offer several methodological clarifications and suggestions for improving transparency and reproducibility.In the article, the authors reported a sample size of 70,190 participants for the period 2007-2018. However, according to the official NHANES documentation, each two-year survey cycle includes approximately 10,000 participants (1). Therefore, the total number of participants across the six survey cycles from 2007 to 2018 should be around 60,000. Through our analysis of the NHANES database from 2007 to 2018, Although the participant selection process is outlined in Figure 1, there is a lack of detailed explanation regarding the number of exclusions based on each covariate. Adding clarification on these figures would enhance the transparency and credibility of the article. Moreover, given the complex survey design of NHANES, weighted analysis is essential to ensure the national representativeness of the results. Clearly stating whether sampling weights were applied would strengthen the validity of the study.Finally, we noticed that the term "microalbuminuria" is used in the introduction.According to the 2021 KDIGO guidelines, this term is now considered outdated and should be replaced with " moderately increased albuminuria " to ensure consistency and accuracy with current clinical standards.In summary, although the study by Li et al. provides valuable insights, addressing the issues mentioned above would help enhance the transparency, reproducibility, and clinical relevance of the research.
Keywords: Composite Dietary Antioxidant Index, Urinary albumin excretion (UAE), Dietary antioxidants, Albuminuria, NHANES
Received: 16 Jul 2025; Accepted: 24 Nov 2025.
Copyright: © 2025 Jin, Tong, Ge and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tong Zhang, zhangtong@xah.xmu.edu.cn
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