The Relationship Between Oxidative Balance Scores and Chronic Diarrhea and Constipation: a Population-based Study

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2024 May 21

PMID 38773415

Authors

Jiayan Hu

Hede Zou

Xiyun Qiao

Yuxi Wang

Mi Lv

Kunli Zhang

Fengyun Wang

Affiliations

Soon will be listed here.

Abstract

Background: Oxidative stress is closely related to gut health. Exposures to oxidative stress in one's diet and lifestyle can be evaluated by the oxidative balance score (OBS). However, the relationship between OBS and intestinal habits is unknown. This study aimed to investigate the relationships between OBS and intestinal habits (chronic diarrhea and chronic constipation) and the underlying mechanisms involved.

Methods: Using data from the National Health and Nutrition Examination Survey (NHANES) database from 2005 to 2010, we included a total of 8065 participants. Twenty dietary and lifestyle factors were selected for the OBS calculates. Chronic constipation and chronic diarrhea were defined using the Bristol stool form scale (BSFS) types 1 and 2 and the BSFS 6 and 7, respectively. Multivariate logistic regression, subgroup analysis, and restricted cubic splines (RCS) analysis were used to evaluate the relationship between OBS and defecation habits. Finally, we used mediation analysis to explore the indirect effects of oxidative stress and inflammatory markers on these associations.

Results: After adjusting for all the covariates, multivariate logistic regression analysis revealed that OBS was negatively correlated with diarrhea (OR = 0.57; 95%CI = 0.39-0.83; P = 0.008)and positively correlated with constipation (OR = 1.75; 95%CI = 1.19-2.25; P = 0.008). The RCS showed a nonlinear relationship between OBS and diarrhea (P for nonlinearity = 0.02) and a linear relationship between OBS and constipation (P for nonlinearity = 0.19). Mediation analysis showed that the C-reactive protein (CRP) concentration and white blood cell (WBC) count mediated the correlation between OBS and diarrhea by 6.28% and 6.53%, respectively (P < 0.05).

Conclusions: OBS is closely related to changes in patients' defecation habits. Oxidative stress and inflammation may play a role in the relationship between the two. This result emphasizes the importance of the public adjusting their lifestyle and dietary habits according to their own situation. However, further prospective studies are needed to analyze the relationship between oxidative stress and changes in defecation habits.

Citing Articles

Oxidative balance score is associated with increased risk of sarcopenia and sarcopenic obesity in non-elderly adults: results from NHANES 2011-2018.

Wang Z, Xu Q, Zhang Y, Wu R, Cui J, Zhou J Nutr Metab (Lond). 2025; 22(1):23.

PMID: 40069772 PMC: 11899308. DOI: 10.1186/s12986-025-00914-3.

Life's Simple 7 and its impact on chronic bowel disorders: a study on constipation and diarrhea in the U.S. adult population.

Sun H, Qi L, Ming Y, Wang W, Hu M Front Med (Lausanne). 2025; 12:1516210.

PMID: 40012973 PMC: 11862994. DOI: 10.3389/fmed.2025.1516210.

Lactobacillus delbrueckii Alleviate Oxidative Stress and Intestinal Injuries by Activating TLR2 and TLR4 Expressions in IPEC-J2 Cells.

Chen F, Wu S, Wang X, Li Y, He B, Fu Y Probiotics Antimicrob Proteins. 2025; .

PMID: 39932646 DOI: 10.1007/s12602-025-10466-w.

Association of the body roundness index with chronic diarrhea and chronic constipation: findings based on the National Health and Nutrition Examination Survey 2005-2010 data.

Wang Y, Chen F, Zhang B, Song Z Lipids Health Dis. 2025; 24(1):33.

PMID: 39891178 PMC: 11783814. DOI: 10.1186/s12944-025-02451-7.

The association between oxidative balance score with constipation and diarrhea in US adults: a cross-sectional analysis of NHANES 2007-2010.

Cao Y, Yang Z, Tang Q BMC Gastroenterol. 2025; 25(1):29.

PMID: 39844079 PMC: 11752723. DOI: 10.1186/s12876-025-03597-5.

References

Yanaka A . Daily intake of broccoli sprouts normalizes bowel habits in human healthy subjects. J Clin Biochem Nutr. 2018; 62(1):75-82. PMC: 5773831. DOI: 10.3164/jcbn.17-42. View

Tu W, Wang H, Li S, Liu Q, Sha H . The Anti-Inflammatory and Anti-Oxidant Mechanisms of the Keap1/Nrf2/ARE Signaling Pathway in Chronic Diseases. Aging Dis. 2019; 10(3):637-651. PMC: 6538222. DOI: 10.14336/AD.2018.0513. View

Coman M, Micioni Di Bonaventura M, Cifani C, Silvi S, Verdenelli M . SYNBIO Probiotic and Antioxidant Dietary Supplementation: Clinical Trial Evaluation of Potential Effects on Airline Flight Crew Members' Well-Being. Microorganisms. 2023; 11(4). PMC: 10145893. DOI: 10.3390/microorganisms11040924. View

Reese A, Cho E, Klitzman B, Nichols S, Wisniewski N, Villa M . Antibiotic-induced changes in the microbiota disrupt redox dynamics in the gut. Elife. 2018; 7. PMC: 6008055. DOI: 10.7554/eLife.35987. View

Aviello G, Knaus U . ROS in gastrointestinal inflammation: Rescue Or Sabotage?. Br J Pharmacol. 2016; 174(12):1704-1718. PMC: 5446568. DOI: 10.1111/bph.13428. View

Kono Y, Kawano S, Takaki A, Shimomura Y, Onji M, Ishikawa H . Oxidative stress controlling agents are effective for small intestinal injuries induced by non-steroidal anti-inflammatory drugs. J Gastroenterol Hepatol. 2016; 32(1):136-145. DOI: 10.1111/jgh.13424. View

Chu C, Rotondo-Trivette S, Michail S . Chronic diarrhea. Curr Probl Pediatr Adolesc Health Care. 2020; 50(8):100841. DOI: 10.1016/j.cppeds.2020.100841. View

Song P, Zhang R, Wang X, He P, Tan L, Ma X . Dietary grape-seed procyanidins decreased postweaning diarrhea by modulating intestinal permeability and suppressing oxidative stress in rats. J Agric Food Chem. 2011; 59(11):6227-32. DOI: 10.1021/jf200120y. View

Zheng Y, Xu L, Zhang S, Liu Y, Ni J, Xiao G . Effect of a probiotic formula on gastrointestinal health, immune responses and metabolic health in adults with functional constipation or functional diarrhea. Front Nutr. 2023; 10:1196625. PMC: 10368241. DOI: 10.3389/fnut.2023.1196625. View

10.

Hussain T, Tan B, Yin Y, Blachier F, Tossou M, Rahu N . Oxidative Stress and Inflammation: What Polyphenols Can Do for Us?. Oxid Med Cell Longev. 2016; 2016:7432797. PMC: 5055983. DOI: 10.1155/2016/7432797. View

11.

Zorov D, Plotnikov E, Silachev D, Zorova L, Pevzner I, Zorov S . Microbiota and mitobiota. Putting an equal sign between mitochondria and bacteria. Biochemistry (Mosc). 2014; 79(10):1017-31. DOI: 10.1134/S0006297914100046. View

12.

Seiler-Ramadas R, Sandner I, Haider S, Grabovac I, Dorner T . Health effects of electronic cigarette (e‑cigarette) use on organ systems and its implications for public health. Wien Klin Wochenschr. 2020; 133(19-20):1020-1027. PMC: 8500897. DOI: 10.1007/s00508-020-01711-z. View

13.

Liu X, Liu X, Wang Y, Zeng B, Zhu B, Dai F . Association between depression and oxidative balance score: National Health and Nutrition Examination Survey (NHANES) 2005-2018. J Affect Disord. 2023; 337:57-65. DOI: 10.1016/j.jad.2023.05.071. View

14.

Yoshida N . Inflammation and oxidative stress in gastroesophageal reflux disease. J Clin Biochem Nutr. 2008; 40(1):13-23. PMC: 2291500. DOI: 10.3164/jcbn.40.13. View

15.

Camilleri M, Ford A, Mawe G, Dinning P, Rao S, Chey W . Chronic constipation. Nat Rev Dis Primers. 2017; 3:17095. DOI: 10.1038/nrdp.2017.95. View

16.

Singh J, Kumar S, Krishna C, Rattan S . Aging-associated oxidative stress leads to decrease in IAS tone via RhoA/ROCK downregulation. Am J Physiol Gastrointest Liver Physiol. 2014; 306(11):G983-91. PMC: 4042111. DOI: 10.1152/ajpgi.00087.2014. View

17.

Bhattacharyya A, Chattopadhyay R, Mitra S, Crowe S . Oxidative stress: an essential factor in the pathogenesis of gastrointestinal mucosal diseases. Physiol Rev. 2014; 94(2):329-54. PMC: 4044300. DOI: 10.1152/physrev.00040.2012. View

18.

Jones D . Radical-free biology of oxidative stress. Am J Physiol Cell Physiol. 2008; 295(4):C849-68. PMC: 2575825. DOI: 10.1152/ajpcell.00283.2008. View

19.

Fradrich C, Beer L, Gerhard R . Reactive Oxygen Species as Additional Determinants for Cytotoxicity of Clostridium difficile Toxins A and B. Toxins (Basel). 2016; 8(1). PMC: 4728547. DOI: 10.3390/toxins8010025. View

20.

Bhutta Z, Black R, Brown K, Gardner J, Gore S, Hidayat A . Prevention of diarrhea and pneumonia by zinc supplementation in children in developing countries: pooled analysis of randomized controlled trials. Zinc Investigators' Collaborative Group. J Pediatr. 1999; 135(6):689-97. DOI: 10.1016/s0022-3476(99)70086-7. View