{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T04:29:43Z","timestamp":1777350583547,"version":"3.51.4"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Oxidative stress plays a crucial role in the female reproductive system. The oxidative balance score (OBS) is a new measure for assessing the balance between antioxidant and pro-oxidative factors in diet and lifestyle. However, limited studies have explored the relationship between OBS and infertility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a cross-sectional study including 2,664 women aged 20\u201345 years, based on data from the 2013\u20132020 National Health and Nutrition Examination Survey (NHANES). The OBS was derived from 16 dietary components and 4 lifestyle factors. We used multivariate logistic regression analysis to examine the association between OBS and infertility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The analysis revealed a significant negative association between higher OBS and infertility risk, with an odds ratio (OR) of 0.98 (95% CI, 0.95\u20131.00) after full adjustment. Compared to the first quartile of OBS, the second, third, and fourth quartiles showed ORs of 0.71 (95% CI, 0.45\u20131.11), 0.79 (95% CI, 0.51\u20131.22), and 0.57 (95% CI, 0.35\u20130.92), respectively. Similarly, women in the highest dietary OBS and lifestyle OBS quartiles had a lower infertility risk compared to those in the lowest quartiles, with ORs of 0.60 (95% CI, 0.39\u20130.94) and 0.54 (95% CI, 0.32\u20130.93), respectively. Furthermore, subgroup analysis indicated that the association between the fourth quartile of OBS and infertility remained consistent, except among women with other ethnicities\u2014including multi-racial, and college graduate or higher.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These findings suggest that high dietary OBS and lifestyle OBS are associated with a lower risk of infertility.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2025.1493253","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T05:28:48Z","timestamp":1738646928000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Higher oxidative balance score is associated with a decreased risk of infertility: an analysis of NHANES 2013\u20132020"],"prefix":"10.3389","volume":"12","author":[{"given":"Mingjun","family":"Ma","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huanying","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kexin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanfen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting","family":"Pan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiaoling","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"key":"B1","unstructured":"39737093\n          Infertility Prevalence Estimates: 1990\u20132021"},{"key":"B2","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1093\/humupd\/dmac044","article-title":"A systematic review and evidence assessment of monogenic gene-disease relationships in human female infertility and differences in sex development","volume":"29","author":"Van Der Kelen","year":"2023","journal-title":"Hum Reprod Update."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e1001356","DOI":"10.1371\/journal.pmed.1001356","article-title":"National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys","volume":"9","author":"Mascarenhas","year":"2012","journal-title":"PLoS Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1152\/physrev.00023.2015","article-title":"Physiological aspects of female fertility: role of the environment, modern lifestyle, and genetics","volume":"96","author":"Hart","year":"2016","journal-title":"Physiol Rev."},{"key":"B5","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1038\/s41572-024-00511-3","article-title":"Polycystic ovary syndrome","volume":"10","author":"Stener-Victorin","year":"2024","journal-title":"Nature reviews Disease primers."},{"key":"B6","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1111\/aogs.13082","article-title":"Endometriosis-associated infertility: aspects of pathophysiological mechanisms and treatment options","volume":"96","author":"Tanbo","year":"2017","journal-title":"Acta Obstet Gynecol Scand."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1148","DOI":"10.1016\/S0015-0282(02)03112-6","article-title":"Effect of endometriosis on in vitro fertilization","volume":"77","author":"Barnhart","year":"2002","journal-title":"Fertil Steril."},{"key":"B8","doi-asserted-by":"publisher","first-page":"e39879","DOI":"10.7759\/cureus.39879","article-title":"Tubal blockage surgery: a retrospective cohort study on clinical characteristics and reproductive outcomes within six years","volume":"15","author":"El-Kharoubi","year":"2023","journal-title":"Cureus."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1400","DOI":"10.3390\/jcm9051400","article-title":"Diet and nutritional factors in male (in)fertility-underestimated factors","volume":"9","author":"Skoracka","year":"2020","journal-title":"J Clini Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2542","DOI":"10.3390\/ijms23052542","article-title":"Diet and male fertility: the impact of nutrients and antioxidants on sperm energetic metabolism","volume":"23","author":"Ferramosca","year":"2022","journal-title":"Int J Mol Sci."},{"key":"B11","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1001\/jama.2021.4788","article-title":"Diagnosis and management of infertility: a review","volume":"326","author":"Carson","year":"2021","journal-title":"JAMA."},{"key":"B12","doi-asserted-by":"publisher","first-page":"592","DOI":"10.3390\/medicina56110592","article-title":"A review of the complex relationship between irritable bowel syndrome and infertility","volume":"56","author":"Anton","year":"2020","journal-title":"Medicina"},{"key":"B13","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1186\/s12958-018-0434-y","article-title":"Lifestyle and fertility: the influence of stress and quality of life on female fertility","volume":"16","author":"Palomba","year":"2018","journal-title":"Reprod Biol Endocrinol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1297484","DOI":"10.3389\/fimmu.2023.1297484","article-title":"Immune and oxidative stress disorder in ovulation-dysfunction women revealed by single-cell transcriptome","volume":"14","author":"Qi","year":"2023","journal-title":"Front Immunol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/1477-7827-3-28","article-title":"Role of oxidative stress in female reproduction","volume":"3","author":"Agarwal","year":"2005","journal-title":"Reprod Biol Endocrinol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1016\/S0899-9007(02)00916-4","article-title":"Free radicals, antioxidants, and nutrition","volume":"18","author":"Fang","year":"2002","journal-title":"Nutrition."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.cbi.2005.12.009","article-title":"Free radicals, metals and antioxidants in oxidative stress-induced cancer","volume":"160","author":"Valko","year":"2006","journal-title":"Chem Biol Interact."},{"key":"B18","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1079\/PNS2006496","article-title":"Alcohol, oxidative stress and free radical damage","volume":"65","author":"Albano","year":"2006","journal-title":"Proc Nutr Soc."},{"key":"B19","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1164\/rccm.200908-1220OC","article-title":"Cigarette smoke-induced oxidative stress: a role in chronic obstructive pulmonary disease skeletal muscle dysfunction","volume":"182","author":"Barreiro","year":"2010","journal-title":"Am J Respir Crit Care Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"9987352","DOI":"10.1155\/2021\/9987352","article-title":"Oxidative stress in association with metabolic health and obesity in young adults","volume":"2021","author":"Jakubiak","year":"2021","journal-title":"Oxid Med Cell Longev."},{"key":"B21","doi-asserted-by":"publisher","first-page":"961950","DOI":"10.3389\/fnut.2022.961950","article-title":"Association of oxidative balance score and lung health from the national health and nutrition examination survey 2007-2012","volume":"9","author":"Xu","year":"2022","journal-title":"Front Nutrit."},{"key":"B22","doi-asserted-by":"publisher","first-page":"300","DOI":"10.3390\/antiox11020300","article-title":"Oxidative balance scores (Obss) integrating nutrient, food and lifestyle dimensions: development of the nutrientl-Obs and foodl-Obs","volume":"11","author":"Hern\u00e1ndez-Ruiz","year":"2022","journal-title":"Antioxidants."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1066159","DOI":"10.3389\/fnut.2022.1066159","article-title":"Association between oxidative balance score and new-onset hypertension in adults: a community-based prospective cohort study","volume":"9","author":"Lee","year":"2022","journal-title":"Front Nutr."},{"key":"B24","doi-asserted-by":"publisher","first-page":"108354","DOI":"10.1016\/j.jdiacomp.2022.108354","article-title":"Inflammation level in type 2 diabetes is associated with dietary advanced glycation end products, mediterranean diet adherence and oxidative balance score: a pathway analysis","volume":"37","author":"Demirer","year":"2023","journal-title":"J Diabetes Complicat."},{"key":"B25","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1186\/s12958-021-00837-7","article-title":"Impact of infertility duration on female sexual health","volume":"19","author":"Dong","year":"2021","journal-title":"Reprod Biol Endocrinol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1524","DOI":"10.1186\/s12889-023-16397-x","article-title":"Association between metabolic healthy obesity and female infertility: the national health and nutrition examination survey, 2013-2020","volume":"23","author":"Tang","year":"2023","journal-title":"BMC Public Health."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1384489","DOI":"10.3389\/fnut.2024.1384489","article-title":"Assessing the role of antioxidant and pro-oxidant balance in mediating the relationship between vitamin K intake and depressive symptoms in adults","volume":"11","author":"Wang","year":"2024","journal-title":"Front Nutr."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1345071","DOI":"10.1155\/2022\/1345071","article-title":"Association between the oxidative balance score and telomere length from the national health and nutrition examination survey 1999-2002","volume":"2022","author":"Zhang","year":"2022","journal-title":"Oxid Med Cell Longev."},{"key":"B29","doi-asserted-by":"publisher","first-page":"e109","DOI":"10.1016\/j.amepre.2021.04.004","article-title":"Trends in secondhand smoke exposure, 2011-2018: impact and implications of expanding serum cotinine range","volume":"61","author":"Tsai","year":"2021","journal-title":"Am J Prev Med."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1908","DOI":"10.1186\/s12889-024-19428-3","article-title":"Associations between the oxidative balance score and constipation: a cross-sectional study of the NHANES, 2005-2010","volume":"24","author":"Wang","year":"2024","journal-title":"BMC Public Health."},{"key":"B31","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1186\/s12937-024-00953-1","article-title":"Nonlinear relationship between oxidative balance score and hyperuricemia: analyses of NHANES 2007-2018","volume":"23","author":"Liu","year":"2024","journal-title":"Nutr J."},{"key":"B32","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.nutres.2024.02.006","article-title":"High dietary inflammatory index increases the risk of female infertility: an analysis of NHANES 2013-2018","volume":"125","author":"Xu","year":"2024","journal-title":"Nutrition research (New York, NY)."},{"key":"B33","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1038\/s41531-022-00302-1","article-title":"Self-reported periodontitis and C-reactive protein in parkinson's disease: a cross-sectional study of two american cohorts","volume":"8","author":"Lyra","year":"2022","journal-title":"NPJ Parkinson's Dis."},{"key":"B34","doi-asserted-by":"publisher","first-page":"1430730","DOI":"10.3389\/fnut.2024.1430730","article-title":"Association between dietary magnesium intake and pelvic inflammatory disease in US women: a cross-sectional study of NHANES","volume":"11","author":"Chen","year":"2024","journal-title":"Front Nutr."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1555","DOI":"10.1007\/s43032-022-01103-w","article-title":"Association between dietary fiber and female fertility: a NHANES-based study","volume":"30","author":"Cai","year":"2023","journal-title":"Reprod Sci."},{"key":"B36","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1016\/j.fertnstert.2013.11.008","article-title":"Female dietary antioxidant intake and time to pregnancy among couples treated for unexplained infertility","volume":"101","author":"Ruder","year":"2014","journal-title":"Fertil Steril."},{"key":"B37","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1016\/j.fertnstert.2007.03.089","article-title":"Use of multivitamins, intake of B vitamins, and risk of ovulatory infertility","volume":"89","author":"Chavarro","year":"2008","journal-title":"Fertil Steril."},{"key":"B38","doi-asserted-by":"publisher","first-page":"3264","DOI":"10.1093\/humrep\/dem330","article-title":"Calcium homeostasis and anovulatory infertility","volume":"22","author":"Farmakiotis","year":"2007","journal-title":"Hum Reprod."},{"key":"B39","doi-asserted-by":"publisher","first-page":"374","DOI":"10.30699\/jogcr.7.5.374","article-title":"Evaluation of selected trace elements and glutathione peroxidase levels in female infertility","volume":"7","author":"Oluboyo","year":"2022","journal-title":"J Obstet Gynecol Cancer Res"},{"key":"B40","first-page":"549","article-title":"Comparison of lifestyle in fertile and infertile couples in kermanshah during 2013","volume":"13","author":"Khosrorad","year":"2015","journal-title":"Iranian J Reprod Med."},{"key":"B41","doi-asserted-by":"publisher","first-page":"13815","DOI":"10.1038\/s41598-017-14261-8","article-title":"Female alcohol consumption and fecundability: a systematic review and dose-response meta-analysis","volume":"7","author":"Fan","year":"2017","journal-title":"Sci Rep."},{"key":"B42","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.2105\/AJPH.84.9.1429","article-title":"Infertility in women and moderate alcohol use","volume":"84","author":"Grodstein","year":"1994","journal-title":"Am J Public Health."},{"key":"B43","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1097\/00001648-199403000-00016","article-title":"Body mass index and ovulatory infertility","volume":"5","author":"Grodstein","year":"1994","journal-title":"Epidemiology."},{"key":"B44","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/S0015-0282(16)59402-3","article-title":"The association between smoking and female infertility as influenced by cause of the infertility","volume":"48","author":"Phipps","year":"1987","journal-title":"Fertil Steril."},{"key":"B45","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.atherosclerosis.2015.08.032","article-title":"Oxidative stress, inflammation, and markers of cardiovascular health","volume":"243","author":"Lakkur","year":"2015","journal-title":"Atherosclerosis."},{"key":"B46","doi-asserted-by":"publisher","first-page":"1396465","DOI":"10.3389\/fendo.2024.1396465","article-title":"Association of oxidative balance score with chronic kidney disease: NHANES 1999-2018","volume":"15","author":"Wen","year":"2024","journal-title":"Front Endocrinol."},{"key":"B47","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.2147\/IJWH.S466189","article-title":"Association between the Oxidative Balance Score and Endometriosis: A Population-Based Study","volume":"16","author":"Zhou","year":"2024","journal-title":"Int J Women's Health."},{"key":"B48","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1007\/s00345-024-05144-5","article-title":"Association between the oxidative balance score and kidney stones in adults","volume":"42","author":"Chen","year":"2024","journal-title":"World J Urol."},{"key":"B49","doi-asserted-by":"publisher","first-page":"734","DOI":"10.3290\/j.qi.b5714863","article-title":"Association between the composite dietary antioxidant index and periodontitis in US adults: a cross-sectional analysis","volume":"55","author":"Jia","year":"2024","journal-title":"Quint. Int."},{"key":"B50","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1186\/s12887-024-05009-1","article-title":"Effect of dietary antioxidant quality score on tobacco smoke exposure and asthma in children and adolescents: a cross-sectional study from the NHANES database","volume":"24","author":"Lin","year":"2024","journal-title":"BMC Pediatr."}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2025.1493253\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T05:28:52Z","timestamp":1738646932000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2025.1493253\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,4]]},"references-count":50,"alternative-id":["10.3389\/fnut.2025.1493253"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2025.1493253","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,4]]},"article-number":"1493253"}}