Antioxidants Studies

As everyone knows, eating and drinking are necessary for life. Less well known, however, is the fact that the body generates what are called free radicals in the process of turning food into energy. Free radicals are chemicals that are capable of damaging cells and genetic material. But eating is not the only way free radicals spring into being. The food we eat and the sunlight we feel also generate free radicals.

To be sure, free radicals come in many shapes, sizes, and chemical configurations. The characteristic feature of this chemical is that it soaks up electrons from bodily substances that yield them, which can leave the “loser’s” structure or function radically altered. Free radical damage can change the instructions coded in a strand of DNA; it can also make a circulating low-density lipoprotein (LDL, sometimes called bad cholesterol) molecule more likely to get trapped in an artery wall. Free radicals also have the potential to alter a cell’s membrane, changing the flow of what enters the cell and what leaves it.

Fortunately, we aren’t defenseless against free radicals. The body puts up natural defenses against free radicals by making molecules that smothers the errant chemicals. We also extract free-radical fighters from food. Often called “antioxidants”, certain kinds of food give electrons to free-radicals without themselves turning into electron-scavenging substances. There are many different substances that can act as antioxidants. The most familiar ones are vitamin C, vitamin E, beta-carotene, and other related carotenoids, along with the minerals selenium and manganese. They’re joined by glutathione, coenzyme Q10, lipoic acid, flavonoids, phenols, polyphenols, phytoestrogens, and many more.

However, the term “antioxidant” can be misleading. These substances do not emit chemical properties that fight so much as they emit properties that facilitate. Indeed, some substances that act as antioxidants in one situation may be prooxidants—electron grabbers—in a different chemical milieu. Another big misconception is that antioxidants are interchangeable. This is not true. Each anti-oxidant has unique chemical behaviors and biological properties. It is believed, and has been strongly corroborated through scientific study, that anti-oxidants evolved as parts of elaborate networks, each substance having a different role to play. It follows that no single substance can fulfill the function of every other substance.

Health Benefits of Antioxidants: What’s the Buzz?

Antioxidants came to public attention in the 1990s. It was then that scientists began to understand that free radical damage was involved in the early stages of artery-clogging atherosclerosis, and that the chemicals may contribute to cancer, vision loss, and a host of other chronic conditions. A number of studies stated that people with low intakes of antioxidant-rich fruits and vegetables were at greater risk for developing these chronic conditions than were people who ate sufficient amounts fruits and vegetables. Clinical trials tested the impact of single substances, especially beta-carotene and vitamin E, on cancer, heart disease, and similar maladies. But even before the results of these trials were in, the media, and the dietary supplement and food industries began promoting the benefits of “antioxidants.” Foods such as frozen berries and green tea were hyped as being rich in antioxidants. The consequences of this publicity were predictable: certain foods were labeled as rich in antioxidants and were marketed as such in stores; the makers of dietary supplements began touting the disease-fighting properties of all sorts of antioxidants.

In the meantime, the results of the actual trials were mixed. Most have not found the hoped-for benefits. And research teams reported that vitamin E and other antioxidant supplements didn’t protect against heart disease or cancer. One study even showed that taking beta-carotene may actually increase the chances of developing lung cancer in smokers. However, some of the trials reported benefits. One such study found that taking beta-carotene is associated with a modest reduction in the rate of cognitive decline.

The rather most, if not downright disappointing, results of the antioxidant trials have not stopped the commercial interests from misrepresenting the benefits of antioxidants in order to make money. Antioxidant supplements are a $500 million dollar industry that continues to grow. Antioxidants are still added to breakfast cereals, sports bars, energy drinks, and other processed foods, and they are promoted as additives that can prevent heart disease, cancer, cataracts, memory loss, and a host of other conditions. The claims made by the food and dietary supplement industries often distort the data. It is true that the package of antioxidants, minerals, fiber, and other substances found naturally in fruits, vegetables, and whole grains help prevent a variety of chronic diseases; but there is no solid evidence that high doses of antioxidants can accomplish the same feat. The conclusion is clear: randomized, placebo-controlled trials—which, when performed well, provide the strongest evidence—offer little support that taking vitamin C, vitamin E, beta-carotene, or other single antioxidants provides substantial protection against heart disease, cancer, or other chronic conditions. The results of the largest such trials have been mostly negative.

Heart Disease and Antioxidants

Vitamin E, beta-carotene, and other so-called antioxidants are not a panacea for heart disease and should not be promoted as such. In the Women’s Health Study, 39,876 initially healthy women took 600 IU of natural source vitamin E or a placebo every other day for 10 years. The results of the study showed that the rates of major cardiovascular events and cancer were no lower among those taking vitamin E than they were among those taking the placebo; however, a 24 percent reduction in total cardiovascular mortality was observed, which can be considered a quite significant result.

Earlier large vitamin E trials, conducted among individuals with previously diagnosed coronary disease or at high risk for it, generally showed no benefit. In the Heart Outcomes Prevention Evaluation (HOPE) trial, the rates of major cardiovascular events were essentially the same in the vitamin E (21.5 percent) and placebo (20.6 percent) groups, although participants taking vitamin E had higher risks of heart failure and hospitalization for heart failure. (3) Another trial, the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico (GISSI), showed mixed results; there were no preventive effects after more than three years of treatment with vitamin E among 11,000 heart attack survivors. Nevertheless, some studies suggest potential benefits among certain subgroups. A recent trial of vitamin E in Israel, for example, showed a marked reduction in coronary heart disease among people with type 2 diabetes who have a common genetic predisposition for greater oxidative stress. In any case, Beta-carotene, as was shown in the Physicians’s Health Study, does not provide any protection against heart disease or stroke.

There have been combinations, but the findings are complicated and unclear. In the Supplementation en Vitamins et Mineraux Antioxydants (SU.VI.MAX) study, 13,017 French men and women took a single daily capsule that contained 120 milligrams of vitamin C, 30 milligrams of vitamin E, 6 milligrams of beta-carotene, 100 micrograms of selenium, and 20 milligrams of zinc, or a placebo, for seven and a half years. The vitamins had no effect on overall rates of cardiovascular disease. In the Women’s Antioxidant Cardiovascular Study, vitamin E, vitamin C, and/or beta-carotene had much the same effect as a placebo on myocardial infarction, stroke, coronary revascularization, or cardiovascular death, although there was a modest and significant benefit for vitamin E among women with existing cardiovascular disease.

Cancer and Antioxidants

There is also no conclusive proof that antioxidants help prevent cancer. Scientists need more time to determine the impact of antioxidants on the risk of getting cancer. In the long-term Physicians’ Health Study, cancer rates were similar among men taking beta-carotene and among those taking a placebo. Other trials have also largely showed no effect, including HOPE. The SU.VI.MAX trial showed a reduction in cancer risk and all-cause mortality among men taking an antioxidant cocktail but no apparent effect in women; it is possible that this is a result of the men in the study having low blood levels of beta-carotene at its beginning. A randomized trial of selenium in people with skin cancer demonstrated significant reductions in cancer and cancer mortality at various sites, including colon, lung, and prostate. The effects were strongest among those with low selenium levels at baseline.

Age-Related Eye Disease and Antioxidants

The effects of antioxidants on age-related eye disease may be one of the most hopeful leads scientists have. A six-year trial, the Age-Related Eye Disease Study (AREDS), found that a combination of vitamin C, vitamin E, beta-carotene, and zinc provided some protection against the development of advanced age-related macular degeneration in people who were at high risk of the disease. Lutein, a naturally occurring carotenoid found in green, leafy vegetables such as spinach and kale, may also protect vision. It is too early to tell what the impact of lutein supplements may be. The trials of such substances have been relatively short, and their ability to slow or prevent age-related macular degeneration has not been ascertained. A new trial of the AREDS supplement regimen plus lutein, zeaxanthin, and fish oil is underway, and it could yield better information.

Potential Hazards of Antioxidants

There have been a few studies which showed that the consumption of antioxidants, as opposed to being beneficial in all instances or at least harmless in fact can interfere with the health of the consumer. The first trial which showed this possible negative effect was undertaken in Finland where heavy smokers were fed beta-carotene. Because of their smoking habits there was a already a lung cancer risk but it was noticed that a significant increase in the incidence of lung cancer amongst the trial group as opposed to the placebo. The trial was stopped so conclusive results are hard to deduce.

A different test which was conducted with heavy smokers exposed to asbestos being fed beta-carotene and vitamin A. This too shows an increase in the incidence of Lung cancer. It must be emphasized that not all trials of Beta-carotene have been negative. A physicians health study which only had a few smokers did not show any significant differences even when followed up after 18 years.

In a separate study showing possible negative effects of a variety of health supplements showed a higher incidence of skin cancer in women being fed supplements of Vitamins C & E, Beta-carotene, selenium and zinc.

Conclusions to be drawn from the above studies, amongst others, is that it is known that although free radicals have been shown to contribute to the incidence of heart disease, cancer, Alzheimer’s and even vision loss, there is no automatic conclusion that can be drawn that antioxidants will fix the problem. And certainly not when consumed away from their normal context.

Studies to date do not show conclusive evidence one way or another but there is certainly no strong evidence to suggest that antioxidants are effective against disease. A rider must be mentioned and that is that the trials conducted till now have been short in duration, conducted with people some of whom had an existing disease.

There has been a noticeable benefit to the consumption of beta-carotene on cognitive ability after 18 years. This is exceptional as it is the only study to have continued so long. (Physicians health follow up study) Nevertheless there is abundant evidence suggests that eating whole fruits, vegetables, and whole grains—all rich in networks of antioxidants and their helper molecules—provides protection against many of these scourges of aging.

Clarification with regard to supplemental studies

There are any number of studies conducted on any number of vitamins and other dietary supplements that are often contradictory. The picture presented to the consumer is confusing and will often seem frustrating in that instead of clarifying things these studies muddy the waters.

Examining exactly what the vitamins trial study did will often go some way to explaining the varying results. Here are a few items to check when looking at apparently conflicting vitamins studies.

  • What was the precise dosage taken by the participants and how long was the study’s duration. This is significant as few studies will have identical dosages and identical time spans. A study in Vitamin D showed that a dosage of 700 plus IU per day had a significant protection against fractures whereas a study of people taking only 400 IU per day showed no such effect. The same applies to the duration as the build up of the protective mechanisms is not a short process.
  • The age, health and life styles of the participants. Studies drawn from young, active gym going participants is likely to differ significantly from heavy drink and smoking office workers. Exercise and other lifestyle choices such as diet affect out health and how the body responds to vitamins.
  • At what stage is was the supplement fed to a study participant. If studying the effect of a supplement on someone already suffering from a disease it may be found that something taken at the onset has a differing effect from something taken when a disease is far advanced. An example being that Folate supplements are only effective against neural tube defects in the early stages of pregnancy.
  • How were the results tabulated and calculated. This is a significant problem as measurement as to benefit may and probably will vary widely. Heart disease is a wide subject and a measurement of coronary thrombosis may miss out on the incidence of strokes.

What are antioxidants and what do they do?

That’s a very good question. They are both natural substances and synthetic substances that help treat free radicals in the body. Free radicals are a natural byproduct of some cellular metabolism. They’re useful for the immune system for killing foreign cells and bacteria; but if the situation gets out of control, they can be harmful to the body. A free radical is a substance that has lost an electron and is therefore an unstable ion. What it wants to do is become stable again. So it attacks a cell that’s close to it and takes an electron from that cell. Then a game of hot potato starts. A cascade of events occur leading to death within a cell. This causes premature aging and can lead to cancer. Antioxidants are substances that protect plants, for instance, in the environment. For example, they protect plants against smog, environmental pollution and ultraviolet radiation. These same properties that protect plants can be used to protect humans. With consumption of nutrients found within plants — such as vitamin C, vitamin E, beta carotene — these natural substances called antioxidants donate electrons and therefore neutralize the harmful effects of free radical damage.

If it works, why aren’t more people taking green tea? Are there any negative effects associated with it?
Green tea has caffeine in it, and caffeine doesn’t agree with certain people. For instance, it can lead to insomnia. It can lead to fibrocystic breast disease in women. It can lead to frequent urination. It can lead to elevated cholesterol and a host of other health problems. It can become addictive. Nevertheless, you will be pleased to know that green tea has one fifth the amount of caffeine that a typical cup of coffee has and one third the amount of caffeine that black tea has. Furthermore, there are extracts available which are virtually caffeine-free. As for why more people don’t take green tea, I don’t think they know about it. The Chinese have known about it for over 4,000 years, but it’s just now becoming available in extract form. People who may not want to drink the six to nine cups of tea that are needed to get maximum benefit can now take it in an extract form — in a capsule form.

VITAMINS AND CORONARY DISEASE

We hear a lot of beneficial effects about certain foods and certain nutrients like the antioxidants in preventing and combating heart disease. What are your feelings about these and what are your food recommendations, if you have any?
Well I think the only proven antioxidant is Vitamin E.

This is for heart disease?
For heart disease. We give eight hundred international units of Vitamin E per day.

Are there any foods that can help fight heart disease?
Unproven nutrients include the blue, green, and red vegetables like eggplant, for example. And grapes have what we call flavonoids in them, which are powerful antioxidants. And in fact you can get grape seed extract that has flavonoids. It’s a strong source of flavonoid.

Can you find these at a health food store?
Yes, and also pine bark, and pine nuts.

These would be O.K. for people to try?
As far as I know, it’s O.K., but they are unproven. The only antioxidant that’s been proven has been fish oil and Vitamin E. So that’s what I prescribe to people.

How about red wine?
The evidence is pretty strong that red wine is beneficial and again the benefit probably comes from the hull of the red grapes, of the dark grapes that they make the wine from.

So that would be O.K., a glass of red wine?
Yes, if you didn’t drink more than ten drinks a week of red wine plus all the other- you have to count all your other alcoholic beverages too. But a glass a day of red wine I think would be good for you, although it’s not scientifically worked out. But I think most people accept that that’s probably a good thing to do.

THE BIG PICTURE

Why do we hear so much about coronary artery disease today? Is it a bigger health problem now or are doctors just more aware of it?
No, I think it’s because we can do so much more about it. The incidence rate has actually been falling until the last two or three years; now that’s gone back up a little bit. But it’s been steadily falling since the 50’s. So it’s not like suddenly we’re all getting the disease. It’s always been there. You know it used to be more than fifty percent of people died of coronary disease. Now it’s down to say thirty six or thirty seven percent.

That actually die of it – the rest are living with it?
They have it and eventually die of it. It’s still the number one killer of the western world; it’s still the number one problem in both men and women.

Working at it through some of those techniques we mentioned about the diet, exercise, and regular screening?
People that need the treatment have to be identified some way. And you can take people that have had coronary or any form of atherosclerosis as the index population and then take the first degree relatives of those and you would be getting the high risk population right there. And then you would have to through doctor’s office checkups or in some way screen the rest of the population to pick the high risk people out of the rest. That’s the way I would see doing it. It seems workable.

Source: Ivanhoe News

NSAIDs help prevent prostate cancer

Daily use of aspirin or another of the class of pain relievers known as NSAIDs could help prevent prostate cancer in older men, say Mayo Clinic researchers. Their study found less than half as many cancers in men who took the drugs on a regular basis than in those who did not.

Prostate cancer is the most commonly diagnosed cancer, affecting about 189,000 men every year. It is also the second leading cause of death from cancer among men.

While new and better detection methods are allowing the disease to be identified at earlier and more treatable stages, these methods do not help prevent the condition. Studies are currently underway to determine the effect of several substances, including selenium, Vitamin E, Vitamin D, and green tea, on prostate cancer risk.

The Mayo scientists decided to study the impact of NSAIDs — nonsteroidal anti-inflammatory drugs — on prostate cancer after other studies linked the drugs to a reduced risk of other cancers. They analyzed data on about 1,300 men participating in a study of urinary tract symptoms. The men were enrolled in the study in 1990 and followed for an average of six years. Information on daily medication use was gathered throughout the study.

The study found 4 percent of the men who reported daily NSAID use developed prostate cancer by the end of the follow up. This compares to 9 percent of those who reported no regular NSAID use. The link between NSAID use and a reduced risk of prostate cancer was more significant in men over age 60.

SOURCE: Mayo Clinic Proceedings, 2002;77:219-225

How big of a problem is prostate cancer?

It’s the most common cancer in men in the United States. Its been about 200,000 cases a year for the last five years or so. That means in the last five years, there are a million affected really with prostate cancer. It’s also the second most common cancer killer in men in the United States, after lung cancer. What’s really important for people to understand is that African-Americans are about three times the risk of getting prostate cancer and three times the risk of dying from prostate cancer.

There are many, many reasons for that, probably although no one knows the relative contribution of each of those reasons. Some of it has to do with access to care, some of it has to do with education, but even in a system like the military where race does not play a factor in access to care, prostate cancer behaves more aggressively in black men than Caucasians. So, there probably is something biologic to it as well.

The good news is that the mortality due to prostate cancer in Caucasian men is now lower than it was before PSA screening was introduced in 1987, but the mortality rate in the United States for African-Americans hasn’t changed at all in the last several decades.

There’s a lot of laboratory evidence to suggest that both vitamin E and/or selenium act as antioxidants. Oxidants are cellular toxins that can cause DNA to mutate and turn into cancer. The real interest in vitamin E and selenium came from two large-scale, randomized trials using lots of participants, looking at other diseases. In the case of selenium, it was a study called the Clark Trial, where they looked at whether or not selenium would prevent recurrence of non-melanoma skin cancer. It didn’t have any effect on skin cancer, but as what we call a secondary end point — sort of a surprise — the incidence of prostate cancer was markedly reduced in the men who took selenium. And, for vitamin E, it was an even larger trial — 29,000 finished smokers — and there the hypothesis was that vitamin E would prevent lung cancer. What was interesting is in fact, the smokers that took vitamin E actually had more lung cancer. So, it doesn’t always work. That’s why we need to do studies. But, again, as a surprise, as a secondary end point, the incidence of vitamin E was markedly reduced by about 40 percent in the men who, rather the instance of prostate cancer was markedly reduced in the men who took vitamin E.

Prostate cancer is still a major killer in the United States. It’s second only to lung cancer with around 31,000 deaths a year. But, even if you don’t die from prostate cancer, if you’re diagnosed with prostate cancer in your 40s or 50s, the side effects of treatment are pretty substantial. Because of the anatomy of the male, treatment for prostate cancer, whether its by radiation or by surgery, can cause difficulty with urination, it can cause difficulty with sexual function, and it can cause bowel difficulties. It would be a lot easier to prevent that from happening than to have many hundreds of thousands of men go through treatment every year and experience all those side effects.

Source: Ivanhoe News

What should people be looking for in their vitamins?

It should be a very well rounded vitamin, meaning a mix of vitamins and minerals. Try to stay away from fillers and dyes because they will affect the way the nutrient is absorbed. Also, look for the natural state of the vitamin so it mimics the way our body absorbs vitamins in food.

For example, the synthetic form of Vitamin E is DL Alpha whereas the natural form is D Alpha, each absorbed by the body differently. The better form is the more natural type, D Alpha. Look for a mineral supplement with the natural form of the vitamin you are trying to increment into your diet.

Many vitamins and minerals have opposite chargers so they repel each other, forcing biochemists to use binders and fillers to help them stay together. Unfortunately, depending on the coat of the binder or filler, the nutrient is altered and either can’t be absorbed or actually enhance the absorption.

Are the spray vitamins easier to absorb than the pill form? – It would depend on somebody’s digestive system. We know the digestion system starts in the mouth, but what we don’t know is where exactly the best place to absorb vitamins is.


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