Positive Health Online

People who say they don't need supplements because they are affluent and on a 'good diet' do not appreciate why they need antioxidants. Antioxidants scavenge free radicals. A major source of free radicals is the processed food of affluent society. Anti-oxidants are needed to counteract the damage done by the diet of affluent nations.

We should get all the nutrients we need from our food. Research now confirms a balanced diet rich in whole grain cereals, nuts, seeds, fruits and vegetables provides essential vitamins, minerals, antioxidants and other nutrients that reduce the risk of cardiovascular disease and cancer.

However, most people these days don't eat that sort of food; they prefer fast food and french-fries. The major source of vitamin C in the United Kingdom is not oranges; it is chips! Unfortunately, the majority of people today do not get the vitamins, minerals and antioxidants they need from their food. This is clear from a USDA survey of 21,500 Americans, which showed that only 3% were on a satisfactory diet and that not one person obtained the recommended minimum daily allowance of ten essential vitamins and minerals.[1]

Affluent diet

Professor John Yudkin, founder of the London University Faculty of Nutrition, taught us that people eat for palatability not nutrition, and you cannot change their eating habits. In a nutshell, junk food tastes nice and people will not be told to eat fruit and nuts. That is why many people informed about nutrition appreciate the vital importance of supplementing the modern diet with extra vitamins, minerals, antioxidants and other nutrients.

The old idea that we can get all the nutrients we need from our diet, and that supplements just make expensive urine, is now widely recognized to be nonsense.

In the words of Dr Walter Willet of Harvard University "Until quite recently, it was taught that everyone in the country gets enough vitamins through their diet and that taking vitamin supplements just creates expensive urine. I think we have proof this isn't true."[2]

People who say they don't need supplements because they are affluent and on a 'good diet' do not appreciate why they need antioxidants. Antioxidants scavenge free radicals. A major source of free radicals is the processed food of affluent society. Anti-oxidants are needed to counteract the damage done by the diet of affluent nations.

Safety guidelines

There is now concern about safe doses of antioxidant supplements. Vitamins and minerals are good for us, but too much of anything can be harmful. Although there is no solid evidence that high doses of single antioxidant vitamins are really harmful, it is common sense not to take too much of any one on their own. There is also a danger that an uninformed 'pick and mix' of high level single vitamins from the health food store can create imbalance. Vitamins and minerals do not occur alone in nature and they work together. Vitamin E, for example, is regenerated by vitamin C and supported by selenium. This is synergy. We should take vitamins and minerals together in the proper balance. Then they will be more effective at lower doses.

The Institute of Medicine, advising the US National Academy of Sciences, has recently set guidelines for maximum and minimum daily intakes of vitamin E, vitamin C and selenium. They recommend we take no more than 1500 IU of vitamin E, 2000 mg of vitamin C and 400 micrograms of selenium per day. Research has shown that optimum levels of antioxidant vitamins and minerals fall with in these guidelines.

The Cambridge Heart and Antioxidant study on 2000 people showed that 400-800 IU Vitamin E per day is optimal for protection against cardiovascular disease, significantly reducing the risk of heart attack.[3] A study in the United States conducted on 87,245 US nurses showed that vitamin E can reduce the risk of coronary heart disease by 40%.[4]

150 – 300 micrograms selenium per day is optimal. Optimum levels of selenium can help protect against heart disease[5] and cancer.[6] 1000 – 2000 mg vitamin C per day – as mineralized ascorbates and 10,000-20,000 IU beta carotene (vitamin A precursor) with the selenium and vitamin E is recommended for routine antioxidant activity.

Degenerative disease

The greatest danger to our health today is chronic degenerative disease. Heart disease, cancer and strokes are number one killers, while arthritis, chronic fatigue and a host of other debilitating conditions are destroying the quality of life of millions of people. Research now suggests that moderate to high levels of antioxidants can alleviate many of these deadly and distressing diseases.

Antioxidants have been shown to slow aging and reduce degenerative disease.[7]

Parkinson's disease can be caused by oxidative stress which is also linked to Alzheimer's disease. Antioxidants have been shown to prevent Alzheimer's disease[8] and slow the progress of Parkinson's disease.[9]

Antioxidant vitamins can protect against cancer[10] and Professor Ames of Berkley has endorsed antioxidants in cancer prevention.[11] Antioxidants have been shown to reduce risk of cancers of the lung, uterus, cervix, mouth and gastrointestinal tract.[12]

Antioxidant vitamins can protect against cataracts[13-15] and reduce the risk of macular degeneration by 43%.[16]

Asthma is reduced by vitamin antioxidants[17] and antioxidants can help children with cystic fibrosis.[18] Antioxidants protect against pulmonary disease and emphysema[19] and alleviate arthritis.[20]

Recent reports in the press have suggested that high levels of antioxidant vitamins and minerals are a health hazard. In fact, the only risk of taking moderate to high levels of antioxidants are that high levels of vitamin C can be laxative, vitamin E can thin the blood and selenium may cause hair loss and brittle nails. 400-1,200 IU vitamin E per day has been shown to inhibit platelet adhesion.[21] The use of vitamin E to thin the blood in the prevention and treatment of heart disease is surely preferable to using warfarin, a rat poison, commonly prescribed for this purpose.

There are few recorded cases of people killing themselves with a vitamin overdose. Over a ten year period, for example, only one fatality occurred through an overdose of nicotinic acid.

Medical negligence

By contrast, tens of thousands of people die every year from medicines at the prescribed dose. The Journal of the American Medical Association (JAMA) published that in the USA in a typical year, prescribed drugs killed 106,000 people in a year and caused 2,216,000 to be hospitalized; drug reactions are now the fourth major cause of death after heart disease, cancer and stroke.[22] Visiting a doctor is more likely to put your health at risk than visiting a health food store.

In the UK people suffering the adverse effects of prescribed drugs and medical error take up a million hospital beds every year.[23] These are just the tip of the iceberg because the vast majority of drug reactions go unreported.[24] The level of disease caused by prescribed drugs could well exceed their therapeutic value.

The UK Health Dept Committee on Medical Aspects of Nutrition and Food Policy (COMA) report that the research in support of antioxidants is inconclusive. The same can be said of most medical and surgical procedures as the BMJ reported that 85% of them are scientifically unproven.[25]

No one can deny the value of modern medicine in emergencies and acute situations. We are all well aware of the dedication and sincerity of doctors and nurses, and everyone knows that drugs do save lives. Nonetheless, research is showing that moderate to high levels of antioxidants can also save lives but without the risk of serious side effects. Health Departments have to be cautious when it comes to new research and no one can argue against safe and sensible guidelines for taking single vitamins. However, issuing warnings against antioxidants is totally irresponsible when research is indicating their value in preventing the three major causes of death namely heart disease, cancer and stroke.

In sanctioning pharmaceutical drugs and discrediting antioxidants, history may record modern medicine on a par with the leeches, quacks and charlatans, and the activity of health authorities deliberately misguiding the public through the media might be contested as medical negligence.

Sensational headlines

Sensational headlines announcing 'Antioxidants may be harmful' followed a press release by Professor Norman Krinsky of Trufts University School of Medicine, who headed the antioxidant study for the Institute of Medicine. He warned against taking high levels of single antioxidants concluding "a direct connection between the intake of antioxidants and the prevention of chronic degenerative disease has yet to be established." He added, "After a comprehensive review of the scientific evidence, our panel concluded too little is known at present to provide a definitive answer."

The same institute spoke in this manner about folic acid. At the time when research indicated 400µg folic acid reduces neural defects by 70% – this occurring only with supplements or fortification not with folic acid rich food,[26] and 400-800 µg folic acid per day could reduce the risk of vascular disease,[27] the Institute ignored the research and actually lowered the RDA for this essential nutrient to substandard levels! Their concern was the possible masking of pernicious anaemia – a very rare disorder among women of childbearing age. The US Institute of Medicine was wrong when they warned against folic acid. They made a serious mistake; they may be wrong again in warning against antioxidants.

Essential supplements

We live in a time when dietary supplements are essential. Antioxidants scavenge free radicals generated by pollution, chemicals, drugs, alcohol, and excessive eating of processed foods. The food we eat can contain chemicals such as preservatives, additives, colourings and pesticide residues. We breathe in car fumes and fumes from resins, paints, aerosols and indoor chlorinated pools. We absorb chemicals through the skin from skin care products, shampoos and conditioners, make-up and sunscreens. Some of these chemicals are toxic – even carcinogenic. In the body they contribute to the free radicals which studies have shown to cause chronic degenerative diseases and cancer. An estimated 500,000 new man-made chemicals have been released since World War II. This means half a million new chemicals are impacting our bodies that our forebears were never exposed to. At the same time the soil is depleted of minerals after decades of application with Nitrogen, Phosphorus, Potassium (NPK) fertilizers. Food processing has compounded the lack of minerals in the food chains of industrialized nations.

Magnesium, selenium, zinc and chromium deficiencies in the modern diet all add to the high levels of degenerative disease.

Magnesium can help reduce blood pressure,[28] and low magnesium increases the risk of hypertension, cardiac arrhythmias, ischemic heart disease, atherogenesis and sudden cardiac death.[29] Low magnesium is also linked to diabetic retinopathy.[30] Low levels of zinc are associated with mental impairment[31] and chromium improves glucose handling.[32] Chronic fatigue has been shown to improve with magnesium[33] and low magnesium could cause premature birth.[34] Calcium supplementation is important because it can increase bone density in children and reduce risk of fractures later on in life[35] and osteoporosis. However, as well as calcium and oestrogen, a wide range of other nutrients are necessary in control of osteoporosis, including vitamins B6, C, D, K, folic acid, magnesium, boron, zinc, copper and silicon. Lack of any one accelerates osteoporosis.[36]

Synergy and balance is vital in antioxidant activity. Vitamin E for example, prevents lipid peroxidation, but in the process it becomes oxidized into a damaging tocopheroxyl radical. This process, however, can be reversed by vitamin C. Vitamin C regenerates vitamin E and glutathione regenerates vitamin C. Glutathione and vitamin E both require selenium for their action.

Selecting supplements

When selecting a supplement for antioxidant protection, look for optimum rather than RDA levels of essential nutrients. Choose a combination of vitamin and plant antioxidants. With minerals choose chelated minerals as these are minerals combined with organic molecules that are absorbed via active transport mechanisms in the small intestine. It is important to select a quality supplement developed on the basis of current research that guarantees potency, uniformity and disintegration. Avoid taking single vitamins. Choose a properly formulated balance of essential antioxidants and chelated minerals and consider the formulator's level of experience, credibility and science.

References:

1. Guthrie and Ccochetti. USDA Food Consumption Survey. 1982.
2. Newsweek 7 June. 1993.
3. Stephens N, Parsons A et al. Vitamin E supplementation in coronary disease patients. Lancet 347(9004):781. 1996.
4. Stampfer M. Vitamin E consumption and the risk of coronary artery disease in women. New England Journal of Medicine [N Engl. J Med] 328:1444-49. 1993.
5. Kok F et al. Decreased selenium levels in acute myocardial infarction. Journal of the American Medical Association [JAMA] 261:1161-64. 1989.
6. Yu Shu-Yu et al. Intervention trial with selenium for the prevention of lung cancer. Biol. Trace Elem. Rsch.24:105-8. 1990.
7. Cutler R. Antioxidants and ageing. American Journal of Clinical Nutrition [Am J Clin Nutr], Suppl. 53(1):373S. 1991.
8. Frilich L and Riederer P. Free radical mechanism in dementia of Alzheimer's type and the potential for antioxidant treatment. Arzneim-Forsch/Drug Rsch 45(1):443. 1995.
9. Fahn S. An open trial of high-dosage antioxidants in early Parkinson's disease. Am J Clin Nutr 53(S):380S-2S. 1991.
10. Duthie S, Ma A, Ross M, Collins A. Antioxidant supplementation decreases oxidative DNA damage in human lymphocytes. Cancer Research 56:1291. 1996.
11. Medical News and Perspectives. JAMA 273(14):1077-8. 1995.
12. Singh V. Premalignant lesions: role of antioxidant vitamins and beta carotene and risk reduction and prevention of malignant transformation. Am J Clin Nutr Suppl. to 53(1) 386S-90S.
13. Jacques P et al. Antioxidant status in persons with and without senile cataracts. Arch Ophthamol. 106:337-40. 1988.
14. Knekt P et al. Serum antioxidant vitamins and risk of cataract. British Medical Journal [BMJ] 305:1392. 1992.
15. Robertson J. A possible role of vitamins D and E in cataract prevention. Am J Clin Nutr Suppl to 53(1):346S-51S. 1991.
16. Seddon J. Dietary carotenoids, vitamins A,C and E and advanced age-related macular degeneration. JAMA 272(18):1413-20. 1994.
17. Hatch G. Asthma, inhaled oxidants and dietary antioxidants. Am J Clin Nutr Suppl. to 61: 625S-30S. 1995.
18. Portal B. et al. Altered antioxidant status and increased lipid peroxidation in children with cystic fibrosis. Am J Clin Nutr 61:843-7. 1995.
19. Britton J. et al. Dietary antioxidant vitamin intake and lung function in the general population. Am J Respir Crit Care Med. 151:1383-7. 1995.
20. Merry P. Oxidative damage to lipids within the inflamed joint. Am J Clin. Nutr Suppl to 53(1):362S-9S. 1991.
21. Steiner M. Vitamin E: More than just an antioxidant. Clin Cardio 16 Suppl. 1:1-16-1-18. 1993.
22. JAMA 279:1200. 15 April 1998.
23. Coleman V. The Betrayal of Trust. EMJ. 1994.
24. Brit J Clin Pharm 43:177-181. 1997.
25. British Medical Journal [BMJ]. October 1991.
26. Cuskelly G. et al. Effect of increasing dietary folate on red-cell folate: implications for the prevention of neural tube defects. Lancet 347:657-9. 1996.
27. Editorial. Can lowering homocysteine levels reduce cardiovascular risk? N Engl J Med 332(5):328-29. 1995.
28. Dyckner T and Wester P. Effect of magnesium on blood pressure. BMJ 286:1847-49. 1983.
29. Altura B. Cardiovascular risk factors and magnesium. Magns Trace Elem10:182-192. 1991.
30. McNair P et al. Hypomagnesia, a risk factor in diabetic retinopathy. Diabetes 27:1075. 1978.
31. J Am Col. Nutr 15:113-120. 1996.
32. Liu V. and Abernathy R. Chromium insulin in young subjects with normal glucose tolerance. Am J Clin Nutr 35:661-7. 1982.
33. Cox I. Red blood cell magnesium and chronic fatigue syndrome. Lancet 337:757-60. 1991.
34. Cunze T et al. The effect of magnesium on maternal blood pressure in pregnancy-induced hypertension. International Journal of Gynaecology Obstetrics 48:9. 1995.
35. Johnston C. Calcium supplementation and increases in bone mineral density in children. N Engl J Med 327:82-7. 1992.
36. Gaby A and Wright J. Nutrients and Osteoporosis. J Nutr Med 1:63. 1990.