Antioxidants: The Case for Supplements

With complete references for researchers

by Hans R. Larsen, MSc ChE



Professor Barry Halliwell of the prestigious King's College in London, England believes that oxidative stress is the
main cause of cancer,
cardiovascular disease, arthritis, and inflammatory bowel disease (1,2).  Professor Halliwell's
opinion is supported by other researchers who believe that diseases like muscular dystrophy, Parkinson's disease,
Alzheimer's disease, cataract formation, and Crohn's disease are also largely caused by oxidative stress (3,4,5).

Oxidative Stress

Oxidative stress occurs when the quantity of free radicals the body has to cope with exceeds the availability of
antioxidants (1). This concept is relatively new and is closely linked to the growing awareness that our environment
is a potent source of disease. Air pollution has been linked to
heart attacks, asthma, and other respiratory diseases
(6,7). Cigarette smoke causes lung cancer,
heart disease and a host of other diseases. Chemicals in our drinking
water have been linked to cancer, hip fractures and Alzheimer's disease (8,9,10). Nitrites and other food additives
have been linked to cancer. Excessive amounts of radiation can cause cancer and allergens in the air we breathe
and the food we eat can cause a whole raft of diseases and even death. We are surrounded by toxic chemicals from
dry cleaning fluids to pesticides and many have been implicated in the development of cancer.
All these environmental stressors are man-made and have only been around for a very short time in evolutionary
terms; not nearly long enough for us to adapt to them.
Our body is constantly coping with oxidative stress whether it has its origins in our digestive processes, our energy-
producing processes or in the processes we use in killing off foreign invaders like bacteria and viruses. When we
add environmental stressors the load can easily become excessive. It has been estimated that each cell in our body
has to cope with something like 10,000 individual attacks by free radicals every day (5).
Fortunately, all living systems have developed defense mechanisms against oxidative stress - if they had not, they
would no longer be around.

Antioxidants

Superoxide dismutase is the body's main defense and is especially effective in deactivating superoxide radicals.
Another natural antioxidant which effectively scavenges free radicals is the selenium-containing antioxidant
glutathione peroxidase.
Progressive researchers are now concluding that our natural antioxidants are no longer able to cope with the
oxidative stress we are exposed to. They believe we need to sharply increase our intake of dietary antioxidants to
help in the fight.
Antioxidants should preferably be obtained through whole, unpolluted food. However, more and more researchers
are realizing that the average intake from the diet is far too low to provide significant help to the body in its fight
against degenerative diseases. This and the fact that a clear link has been established between a low intake of
antioxidants and heart disease and cancer makes it clear that we need to boost our antioxidant intake through
supplementation (11,12,13,14,15).

Vitamin C

Numerous epidemiologic studies have found that vitamin C or vitamin C-rich foods prevent cancer and heart
disease and even asthma (7,14,16,17,18,19). Now evidence is accumulating that direct supplementation with
vitamin C has many beneficial effects as well.
Researchers at the Arizona State University have found that supplementing with 500 mg/day of ascorbic acid for two
weeks increased the glutathione concentration in the blood by 50 per cent (19). This is good news as glutathione is
one of the body's most important natural antioxidants.
A team of scientists at the University of California have found that a minimum daily intake of 250 mg of vitamin C is
required to protect human sperm against oxidative degradation (20). This is far higher than the actual mean daily
intake which, in the United States, is about 70 mg/day or just enough to prevent scurvy (14,17).
Researchers at Harvard Medical School concluded from an eight-year study of 50,000 nurses that supplementing
with vitamin C (250-500 mg/day) for ten years or longer significantly lowers the risk of cataract formation (21).
Vitamin C is generally safe even in large doses. However, people who are born with a gene that increases iron
absorption should not supplement with more than 500 mg/day without consulting their health care professional (22).

Vitamin E

The need to supplement is perhaps most obvious in the case of vitamin E (alpha-tocopherol). Alpha-tocopherol is a
fat-soluble antioxidant which protects our cells against free radical attacks (23,24).  It is particularly important in
protecting against peroxidation of low-density lipoproteins (LDLs) and thereby preventing atherosclerosis
and cardiovascular disease (23,24,25,26,27,28).
Researchers at the Harvard Medical School have found that men and women who supplemented with more than 100
IU/day of vitamin E for at least two years lowered their risk of coronary disease by 37 to 40 per cent. This study was
very comprehensive and involved more than 125,000 nurses and male health professionals. The study found that
even the highest dietary intakes of vitamin E were far too low to afford any protection and that multivitamin pills also
contain too little vitamin E to provide any protective effect (29,30).
Other researchers have found that supplementation with vitamin E for at least six months lowers the risk of
developing oral cancer by 50 per cent (31). Italian scientists report that supplementation with 900 mg/day of
synthetic vitamin E improves the glucose balance in diabetics (32). Daily supplementation with 400 IU/day of vitamin
E has also been found to improve the immune response in both young and elderly people (33,34). Other studies
have shown that vitamin E supplementation helps relieve intermittent claudication and cuts the risk of lung cancer in
half (35,36,37). Supplementation with 400 IU/day of vitamin E and 600 mg/day of vitamin C has been found to lower
the risk of cataract formation (38). Oral supplementation with 400 IU/day of vitamin E has even been reported to be
beneficial in the treatment of dermatitis (39).
Vitamin E is safe in intakes as large as 3200 IU/day but medical advice should be obtained before starting a
supplementation program by individuals who have a vitamin K deficiency, a tendency to prolonged bleeding or who
are taking anticoagulants (40,41).

Beta-carotene

Beta-carotene is another fat-soluble antioxidant which is highly effective in protecting against free radical attacks.
Japanese researchers have found that supplementation with 30 mg/day of beta-carotene protects against damage
caused by x-ray irradiation (42). Italian scientists have found that beta-carotene protects against colon cancer and
Canadian researchers have found a protective effect against breast cancer (43,44). Oral supplementation with beta-
carotene has been found to reverse oral leukoplakia and to prevent suppression of the immune system (45,46).
Several studies have found that people with a low level of beta-carotene in their blood have a higher risk of
developing lung cancer, stomach cancer, coronary heart disease, and cataracts (47,48,49,50,51,52,53). Another
study found that supplementing with beta- carotene (50 mg every second day) halves the risk of heart attack and
heart disease (54,55).
Beta-carotene supplements are well absorbed, especially with a fatty meal and some recent research even
concludes that beta-carotene from supplements is absorbed more efficiently by the body than is beta-carotene from
carrots (56,57).

Selenium

The importance of selenium as a dietary antioxidant is becoming increasingly clear. Selenium is an important
component of the body's natural antioxidant, glutathione peroxidase, and also plays an important role in combatting
the toxic effects of mercury and cadmium (58,59,60). A low content of selenium in the blood has been linked to an
increased risk of cancer and heart disease (59,61,62).
Supplementation with 200 micrograms/day of selenomethionine has been found to increase the level of glutathione
peroxidase in the blood (63). A large trial in China found that supplementing with 50 micrograms/day of selenium
(plus 15 mg beta-carotene and 30 mg vitamin E) lowered the risk of dying from stomach cancer by 21 per cent
(64,65). Other Chinese researchers have found that supplementation with 200 micrograms per day of selenium
significantly lowers the risk of developing liver cancer in a high risk population (66).

Coenzyme Q10

Some very recent research has shown that Ubiquinol-10, the reduced form of ubiquinone-10 (coenzyme Q10) is
even more powerful than vitamin E and beta- carotene in protecting low-density lipoproteins (LDLs) against
peroxidation (67,68,69,70). It is, unfortunately, only found in very low levels in LDLs, but its concentration can be
significantly increased by supplementing with coenzyme Q10 (70). Japanese researchers have found that oral
supplementation with coenzyme Q10 improves the exercise capacity of patients with angina pectoris (71). Oral
supplementation has also been used with good success in patients suffering from congestive heart failure and
essential hypertension (72,73,74,75). Research is ongoing to evaluate the benefits of ubiquinone supplementation
prior to cardiac surgery and preliminary results are very promising (76,77). There is also some evidence that
coenzyme Q10 is useful in the treatment of ventricular arrhythmias and mitral valve prolapse (78,79,80).
Coenzyme Q10 is relatively free of adverse effects in daily intakes as high as 300 mg/day (81). Most treatment
protocols use between 30 and 100 mg daily (81).

Recommended Daily Allowances

The evidence is indeed overwhelming and growing daily that supplementation with antioxidants can help prevent the
development of most degenerative diseases. So what are the RDAs (Recommended Daily Allowances) for
antioxidants? Surprisingly enough, there are none! Beta-carotene, selenium, and coenzyme Q10 have no RDAs
although the National Academy of Sciences has stated that a daily selenium intake of 50-200 micrograms is safe
and adequate (61). Two of the most powerful antioxidants, ascorbic acid (vitamin C) and alpha-tocopherol (vitamin
E), are also vitamins and as vitamins they have RDAs of 60 mg/day and 12-15 IU/day respectively.
However, to suggest that an RDA for a vitamin which acts as a catalyst without being consumed bears any
relationship to the RDA for an antioxidant which is consumed in carrying out its function demonstrates a lack of
understanding of basic chemistry. As a matter of fact, the way RDAs are determined leaves a lot to be desired.
RDAs are based on two very erroneous assumptions: one, that the average American diet is healthy - which is hard
to accept considering that three out of four of the people eating this diet die prematurely from either cancer or
heart
disease. The other assumption is that our vitamin requirements are the minimum amounts needed to avoid
developing serious deficiency diseases such as scurvy, beriberi, and pellagra.
Just how illogical some RDAs are can be illustrated by reviewing the case of vitamin E. In 1968 the RDA for adults
was set at 30 IU/day even though extensive dietary surveys showed that even the best American diet could only
supply about 20 IU (15 mg). In 1974 the RDA was lowered to 15 IU/day for men and 12 IU/day for women to reflect
this fact. Perhaps the crowning irony is that one of the key members of the panel who supported the reduction in the
RDA for vitamin E in 1974 admitted in 1991 that he was himself taking 400 IU of vitamin E every second day "to
decrease the undesirable products of lipid peroxidation in human tissues" (82,83).

The Case for Supplements

The tide is now turning and more and more researchers and even medical doctors are recommending daily
supplementation with antioxidants. Dr. Gladys Block of the University of California points out that only 9 per cent of
all Americans consume the recommended five or more servings a day of fresh fruits and vegetables. She and a
group of progressive medical doctors recommend that people take antioxidants to reduce their risk
of cancer (14,15). Recently a scientific advisory panel to the U.S. government sponsored Alliance for Aging
Research advised all healthy adults to sharply increase their intake of selected antioxidants. They recommend a
daily intake of 250-1000 mg of vitamin C, 100-400 IU of vitamin E, and 10-30 mg of beta-carotene (84).
To put this in perspective, to get 1000 mg of vitamin C from the diet one would need to eat 14 oranges or 10 cups of
cooked broccoli a day; to get 400 IU of vitamin E would require the consumption of 200 cups of brown rice or 80
cups of cooked spinach each and every day.
To eat a healthy diet, exercise and avoid smoking is still very good advice for maintaining one's health; however, it is
now also clear that supplementing with appropriate amounts of antioxidants is highly beneficial, generally safe,
relatively cheap and a very effective way of achieving a significant degree of protection against cancer,
heart
disease and most other degenerative diseases.

Scientific research suggests that minimizing deleterious free radical reactions by ensuring optimal antioxidant levels
may hold the key to
extending the healthy human life span. Studies have shown that people who live to be 100
years or older often demonstrate higher blood levels of antioxidants than their much younger counterparts.
Furthermore, antioxidants may help protect against mitochondrial dysfunction, another harmful condition that
commonly accompanies aging and disease states.
Numerous antioxidants—lipoic acid, green tea polyphenols, lycopene, and vitamins A, C, and E—have been
associated with protection against many afflictions that commonly accompany aging, such as Alzheimer’s disease,
muscle loss (sarcopenia), cataracts, and memory impairment. By protecting against the aberrant biochemical
changes that occur with aging, antioxidants may thus represent a veritable fountain of youth.



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These statements have not been evaluated by the Food and Drug Administration. These  products are not intended to
diagnose, treat, cure or prevent the medical conditions or diseases  highlighted on this page. They are only intended as a
nutritional support.  Always check with your health care professional before starting a supplemental program.
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