by

Charles A. Bertrand, M.D., FACP, DIM-CD (Ret.)
Associate Clinical Professor of Medicine at New York Medical College
and at the Medical University of South Carolina

ANTIOXIDANTS - TO USE OR NOT TO USE?

Antioxidants have been around for a number of years and there have been considerable claims about their effectiveness. These range from prevention of heart disease, cancer, cataracts, etc., but the question is, how effective are these substances? This is addressed in an interesting discussion found in the Harvard Health Letter for February, 1999.

What are these substances? In nature, they are fruits and vegetables, such as dark green, yellow and orange colors, including vegetables such as spinach, collard greens, broccoli, carrots, peppers and sweet potatoes. They also include yellow fruits such as apricots and peaches.

All cells in the body use oxygen in order to break down the three types of food - fats, proteins and carbohydrates. Similar to the exhaust from an automobile, when oxygenation occurs the molecules lose one electron and these are then referred to as free radicals. The electrons tend to attach themselves to other substances such as DNA material and other cellular elements. It is thought, and with considerable justification, that this process has a great deal to do with the development of heart disease as well as formation of certain cancers and, in addition, possibly some malfunction of the eye.

As far as the heart is concerned, free radicals may interact with low-density lipoproteins (LDL) in the blood vessel wall and this leads to changes that produce coronary artery disease. A number of studies indicate that by taking vitamin E - either from food or in pill form such as 400 international units a day - that the incidence of heart disease can be reduced by about 30-40%. While the precise dose of vitamin E is in question - and the amount given varies from 100 to 800 international units - probably about 400 units a day is about right. However, there is one caveat - patients who take warfarin (Coumadin), or other anti-coagulant medications, should first check with their physicians before taking vitamin E supplements. The use of vitamin C and betacarotene are less effective in preventing heart disease, if indeed they are effective at all.

As far as cancer is concerned, the use of antioxidants apparently lowers the risk of colon cancer, cancer of the stomach, lung, breast, and possibly prostate as well. The American Cancer Society gives an estimate that about one third of cancer deaths are related to diets that are low in fruits and vegetables and high in fat.

As far as the eye is concerned, there is some evidence that free radicals play a role in causing cataracts by damaging the protein in the lens of the eye and possibly taking vitamin C and E, as well as betacarotene, may reduce the risk of cataracts somewhat. This is not completely definite. However, there seems to be better evidence that the use of such carotenoids reduces the incidence of macular degeneration and this is a very important consideration. Specifically, one study showed that subjects with the highest reported consumption of such carotenoids had a 43% lower risk of macular degeneration.

These observations are very important and I believe one cannot possibly go wrong by going to the produce stand frequently and consuming fruits and vegetables. I know of no significant side effects from such an action. In addition, vitamin E and vitamin C supplements are probably of value. However, many studies are ongoing and it will be most interesting to see what the final results are some years from now.




The advice provided on this website is intended to be general in nature and should not be relied upon for specific treatment. If you need personal medical attention please contact your physician.

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