Antioxidant Supplements: Do We Need Them?

Antioxidant Foods

Antioxidants and Free Radicals

All cells face constant threats from what are known as free radicals.  We obtain these potential scoundrels from the metabolism of the food we eat, the air we breathe and from sunlight’s action. Free radicals are in varying chemical states, but their main danger lies in their need for obtaining electrons for stability. In order to do this, they “steal” electrons from nearby substances such as body cells and DNA, causing potential damage and destruction. They may damage the instructions in a DNA strand creating a harmful mutation or create  low-density lipoproteins (LDL) that could increase heart disease risk in an artery of the heart, or alter a cell membrane that could affect what enters or leaves a body cell. The body also uses free radicals in a necessary way as part of the immune system to help destroy foreign invaders such as bacteria, viruses, and toxins.

Antioxidants are found naturally in the body such as glutathione, coenzyme Q10, superoxide dismutase among other systems. We obtain many from various foods in the form of vitamins (C, E, beta-carotene and related carotenoids), minerals (selenium, manganese) and various phytonutrients such as flavonoids, phenols, polyphenols, phytoestrogens, and many more found in many plant foods.

Antioxidants probably number in the hundreds or thousands of different substances. Their main function is to act as an electron donor to help squelch the actions of harmful free radicals. Some antioxidants in certain situations can be called prooxidants – electron grabbers. This is likely to be the method found in the defense of the body (e.g. immune system)  Nevertheless, they are all considered to be unique with different roles. “So, no single antioxidant can do the work of the whole crowd.” We obviously need a variety of foods to provide as many as we need to get the job done.

Health Benefits of Antioxidants – What’s the Hype?

Antioxidants came into attention when the research suggested that free radical damage may be involved in chronic diseases such as heart disease, cancer, and vision loss. Studies initially indicated that people who ate the most fruits and vegetables had lower risk of these diseases than people who ate lesser amounts. Clinical trials began to test individual nutrients found in fruits and vegetables that were known antioxidants (vitamin C, E, and beta-carotene) to test their efficacy against these diseases. This took the food and supplement industry and media by storm for a long time with proclaiming protection against diseases by consuming large amounts of antioxidants provided by their products.

However, despite these results and disappointments, antioxidant supplements represent a $500 million-dollar industry that continues to grow. Antioxidants continue to be added to cereals, sports and energy bars and drinks, and other processed foods. Lately, however, the hype appears to have abated somewhat due to the reports of no effects of these vitamins and minerals, and phytochemicals (my opinion).

Heart Disease and Antioxidants

In the Women’s Health Study, 39,876 women took 600 IU of natural vitamin E or a placebo every other day for 10 years. The results? At the end, the rates of major cardiovascular events and cancer were no lower among those taking vitamin E than they were among those taking the placebo.  One large study (the HOPE Trial) found that those taking Vitamin E versus a placebo showed no benefits vs the placebo and vitamin E and that those in the Vitamin E group actually had higher risks of heart failure and hospitalization for heart failure.  Not all trials were negative, however. In a recent trial of vitamin E in Israel, there was a market reduction in coronary heart disease among people with type 2 diabetes.

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.

Age-Related Eye Disease and Antioxidants

Some good news for  antioxidant supplements was found in a six-year trial, the Age-Related Eye Disease Study (AREDS). The results were that a combination of vitamin C, vitamin E, beta-carotene, and zinc offered some protection against the onset of advanced age-related macular degeneration in people who were high risk for the disease.

Potential Hazards of Antioxidants

Several studies have raised some concerns about supplemental beta-carotene.  One study even found that when smokers were fed beta-carotene supplements, the chances of developing lung cancer were increased.  Follow-up studies reported the same results. Another possible caution: In the SU.VI.MAX Trial, rates of skin cancer were higher in women assigned to take vitamin C, vitamin E, beta-carotene, selenium, and zinc supplements.

The studies so far have been inconclusive and are far from providing strong evidence that supplementation with antioxidants have much impact on chronic disease prevention. There was some positive benefits of beta-carotene on cognitive function in the Physicians’ Health Study after 18 years of follow-up; however most studies are of shorter duration, so few comparisons can be made.

What to do? There is abundant evidence that the first observations of fruit, vegetable and whole grain consumption were correct since subsequent studies have supported the fact that consumption of antioxidants via eating natural whole foods provides protection against many of our common chronic diseases.

Bottom Line: Get your antioxidants from whole, natural foods, not supplements. Research is still limited and results are not conclusive, but supplement companies still claim benefits even though more evidence of safety and efficacy is sorely needed.

CBD: The Facts

CBD: WHAT YOU NEED to KNOW

You may have noticed that cannabidol (CBD) seems to be available almost everywhere you look. No single compound expanded its market in 2019 quite like CBD did. This cannabinoid has the bragging rights for new product diversity, after finding its way into water, lattes, jellybeans, hummus, cosmetics and even doggie treats.

CDB products have claimed to treat or even cure a plethora of ailments such PTSD, cancer, arthritis pain, anxiety, sleep disorders, depression, Crohn’s and opiod addiction to name a few. The question remains: how could a single family of molecules help so many different maladies? The most obvious response is that they might not; all of this research might not pan out.

The FDA has approved only one CBD product, a prescription drug product called Epidiolex to treat two, severe forms of epilepsy. It is currently illegal to market CBD by adding it to a food or labeling it as dietary supplement. Some CBD products are being marketed with unproven medical claims and are of unknown quality.

So far, the FDA has warned about some possible side effects:

  • CBD can cause liver injury.
  •  CBD can affect the metabolism of other drugs, causing serious side effects.
  • Use of CBD can cause changes in alertness, drowsiness, especially with alcohol.
  • CBD can cause changes in mood as agitation and irritability.
  • GI distress, decreased appetite, abdominal pain.
  • There are also disturbing regulation issues like cumulative exposure  and how much is actually in the various products? For example, the FDA has tested the chemical content of some cannabinoid compounds and many were found to NOT contain the levels they claimed. Some have been found to contain pesticides, heavy metals, infective agents, and the neuroactive compound THC, the euphoria -inducing compound in marijuana.
  • A study in JAMA documented that in 84 products sold online, 26% had less CBD than advertised and 43% had more.

In May, the FDA held a public hearing on the safety and efficacy of CBD products. In June, a bipartisan team of legislators introduced a bill aimed to streamline research, and in September, the NIH (National Institutes of Health) announced a $3 million research package to investigate the use of cannabinoids and other cannabis-based, non-THC compounds for pain management.

For a full comprehensive report from the FDA:

Disclaimer: Pop-up advertisements are appearing on this blog  without permission, and Food, Facts, and Fads is not associated with any brand that appears. In my opinion, with the list of side effects that have been associated with these products, it would be prudent to be careful with their use until regulations can be put in place by the FDA. As with all supplements, inform your doctor if you are using any of these products due to interactions with regular prescriptionn  medications.

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The Myths and Realities of Dietary Supplements

Dietary Supplements: The Myths and Realities

In 1994 Congress passed the Dietary Supplement Health and Education Act, which led to an explosion of manufactured compounds which are now number to more than 80,000 products on the market and the number continues to grow. Types of dietary supplements include:

  • Vitamins and minerals (Vitamin C and E, selenium)
  • Herbs (botanicals such as ginseng, ginkgo)
  • Proteins and amino acids (chondroitin sulfate, creatine)
  • Hormones, hormone precursors (DHEA, vitamin D)
  • Fats (fish oils, EPA, DHA)
  • Other Plant extracts (garlic capsules, fiber, echinacea, green tea)

A recent edition of Consumer Reports (December 2019) has provided a very comprehensive article by Kevin Loria entitled “Shop Smarter About Supplements”  that everyone should read if you take any dietary supplements to fully understand why consumers should be aware of the realities, both positive and negative of these products. Americans place lot of trust in diet supplement safety even though they are largely unregulated.

Here are some FACTS: Source: Consumer Reports

  • Percentage of Americans who take a supplement at least once a week: 68%
  • Percentage of Americans who take a supplement once a day: 54%
  • Percentage of Americans who say “supplements are safe”: 71%
  • Percentage of Americans who think supplements are tested by the Food and Drug Administration (FDA): 48%
  • Percentage of Americans who think the term “natural” means a supplement is safe or wholesome: 33%
  • Percentage of Americans who think supplements are safer than Rx or over-the-counter drugs: 38%
  • Percentage of Americans who think supplements usually work as well as Rx drugs: 32%

However, under the Dietary Supplement Health and Education Act, diet supplements do not have to be tested prior to marketing or shown to be safe or effective. Although they are often advertised to relieve certain ailments, they are not considered to be drugs. They are not subjected to vigorous testing to prove safety or effectiveness, as drugs must be. The FDA largely relies on any claims from the manufacturers.  It has been shown that many industry-funded studies only favor positive results and many negative effects never see the light of day. So when you read in a headline for a supplement, “clinical trials have shown…,” the bias of the manufacturer of the study results may be suspected.

In fact, each supplement label must include the following declaration of any claim:

“This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.”

To summarize the realities:

  • FDA does not approve, test, or regulate the manufacture or sale of dietary supplements.
  • The FDA has limited power to keep potentially harmful dietary supplements off the market.
  • Dietary supplements often do not list side effects, warnings, or drug or food interactions on product labels.
  • Ingredients list on dietary supplement labels may not include all active ingredients.
  • Dietary supplements may not relieve problems or promote health and performance as advertised.
  • Many products may remain on the market because “there’s a strong placebo effect.”
  • “People will feel better if they think they’re going to feel better.”

What Can You Do?

  • Purchase supplements labeled  USP (U.S. Pharmacopeia) and Consumer Laboratories (CL). They are tested for purity, ingredients and dose but does not address product safety of effectiveness directly.
  • Terms such as release assured, laboratory tested, quality tested, and scientifically blended on supplement labels guarantee nothing.
  • Check expiration dates on supplements.
  • Choose supplements containing 100% of the Daily Value or less.
  • Take supplements with meals.
  • Avoid calcium supplements made from oyster shells, bone or coral calcium. They may contain lead or aluminum.
  • Store supplements where small children cannot get at them. A high incidence of trips to the ER involve overdosing of a certain supplement by young children. Taking a large dose of iron can be life-threatening that can damage the intestinal lining and and may cause liver damage.
  • Tell your health provider about the supplements you take.  Consult your provider about health problems before you start taking supplements to try to treat health problems with herbal supplements.

Source: Judith E. Brown, Nutrition Now, 7th Edition.