Explaining Antioxidants to Patients: Part 1

What are antioxidants?

Have you ever seen hydrogen peroxide poured onto an open wound? The liquid forms bubbles as it consumes the dead, infected flesh. The right amount cleans up the wound. But if the hydrogen peroxide solution is too strong and excessive, damage to healthy tissue takes place. That is what antioxidants stop from happening inside our bodies.

Antioxidants stop excessive oxidative damage by inactivating rouge, fly away electrons and other molecule parts. It’s these unstable particles getting loose and dissolving everything in its path, like the Tasmanian Devil on a Looney Toons cartoon, that destroy cell membranes, receptors, and enzymes. Too much free radical activity is associated with inflammation. A little bit of natural hydrogen peroxide is good and natural, too much is bad.

Oxygen is thought to be the most common free radical in the body. Have you ever noticed how lettuce and other delicate vegetables are preserved and stay fresh longer when put into an air tight container to reduce exposure to oxygen?

More potent than the oxygen we breathe are oxygen-containing molecules such as hydrogen peroxide and hypochlorous acid which can change into the super strong radical anions called hydroxyl (-OH) and other destructive anions.

Some people drink hydrogen peroxide thinking it will improve their health, and then take antioxidant pills. For those people I say, "stop micromanaging your body. It knows what to do." Our bodies are smarter than all of us.

With so many vitamins, minerals, nutraceuticals and herbs, how do we know which ones have antioxidants properties?

One of the main tests is called the oxygen radical absorbance capacity (ORAC). Other measurement tests include the Folin-Ciocalteu reagent, and the trolox equivalent antioxidant capacity assay.

According to the Natural Medicines Research Collaboration, the following products have noticeable antioxidants activity: selenium, strawberry, black currant, blackberry, carrot, cranberry, dandelion, globe artichoke, lutein, lycopene, melatonin, noni, pycnogenol, raspberry, seaweed/kelp/bladderwrack, vitamin A, vitamin E and vitamin C.¹

Are antioxidants good for general health?

Observational studies have consistently shown that diets high in vegetables and fruits (that are rich in antioxidants) are associated with a reduced risk of cancer and cardiovascular disease.^2-3

Whole foods, especially vegetables, are thought to be the best deliverer of antioxidants and vitamins in the perfect amount and form. But the real question is: Is it the vitamins in the fruits and vegetables that yield the health benefits, or are the vitamins just a marker of good health, and something else in the whole foods is yielding the health benefits?

Synthetic antioxidants pills are not the whole package of goodness that are vegetables and other whole foods. They are only a small portion of the goodness.

In a 2012 review of 78 randomized trials involving 296,707 participants, researchers found no evidence that antioxidant supplements (eg, beta-carotene, vitamin A, vitamin C, vitamin E, selenium) could reduce mortality.⁴ These findings imply that a junk food diet with antioxidant pill supplements is not equally beneficial to a whole food diet rich in fruits and vegetables.

Can synthetic antioxidants pills adversely affect our health?

Some researchers suggest possible harm in certain subgroups.⁵ In fact, the US task force recommends against the use of beta-carotene or vitamin E supplements for the prevention of cancer or cardiovascular disease.⁶

It’s also important to know that beta-carotenes are precursors to vitamin A. So, whatever applies to beta-carotene, also applies to vitamin A.

There is also emerging evidence that antioxidant use can impede athletic performance in healthy individuals. A 2015 review article looked at the use of vitamin E, quercetin, resveratrol, beetroot juice, other food-derived polyphenols, spirulina and N-acetylcysteine (NAC) in athletes. They concluded that acute intake of Vitamin E and NAC is likely to be beneficial. However, chronic intakes of most antioxidants have a harmful effect on performance.⁷

The Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine supports this conclusion and does not recommend the use of antioxidants to counteract the oxidative stress from exercise.⁸

Despite some negative information, antioxidant pills do have a place in therapy. They must be used wisely, like drugs and medicine, to bring an unhealthy body back into alignment with natural health. It is not recommended that healthy people take antioxidants, but it is recommended that people with certain diseases take specific antioxidants to alleviate symptoms of the disease, and possibly slow the progression of the condition.

Part 2 of Explaining Antioxidants to Patients will address the medical evidence regarding these various physical conditions where antioxidants have been used with good results.

References

• Therapeutic Research Center. Natural Medicines. Natural Medicines Research Collaboration website. https://naturalmedicines.therapeuticresearch.com/. Accessed April 1, 2019.
• Jha P, Flather M, Lonn E, et al. The antioxidant vitamins and cardiovascular disease. A critical review of epidemiologic and clinical trial data. Ann Intern Med 1995; 123:860.
• Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, et al; American Cancer Society 2010 Nutrition and Physical Activity Guidelines Advisory Committee. American Cancer Society guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin. 2012;62:30-67.
• Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane Database Syst Rev. 2012 Mar 14;3:CD007176.
• Fruits and Veggies in Diet=better health: Stanner, S., Hughes, J., Kelly, C., & Buttriss, J. (2004). A review of the epidemiological evidence for the ‘antioxidant hypothesis’. Public Health Nutrition, 7(3), 407-422. doi:10.1079/PHN2003543
• US task force statement: https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/vitamin-supplementation-to-prevent-cancer-and-cvd-counseling
• Braakhuis, A.J. & Hopkins, W.G. Sports Med (2015) 45: 939. Impact of Dietary Antioxidants on Sport Performance: A Review https://doi.org/10.1007/s40279-015-0323-x. Accessed April 9, 2019.
• Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance. Thomas, D. Travis et al. Journal of the Academy of Nutrition and Dietetics , Volume 116 , Issue 3 , 501 - 528