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For the week of: 1/4/99

Question: "I hear a lot about anti-oxidants and get the feeling I should be taking them even though I'm a fairly healthy woman in my upper 40's. What are anti-oxidants and what do they do? I would appreciate any suggestions as to exactly what I should be taking, also. Thank you."

Dr. Norm S. Cohen, M.D.

by Norman S. Cohen. M.D.
Medical Director,
The Longevity Center



Answer:
Before defining what an "anti-oxidant’ is, it is necessary to understand the "free radical" theory of disease progression and age associated illness.

Why do our bodies deteriorate in so many ways with aging and what can we do about it? Scientists have been trying to answer these questions for years and the fact is, we are finally getting some good answers.

In the late 1960’s two doctors proposed a theory which attempted to explain how and why many of the diseases normally associated with the aging process become initiated and are encouraged to progress. This theory has become to be know as the "free radical" basis for disease. These doctors were way ahead of their time. We know that much of what they proposed in this theory is true. We also know that there are certain very effective methods to deal with it.

Free radicals are minute chemical particles that are manufactured and released in our cells during normal cell function. In fact, they occur most commonly from the breakdown of one of the byproducts of the oxygen our cells use to stay alive. Free radicals cause injury to our cells. They can interfere with the lining of the cell, interfere with normal cell function, disrupt and even destroy the cell. Since are our bodies are made up of countless cells, excess free radical production can have a major impact on our vital organs and overall health.

If you have ever had too much to drink and have woken up with a hangover, you have felt the effects of serious free radical damage. Alcohol is a potent generator of free radicals. It also gets to the brain very readily. Another potent generator of free radicals is nicotine. This is why smoking is such an overwhelming health risk. If you compare a 50 year old smoker to a 50 year old non smoker, you will see a visible difference just in their appearance. Smokers often appear 10 to 20 years older than their chronological age and that is only on the surface! The effects on their internal organs, heart, lungs and vascular system are dramatic.

Another way that free radicals hurt us is by changing the harmful form of cholesterol, the so called LDL cholesterol. Free radicals help to cause a chemical change in this cholesterol molecule which changes it to its "oxidized" form. It is the oxidized form of the LDL cholesterol that gets consumed by certain immune system cells called macrophages. Though the process is much more complex than I have chosen to explain, these "cholesterol rich" macrophages team up with other molecules and calcium along the walls of blood vessels to form the plaque that blocks our arteries.

The entire process of free radical damage and generation of plaque due to the help of free radicals is often referred to as "oxidative stress". The term "anti-oxidant" refers to any substance that tends to neutralize or keep the free radical process in check. Our bodies certainly have safety systems that do just that but they need to be working at full capacity. For this they need certain vital nutrients. In addition, many vitamins and other important "nutritional supplements" are direct scavengers of free radicals. This means they neutralize free radicals and render them harmless before they have a chance to act in an adverse way.

It has long been argued that if a person eats a well balanced diet, there is no need for nutritional supplementation. However, that fact is that most Americans, though they eat well, do not eat properly. Many of the things we eat have little or no nutritional value and many people, despite never going hungry, do not get adequate nutrients from the foods they eat.

It would be cumbersome to try to give a description of the role that each and every vitamin and nutritional supplement plays in our health. The following is a short list and brief description of some of the more important supplements and anti-oxidants from which most people can derive benefit for prevention and for the improvement of certain conditions:

  • Vitamin C - This is also called ascorbate or ascorbic acid. Vitamin C has a wide range of functions in the body. Its role in the immune system is well know. Large doses of vitamin C help to alleviate cold and flu symptoms by boosting immunity. Vitamin C is also an excellent antioxidant. Antioxidants help neutralize the production of free radicals which are chemical complexes that cause harm to our cells and play a major role in the disease process. Vitamin C is essential to collagen production. Collagen is the tissue that holds our bodies together.

  • Vitamin E - Tocopherols - This is the common form of vitamin E and an excellent antioxidant that has a very positive effect on the circulatory system. Much has been published about how vitamin E lowers the risk of heart disease. It improves the efficiency of oxygen use by the muscle. It also works as a mild blood thinner which helps prevent clotting.

When taking vitamin E be aware that the most common form dl-alpha tocopherol is the synthetic (manufactured) form. The natural form is twice as active and would be d-alpha instead of dl-alpha. Almost all the vitamin E sold by health food stores is the synthetic. The natural form is the preferred form but harder to get and more expensive.

  • Vitamin E - Tocotrienols - This is a "new generation" vitamin E with some different properties than the tocopherols. In nature, these substances are found in rice bran and palm. Now they can be extracted and placed in supplement form. These substances can have considerable effect on blood lipids and can lower LDL-cholesterol. Tocotrienols also help to prevent platelets from sticking together thus reducing the risk of cardiovascular disease from thrombosis. Tocotrienols have also been shown to slow down or delay tumor growth in the laboratory.

  • B Vitamins - Many vitamins fall into this category. These include: B1 (thiamine), B2 (riboflavin), B3 (niacin), B5, B6 and B12. These vitamins have a variety of positive effects and frequently work together. B12 can give a person more energy and help depression even in the absence of an obvious deficiency. B6 has been used in high doses for PMS and also for nausea. Niacin is recommended for high cholesterol.

These are just a few examples of the positive effects of the B vitamins. There are many others. They have antioxidant properties as well. Folic acid, also called Folate, is an important B vitamin. It has been demonstrated that a deficiency in folic acid can lead to an increased risk of birth defects. It has also been suggested that folic acid plays a role in the prevention of cancer. Finally, it has been shown that folic acid and other B vitamins help to neutralize the increased risk of heart disease associated with increased serum levels of homocysteine.

  • Vitamin A - This vitamin is generally formed in the body by converting beta-carotene in the intestine. Vitamin A is important in the immune system and for vision. Natural Vitamin A is found in animal products. Therefore, if one does not eat much of these, the conversion of beta-carotene becomes the most important source. Supplementing both beta-carotene and vitamin A is a good idea. However, vitamin A is one of the vitamins that we know can be harmful if the dose is too excessive.

  • Coenzyme Q 10 (Co Q 10) - This very important substance is found everywhere in the body. It plays a very important role in cellular respiration. In other words, it makes it possible for our cells to use the oxygen that we depend upon to sustain life and generate energy. Many patients with poor cardiac function benefit from supplementation of CO Q 10. Symptoms of angina have been reported to improve and cardiac muscle strength has been improved for many patients. Anecdotal reports of improvement in breast cancer diabetes, poor immunity and other conditions have also appeared.

When choosing a Co Q 10 product, the benefit that one will derive is directly proportional to the quality of the product. Many Co Q 10 supplements do not contain the stated amount of the substance and the absorption of what it does contain, can be very inconsistent. It is important to use a product that has been shown to increase amounts of Co Q 10 on a cellular level.

There many other supplements and foods such as soy protein , Pycnogenol, and Melatonin to name a few, that have potent anti-oxidant value. However for basic prevention a program that provides adequate amounts of the essential vitamins described above, along with Co Q 10 is a sensible practical approach to basic anti-oxidant supplementation.

For most people who are simply looking for prevention, the recommendation would be to take an excellent quality multivitamin and mineral supplement, 800 IU of natural vitamin E and 30 -50 mg of Co Q 10. Obviously, there are many other supplements which are not necessarily anti-oxidants that can be of benefit to certain individuals for prevention as well as specific conditions Examples would be calcium for women and saw palmetto for men over 40. Perhaps we can discuss some of these in the future.

One last comment. Make sure, as best you can, that you are buying pharmaceutical grade products. This means that there is much more quality control in these products and you can be reassured that you are getting what is represented on the label.

by Norman S. Cohen. M.D.
Medical Director,
The Longevity Center

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