chapter 5 Anti-oxidants - Health supplements 5 Anti-oxidants.pdf · vitamins and other anti-oxidant...

56 HEALTH DEFENCE

Chapter 5

Anti-oxidants to the rescue

If free radicals cause illness and prematuredeath, boosting anti-radical defences shouldimprove health and life span.

In animal studies, high doses of anti-oxidantshave prolonged life significantly.

We don’t yet have enough human data, but awell-designed anti-oxidant programme willprobably extend our healthy lives too. Even amodest increase in anti-oxidants and otherphytochemicals (compounds found in fruit andvegetables) makes a difference: vegetarianslive longer than their meat-eating fellowcitizens. Taking larger amounts of the rightcompounds would almost certainly give useven longer and healthier lives.

Animal experiments suggest that it might bepossible for us to live to the age of 120 or so. Humans tend tohave somewhat better anti-oxidant defences, so there might notbe quite as much room for improvement in humans as there is inmice. On balance, however, an additional 20 years or so of goodhealth seems achievable – although many life scientists wouldsay that was too conservative.

The slow burnSeen as an energy equation, the only difference between anexplosion, a fire and a human being is the rate of burning.

• Anti-oxidants are the first line of

defence against free radical damage and

could add many years to your life span

• Studies show that the doses of anti-

oxidants needed for good health are far

larger than current Recommended Daily

Allowances

• Anti-oxidants come in vitamin, enzyme

and compound forms. These can all help

slow the ageing process

• Trace metals are vital for anti-oxidant

enzymes to work

• No single vitamin or mineral is sufficient

– our bodies need combinations of anti-

oxidants which work in harmony

• The risk of heart disease, blindness,

cancer, asthma, dementia and arthritis

can all be reduced with anti-oxidants

An explosion is anextremely fast fire – buthumans are on fire too, albeitin a very slow and controlledmanner, consuming oxygenand carbon compounds, andburning them to producewater, carbon dioxide, ATP(the energy molecule), andfree radicals. The low heatproduced in this slow firekeeps us warm and alive.

To stop it from burning out of control and damaging us, we tendthe fire very carefully: we parcel it up into tiny, enzyme-regulatedsteps, surround it with firebreaks, and place fire extinguishers inevery corner to douse the excess free radicals. The ‘fireextinguishers’ are anti-oxidants.

There are basically three lines of anti-oxidant defences:

1st line Anti-oxidant enzymes are madein the body and contain an atom ofselenium, zinc, manganese,copper or iron. Small amounts ofthese metals are vital to our health.

2nd line Anti-oxidant micro-nutrients areobtained from our diet. Theseinclude Vitamins A, C and E, andthe B vitamins. Co-enzyme Q10,flavonoids and carotenoids areimportant vitamin-like compoundswhich have anti-oxidantproperties.

3rd line Anti-oxidant compounds areformed in the body, and are madeup from elements in the diet. Theseinclude melatonin, glutathione,oestrogen, alpha-lipoic acid, Q10and others.

Hardly anyone eats a diet containingenough of all the anti-oxidant minerals,

Nutrient defence in depth

THE DEFENCE BOOSTERS : Anti-oxidants

HEALTH DEFENCE 57

Try this experiment at home

Cut an apple in half. Leaveone half untreated and itwill go brown ie: it oxidises.

Soak the other half in lemonor orange juice. The anti-oxidant Vitamin C slows thebrowningoroxidisingprocess.

a n t i - o x i d a n t e nz y mesanti-oxidant micro-nutrie

nts

anti-oxidant compoundsanti-oxidant enzymes

anti-oxidant micro-nutrients

anti-oxidant compounds

cell

freeradicals

Different free radicals needdifferent anti-oxidants.

vitamins and other anti-oxidant compounds(169-173, 199). It’s importantto get enough of all of them, as they work best together in a kindof defence shield. The fact that we don’t get enough of them(169, 265-

272) is the main reason why most of us die of free radical-relateddisease.

Anti-oxidants in the dietThere are anti-oxidants in every living tissue, in every organ andcell of our body, and in almost every food that we eat. Meat, fish,poultry, milk, egg, vegetables and fruit, nuts, grains and pulses allcontain anti-oxidants: if they didn’t they would rapidly oxidise andturn rancid on the hoof, or on the vine.

Unfortunately, the major anti-oxidants in meat(1), milk and eggs(2)

are destroyed by cooking. Nor is there much point in ordering raweggs and steak tartare, because even if the anti-oxidants weren’tdestroyed by cooking, they would be broken down in the digestivetract.

The anti-oxidants in fruits and vegetables are more likely tosurvive the cooking process (although you will destroy themeventually if you cook your fruit and vegetables to a pulp, so lightlycooked is best). Anti-oxidants in fruits and vegetables aregenerally well absorbed – though some people absorb thembetter than others(123).


58 HEALTH DEFENCE

When a cell is protected

by an anti-oxidant shield

– the right combination

of anti-oxidant enzymes,

vitamins, minerals and

other components – the

‘shield’ absorbs most of

the free radicals.

Why vegetarians live longer

Plant foods contain anti-oxidants which cansurvive cooking to beabsorbed by the body.

They also containcompounds whichstimulate the body intoincreasing the levels ofits own anti-oxidant andde-toxifying enzymes(240);and other compoundswhich benefit our health.This is why vegetarianslive longer.

Having been absorbed

(or ‘quenched’) by the

anti-oxidant shield, the

free radical loses its

destructive energy and

is neutralised.


HEALTH DEFENCE 59

Anti-oxidants in the bodyDietary factors exert an enormous influence on the levels of freeradicals in our bodies. But there are many non-dietary lifestylefactors, such as smoking, sunbathing and aerobic exercise, whichincrease the amount of free radicals in our bodies.

Chronic infection, whether bacterial, viral or fungal, is anothercause of increased free radical formation. This too is linked toincreased DNA damage and an increased risk of cancer. Somebacteria appear to be more dangerous than others in this respect:helicobacter pylori as a cause of stomach cancer and papillomavirus as a cause of cervical cancer are among the bestdocumented.

The body’s first response to increased amounts of free radicals,whatever their origin, is to defend itself by increasing the levels ofits anti-oxidant enzymes(3, 4). This same defence response is foundthroughout the animal kingdom, and in plants also(11).

Most dietary advice concentrates on the health benefits of anincreased intake of the anti-oxidant vitamins – but the major anti-oxidant enzymes are diet-dependent too. Each enzyme requiresan atom of either zinc, iron, selenium, copper or manganese; andall of these must be obtained from our food. This can be a realproblem, because there is good evidence of widespread depletionin one or more of these vital trace elements(169-173, 199, 265-272).

Shoring up the defencesBecause micro-nutrient depletion is so prevalent(169-173, 265-272), manyof us have sub-optimal anti-radical defences.

There’s good evidence that our impaired anti-oxidant defencesare a significant cause of ill health(164) – and a good case for sayingthat our governments should spend less money on treating illnessand more on preventing it with better nutritional education.

Together with improved food labelling, properly thought-outfood fortification programmes and a health-orientated agriculturalpolicy which would shift subsidies from meat and dairy productionto fruit and vegetable growers, this would improve the health ofthe entire nation.

Anti-oxidants are

even more vital if

you:

• Smoke(226)

– even passivesmokers(166)

• Sunbathe

• Exerciseexcessively

• Suffer chronicinfections

• Suffer chronicinflammatorydisease

• Have had a heartattack(179)

Free radicals andnational disease

prevention

Free radicals are involvedin many diseases,including coronary arterydisease, Alzheimer’s,arthritis, cataracts andsome cancers(120).

A minor part of theNational Health Servicebudget spent onnutritional educationcould make a big impacton health statistics.

THE DEFENCE BOOSTERS: Anti-oxidants

60 HEALTH DEFENCE

But don’t hold your breath. Waiting for governments to makesensible decisions can take a long time, and in this area of policy-making there is strong opposition to change from groups with avested interest in the status quo.

In the meantime, there’s one simple nutritional step we can alltake to improve our anti-oxidant defences, which would greatlyincrease our chances of living a long and healthy life: eat morefruit and vegetables. But even this is no guarantee of achievingoptimal nutrition.

Trace metalsDepleted soils produce crops low in specific minerals. This isparticularly important in the case of selenium, and is the maincause of the selenium depletion which occurs throughout much ofNorthern Europe, mainland China, parts of Africa and elsewhere.

If you live in an area where the soil is depleted, or you eat foodsimported from regions with depleted soils, or you eat a lot ofprocessed foods, your anti-oxidant enzyme defences areprobably sub-optimal. The combination of impaired anti-oxidantdefences and increased exposure to free radicals is a recipe forpremature ageing and illness(84).

OFFAL MEATS CONTAIN THE MOST ANTI-OXIDANTS

With the exception of Co-enzyme Q10, most micro-nutrients arepredominantly derived from plant foods, which is why it’s a good idea to eatmore fruit, vegetables, nuts, grains and pulses.

This is not to say that meat is intrinsically unhealthy. The trace anti-oxidantmetals, and some anti-oxidant compounds, including the carotenoids, are notexclusive to plants, and can be found in meat too. Unfortunately, they tend toconcentrate in parts of the animal that we do not often eat.

Liver and kidney (and testes and brain) are among the best sources of tracemetals, and of some vitamins like A, K, E and Co-enzyme Q10.

However, offal meats are becoming more unpopular for human consumption,and in many affluent cultures are predominantly used for pet food. The meatwe eat is mostly skeletal muscle, which is not as good a source of manymicro-nutrients.

Full range = Full protection

In the light of recentclinical trials, ourimproving knowledge ofanti-oxidant mechan-isms in the body, andthe imperfect state oflate 20th-centurynutrition, the optimalanti-oxidant programmeshould include VitaminsC, D, E and the Bgroup, Co-enzyme Q10,and a range ofcarotenoids (includingalpha and betacarotene, cryptoxanthin,lutein and lycopene);plus flavonoids; plusthe full range of anti-oxidant trace metals.

Alpha-lipoic acid andmelatonin are alsoimportant anti-oxidants.

Surgery

Tissue damage duringsurgery is exacerbatedby free radicals(20, 93).Anti-oxidants reduceoedema, speed healingand improve recovery(18, 19).


HEALTH DEFENCE 61

Stone Age clues to 20th-century livingHumans evolved eating an omnivorous diet, and a quick glanceat eating habits on different continents, in different countries,even in members of the same family, shows that we are capableof getting by on a bewildering variety of foodstuffs. A poor diet,however, will pick us off sooner rather than later.

Although this is something of a generalisation, people who livein the developed countries eat too much meat and dairy produce,too much sugar and white flour, too many empty calories and notenough micro-nutrients. From this starting point, what we need inorder to thrive is more plant foods.

When you consider how life evolved, it’s not so surprising. Thefirst living cells which needed to be able to absorb energy fromsunlight, also had to mop up excess free radicals which wouldhave otherwise killed the cells. The green pigment chlorophylldoes both of these things; but it is more efficient to have separatecompounds, some to absorb energy (photosynthetic) and someto neutralise radicals (anti-oxidants). This is why most plantsproduce chlorophyll and a range of other, more effective anti-oxidants.

Many of these anti-oxidant compounds are coloured, rangingfrom purples, blues and greens to yellows, oranges and reds.These anti-oxidant compounds are responsible for most of thecolours in the plant kingdom, from the bright coloration of flowersand fruit to the rust of autumn leaves.

Some time later in evolutionary history, the first animalsappeared. Animals don’t photosynthesise. They don’t need toproduce anti-oxidants in quite the same way as plants; they don’tneed sunlight for energy, and can afford to block it out withphysical barriers such as pigmented skin or shell.

They still need anti-oxidants, however, to neutralise the freeradicals produced by the oxygen they breathe; and the easiestway to get anti-oxidants is to eat plants – taking in both theircalorie energy and their anti-oxidants. (Carnivores solve theproblem in a different way, gaining their anti-oxidant metals andvitamins from offal meats.)

Glasgow gloom

There’s a particularlyhigh incidence of heartattacks in youngScottish smokers intheir 30s and early40s(84).

This is due to the hugefree radical loadimposed by theirtobacco habits and adiet singularly lackingin fresh fruits andvegetables. Hence theyare low in anti-oxidantcompounds and in thetrace anti-oxidantmetals.

Super mice

Mice fed on lycopene,a carotenoid found intomatoes, areprotected againstradiation injury(13).

Vitamins C and E aresimilarly protective atlarge doses (ie 1,000IUof Vitamin E a day and2,000mg of Vitamin Ca day(14, 241, 242)), as areother carotenoids(118,119).


62 HEALTH DEFENCE

When we eat plant foods we take in their anti-oxidant defences.The carotenoids and flavonoids are a good example of thisborrowed (or stolen) defence system. These compounds protectplant cells from free radicals caused by exposure to solarradiation and save them from free radical damage.

When we eat these compounds they protect our skin (and othertissues) from free radical damage in exactly the same way as theyprotected the original plant(12, 118, 119). Similarly, the anti-oxidantVitamins E, C and beta carotene protect against free radicaldamage caused by ionising radiation in patients receiving radio-therapy(92).

Other animals gain exactly the same benefits. Pigs are very likehumans in their metabolism; free-range pigs, which forage for theirown food, have better anti-oxidant defences, and are less rancidthan their factory-farmed cousins who eat depleted diets(15).

Finding the right combinationAnti-oxidants work best to prevent disease when given together,rather than as monotherapies(60-62,77,230,273,288). Our foods containcomplex mixtures of anti-oxidants, and, before the arrival of thesupplement industry, we obtained all our anti-oxidants from food.

For example, many supplements contain beta carotene, butthere are over 600 carotenoids in fruits and vegetables, so whysupplement with just one?

Although beta carotene is the main carotenoid in most diets, ourbodies also contain, and probably need, alpha carotene (fromcarrots or pumpkins), lutein (kale, broccoli and avocado), lycopene(tomatoes), cryptoxanthin (oranges), zeaxanthin (red pepper andspinach) and others(78, 243-245).

The many studies which have looked at the effects of singleanti-oxidants are, in part, an unfortunate hangover from thepharmaceutical mind-set. Despite the headlines, it is not veryhelpful to single out any one micro-nutrient (such as lycopene orselenium) as being ‘anti-cancer’: it is the general nutritional statusthat is important. For example, low selenium has been linked toarthritis and myocardial disease in China, coronary artery diseasein Finland, breast cancer in New Zealand, and goitre in Zaire.

Solo effort

One exception to thegeneral rule that anti-oxidants work best incombination may be Co-enzyme Q10, whichcombines anti-oxidantand mitochondrialsupporting actions, andis relatively unlikely tohave any significant pro-oxidative potential(79) (butsee Chapter 9, Q10 andL-carnitine).

Even Q10, however,can turn pro-oxidantduring intensiveexercise, and so it’sbest combined withbeta carotene andVitamin C(238).

Individualvariations

Some individualsabsorb micro-nutrientsfrom the gut betterthan others. Thedifferences appear tobe largest with the fat-soluble nutrients suchas beta carotene(207)

and Co-enzyme Q10(208).

Each country has a typical nutritionalprofile through which the low seleniumfilters, causing a characteristic pattern ofillness in each different territory.

The section at the end of this chapter isan attempt to design anti-oxidant andnutritional programmes for specificillnesses; but what about the healthyperson who just wants to stay healthy?Which anti-oxidants should they take?

Scientists use a number of different teststo measure the anti-oxidant effectiveness ofdifferent compounds, but have not yetreached any general agreement as to whichtest is the most meaningful. This is not anideal state of affairs, but nevertheless a fewgeneral patterns have emerged.

Many tests show that Vitamin C tends tobe used up first. When the C is gone, thecarotenoids go next, then Vitamin E; andwhen the E has all been used up, lipidoxidation begins(248). Adding either C or Ewill prevent the lipid oxidation but does notprotect proteins from oxidative damage. Toprotect proteins you must add other anti-oxidants such as flavonoids or glutathione(of which more later). So when it comes toanti-oxidants, monotherapy (ie: attemptingto prevent free radical damage with a singleanti-oxidant) is both theoretically and demonstrably wrong.

To help you choose a supplement that will best provide ancomprehensive anti-oxidant shield and a strong immune system,I will summarise, as we progress, my conclusions on whichnutrients you need, at what levels and in which form, in boxesheaded ‘Look for’ – like the one on the next page.

In order for you to quickly check what foods – or spices and herbs– you should emphasise in your diet, we have highlighted these inside boxes headed ‘Include’ – like the one on page 67.

Anti-oxidants worktogether. When VitaminE neutralises a lipid freeradical, it becomes afree radical itself – anda pro-oxidant, unlessneutralised (‘refreshed’)by a carotenoid. Thecarotenoid is oxidisedin this reaction, andbecomes a dangerouspro-oxidant in turn; onewhich can cause con-siderable tissue damageunless it is neutralisedby Vitamin C.

Now the C becomes aradical – but a stable,and therefore a safeone, which is watersoluble and can beexcreted in the urine.Vitamin C can beregarded as thefoundation of the anti-oxidant systems.


HEALTH DEFENCE 63

The anti-oxidant cycle

Lipid

Vitamin E

Vitamin C

Carotenoid Carotenoid

Vitamin E

Lipid

Free radicalformed in body

Vitamin C

Free radicalexcreted from

body


64 HEALTH DEFENCE

How much? SODAs (Suggested Optimal Daily Amounts) may well represent thebest dosage levels found in the American subjects who wereinvestigated, but are they genuinely optimal doses for humans ingeneral? Are they safe? Could one run into problems with anti-oxidant overdose?

There are so many anti-oxidant nutrients that it would takehundreds of trials to be absolutely definitive about the best dosesand combinations of anti-oxidants for short-term health. Industryis unlikely to fund such trials.

And to discover the best doses/combinations to increase life-long health and life span would require generations of scientists,and an equal number of generations of human guinea pigs.

The problem is that anyone eating a varied diet is consuminghundreds of different anti-oxidant compounds, and for many ofthese there is not enough data to recommend optimal dosageranges, let alone specific optimal doses. There are, however,guidelines which cover a handful of the more establishedcompounds and the following are best guesses for generalpreventative regimes.

Vitamin C – 500mg/day in two doses, morning and night ortime release (natural or synthetic)

In the guinea pig (one of the few animals other than humanswhich cannot make its own Vitamin C), oxidative damage to theliver is prevented at a dose some 20-40 times larger than the tinydose that prevents scurvy(57). In human terms, this works out at500-1000mg/day. Other clinicians have found that 500mg in themorning, and 500mg at night, keeps blood levels of C highenough to ensure that a little spills out into every urine sample,implying good anti-oxidant cover around the clock.

Larger doses are seldom needed, but appear to be safe(287); atdoses of up to 5g (5,000mg)/day there is no increased oxalate inthe urine(64), and probably little increased risk of kidney stones(232).Nevertheless, I recommend anyone taking large doses of VitaminC to drink plenty of fluids. The UK Food Standards Agency’supper safe limit is 1000mg (see page 348).

Neanderthal Diet

Analysis of theNeanderthal dietsuggests that ourancestors evolved on400-500mg ofVitamin C a day.

LOOK FOR…

a supplement with at least 500mg of Vitamin

C in time-release form.

Across Europe the

LOOK FOR…

a supplement thatcombines Vitamins A, Cand E with a flavonoidcomplex, eg grapeseedor bilberry extract, plus

the trace mineralsneeded by

oxidant enzymes, iemanganese – 4mg

zinc – 10mgcopper – 2mg

selenium – 120mcg

Minerals in chelate formare claimed to be best

absorbed.

In this form the minerals

LOOK FOR…

a mixed carotenoidsupplement with 7mg of beta-carotene, plusadditional carotenoids

including alpha carotene,lutein, cryptoxanthin,zeaxanthin, lycopene.

The average intake ofbeta-carotene is only

1-2mg/day(247).

THE DEFENCE BOOSTERS: Anti-oxidants

HEALTH DEFENCE 65

Beta carotene – 7-10mg/day – mixed, natural sourcecarotenoids are best(239) – always combine with Vitamin C

This dose puts you in the top few per cent of the population, agroup which appears to be at reduced risk of oral and coloncancers, coronary artery disease and cataracts. Larger doses aregenerally safe: 500 patients with skin conditions took 180-300mgbeta carotene/day for 10 years, without adverse effects(63).However, smokers and others at risk of lung cancer must becautious with beta carotene (see Chapter 13, Cancer).

It is best to combine beta carotene with other carotenoids: 6mglycopene and 6mg lutein per day is a reasonable level, and betacarotene should always be taken with Vitamin C.

Vitamin E – over 149IU (100mg)/day – mixed tocopherols arebest(156, 251, 292)

Various lines of evidence suggest that a dose of 50-100mg a daymixed tocopherols is optimal in terms of disease prevention(110, 274),when combined with a comprehensive micro-nutrient programme.If the restricted D-alpha form is used, higher doses are required(150-260mg/day), as its anti-oxidant capacity is less(154, 251).

Smokers should becautious of betacarotene supplements(see Chapters 12 & 13)!

LOOK FOR …

a supplement with at least 149IU (100mg)of Vitamin E as mixedtocopherols or 400IU

(265mg) of naturalVitamin E per day.

The average intake ofVitamin E is just

15IU (10mg) a day(246).

TOP BETA CAROTENE FOODS

100g of carrot contains approximately 5-8mg of beta carotene in only 35calories. Foods high in beta carotene are:

Carrots Sweet potato SquashSpinach Kale ApricotsPeach Red pepper Broccoli

TOP VITAMIN C FOODS

Yellow pepper 341mg in 1 medium fruit Strawberries 85mg in 1 cupPapaya 188mg in 1 medium fruit Broccoli 58mg in 1/2 cupGuava 165mg in 1 medium fruit Brussels sprouts 48mg in 1/2 cupOrange juice 97mg in 8oz Potato 26mg in 1 mediumGrapefruit 94mg in 8oz Tomato 24mg in 1 mediumKiwi fruit 75mg in 1 medium fruit

NB Canned fruits have much lower levels of Vitamin C.


66 HEALTH DEFENCE

Synthetic Vitamin E is not recommended. Whereas plantsproduce mixed tocopherols containing the different stereoisomers innaturally occurring ratios, chemical synthesis produces eightstereoisomers in amounts determined by the reaction process.Worryingly, some of these promote smooth muscle cell proliferationin blood vessel walls(58), and could therefore increase the risk of heartattack.

Very high doses of D-alpha are not useful and may be harmful,especially if given alone(157, 236, 289-291). They may also inhibit theabsorption of beta carotene(59) and Vitamin K.

The Pot of LifeThe Indian Ayurveda medical tradition uses a medicinecalled Amrit Kalash, which translates as ‘Pot of Life’.

Amrit Kalash has been used for centuries to improvegeneral health and to extend life, as its namesuggests. It comes close to being a dose-finding(although uncontrolled) experiment with long-termanti-oxidants in a large human population.

A glance at the list of fruit and vegetable ingredientsreveals that it must contain a rich mix of anti-oxidants.Samples of the syrup and the tablets (Amrit Kalashcomes in two parts) have been analysed in variouslaboratories and contain moderately high levels ofanti-oxidants, including Vitamins C and E, and a widerange of carotenoids and flavonoids. It also containsother compounds which boost levels of the body’santi-oxidant enzymes.

The overall effect on anyone consuming Amrit Kalash isa significant increase in anti-oxidant status, and anequally significant decrease in free radicals in the body.

The levels of anti-oxidants in Amrit Kalash are someway above the anti-oxidant RDAs and underline theinadequacy and timidity of current governmentnutritional guidelines.

It is possible that even the doses in Amrit Kalash maybe on the low side in terms of what we need for optimalhealth today. They were designed for people eating apredominantly vegetarian diet, and who were thereforeconsuming more anti-oxidant compounds than we do.

In addition, Amrit Kalash was designed for peopleliving in a pre-industrial age. They probably breathedcleaner air than ours, and were exposed to fewersources of free radicals than we are.

TOP VITAMIN E FOODS

Wheatgerm oil 20mg in 1 tbs Peanuts 25mg in 1 ozSunflower seeds 14mg in 1 oz Sunflower oil 6mg in 1 tbsHazel nuts 7mg in 1 oz Almonds 7mg in 1 oz

To obtain the levels of Vitamin E believed to contribute to cardio-protection(ie around 100mg mixed tocopherols), you would need to eat a half kilo ofalmonds (2,000 calories); or 5 tablespoons of wheatgerm (80 calories).

The only practical solution is a supplement. Vitamin E works in combinationwith Vitamin C, selenium and carotenoids.

Go for the largerdoses!

Some people absorbvitamins less well thanothers – so go for thelarger doses(207,208). Theycan all be safely takentogether(144, 145, 206, 231).

Micro-nutrientsaren’t medicines

Recent interventionstudies with Vitamin Ealone have beendisappointing. Thisindicates that micro-nutrients should not beused as single agents(like drugs), butintegrated into acomprehensive nutritionalsupport programme.


HEALTH DEFENCE 67

‘New’ anti-oxidants

Glutathione

Glutathione is not a micro-nutrient: we make it ourselves, insidethe body’s cells where it is probably the most important anti-oxidant and detoxifying agent. The energy to make this vitalcompound comes from the mitochondria; if these are impaired,the resulting decline in glutathione leaves our cells vulnerable tofree radical damage and death.

With age, the mitochondria become less efficient and levels ofglutathione fall. The mitochondria accumulate more free radicaldamage(105) and produce less energy. Levels of glutathione fall stillfurther, forming a vicious circle that is probably a central part ofthe ageing process.

All the evidence suggests that maintaining high glutathionelevels might be a very good thing(75, 76). Boosting glutathione levelsin mosquitoes, for example, increases their life span by up to 40per cent. This strategy appears to be quite safe. Doses of up to250mg per kg of body weight per day of glutathione have beengiven to animals with no ill effects. This approximates to 15g aday in a human: the doses used in clinical studies so far areconsiderably lower, at 300-600mg a day.

Glutathione is a small molecule which can be absorbed fromthe gut, although not much enters the cells(83). However, it couldhave positive effects by interacting with the cell surface. It hasbeen suggested that in this way glutathione may boost theimmune system(83), sex hormone production and cognitiveenhancement. Some clinicians claim it may also reduce theproduction of inflammatory substances, which would benefitarthritis and asthma.

Glutathione given as a drug, however, doesn’t increase levelsof glutathione inside the cells. Drug companies have developedsynthetic versions with some success(106, 216, 217). Alternatively, trythe glutathione analogue, alpha-lipoic acid, plus Co-enzyme Q10,mixed carotenoids and a wide-spectrum anti-oxidant preparation.

Yet again we come back to the idea of anti-oxidantcombinations. Glutathione is a major anti-oxidant inside our cells;

Fresh fruits, vegetablesand whole grains providemany of the vital anti-oxidants.

In addition you shoulddrink (in moderation!), redwine, rather than white, orgreen tea.

Wine, thyme, ginger,garlic, ginseng, liquorice,chilli, ginkgo, paprika,cocoa, green tea andturmeric all containpowerful anti-oxidants thatwill reduce your ‘rancidityindex’ (72-74, 204, 240, 241, 285).These ingredients areexplored further inChapter 6, Flavonoids &Isoflavones.

INCLUDE …


Vitamin C is crucial in plasma and in the extracellular fluids thatbathe our cells; Vitamin E is essential in the cell membranesbetween the two fluid compartments. All three anti-oxidants aremutually supportive, and we need all three – plus Co-enzymeQ10, flavonoids and carotenoids, our own anti-oxidant enzymes,and a range of other anti-oxidant compounds.

Melatonin

Melatonin is one of the most recently ‘discovered’ major anti-oxidants. Long known as the ‘dark hormone’, melatonin isreleased by the pineal gland, located at the base of the brain,during the hours of darkness.

This relatively small molecule is now emerging as an importantanti-oxidant(198, 203). It is a very potent quencher of free radicals,doing the jobs of both Vitamin C and Vitamin E in the types of freeradicals it neutralises. It is active outside the cell, in the cellmembranes and, like glutathione, inside the cell itself. It has beenshown to be equally effective in protecting against cataractscaused by glutathione depletion and against DNA damagecaused by free radicals(205). Few compounds have such a broadspectrum of anti-oxidant activity, or such an extensive ability toprotect against free radical damage. So what is its relevance toour health?

68 HEALTH DEFENCE

Curcumin – the ‘hot’new supplement

Curcumin, found in thespice turmeric, is apotent anti-inflammatoryand anti-oxidant(69).

It also boosts levels ofthe anti-oxidant enzymeglutathione peroxidase,which protects againstfree radicals in the eyeand other tissues(240); andreduces protein cross-linkage, thereby slowingthe ageing process.

Curcumin at about 100-300mg a day would notonly improve your anti-oxidant status, but islikely to ease jointstiffness.

To obtain 100mg ofcurcumin, you’ll need400-800mg of turmeric ora 95% curcuminoidextract.

Melatonin

Where melatonin canbe sold over thecounter, it usuallycomes in 2mg tablets.

Take melatonin in theevening, as it makesyou feel drowsy.Frequent flyers find thatmelatonin capsuleshelp them to recoverfrom jet lag morequickly(279-282).

HIGH IS HEALTHY

The exception to the general rule that glutathione levels fall with age is inthe very healthy elderly, who appear to combine slowed biological ageingwith unusually high levels of glutathione(75, 76). A (small) American study of 33people over 60 found that those with the highest levels of glutathione werethe healthiest(75). They had lower blood pressure, lower cholesterol levels,were less likely to be overweight, and rated themselves as healthier thanaverage.

At the opposite end of the scale, those with chronic disease conditionssuch as heart disease, arthritis and diabetes had lower than normal levels ofglutathione. Dramatically reduced glutathione levels are also found in acuterespiratory distress syndrome (ARDS), which has a 50 per cent mortalityrate(215); and in HIV infection, where glutathione depletion worsens as thedisease progresses to AIDS. Both conditions respond well to the syntheticglutathione precursor Procysteine(106, 216, 217).


HEALTH DEFENCE 69

Firstly, it emphasises the positive aspects of a good night’ssleep, in a dark room, to maximise melatonin production.Exposure to light blocks melatonin synthesis, which is whyinsomnia is associated with reduced melatonin. This may alsoexplain why recent surveys show that chronic insomnia is linkedto a somewhat decreased life expectancy.

Secondly, the ability to synthesise melatonin decreases withage. This is yet another cause of the increased vulnerability tofree radical damage found in old age, and which is an importantpart of the ageing process. This could explain the health benefits(including longevity) which have been ascribed by Indian mysticsto drinking their own morning urine, which contains high levels ofmelatonin. Unaccountably, many people prefer to take theirmelatonin in tablet form.

Anti-oxidants as healers

Coronary Artery Disease

Coronary artery disease is basically driven by inflammation/oxidation in artery walls (see pages 229-231). However, oxidationof LDL cholesterol plays a role too: lipid and cholesterol oxidationproducts attack artery walls, increase the risk of clotting(80) andraise blood pressure(25-26), all of which increase the risk of heartattacks.

Many anti-oxidants help protect LDL cholesterol fromoxidation. When supplements of selenium and the Vitamins Cand E are given to human volunteers, their cholesterol becomesmore resistant to oxidation(22, 23, 28, 95, 193). Vitamin E has been linkedin some studies to a reduction in the risk of heart attacks(109, 110, 201),and with a reduced progression of atheroma (furring of thearteries)(121) in ways which are now well understood(253). So shouldwe all be taking Vitamin E?

Yes, but not on its own. Under certain conditions, Vitamin Ecan accelerate the oxidation of LDL cholesterol(111, 158) unless thereis enough Vitamin C (or flavonoids) around to protect the VitaminE itself from being oxidised(165). (See the E-C Cycle on page 63.)

LOOK FOR…

a supplement thatincludes selenium as

Junk food warning

Fatty meals make yourarteries malfunction – akey early step towardsatheroma formation.This effect can beinhibited by a combin-ation of Vitamin E(400IU) or mixedtocopherols (150IU) andVitamin C or bypycnogenol(12, 126, 127, 275)

(flavonoids extractedfrom pine bark).

Anti-cancer too?

Melatonin has anti-cancer effects in avariety of models(276-278).The human implicationsare not yet clear.

Night milk

‘Night milk’, from cowsmilked at night,contains highmelatonin levels andhas long been reputedto have beneficialproperties(200).


70 HEALTH DEFENCE

This is probably one of the main cardioprotective roles ofVitamin C. However, Vitamin C also helps to maintain the lining ofthe arteries(242, 245) and reduces levels of clotting factors in theblood(122). It used to be thought that Vitamin C could increaselevels of the ‘good’ HDL (high-density lipoprotein) cholesterol, butthis now looks unlikely(30).

All this means that Vitamin E should really be taken withVitamin C, Co-enzyme Q10 (which appears to be a critical anti-oxidant in LDL), the metal trace elements manganese, zinc andcopper, which are necessary for the anti-oxidant enzymes tofunction properly, and flavonoids – because all these anti-oxidantdefence systems work together(112, 113, 230).

This sort of combination will undoubtedly help to prevent LDLoxidation in the plasma and slow the migration of oxidisedcholesterol from the plasma into the artery walls.

In anyone over the age of 20, however, some oxidised LDLcholesterol is already inside the artery walls, and here we needdifferent agents to stop the disease process(114). The flavonoidsenter the vessel walls, damping down the inflammation of thearteries (arteritis) that drives atheroma and hypertension (seeChapters 6, Flavonoids & Isoflavones, and 14, Heart Disease),and allowing them to heal. Beta carotene may be important too: itdoes not protect circulating LDL from oxidation(196, 197), but itprevents cells in the blood vessels’ walls from further oxidising theLDL that is already there(94).

The evidence that anti-oxidants reduce the risk of coronaryartery disease is overwhelming. Conversely, some eminentscientists now say that a poor anti-oxidant status is a betterpredictor of the risk of heart attacks than high cholesterol levels,blood pressure or any other of the known risk factors(27, 96, 107).

Oxidative damage also contributes in diabetics to coronary arterydisease, cataract, nephropathy (damage to the kidneys) andneuropathy (nerve damage) soar. The increased oxidative stress inthese patients means they have more oxidised lipids(24) in their bloodand abnormally low levels of anti-oxidants. Their Vitamin C levelsare often so low that some late stage diabetics are close to sufferingfrom scurvy(97). High dose anti-oxidants are clearly indicated –together with anti-glycosylants (see page 269).

Diabetic?

In severe cases ofdiabetic retinopathy,Vitamins C and E andoligomeric procyanidin(OPC) flavonoidsshould be added. Anadditional angiostatsuch as genistein orpossibly shark cartilageor the drug thalidomidemay be useful.

Liver damage

Free radical damage isan important cause ofliver disease(194). Variousanti-oxidants, includingVitamin E andflavonoids from redwine and milk thistle,have been shown toprotect the liver(98, 99).

It may also be prudentto limit the intake ofiron(66); and take betaineif there is any fattyinfiltration (see Chapter11, Betaine).

Low fat

Low fat diets need anti-oxidant support(108), asthey reduce theabsorption of fat-soluble micro-nutrientsin the diet such asVitamin E and thecarotenoids.


HEALTH DEFENCE 71

Blindness

Cataract and age-related macular degeneration (damage to theretina) are the two leading causes of blindness in the developedcountries. In the USA, cataract surgery is the single largest itemin the Medicare budget, costing some $3.2 billion per annum.Worldwide, cataracts blind 50 million people every year; and thetragedy is that much of this is preventable.

The risk of cataract is increased by oxidative stresses such asincreased exposure to UV, which oxidises the normallytransparent proteins in the lens of the eye, and possibly smoking.The risk is reduced by anti-oxidants such as Vitamins C and E,alpha-lipoic acid, turmeric and possibly beta carotene(36, 40, 61, 192, 240).

It is estimated that 30-50 per cent of all cases of cataract couldbe prevented by eating more anti-oxidants(34, 256, 300). Add asupplement of riboflavin to boost the metabolism of glutathione,an important anti-oxidant in the eye(273). For comprehensive cover,also add half an aspirin or a spoonful of turmeric, which protectlens proteins from destructive glycosylation reactions(125, 240).(Glycosylation is the cross-linking of proteins.)

Essential for eyes

Supplements of luteinand zeaxanthin build upthe protective layer inthe retina(227). Theyprotect the retina byabsorbing damaginghigh frequency light,and neutralising freeradicals.

They are in additionprecursors for the visualpigments (the rhodopsins).

The increasingincidence of maculardegeneration inyounger people isprobably the result ofdiets depleted in thesecarotenoids – and richin ‘empty calories’!

Supplements oflutein and zeaxanthin. A diet rich in kale andspinach, which containthem, has been shownto thicken the layer ofmacular pigment in theeye. This provides anti-oxidant protectionagainst free radicaldamage caused by lightentering the eye(227).

Always combine withVitamin C.

INCLUDE

CONFLICTING RESULTS

In two studies, high dose Vitamin E (in supplement form) reduced the risk ofheart attacks by around 40%(109, 110), but not in other studies.

In two different studies of non-smokers, it was found that in those whose dietcontained the highest amounts of beta carotene, the risk of heart attacks wasreduced by over 70 per cent, compared to the lowest beta carotene group(81, 229).In a group of doctors with coronary artery disease who were given 50mg betacarotene per day, subsequent heart attacks were not reduced(29, 128). In anothermajor trial, it was shown that in people whose diet contained high amounts offlavonoids, the risk of fatal heart attacks was reduced by as much as 75 per cent,compared to the lowest flavonoid consumers(124).

These dietary studies are difficult to analyse. A diet rich in flavonoids, or in betacarotene, is also likely to be high in other plant compounds such as lutein, apowerful anti-oxidant which protects LDL cholesterol from oxidation up to tentimes more effectively than Vitamin E(32, 33, 176), and lycopene which is alsostrongly cardio-protective(129, 152).

This means that we cannot always be sure which anti-oxidant is the importantone; but perhaps the methodological problems are less serious than they seem,because all the major anti-oxidants probably contribute to the reduction in risk(81, 286).

The lesson, again, is that you need a combination of nutrients for protection.


Macular degeneration is the other major cause of deterioratingsight. Here again, oxidative damage is involved and anti-oxidantssuch as E, C and beta carotene are protective(35). This is probablynot the most effective combination of anti-oxidants, however. Inprimates, the main anti-oxidants in the retina are the carotenoidslutein and zeaxanthin(38, 39, 160-162). The optimal strategy to preservesight, even if it has started to fail, is almost certainly acombination of lutein and zeaxanthin, together with Vitamin C,riboflavin, lycopene, selenium and a turmeric supplement to boostthe anti-oxidant enzyme glutathione peroxidase; and theflavonoids in bilberry, a herb traditionally used to treat visualcomplaints(37).

Parkinsonism

In Parkinsonism, toxic tetrahydroquinolones are found in theaffected areas of the brain. These compounds are mitochondrialtoxins and they cause a decrease in glutathione, an increase infree radical formation, and an increase in nerve membranedamage and death.

If a horse is unwise enough to eat yellow star thistles, whichcontain compounds called sesquiterpene lactones, the same sortof things happen – and the horse develops a condition rather likeParkinsonism.

If the changes in mitochondrial function and anti-oxidant statusare an important part of the disease process in Parkinsonism, anutritional approach must be worth trying. This would include a

72 HEALTH DEFENCE

Chrysanthemumalert !

Sesquiterpene lactonesare also found inchrysanthemums andrelated flowers. Inhumans exposure cancause extremesensitivity to light, and(possibly) a dangerouslung condition calledfibrosing alveolitis(202).

Maculardegeneration –

new trial

A basic combination ofbeta carotene,Vitamins C and E andzinc reduced the risk ofdeveloping theadvanced stages of thedisease by about 25%,and the risk of visionloss by about 19%(285).A more sophisticatedformula should givealmost completeprotection.

SYNTHETIC ANTI-OXIDANTS

For those who prefer a medical to a nutritional approach, the drug companiesare developing new synthetic anti-oxidants. Synthetic selenium compoundsare already in use (ie Ebselen), and are reportedly very effective; but somechemists believe that an even newer group of anti-oxidant compounds basedon tellurium may do even better(70).

The problem with synthetics, however, is that we have never encountered thembefore, and the possibility of new adverse effects cannot be ruled out entirely. Ona slightly less contentious note, a new stable, water-soluble and (so far) non-toxicanti-oxidant called fural glucitol, or 2,4-monofurfurilidensorbitol, is probably goingto be a very popular ingredient in future ‘cosmeceuticals’(71).

Plenty of cooked tomatoesin your diet – they providean important anti-oxidantcalled lycopene.

A supplementlevel of 5mg oflycopene a dayis recom-mended. This isroughly equivalent to eating100ml of tomato paste.

INCLUDE …


HEALTH DEFENCE 73

wide spectrum anti-oxidant combination, plus Co-enzyme Q10 andbeta carotene to try to improve mitochondrial function; cysteine andalpha-lipoic acid to help boost glutathione levels; and flavonoids tobind free iron, which is released when cells in the brain die andtriggers the production of more free radicals(222, 223).

For flavonoids in this case read hawthorn flavonoids. Thesepowerful anti-oxidants enter the brain (hawthorn is known tocause sedation) and probably enter and protect nerve cellmembranes from oxidative damage. I would combine the abovewith thyme oil, or thymol, which has a similar effect(255). There issome evidence that nitrous oxide (NO) radicals may be involved,so turmeric, together with beta carotene, or the even moreeffective carotenoid lycopene, is also worth incorporating in theprogramme(100, 101).

Finally, add Vitamin E to this multi-component regimen.Vitamin E alone is not very helpful in treating this condition(48, 49, 174,

175, 178, 214), but chronic Vitamin E depletion is linked to a form ofbrain damage in animals rather like the damage found inParkinsonism(233). In humans who cannot absorb Vitamin E, therisk of Parkinsonism also rises.

Something rather similar to Parkinsonism is found in patientsgiven long-term anti-psychotic medication. They often develop asyndrome, called tardive dyskinesia (TD). Free radical damage isthought to be involved.

Some scientists report that large doses of Vitamin E help (43-45,

257), although the evidence is disputed(224). E is an important anti-oxidant in the brain(49), but months of high-dose supplementationare needed to pump up the levels to where they are needed(49-52,

235). By that time, much of the nerve damage caused by the anti-psychotic drugs may have already occurred – so it might bebetter to co-prescribe anti-oxidants from the start.

Asthma (see also Chapter 19, Asthma)

Cases of asthma are doubling every 10 years. This astonishingtrend has generated much research into possible causes of thedisease, such as atmospheric pollution, excessive hygiene inchildhood, or exposure to the house dust mite – but no case hasas yet been proven.

Worth trying

Some brave cliniciansshould prescribe thymeoil with anti-psychoticagents, to see whetherTD can be prevented.

Saving 100,000lives a year

The US National Centerfor Health Statisticscalculates that if everyadult in the US took anextra 500mg of VitaminC a day, it would cutheart disease deathsby 100,000 a year!

The equivalent UKfigure is probably25,000.

A year’s supply ofVitamin C costs about£30. A by-passoperation costs about£25,000.

Try turmeric

Turmeric’s activeingredient, curcumin,blocks the productionof NO radicals.

Some work links asthma to car exhaust fumes; diesel fumes inparticular have been shown to lead to the formation of dangerousNO (nitrous oxide) radicals and anti-oxidant depletion(104). This can’tbe the whole story, however, because although Stockholm hasmuch cleaner air than London, their asthma problem is just as bad.

Nutritional factors have a part to play; recent surveys showthat children in the Mediterranean countries are relatively unlikelyto get asthma(228)(see Chapter 19, Asthma). Decreased anti-oxidant consumption may well make asthma more likely. VitaminC is important in protecting the lungs from oxidative damage: ahigh C intake is linked to better lung function, even in smokersand in patients suffering from chronic obstructive lung disease(82) .

Fish oil reduces inflammation of the airways in high doses (8-10g/day); but must always be combined with anti-oxidants,preferably Vitamins E and C and flavonoids (see box opposite).

These will reduce the formation of LOPs (Lipid OxidationProducts), which may contribute to the inflammation of the lungs(see Chapter 8, Essential fatty acids) which underlies asthma.

A high magnesium intake is linked to improved lung function(52),and some clinicians have found magnesium aerosols useful inrelaxing the airways of their asthmatic patients(53).

Rheumatoid Arthritis

Low anti-oxidant consumption is a risk factor for developingarthritis(54). Some anti-oxidants such as beta carotene reducesymptoms in animal models of arthritis(55). Other anti-oxidants,such as those found in ginger(72), reduce joint swelling and pain inclinical trials(56), but these flavonoid compounds have specific anti-inflammatory properties. (See also Chapter 10, Amino sugars)

Tumour necrosis factor alpha (TNF-alpha) is important ininflammatory conditions such as asthma, Crohn’s disease andarthritis, and anti-TNF antibodies have been used with somesuccess in clinical trials of arthritis(129, 136, 137). The success, however,was tempered; patients who made antibodies to the anti-TNFantibodies developed allergy-type responses.

The nutritional approach may offer a more durable solution. Thespice turmeric contains curcumin, a powerful inhibitor of TNF-


74 HEALTH DEFENCE

Turmeric andginger in your diet if youhave arthritis.

Turmeric has long beenused as a herbal anti-inflammatory agent. Theonly known side-effect isthat, in some people, itturns the sweat yellow!

INCLUDE

Asthma

A new theory ofasthma is propoundedby Professor BrianHills, of the MaterMisericordiae Hospitalin Brisbane. He thinksthe current epidemicmay be caused bydepletion of theprotective phospholipidlayer that lines thelungs, caused in turnby reduced intakes ofdietary phospholipids(130-132, 134, 135).

I believe Professor Hillsis on the right track. Ihave had outstandingresults with acombination of lecithin(mixed phospholipids),sterols, broadspectrum anti-oxidants,and turmeric andginkgo (which blockTNF-alpha and PAF,two key inflammatorymediators in asthma)(117).


HEALTH DEFENCE 75

alpha(69). In my experience, a combination of turmeric and ginger,which blocks the key inflammatory enzymes, has powerful anti-arthritic properties; when combined with sterols. High dose (ie 8-10g a day) fish or hemp oil, plus 1200mg per day of Vitamin E(258)

and 1-2g of Vitamin C may offer additional benefits.

Skin and stomach ulcers

Free radicals are involved in the destruction of tissue that leads toulcers of the skin(220) and digestive tract(218, 219, 221). Smoking, whichdecreases our anti-oxidant defences, is a risk factor; converselyanti-oxidants can treat these conditions(218, 220) and, if usedprophylactically, may prevent them. The flavonoids may beparticularly useful here (see Chapters 6, Flavonoids & isoflavones,and 10, Amino sugars).

Is anti-oxidant poisoning possible?Anti-oxidants are not panaceas, and should not be usedindiscriminately. Nor should anyone imagine that because largedoses of anti-oxidants are good, larger ones are necessarily better.However, despite theoretical concerns that very high doses of anti-oxidants might cause toxicity, immuno-suppression, pro-oxidativedamage or even increase the risk of cancer, there are few caseswhere anti-oxidants have actually been shown to cause harm.

1 Direct Toxicity

The majority of anti-oxidant micro-nutrients are safe even invery large doses, and very much safer than most medicaldrugs(249). With the few micro-nutrients which are potentiallyhazardous in overdose, we generally have mechanisms toregulate intake and tissue levels. If the body has enough zinc,for example, it reduces the amount of zinc it absorbs from thegut, thereby keeping body levels in the right range(5). The sameis probably usually true for copper(6).

Of all the trace metal anti-oxidants, selenium has the worstreputation for toxicity. But let’s keep that in perspective. Therecommended daily intake of selenium is around 100-200mcg,depending on lifestyle factors. Doses 30 times higher havebeen used to treat various conditions without adverse effects.

Toxic Pre-eclampsia

Toxic Pre-eclampsia,which can occur nearthe end of pregnancyis dangerous formother and baby. Thecondition is linked withlow anti-oxidantstatus(138-143). In onemajor trial, Vitamins Cand E reduced theincidence by 76%!(144)

No overnightmiracle

Some of the nutrientsrecommended taketime to affect your anti-oxidant status.

It can take months forVitamin E levels to buildup, for example.

Selenium needs

A high intake of poly-unsaturated oilsincreases seleniumrequirements, as dosmoking, exposure toheavy metals such asmercury and lead, anda diet deficient in otheranti-oxidants(172, 173, 180-185).


76 HEALTH DEFENCE

The toxic dose of many selenium compounds is around 40times the recommended daily dose(102, 103, 186-191). By way ofcomparison, the toxic (even lethal) dose of a familiar medicinelike paracetamol can be less than 10 times the therapeutic dose.

Vitamin E is very safe(65, 68, 74, 259-261). However, high doses canreduce the ability of the blood to clot and, if given to patientswith atherosclerosis, high blood pressure and lesions of thesmall blood vessels (ie smokers), may increase the risk ofhaemorrhagic stroke. This may have occurred in the FinnishATBC study, cited elsewhere. Perhaps the trialists, who wereall smokers, should have been primed beforehand withVitamin C and Crataegus (hawthorn) flavonoids(259-261).

Vitamin A increases the incidence of certain birth defectsat doses as low as 10,000 IU/day (195) (ie 4 x RDA), so shouldbe used with caution by women of child-bearing age. Betacarotene is a safe substitute, but must always becombined with Vitamin C, and never with smoking (seeChapter 13, Cancer).

2 Immuno-suppression

Our immune cells produce free radicals to help destroy certainkinds of disease-causing micro-organisms. For this reasonsome clinicians have suggested that anti-oxidant supplementscould cause immuno-suppression.

Theoretically, extremely large doses of anti-oxidants takenduring the start of an infection might make the infection worse.However, in practice anti-oxidants appear unlikely to causeimmuno-suppression, except at implausibly large doses.

For most of us, anti-oxidant supplements are more likely toresult in improved immune function(16, 17, 262-264). Immune cellsaccumulate Vitamin C as and when they need it, and theyneed it whenever they’re active in order to protect themselvesfrom the free radicals they produce. When there isn’t enoughVitamin C available, activated immune cells kill themselveswith their own free radicals. The resultant immuno-suppression and free radical damage caused by the immunecell’s death may lead to even greater tissue damage (17).

Vitamins A and D

Very high doses ofVitamins A or D candamage the liver.

Even here, however,safety margins arelarger than previouslythought. The upper safelimit for Vitamin D isnow shifting from 50 to250mcg(294).

!

Selenium – Safety Data*

Dose(mcg/day)

Deficiency 10-20(Keshan)

Estimated safe/ 50-200adequate

Cancer 200-800protection

Max. acceptable 500intake

Highest nationalintake (Greenland) 1,280

Lowest observedadverse effect >5000

*Swedish State Nutritional Agency


HEALTH DEFENCE 77

Low selenium linked to low fertilitySelenium deficiency is extremely common insome countries(234). In parts of China andAfrica, selenium deficiency is linked to aparticularly severe form of arthritis, cardiacdamage, infertility, thyroid problems(7, 42), anincreased risk of cancer and acutepancreatitis(250).

Selenium depletion is even more common.There are many countries such as Finland(where the soil is now routinely seeded withselenium salts), New Zealand and the UKwhere selenium levels are low enough to bea potentially significant cause of ill health(85-89).

The UK recommended daily intake ofselenium is 60mcg/day for women, and 75mcg/day for adult men.

However, levels of selenium in the British dietfell between 1978 and 1994, from 60mcg/dayto around 30mcg(91). This fall occurred whenthe UK stopped importing Canadian wheatand switched to home-produced varieties,grown on selenium-deficient soil(90).

As a result, selenium depletion is increasing,particularly in those who eat a lot of PUFAs,are exposed to heavy metals, or who haveamalgam (mercury) dental fillings(172-173).

The elderly are another high risk group, asthey tend to have greater body loads of heavymetals, and are more likely to be depleted inselenium and the other essential anti-oxidanttrace metals(10).

Signs of early selenium depletion are alreadyemerging. Selenium is essential for fertility,

and selenium deficiency leads to reducedfertility in all animal species studied(42).

If you give selenium supplements to infertile,selenium deficient animals, embryonicmortality falls, sperm motility improves, andconception rates increase.

In a recent study of Scottish men, seleniumsupplements increased their sperm motilityconsiderably, indicating that they wereselenium depleted before the supplementationprogramme started. When the supplementsstopped, their sperm motility fell back to pre-treatment levels(8).

Low levels of Vitamins C and E, and thecarotenoids impair fertility too, and a micro-nutrient support programme containing allthese elements should be tried in cases ofotherwise unexplained infertility(9, 237, 293).

But too much may be dangerous.

Different forms of selenium have differentlevels of toxicity.

Selenite, selenate and seleno-methionine arethe most toxic; but even here relatively minorproblems, such as prolonged clotting time,only begin to appear at doses of 750mcg aday(186-188).

Excess selenium may become pro-oxidative(190-191) and may be linked to anincreased cancer risk(189). 150-200mcg/day isprobably close to optimal.

Anti-oxidants given late in the course of an illness, when theimmune cells have quietened down, could help by reducingthe symptoms of inflammation(163).

Exercise and anti-oxidantsExercise increases the formation of free radicals up tofive-fold, so does this mean exercise is dangerous foryour health? Actuarial tables reveal that in exercise, asin so many other things, moderation is the key.

People who take a moderate amount of exercise live,on average, longer than those who take no exercise.One Czech study showed, however, that former high-level professional athletes have a rather shorter life-span, and do no better than those who take noexercise at all(283, but see also 284).

It seems likely that these athletes’ increased risk ofcancer, heart disease and arthritis in their later yearswas related to their increased exposure to freeradicals during prolonged periods of extremely intensephysical exertion.

Muscle damage caused by free radicals occurs evenin the most highly trained athletes(144, 145, 177). With reallyheavy exertion, the level of free radical damage canlead to DNA damage, and contribute to immuno-suppression and an increased susceptibility to skinand upper respiratory tract infections(146-147).

For some reason men tend to be more badly affectedthan women; but in both sexes, anti-oxidantsupplements such as Vitamins E and C, and Co-enzyme Q10 reduce muscle damage, with a resultingincrease in stamina and a corresponding decrease inpost-exercise pain and stiffness(148-153, 275). These anti-

oxidants also reduce inflammation of the airways(209).

Partly as a result of these findings, many professionalathletes now rely on ‘tanking’, ie taking large doses ofbroad-spectrum anti-oxidants. This speeds up post-exercise recovery, reduces DNA damage anddecreases the incidence of infection(146-147). And just incase anyone thinks this is merely a placebo effect,identical benefits have been shown in rats!(154-155)

The increased life span associated with moderateexercise is probably due to increased levels of anti-oxidant enzymes in the body. This enzyme boost is thebody’s way of adapting to the extra free radical loadcaused by increased oxygen demands during exercise.

The up-regulated enzymes work very efficiently andgo on doing so even after the athlete leaves the trackand goes home, leading to a significant reduction infree radicals in the body, and thereby slowing keyaspects of the ageing process(156).

Athletes and sportspersons should remember thattheir increased anti-oxidant enzymes won’t be able towork effectively if they are deficient in any of the vitaltrace metals needed to let anti-oxidants workefficiently.

Professional athletes in particular, should maintain anadequate intake of the anti-oxidant trace minerals,high doses of the anti-oxidant vitamins and the aminoacid glutamine.


78 HEALTH DEFENCE

You can increase the amount of anti-oxidantenzymes your body makes with moderate exercise.The minimum ‘dose’ of exercise to boost your anti-oxidant enzymes is probably around 20 minutes ofaerobic activity three times a week (sufficientlyintensive to raise a sweat and the pulse rate).

Professor Ken Cooper of Dallas University hasshown that this is the minimum ‘dose’ of exercisewhich improves health status and life expectancy.

Twenty minutes three times a week tones the heart,lowers blood pressure, improves blood cholesterolratios and reduces the blood’s tendency to formclots.

The fact that moderate exercise also reduces the riskof cancer(156) probably means that this ‘dose’ ofexercise is sufficient to trigger a compensatoryincrease in the level of anti-oxidant enzymes too.

EXERCISE BOOSTS THE BODY’S PRODUCTION OF ANTI-OXIDANT ENZYMES!


HEALTH DEFENCE 79

The Anti-oxidant Checklist

Eat more fruit, vegetables, nuts andwholegrain foods.

Drink alcohol in moderation, preferablyred wine.

Take moderate amounts of exercise toboost your anti-oxidant enzyme levels –20 minutes of exercise three times aweek is the minimum.

Get a good night’s sleep in a dark roomto boost your melatonin levels. Capsulesare available in some countries.

Most people would benefit from a dailysupplement of Vitamins C (500mg), D, E (100mg mixed tocopherols or 265mgD-alpha), B group, Q10, mixedcarotenoids (10-20mg) and alpha-lipoicacid.

Mineral supplements of zinc, selenium,copper and manganese will ensure theanti-oxidant enzymes are workingproperly.

Supplement with iron only if irondeficiency has been diagnosed.

Curcumin, thyme, rosemary, ginger,garlic, chilli, ginkgo, cocoa and green teaare all good anti-oxidant ‘extras’ (72-74, 241).

If you smoke, exercise, sunbathe or aresuffering from chronic inflammation orinfection, you need extra anti-oxidants.

Athletes should supplement withhigher dose E, C, beta carotene andQ10 to reduce muscle damage.

To protect against and treat the following,incorporate these into your diet andsupplement mix:

Heart disease: selenium (100-200mcg),C, E, Q10 (90-270mg) and mixedcarotenoids, grapeseed, hawthorn orbilberry flavonoids, betaine.

Cataracts: C, E, alpha-lipoic acid,mixed carotenoids, riboflavin (B2) andturmeric.

Macular degeneration: Vitamins E andC, lutein, zeaxanthin, selenium, bilberryextract, lycopene and riboflavin (B2).

Parkinson’s disease: Full anti-oxidantcombination, including Vitamins E andC, Q10, beta carotene, cysteine/alpha-lipoic acid, hawthorn extract, thyme oil.

Asthma: Fish oil, Vitamins C and E,magnesium, turmeric, ginkgo, lecithinand/or betaine and sterols.

Arthritis: Vitamins C and E, ginger,curcuminoids, fish or hemp oil andsterols.

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