When excessive oxidation occurs for prolonged periods, it can take a toll on the system. Changes occur in cells which include damage to fatty acids, inactivation of enzymes, deterioration of cell membranes, breakdown of proteins, and damage to the DNA. For instance, if oxidants damage DNA, the eventual consequence could be a higher likelihood of cancer. If the damage occurs in arteries that supply blood to the heart, it could lead to hardening of the arteries and a heart attack. All these changes lead to disease and premature aging. Over the past few years, scientific evidence has slowly accumulated indicating that taking antioxidant supplements could potentially reduce the risk of certain illnesses and maintain brain health. There is, as of now, no proof that ingesting antioxidants prolongs life span in humans, but enough evidence has accumulated on the benefits of antioxidants that one should not casually dismiss their potential in improving quality of life and slowing the progression of certain chronic degenerative disorders.

But with the thousands of antioxidants available in our foodstuffs and the dozens available as supplements, which ones should you take, and in what dosages? This chapter will provide you with practical guidelines.

Measuring antioxidant levels
There are several kinds of tests are used to measure a food's antioxidant power. The most popular test is Oxygen Radical Absorbance Capacity (ORAC). ORAC measures an antioxidant's ability to protect against the most common free radical in human plasma, the peroxyl radical. ORAC is a helpful starting point to guide consumers to foods that are rich in antioxidants as part of a diet that contains many different antioxidant-rich foods, especially since new antioxidants are being discovered all the time. But most nutrition researchers view antioxidant-counting surveys critically. How a food behaves in a test tube is one thing; how it behaves in our bodies is another.

What Can Antioxidants Do for You?
As a rule, you are not likely to notice any immediate cognitive benefits from taking the antioxidants discussed in this chapter. Therefore, do not expect any dramatic changes in mood, energy, alertness, and memory. Antioxidants can be compared to health insurance. You pay your monthly fee but don’t often get the benefits until years later when you need a hospital bill paid. Antioxidants serve to protect your brain cells, proteins, and DNA from the gradual damage that occurs with the aging process. However other nutrients that have antioxidant benefits, such as CoQ10 and lipoic acid, which are mind energizers—they have immediate cognitive effects. Taking high doses of certain antioxidants, particularly synthetic vitamin E, may be counterproductive.

Antioxidants, less is more
People seeking to improve their health with vitamin antioxidants may want to think twice before popping pills containing vitamin A, vitamin E, and beta-carotene. New research suggests that these antioxidants may actually increase the risk of death by 5 percent. In contrast, the Danish researchers did not discern any significant influence of vitamin C and selenium on longevity. Dr. Goran Bjelakovic and his colleagues searched the medical literature through 2005 to identify trials involving adult subjects comparing beta-carotene, vitamin A, vitamin C, vitamin E, and selenium, singly or combined, versus inactive "placebo" or versus no treatment. Their search turned up 68 trials with 232,606 participants. When all trials were considered, antioxidant supplements had no effect on the risk of death. However, when the analysis was limited to only the highest quality studies, the supplements increased the risk of death by 5 percent. Further analysis showed that only vitamin A, vitamin E, and beta carotene seemed to increase the risk of death, not vitamin C or selenium. The untoward effect of these antioxidants was noted whether they were taken separately or together. The authors stress, however, that they evaluated only synthetic antioxidants, so their "findings should not be translated to potential effects of fruits and vegetables." Journal of the American Medical Association, February 28, 2007.

What Conditions Do Antioxidants Benefit?
It’s quite likely that, over the long run, antioxidants could slow the progression of heart disease, cancer, age related cognitive decline, Alzheimer’s disease, Parkinson’s disease, and perhaps other conditions, though there is no definite proof yet.

What Are Some Examples of Oxidants?
There are quite a number of damaging oxidants that we are exposed to on a daily basis. The most common are hydroxyl (OH), superoxide (O2), hydrogen peroxide (H202), and ozone (03).

Brain Cells Can Get Oxidized
The cell membrane of neurons is made mostly of phospholipids, which contain fatty acids. Nerve fibers that travel from the brain to the spinal cord, and from the spinal cord to the rest of the body, are also insulated with a white-colored fatty substance called myelin. With time, these fats can become oxidized, interfering with proper nerve activity. The process of fats becoming oxidized is called lipid peroxidation. The oxidation of fats contributes to brain aging and can accelerate degenerative disorders such as Alzheimer’s disease. You may recall from chapter 7 that the brain contains a great deal of polyunsaturated fatty acids, such as DHA and arachidonic acid, which are particularly susceptible to oxidation. As we age, many of these fatty acids in the brain become damaged due to oxidation and they lose some of their double bonds, thus becoming more saturated. Neurons in the brain become less efficient the more the fatty acids become saturated. Antioxidants can thus play a protective role in keeping the fatty acids in the brain healthy. After all, about 60 percent of the brain is made of fat.

Antioxidants and Memory
Although many antioxidant pills do not immediately influence cognition and memory, they very well could have a positive effect in the long run. Researchers at the University of Bern, in Switzerland, evaluated a total of three hundred male and one hundred thirty female volunteers, aged sixty-five to ninety-four, over twenty-two years. In 1971, they measured blood levels of three antioxidants: vitamin E, vitamin C, and beta-carotene. They also performed extensive memory testing. They found that higher levels of antioxidants, particularly vitamin C and beta-carotene, were associated with better performance in memory testing. The researchers state, "These results indicate the important role played by antioxidants in brain aging and may have implications for prevention of progressive cognitive impairments."
   The researchers only tested blood levels of three antioxidants. It is quite likely that a number of other antioxidants play a role in helping us preserve memory and mental capacities in our later years. For instance, an eight-month study in rats showed administration of extracts from strawberries and spinach, either alone or with vitamin E, was able to slow damage to brain cells due to the aging process (Joseph 1998).

Antioxidants, longevity, and flawed study
A new study published in The Journal of the American Medical Association claims that taking antioxidant supplements such as beta carotene and vitamin E can shorten lifespan. This study is worthless and I will explain why.
Researchers first included 68 studies involving 232,606 people and found no significant effect on mortality -- neither good nor bad -- linked to taking certain antioxidants. When they eliminated the "lower-quality" studies and looked only at the most trustworthy ones, they actually found a higher risk of death for people taking vitamins: 4 percent for those taking vitamin E, 7 percent for beta carotene and 16 percent for vitamin A.
   Comments: Who determined which studies were "lower quality?" It is possible that another group of researchers may have had a different opinion on what constitutes lower or higher quality. I can already sense a bias. Donald Berry, chairman of the department of biostatistics at the University of Texas M.D. Anderson Cancer Center, said of this study "There are so many choices you can make when you're doing these analyses."

Final findings were based on an analysis of 47 studies involving 180,938 people who were randomly assigned to get real vitamins or dummy pills. Some involved very high doses far exceeding the recommended daily amount of the vitamins; others involved normal or low doses.
   Comments: The pooled studies were too diverse to make any sense. The trials ranged from a three-month study of 109 elderly nursing home residents to a 12-year study of 22,071 male doctors. And the vitamin dosages varied significantly from study to study. What if I analyzed various studies on the benefit or harm of drinking wine and pooled studies that included the health effect of one glass of wine a day and other studies where people drank a bottle of wine a day. It's possible that those who drink one glass of wine may live longer while those who drink a bottle of wine a day may die sooner due to liver damage. But when the results of the one drink and the full bottle studies are pooled, the statistical analyses could indicate that drinking wine shortens lifespan. Meir Stampfer, professor of nutrition and epidemiology at the Harvard School of Public Health, agrees with my viewpoint. Dr. Stamfer said the studies were too diverse to pool together because they looked at various combinations and doses of antioxidants tested in different groups of people. "This study does not advance our understanding, and could easily lead to misinterpretation of the data," said Stampfer.

The study's senior author, Dr. Christian Gluud of Copenhagen University Hospital, said, "The main message is that prevention by beta carotene, vitamin A and vitamin E cannot be recommended. These three antioxidant supplements may increase mortality."
   Comments: Dr. Christian Gluud should take a sabbatical from interpreting research results from nutritional supplement studies and go back to school to take a course in nutrition 101. I can, without hesitation, say that this doctor is ignorant. Firstly, Dr. Gluud, does not seem to recognize that different dosages of supplements can have different effects. There is also no mention that most people who took vitamin E in the past, and also currently, take a synthetic version of one form of vitamin E, dl-alpha tocopherol, whereas there are several forms of natural vitamin E. It is possible that high doses of synthetic vitamin E may not be helpful, whereas low doses of a natural vitamin E complex including alpha, delta, and gamma tocopherol could be beneficial. This is also true of beta carotene. There are many forms of carotenoids, and taking a high dose of a single carotenoid, such as beta carotene by itself, is not the answer.
   Bottom line: There is no proof at this time that taking vitamins will help you live longer, nor is there good evidence that they will shorten lifespan. In order for us to know how vitamins influence longevity, several well controlled studies have to be done on individual vitamins in varying dosages for at least a 20 to 30 year period while keeping dietary intake similar in all the study participants. This is not practical and not likely to be done soon. For the time being if you do plan to take antioxidant supplements, take products that have a wide range of nutrients in low amounts as opposed to just 2 or 3 in high dosages. I am not convinced that taking megadoses of a single form of synthetic vitamin E or single carotenoid is a good option. One good daily formula with lots of different nutrients and antioxidants in small amounts is MultiVit Rx which can be taken at one, two, three, or four capsules a day depending on your preference.

Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis.
JAMA. 2007 Feb 28;297(8):842-57. Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. The Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Center for Clinical Intervention Research, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Antioxidant supplements are used for prevention of several diseases. To assess the effect of antioxidant supplements on mortality in randomized primary and secondary prevention trials. We searched electronic databases and bibliographies published by October 2005. All randomized trials involving adults comparing beta carotene, vitamin A, vitamin C (ascorbic acid), vitamin E, and selenium either singly or combined vs placebo or vs no intervention were included in our analysis. Randomization, blinding, and follow-up were considered markers of bias in the included trials. The effect of antioxidant supplements on all-cause mortality was analyzed with random-effects meta-analyses and reported as relative risk (RR) with 95% confidence intervals (CIs). Meta-regression was used to assess the effect of covariates across the trials. We included 68 randomized trials with 232 606 participants (385 publications).  When all low- and high-bias risk trials of antioxidant supplements were pooled together there was no significant effect on mortality. Multivariate meta-regression analyses showed that low-bias risk trials and selenium were significantly associated with mortality. In 47 low-bias trials with 180 900 participants, the antioxidant supplements significantly increased mortality. In low-bias risk trials, after exclusion of selenium trials, beta carotene, vitamin A, and vitamin E, singly or combined, significantly increased mortality. Vitamin C and selenium had no significant effect on mortality.  Treatment with beta carotene, vitamin A, and vitamin E may increase mortality. The potential roles of vitamin C and selenium on mortality need further study.

Antioxidant questions
Q. I received an email from Dr. Mercola regarding Purple Defense. He says muscadine grapes, most commonly purple or bronze in color, are native to the southeastern United States. The natural whole-food ingredient in Purple Defense may be the most powerful antioxidant ever discovered. Bio-Active Muscadine Compounds include ellagic acid, quercetin, resveratrol, anthocyanidins, cyanidin, OPCs (oligomeric procyanidins), tartaric acid, caffeic acid, chlorogenic acid, peonidin, cinnamic acid, delphinidin, epicatechin, petunidin, gallic acid, geraniol, vitamin C, myricetin, kaempferol, coumaric acid, and malvidin. Dr. Mercola claims it is the best antioxidant on the market.
   A. Purple Defense is a good product, but there are countless other antioxidant products on the market that are also beneficial, including resveratrol, Mangosteen, goji berry, pomegranate, berry compounds, other grape extracts. You need to see the price and determine whether you are getting a good value for your money.

Q. I, too, found that recent meta research claiming anti-oxidants were useless for life extension to be somewhat troubling. I have been supplementing my diet with daily does of vitamins A, C, and E for almost forty years now. I started doing this during the 1960's after reading that there was a study that showed that laboratory rats given a diet
rich in anti-oxidants tended, on average, to live about 1/3 LONGER than the control animals who did not receive the anti-oxidants. Also, the health of the rats fed the anti-oxidants tended to be better, overall, than that of the control animals.
   A. There is no proof at this time that taking antioxidant vitamins will help you live longer, nor is there good evidence that they will shorten lifespan. In order for us to know how antioxidant vitamins influence longevity, several well controlled studies have to be done on individual vitamins in varying dosages for at least a 20 to 30 year period while keeping dietary intake similar in all the study participants. This is not practical and not likely to be done soon. For the time being if you do plan to take antioxidant supplements, take products that have a wide range of nutrients in low amounts as opposed to just 2 or 3 in high dosages. I am not convinced that taking megadoses of a single form of synthetic vitamin E or single carotenoid is a good option. One good daily formula with lots of different nutrients and antioxidants in small amounts is MultiVit Rx which can be taken at one, two, three, or four capsules a day depending on your preference.

Q. Regarding OPC-3. This is a supplement with powerful antioxidants. OPC-3 has been shown to help maintain healthy circulation by strengthening capillaries, arteries and veins. Also supports healthy blood-vessel dilation and circulation. Could this be a natural approach to someone with Raynaud's Syndrome. I myself have taken OPC-3 product for over nine months, having suffered greatly for the past five or six years with Carpel Tunnel to the point of fearing I would have to give up my sports; fishing in Alaska, snowmobiling and my love for horses due to the pain, numbness etc. Not the case, I have been pain free since July/August and continue to enjoy my sports and caring for ten horses on a daily basis. I sleep better and do not have the numbness in my hands and lower arms that I experienced nightly as well as talking on the phone and driving long distances.
   A. OPC refers to Oligomeric Proanthocyanidins, bioflavonoid complexes that help fight free radicals within the body. OPC-3 has these antioxidants: grape seed extract, red wine extract, Pycnogenol, bilberry extract, and bioflavonoids. All of these antioxidants could be very helpful in maintaining health.
Q. I've heard many recommendations on how to mix like goji, acai and other superfruits with yoghurts or other dairy products. Aren't there any risks that the milk proteins (or soy protein if you use soy products) would interfere with the antioxidants and destroy them, like in coffee or tea? Or is that specific for the antioxidants found in coffee and tea?
   A. This is a good question. We have not seen studies regarding the antioxidant effectiveness of goji or acai when mixed with dairy products. Our best guess is that they would still be effective, even if the antioxidant activity is partially blunted.

Q. Does the herb tongkat ali have antioxidant uses?
   A. It may, but this herb should not be used more than 3 times a week.