This is my response to the recent article in Acupuncture Today - The Dangerous Hype of Antioxidants By Marlene Merritt, DOM, LAc, ACN.
_This article is attempting to tell us that taking anti-oxidant supplements is in fact “bad for us.” The author cites some specific resources, however only directly sites them in one small paragraph of the entire article, leading me to believe the rest of the article is entirely her own speculation. The entire article seems to be a perfect example of making statistics say what you want them to. Upon examining the actual citations we can see that her extrapolated opinion is not very in-line with what most of the research studies actually found.
Let’s take a look at one point where she actually cites resources:
“Not only does taking antioxidants seem to make no difference for cardiovascular disease2, but it also has been linked to increased rates of lung cancer3,4, gastrointestinal cancer5, prostate cancer6, reduced apoptosis7 and increased mortality8. Adding antioxidants can also impair ovulation9.”
Reading this makes one feel as though taking anti-oxidants will actually increase your chance of getting cancer, along the lines of smoking cigarettes or working in a coal mine. This statement she makes is entirely false, as the articles she cites do not link taking anti-oxidant supplements to an increased rate of cancer AT ALL, rather they point out a possible increased rate of mortality from cancer the patient already has. And after her entire article of unsupported information about how anti-oxidants can increase the risk of cancer or death from cancer she ends the article with the only realistic point:
“Don't believe the marketing hype — for your long-term health, avoid mega doses of synthetic vitamin isolates.”
When I took a look into the actual research journal articles she cited (and I have pasted some excerpts below) I’ve come a to a few conclusions on this matter.
- Most of the research studies she cites only have to do with patients who already have cancer or other diseases, and most focus on the increased mortality rate among cancer patient - NOT the increased cancer rates "caused by anti-oxidant use." There is no reference to actual prevention in healthy individuals. In some cases there is reference to healthy individuals that supports the use of anti-oxidants, some of the articles even reference the fact that there is and has been a significant amount of research done in support of anti-oxidant supplementation to prevent disease.
-These studies that site an increase in mortality among those patients already suffering from cancer only show a statistically significant result when the data is analyzed in a specific manner, in another way there is no significant result. In one study they account the possible mortality rate increase to be associated with those individuals using the highest amount of alcohol. (3)
-The study regarding ovulation (9) only examines the effect of anti-oxidants in mice (not humans) and this study was performed not by giving the mice supplements but by the “administration of broad-range scavengers of oxidative species into the ovarian bursa of mice.”
The only real conclusion I can make from these research studies is regarding apoptosis (“cell suicide” or the ability for a cell to destroy itself). Free radicals are what help the cells complete this process of their existence, and therefore when a cell is infected with cancer or disease apoptosis is the way that the cells help to heal the entire body. By destroying itself the cell is saving the body. When we introduce anti-oxidants into the picture, the process of apoptosis is interrupted and slowed down. This can account for the reason that use of anti-oxidants in patients with cancer and disease fared worse with the use of anti-oxidant supplementation - the supplements were keeping the unhealthy cells alive along with the healthy cells, and since those infected cells were not allowed to die it may have increased the ability for their disease to spread and thus increasing their rate of mortality.
Meritt’s article however does not specify this point, and instead blindly accuses anti-oxidant supplementation as a non-useful tool for health if not a harmful one. Perhaps if she would have looked into research journals about the use of anti-oxidants for prevention of disease in healthy individuals she may have found different results.
Bottom line here is above all eat right, choose good food, and keep moderation in mind. And if you do choose to use supplements, choose ones that use scientific research and testing in their manufacturing process, not just the cheapest bottle on the shelf. The contamination of many vitamins and supplements might be far worse for you than that vitamins themselves... but that's an entirely different topic.
Excerpts from Meritt’s cited resources:
1. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD007176
“Overall, the antioxidant supplements had no significant effect on mortality in a random-effects meta-analysis (relative risk [RR] 1.02, 95% confidence interval [CI] 0.99 to 1.06)”
“...but significantly increased mortality in a fixed-effect model (RR 1.04, 95% CI 1.02 to 1.06)”
“We found no evidence to support antioxidant supplements for primary or secondary prevention. Vitamin A, beta-carotene, and vitamin E may increase mortality. Future randomised trials could evaluate the potential effects of vitamin C and selenium for primary and secondary prevention. Such trials should be closely monitored for potential harmful effects. Antioxidant supplements need to be considered medicinal products and should undergo sufficient evaluation before marketing.”
2. Use of antioxidant vitamins for the prevention of cardiovascular disease: meta-analysis of randomised trials. Lancet 2003;361:2017-23
“Vitamin E did not provide benefit in mortality compared with control treatment (11.3 vs 11.1%, odds ratio 1.02 [95% CI 0.98-1.06] p=0.42) or significantly decrease risk of cardiovascular death (6.0 vs 6.0%, p=0.86) or cerebrovascular accident (3.6 vs 3.5%, p=0.31)”
“Beta carotene led to a small but significant increase in all-cause mortality (7.4 vs 7.0%, 1.07 [1.02-1.11] p=0.003) and with a slight increase in cardiovascular death (3.4 vs 3.1%, 1.1 [1.03-1.17] p=0.003).”
3. Risk factors for lung cancer and for intervention effects in CARET, the Beta-Carotene and Retinol Efficacy Trial. J Natl Cancer Inst 1996, 88(21):1550-1559
“CONCLUSIONS: CARET participants receiving the combination of beta-carotene and vitamin A had no chemopreventive benefit and had excess lung cancer incidence and mortality. The results are highly consistent with those found for beta-carotene in the Alpha-Tocopherol Beta-Carotene Cancer Prevention Study in 29133 male smokers in Finland.”
“There are suggestions of associations of the excess lung cancer incidence with the highest quartile of alcohol intake (RR = 1.99; 95% CI = 1.28-3.09; test for heterogeneity of RR among quartiles of alcohol intake has P = .01, unadjusted for multiple comparisons) and with large-cell histology (RR = 1.89; 95% CI = 1.09-3.26; test for heterogeneity among histologic categories has P = .35), but not with base-line serum beta-carotene concentrations.”
4. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. N Engl J Med. 1994 Apr 14;330(15):1029-35.
“no reduction in incidence was observed among the men who received alpha-tocopherol (change in incidence as compared with those who did not, -2 percent; 95 percent confidence interval, -14 to 12 percent).”
“Unexpectedly, we observed a higher incidence of lung cancer among the men who received beta carotene than among those who did not (change in incidence, 18 percent; 95 percent confidence interval, 3 to 36 percent).”
“Fewer cases of prostate cancer were diagnosed among those who received alpha-tocopherol than among those who did not. Beta carotene had little or no effect on the incidence of cancer other than lung cancer. Alpha-tocopherol had no apparent effect on total mortality”
“Total mortality was 8 percent higher (95 percent confidence interval, 1 to 16 percent) among the participants who received beta carotene than among those who did not, primarily because there were more deaths from lung cancer and ischemic heart disease.”
“CONCLUSIONS: We found no reduction in the incidence of lung cancer among male smokers after five to eight years of dietary supplementation with alpha-tocopherol or beta carotene. In fact, this trial raises the possibility that these supplements may actually have harmful as well as beneficial effects.”
5. Antioxidant supplements for preventing gastrointestinal cancers. Cochrane Database Syst Rev 2004;(4):CD004183
“Neither the fixed effect (RR 0.96, 95% CI 0.88 to 1.04) nor random effects meta-analyses (RR 0.90, 95% CI 0.77 to 1.05) showed significant effects of supplementation with antioxidants on the incidences of gastrointestinal cancers.”
“Among the seven high-quality trials reporting on mortality (131,727 participants), the fixed effect (RR 1.06, 95% CI 1.02 to 1.10) unlike the random effects meta-analysis (RR 1.06, 95% CI 0.98 to 1.15) showed that antioxidant supplements significantly increased mortality.”
Meaning -> In one way of analyzing the data there was no significant result, however in another way of analyzing the date the was a statistically significant result.
6. Multivitamin use and risk of prostate cancer in the National Institutes of Health–AARP Diet and Health Study. J Natl Cancer Inst 2007;99:754-64
“No association was observed between multivitamin use and risk of localized prostate cancer. However, we found an increased risk of advanced and fatal prostate cancers (RR = 1.32, 95% CI = 1.04 to 1.67 and RR = 1.98, 95% CI = 1.07 to 3.66, respectively) among men reporting excessive use of multivitamins (more than seven times per week) when compared with never users.”
7. Zeisel, S. J. Nutr. November 1, 2004 vol. 134 no. 11 3179S-3180S
“There is a well-documented association between increased consumption of antioxidants and decreased incidence of cancer (1–4). These epidemiological studies are supported by animal-model and cell-culture studies correlating oxidative DNA damage to the process of carcinogenesis (5,6)”
“Antioxidants, by preventing oxidant-mediated damage to diverse targets (DNA, RNA, proteins, and lipids), may play a protective role in healthy individuals with no existing cancer cells that must be eliminated; however, by inhibiting apoptosis, these same antioxidants may exert a cancer-promoting effect in cancer patients and in individuals with precancerous DNA changes.”
8. Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med 2005;142:37-46
"However, several trials of high-dosage vitamin E supplementation showed non–statistically significant increases in total mortality."
"High-dosage (≥400 IU/d) trials were often small and were performed in patients with chronic diseases. The generalizability of the findings to healthy adults is uncertain. Precise estimation of the threshold at which risk increases is difficult. "
9. Reactive oxygen species are indispensable in ovulation, Proceedings from the National Academy of Sciences, January 10, 2011
“Our experiments show that administration of broad-range scavengers of oxidative species into the ovarian bursa of mice, hormonally induced to ovulate, significantly reduced the rate of ovulation.”
Kim Peirano, MS, L.Ac.