Dr. Lisa Melton of the London-based registered charity Novartis Foundation, has written The antioxidant myth: a medical fairy tale, published in the New Scientist, that takes a look at the benefit of whole foods versus antioxidant supplements -- and concludes that something is lost in the extraction from whole foods making supplements essentially useless to health benefit. She even suggests, based on research, that some antioxidant supplements have been shown to create health problems.How did the popularity of antioxidants supplements -- and they are popular as it is estmated half the adults in the US take antioxidant supplements daily -- come to be thought of as an effective way to ward off diseases like cancer, diabetes and heart disease? Because researchers have found that foods rich in antioxidants do provide a true health benefit in disease prevention. But something may be lost in the extraction process of antioxidants from whole foods to supplement form, and this is Dr. Melton's concern.
On the other side of the debated antioxidant supplement fence, are those who do believe that supplements provide substantial benefit and argue that the clinical testing needs to be reframed and revised to better analyze antioxidant supplements.
Dr. Melton 's main point is that whatever the antioxidant health benefits of a diet rich in fruits and vegetables might be, you cannot reproduce it in antioxidant supplements.
I have to agree, in that the health benefits, including cancer prevention, would seem to come from a synergy of nutrition and antioxidant properties found in whole foods that cannot be replicated by the extraction of one part of the whole with the expectation that the same health benefit will be experienced.
I would also agree that there may be a real need for better testing methods designed to further examine the benefits of antioxidant supplements. Until then? There appears no short cut to good health in the form of a pill. For cancer prevention and good health, make sure you include adequate daily servings of antioxidant-rich whole food fresh fruit and vegetables in your diet.
1. I agree that it appears better to get our antioxidants from real food when we can, and that's what I do. But that is not always practical, and research does in fact suggest that some antioxidants are effective in supplement form. It is not wise to condemn all supplements just because some have not proven effective.
Take selenium, for example, which is mentioned in the article. While so important for animal health that selenium levels in the soil are monitored all over the US and animal feed is supplemented where necessary, a decade or two ago it was not considered very important for human health. One key piece of research that changed this was the "Clark study" reported in 1996. It tracked the impact of a 200 mcg daily supplement of selenium on skin cancer as a primary end point, and also on prostate, lung and breast cancer as secondary endpoints. The results showed it did not do a thing for skin cancer, but there were two thirds fewer prostate cancer cases in the selenium group compared to the placebo group, and there were reductions in lung and colon cancer of roughly 50%. Subsequent re-analysis indicated the results were particularly strong for prostate cancer for those deficient in selenium, and not so significant for other patients. However, heavily populated areas in the US are deficient in soil selenium. It is difficult to get enough from foods, unless you want to spend a lot of time cracking Brazil nuts and consuming some other unusual foods that are hard to get out of season. A very large clinical trial, the SELECT trial, is now ongoing to determine whether these results stand up for selenium with or without vitamin E versus placebo for prostate cancer and various other diseases as secondary study endpoints.
Other key supplements for prostate cancer, the cancer I know too well, are lycopene, vitamin E (especially the gamma form), and vitamin D3. We saw a blog on vitamin D3 just the other day. It's clear that most of us will not be able to get enough from the sun to last us year round, including the months with little UVB energy reaching us from the sun. I'm thinking that getting enough from diet will also be difficult, and there is a simple blood test that can confirm that the supplement is making a difference. It is known that some supplements are worthless, but well-made supplements for vitamin D3 are clearly effective.
While the benefit of vitamin E, and particular forms of vitamin E, is still undecided, there appears to me to be a consensus that it is at least important for smokers in avoiding or minimizing prostate cancer and may well be important for many of the rest of us. I'm not sure how hard it would be to get enough from food, but personally I use a supplement.
My impression regarding lycopene is that it is very safe and easy to get enough from foods such as tomato juice, V8 juice, catsup, tomato sauce, cocktail sauce, watermelon and pink or red grapefruit. I'm following advice to get at least 30 mg a day, and I take supplements infrequently, only when travel or other special circumstances make it difficult to get the foods I rely on. Still, some very impressive small studies have been done that show what appears to be a rapid impact of lycopene supplementation on prostate cancer prior to surgery, decreasing the severity of the case and improving outcomes.
I think most of us are aware that there are vast differences in quality among supplement makers. Some brands are worthless, as determined by various independent studies, including government studies. Saw palmetto is a good example. While the Permixon brand appears effective per formal studies, and while some other brands are probably reliable, other brands have virtually none of the active ingredient.
I do not have access to Dr. Melton's full article, but I think she has taken an extreme and untenable position, despite making some valid points. I'm prepared to expand points made above, citing supporting research.
Jim
Posted at 3:08PM on Aug 5th 2006 by Jim