DOCTOR'S VIEW ARCHIVE
Carolyn Janet Crandall, MD, MS, FACP
Medical Editor: William C. Shiel, Jr, MD, FACP, FACR
Should women take antioxidant supplements?
The idea of antioxidants for heart protection sounds great. This is because in the research laboratory oxidation plays a big role in formation of atherosclerotic plaque (the cholesterol-formed substance that can eventually rupture to cause a heart attack).
If oxidation is bad, shouldn't antioxidant supplements be helpful for the
In the last several years, the long-awaited reliable scientific studies (large, controlled clinical studies) were finally performed to test whether antioxidant supplements really protect the heart. Heart protective effects of antioxidant supplements have been tested on more than 100,000 people in recent well-designed trials. To date, trials have been completed for vitamin E (5 large trials), beta-carotene (3 large trials), and antioxidant mixtures (2 large trials). Each of these trials showed no effect of antioxidant supplements on cardiovascular disease occurrence. Only a few controlled clinical studies showed beneficial effect for vitamin E (with or without vitamin C), and those studies were performed in people who already had heart disease, or were at high risk of heart disease. As a result, the American Heart Association released a "Science Advisory" regarding antioxidant vitamin supplements and cardiovascular disease. The statement concluded that scientific data does not justify the use of antioxidant vitamin supplements for reducing cardiovascular risk.
Similarly, the U.S. Preventive Services Task Force (USPSTF), which
We've learned some lessons along the way...
Antioxidant compounds cannot just be lumped together, as they each have distinct effects. Starting antioxidant supplements earlier in life may be required for heart protection. Moreover, it may be difficult to find heart disease benefits of antioxidant supplements in studies that in general, were under 5 years in duration, compared to a life-long diet rich in antioxidants. Obviously we have much to learn about the details of the oxidization-antioxidation balance.
The bottom line is that for better or worse, a diet high in antioxidants from food sources, just doesn't translate to taking antioxidants as supplements for heart protection. Vitamin supplements don't take the place of a healthy diet.
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