Antioxidant supplements for cholesterol control -
There is increasing evidence that antioxidants are more effective when obtained from whole foods, rather than isolated from a food and presented in tablet form. Research shows that some vitamin supplements can increase our cancer risk. For example, vitamin A beta-carotene has been associated with a reduced risk of certain cancers, but an increase in others — such as lung cancer in smokers if vitamin A is purified from foodstuffs.
A study examining the effects of vitamin E found that it did not offer the same benefits when taken as a supplement. A well-balanced diet, which includes consuming antioxidants from whole foods, is best.
If you need to take a supplement, seek advice from your doctor or dietitian and choose supplements that contain all nutrients at the recommended levels. Research is divided over whether antioxidant supplements offer the same health benefits as antioxidants in foods.
To achieve a healthy and well-balanced diet , it is recommended we eat a wide variety from the main 5 food groups every day:. To meet your nutritional needs, as a minimum try to consume a serve of fruit and vegetables daily.
Although serving sizes vary depending on gender, age and stage of life, this is roughly a medium-sized piece of fruit or a half-cup of cooked vegetables.
The Australian Dietary Guidelines External Link has more information on recommended servings and portions for specific ages, life stage and gender. It is also thought antioxidants and other protective constituents from vegetables, legumes and fruit need to be consumed regularly from early life to be effective.
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The most active and available form of vitamin E is α-tocopherol. Vitamin E is incorporated into lipoproteins and cell membranes, limiting LDL oxidation. Vitamin E is the predominant antioxidant in LDL.
Vitamin E is found in vegetable and seed oils, in wheat germ and, in smaller quantities, in meats, fish, fruits and vegetables. The recommended dietary allowance RDA of vitamin E is 30 IU per day equivalent to 30 mg per day.
It is difficult to obtain high doses of vitamin E in the average diet. Multivitamins usually contain 30 to 50 IU of vitamin E.
Vitamin C is the predominant plasma antioxidant. This water-soluble vitamin scavenges plasma free radicals and prevents their entry into LDL particles.
Vitamin C improves endothelium-dependent vasodilation and reduces monocyte adhesion. Dietary sources of vitamin C include citrus fruits, strawberries, cantaloupe, tomatoes, cabbage and leafy green vegetables.
Cooking can destroy vitamin C; therefore, the vitamin is best obtained in raw foods or supplements. The RDA for vitamin C is 60 mg, but increased amounts are recommended for smokers, patients with healing wounds and pregnant or lactating patients.
Many carotenoids are known, but their functions are not yet understood. β-Carotene is a vitamin A precursor carried in plasma and LDL. No RDA has been established for carotenoids.
Many epidemiologic studies have linked diets high in antioxidants with reduced CHD risk Tables 1 13 — 16 and 2 17 — Epidemiologic studies cannot prove causality for various reasons, such as selection bias.
Thus, randomized, controlled trials are essential to assess treatment benefits. Plasma levels of vitamins E and C, β-carotene and selenium have been inversely correlated with cross-cultural CHD mortality Table 1. study found an inverse correlation of CHD with fruit and vegetable consumption. Prospective cohort studies are summarized in Table 2.
In a study of more than , female nurses between the ages of 30 and 55 years, food frequency questionnaires assessed daily intake of dietary and supplemental vitamins E, C and β-carotene.
Risk reduction was noted with a daily intake of greater than IU of vitamin E but not with daily use of multivitamins, vitamin C supplements or β-carotene supplements. The Health Professionals Study, 20 which included 39, male health care professionals, noted a 40 percent risk reduction for men in the upper quintile of vitamin E intake about IU per day compared with men in the lowest quintile 6 IU per day.
In this study, no benefits were found for vitamin C supplementation. After adjustment for risk factors and vitamin C intake, men in the highest quintile of β-carotene intake 19, IU per day demonstrated a 29 percent CHD risk reduction compared with those in the lowest quintile 3, IU per day ; however, this benefit occurred only in smokers.
Both studies of health care professionals found that vitamin benefits occurred only after one to two years of supplementation. Supplement use was also examined in a study of 11, elderly persons.
Combined vitamin E and C supplementation reduced total mortality by 42 percent and CHD mortality by 53 percent. The average dosage of vitamin E was greater than IU per day. Randomized, controlled trials of antioxidant vitamin supplementation are summarized in Table 3.
Supplementary vitamin E in a dosage of greater than IU per day was associated with reduced lesion progression. Vitamin C supplementation was not associated with this benefit. In another study, a single high-fat meal i. The Chinese Cancer Prevention Trial 23 randomized patients to receive either β-carotene 15 mg per day , vitamin E 30 mg per day and selenium 15 μg per day , or placebo.
This study found that supplementation resulted in a 9 percent reduction in total mortality and a 21 percent decrease in deaths from gastric cancer. The Alpha-Tocopherol Beta-Carotene Cancer Prevention Study 24 measured the effects of vitamin E 50 IU per day and β-carotene 20 mg per day supplementation on lung cancer and CHD.
The incidence of nonfatal myocardial infarction was lower in all groups receiving supplementation and was significantly lower 32 percent in the group that received vitamin E.
Supplementation with vitamin E was associated with a nonsignificant increase in cerebral hemorrhage. Supplementation with β-carotene was associated with increased mortality rates for CHD 11 percent and lung cancer 18 percent , as well as an increase in overall mortality 8 percent. The incidence of fatal CHD was significantly higher in the group that received β-carotene alone 75 percent and in the group receiving both vitamins 58 percent.
Vitamin E supplementation is supported by several studies Tables 2 17 — 21 and 3 22 — Increased vitamin E levels are associated with decreased CHD mortality and inversely correlated with risk of angina.
Vitamin E significantly reduced the incidence of overall fatal and nonfatal CHD events by 47 percent and the incidence of nonfatal myocardial infarction by 77 percent; however, supplementation did not have a significant effect on overall mortality relative risk: 1.
Event reduction was better with supplementation at IU per day, but the study was not powered to assess dose-response significance. This clinical trial strongly supports evidence that vitamin E in dosages greater than IU per day reduces CHD events. Vitamin C significantly improves arterial vasoreactivity and vitamin E regeneration.
The National Health and Nutrition Examination Survey-I cohort study 29 found an inverse relationship between the highest vitamin C intake diet and supplements and CHD risk over 10 years in 11, U.
men and women 25 to 74 years of age. The only large primary prevention trial has been a study of 29, poorly nourished residents of Linixian, China. The patients who received vitamin C in a dosage of mg per day and molybdenum in a dosage of 30 μg per day demonstrated no significant reduction in total or cerebrovascular mortality.
Many studies have demonstrated the ability of vitamin C to improve arterial vasoreactivity. A single dose 2 g of vitamin C has been found to improve vasoreactivity in chronic smokers, 8 patients with hypercholesterolemia 10 and patients with CHD. Research supports the benefit of a carotenoid-rich diet, but not β-carotene supplementation.
The Beta-Carotene and Retinol Efficacy Trial 27 combined β-carotene and retinol supplementation in 18, smokers and patients with asbestos exposure.
However, the study was terminated prematurely because of a significant increase in lung cancer mortality and a non-significant increase in CHD mortality. In 12 years of β-carotene supplementation in 22, male physicians, no significant beneficial effects on CHD mortality, nonfatal MI or stroke were found.
A non-significant 20 to 30 percent reduction in CHD events occurred in the physicians who had clinical evidence of atherosclerosis.
Vitamins C, E and β-carotene have few side effects. No significant toxicity has been noted for vitamin E in dosages of to 3, IU per day. Therefore, caution is recommended when vitamin E supplementation is used in patients receiving anticoagulant therapy. In vitamin E clinical trials, no significant differences in bleeding rates were noted in supplemented and unsupplemented subjects.
Vitamin C supplementation is usually non-toxic, although diarrhea, bloating and false-negative occult blood tests can occur at dosages greater than 2 g per day. The intestinal absorptive capacity for vitamin C is approximately 3 g per day.
However, confusion arises about excess vitamin C intake causing increased oxalic acid excretion and, thus, a possibly increased risk of oxalate kidney stones as urinary vitamin C is converted to oxalate with air exposure.
Given in dosages of 30 to mg per day, β-carotene has minimal side effects. Other antioxidants that may provide protection against CHD include selenium, bioflavonoids and ubiquinone. One study 33 found that selenium levels are inversely associated with CHD mortality. One review 7 noted that conflicting results were reported in other studies.
Flavonoids are antioxidants found in tea, wine, fruits and vegetables. These antioxidants reduce platelet activation, but studies do not yet support an associated reduction in CHD. Ubiquinone, a reduced form of coenzyme Q 10 , decreases LDL oxidation, but no eventreduction data are available.
The results of studies of garlic supplements have been conflicting regarding lipoprotein and platelet effects.
The B-complex vitamins, especially folate, pyridoxine vitamin B 6 and cyanocobalamin vitamin B 12 , may reduce CHD risk through a lowering of homocysteine levels. Folic acid supplementation in a dosage greater than μg per day reduces the plasma homocysteine level.
Use of a daily multivitamin supplement containing folate μg would reduce plasma homocysteine levels in most persons. Oxidized LDL is atherogenic, and specific antioxidants can inhibit LDL oxidation. Epidemiologic studies report inverse relationships between CHD and supplementation with vitamins E, C and β-carotene.
Clinical trials to reduce CHD events currently support vitamin E supplementation in dosages greater than IU per day. Vitamin C promotes vitamin E regeneration and significantly improves vasoreactivity, but clinical event reduction has not been established.
The results of β-carotene studies have generally been unfavorable, primarily for smokers. Folate reduces serum homocysteine levels, but trials focusing on CHD events have not been completed. Fish oils help by lowering cholesterol and promoting a healthy heart. The exact link between antioxidants and heart health is unknown.
The general consensus is that a healthy diet is beneficial for total body health. Improving overall health undoubtedly benefits the heart. The healthier the body is, the less strain is placed on the heart.
When there is an imbalance between antioxidants and free radicals, the body is subject to oxidative stress. The true damage of oxidative stress lies with the modification of DNA, causing cellular mutations. Mutated cells cannot function properly and lead to damaging consequences.
Many conditions, including heart and blood vessel disorders, are caused by free radical damage. Antioxidants are also thought to help break down cholesterol that can build up on arterial walls.
Antioxidants as a whole may not directly benefit heart disease. For more information about supplements that can lower cholesterol and prevent heart disease, speak with a healthcare provider. Medical Conditions. HRT helps women with menopausal symptoms, reduces risk of some conditions, and improves mood, and helps men with hypogonadism.
Millions of Americans struggle with hypertension. Along with an improved diet, certain supplements may help lower blood pressure. Celiac disease can make processing gluten difficult for many individuals, but these supplements can help with nutrition and make life easier.
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Recent experimental and epidemiologic evidence suggests Carcinogenic prevention methods some antioxidant cholesgerol appear Antkoxidant be important Antiooxidant reducing the forr of coronary heart disease CHD. These antioxidants Antioxidant supplements for cholesterol control ascorbic acid supplementd Cα-tocopherol vitamin Efolate, β-carotene, ubiquinone coenzyme Q 10bioflavonoids and selenium. This article reviews evidence linking the intake of nutritional supplements with the prevention of CHD and also provides clinical recommendations. Low-density lipoprotein LDL cholesterol is the primary lipoprotein found in atherosclerotic plaque. LDL oxidation is a key factor in the development of atherosclerosis. Antioxidants in plasma, the LDL particle and the cell wall reduce LDL oxidation.
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