How to Lead the Antioxidant Lifestyle

INTRODUCTION: Dr. Glassman and Dr. Leaf are physicians specializing in internal medicine at the Veterans Administration Medical Center and the University of California at Los Angeles (UCLA). Peter Glassman is also a competitive inline speedskater who races locally and nationally at the Pro-Master level. He lives in Los Angeles, California and trains along the Santa Monica Bike Path, where he (sometimes literally) runs into Kathie Fry. He started inline skating in 1991 and now averages between 50 to 90 miles a week on skates. He cross-trains by cycling, running and lifting weights.

In 1970, Linus Pauling started the antioxidant revolution when he published his bestseller, Vitamin C and the Common Cold. He argued convincingly, but as it turns out wrongly, that high doses of Vitamin C were a cure-all for many illnesses. In the thirty years since, we have found out that Pauling was right about antioxidants being the key to health and longevity but he was wrong about antioxidant supplements being the cornerstone of a healthy and long life.

That statement sounds paradoxical, and in a way it is, but allow us to explain further. Antioxidant supplements are vitamins, like Vitamins C or E, or minerals, like selenium and zinc. These compounds, in theory, will help detoxify substances that cause you to oxidize. You have all seen things oxidize. Rust on metal or the browned inside of a cut apple are examples of oxidation. Human beings don't rust or change color, of course, but they can still oxidize. It's just called something different: illness and disease. So, if oxidation makes humans ill or diseased then it makes sense that taking antioxidant vitamins will be beneficial. Unfortunately, it hasn't worked out that way.

Oxidation, as many will know, is a formal term for what could better be described as "free radical attack on bodily tissues and organs". Most free radicals that cause damage in the human body are derived from oxygen, hence the term "oxygen free radicals". These rather toxic substances are formed in cells when oxygen, fats and sugars are combined to form the energy packets that allow us to live and play. The energy production takes place in the part of the cell called the mitochondria. This little furnace fortunately has a lot of its own internal antioxidant systems to detoxify free radicals. These and other detoxification systems are often based on enzymes, for example catalases, peroxidases and dismutases, that inactivate and detoxify free radicals.

While detoxification in the mitochondria is very efficient, about 1% of free radicals leak out and begin to cause damage to the surrounding cells and tissues. That 1% may not sound like much but over a person's lifetime it amounts to quite a few free radicals running wild. Free radicals attack Deoxyribonucleic Acid (DNA), proteins and fats. Prolonged attack can injure the structural and functional components of our bodies. In other words, this causes illness, such as heart disease, and it prematurely ages organs and tissues.

Why Antioxidant Vitamin Supplements Don't Work

You might think that antioxidant supplements like Vitamin C would come in handy to mop up those free radicals. That is possible, just as it is possible to catch a horse after it's bolted from a barn. A more efficient and effective way is to simply close the barn door before the horse runs away. Vitamins help catch the horse, but only after the horse has run away. If you really want powerful antioxidant protection, you must "turn on" your internal antioxidant systems that stop free radicals from leaving the cell or, if they do, that clean up the loose free radicals before they cause injury. Put simply, you must close the door before free radicals get out of the barn. Antioxidant vitamins do not really help to close the door so, logically, they won't work well to quell free radical attack on bodily tissues and organs.

But how can that be, you might ask, when so many studies, and people, keep saying how good antioxidants are health and fitness? Let us explain. There are a number of studies that suggest that antioxidant supplements (vitamins and minerals in tablet form) improve lifespan and/or health. These suggestive studies provide clues, sometimes powerful clues, that link antioxidants to improved health and aging: for example, that taking Vitamin C reduces the risk of heart attack. But suggestive studies, even the best ones, do not provide solid evidence of "proof", only evidence of a possible link.

The best studies to establish "proof" are known as randomized intervention studies. This is the gold standard in medical science and is used to determine whether an intervention or medication has true benefit in humans. In a randomized study, people are assigned, at random, to either get a "real pill" or a "fake pill". No one knows which one they are getting. The pills look and taste the same. In addition, the researchers who oversee the study are "blinded", meaning they don't know who is taking which pill until the end of the study. At the end of a specified period of time, those who are taking the real pill and false pill are compared to see who did better. When people taking the real pill do better than people taking the false pill, then, and only then, can the medicine truly be considered beneficial.

When this type of gold standard study is applied to the science of antioxidant supplements, the evidence indicates that supplements provide no demonstrable benefit to healthy and well-nourished people. That is not to say that there might not be a small benefit that has not yet been found. But, in truth, if there were a large benefit, the many scientific studies in this area would have found it by now.

Some might find this depressing, especially antioxidant vitamin makers who stand to lose millions of dollars. Nevertheless, Linus Pauling's underlying concept remains valid. That is, by improving antioxidant status, you can improve health. Although taking supplements does not do much to improve antioxidant status, other things can. We talk about this below.

How Stressed Are You?

Before we go further, please take this quiz to help determine how balanced, or unbalanced you are - in an oxidative sense.

So, now you know where you stand.

But what do you do with that information, especially because antioxidant vitamin supplements don't seem to provide much benefit? To understand our approach, you first need to know about something called the Oxidative Balance.

Oxygen is vital to life yet it, and certain other substances, promotes free radical formation. Anything that promotes free radical production is known as a Pro-oxidant or, in other words, causes oxidative stress. Antioxidants, on the other hand, detoxify free radicals or, in other words, reduce oxidative stress.

We are constantly being exposed to forces that increase oxidative stress (pro-oxidants) and that reduce oxidative stress (antioxidants). So, each of us has an Oxidative Balance which is an equilibrium between oxidative stress (free radical attack) and our ability to detoxify free radicals (antioxidant activity). Too much oxidative stress causes an oxidative imbalance and can be detrimental to health and lifespan. Therefore, by knowing what promotes antioxidant activity within us and by learning what can decrease pro-oxidant activity, we can shift the balance to our favor. As we already explained, antioxidant supplements only pick up after the mess has been made. So, something else must be able to shift the Oxidative Balance.

The Antioxidant Protection Program

Research indicates that there are 2 things that can shift Oxidative Balance more than any other activity. Those two things are routine aerobic exercise and a proper dietary plan

Aerobic exercise, such as skating or biking or running, improves Oxidative Balance in 3 ways. First, it lowers resting free radical formation. Put another way, a fit person uses less energy when doing the same activity as a non-fit person. Less energy equals less fuel made in the cell. That translates to fewer free radicals formed and therefore fewer free radicals let loose. Second, aerobic exercise raises the lactic acid threshold -- the point when lactic acid build-up is greater than clearance of lactic acid from the muscles. As it happens, free radical formation skyrockets as we approach and then cross the lactic acid threshold. By raising the threshold, we increase the zone in which we use energy efficiently. Third, aerobic exercise helps train muscle tissue to quickly clear and detoxify free radicals. In other words, it 'revs' up the internal antioxidant systems in those muscles.

We refer to exercise as the "paradoxical antioxidant" because while any given vigorous activity temporarily increases free radical formation, long-term exercise improves Oxidative Balance.

The other thing that improves Oxidative Balance is a lower fat diet plan that emphasizes Mediterranean-style dishes and foods that are high in naturally occurring antioxidants. Lower fat refers to a diet that uses between 25% to 30% of calories from fat. Mediterranean-style foods are those that are typically found in countries that border the Mediterranean Sea, like Italy, Spain, Portugal and Greece and Turkey. In particular, research indicates that fish-based and fowl-based diets, using low-fat milk products and that have a lot of fresh vegetables and fruit provide can reduce, for example, risk of heart disease.

Furthermore, the Mediterranean diet is primarily based on olive oil, a monounsaturated fat. This type of fat is neither prone to free radical attack, as are polyunsaturated fats, nor prone to being oxidized, as are saturated fats. In other words, monounsaturated fats are 'neutral" in an oxidative sense.

That antioxidant rich foods are beneficial but not antioxidant supplements must strike some readers as ironic. However, there are other factors in antioxidant rich foods that, as far as is known, cannot be isolated and put into a vitamin tablet. This fact holds true whether the vitamin tablet is synthetic or natural. We personally believe that the only "natural" antioxidant is one that comes along with its natural food source.

Finally, we do not believe in trying to attain a specific weight just because a chart says that you should. On the contrary, it is our opinion that if you emphasize good food planning and proper exercise you will find your own "balance" when it comes to weight. In terms of a diet plan, we would rather that, over time, you emphasize 8 important, yet relatively simple, points:

1. Reduce overall fat intake to 25 to 30% of total calories. Most western diets include at least 35% to 40% of calories from fat.
   
   
2. Replace saturated fats, as much as is feasible, primarily with monounsaturated fats like olive oil. Use polyunsaturated fats sparingly.
   
   
3. Eat 2 or more fish or seafood meals and 2 or more poultry meals each week. These should be non-fried or lightly pan-fired.
   
   
4. Replace fat calories with low-fat, complex carbohydrates such as whole grains and pastas.
   
   
5. Eat 4 or more servings of fresh fruits and vegetables each day.
   
   
6. Eat 4 or more servings of fresh fruits and vegetables each day.
   
   
7. Use lower fat milk products, such as 1% or 2% milk or low-fat yogurt.
   
   
8. Eat foods as close to their natural state as possible. This preserves naturally occurring antioxidants.

Because of the brevity of this article, we can only give highlights of how to achieve a beneficial Oxidative Balance. If you are interested, you may wish to read our new book, The Oxidative Balance: How to Lead the Antioxidant Lifestyle, available from our publisher, EMIS Medical Publishers and many bookstores.

And, if you are not interested, keep one thought in mind - with apologies to Neil Young: "Rust never sleeps".