Antioxidants - what's all the hype about?
by Stephanie Russell, RD, LD

The way the term antioxidants has been portrayed in the mainstream media might lead one to believe it is synonymous with words like "magic" or "miraculous." Such beliefs have resulted in consumers flocking to health stores to purchase antioxidant-rich dietary supplements by the truckload. In fact, the American Heart Association reports that 30% of Americans are taking some type of antioxidant supplement. Some people taking these supplements report doing so simply because a friend or relative has told them they should. However, most people claim to take antioxidant supplements for their supposed disease-fighting and/or disease-prevention properties. Less often, individuals report taking these supplements based on recommendations from a qualified health professional, such as their Medical Doctor or a Registered Dietitian. Despite the widespread consumption of antioxidant supplements, many consumers report being confused about antioxidants and what they do, how they work, how much they need, and where they should be getting them (i.e. whole food vs. dietary supplement).

Research has found that consumption of antioxidant-rich diets, such as those high in fruit and vegetable intake, may play an important role in promoting overall health. Specifically, studies have consistently linked increased consumption of fruits and vegetables with a decreased risk of development of certain degenerative diseases, such as heart disease and cancer. However, there is still much that is unknown about these seemingly "magical" antioxidant compounds. Thus, focusing on what is known can help people make smart, responsible choices when it comes to meeting their daily antioxidant needs.

What is an antioxidant and how do they work?

Antioxidant is a general term that encompasses several vitamins, minerals, and also non-nutrient compounds such as flavonoids. They occur naturally in a variety of plant foods and beverages such as fruits, vegetables, whole grains, nuts, seeds, certain teas, coffee, red wine, dark chocolate, and even beer. Flavonoid antioxidants are responsible for the colorful pigments in fruits and vegetables, such as the deep blue of blueberries and the rich red of tomatoes, but are also found in less colorful foods such as onions, nuts, and seeds. Certain body enzymes also have antioxidant activity, and often work together with these dietary antioxidant compounds in the body.

Antioxidants function either independently, or as part of a system to prevent or repair cellular damage caused by oxidative stress, which may lead to cellular dysfunction and development of certain diseases or conditions (i.e. diabetes, heart disease, cancer, infection, aging, decreased immunity). In simple terms, oxidative stress is caused by free radicals, molecules that contain an unpaired electron such as reactive oxygen species (ROS), which can wreak havoc on healthy cells in an attempt to become a more stable molecule. There are environmental triggers of oxidative stress such as smoking, pollution, certain foods, ultraviolet rays, and strenuous exercise. However, production of free radicals is also a normal by-product of our body's many internal metabolic processes. Dietary antioxidants are important in that they help minimize damage caused by oxidative stress, and thus decrease the risk of disease development.

Supplements vs. whole foods

Although research is strong regarding the health benefits of consuming a diet high in antioxidant-rich fruits and vegetables, it is important to note that the same results have not been consistently shown in studies using antioxidants derived from dietary supplements. In fact, in some instances high doses of antioxidants may be harmful, and under certain conditions can even act as pro-oxidants. There are several possibilities as to why the same health benefits have not been observed with intake of antioxidant supplements as with whole foods.

Just as there was a time when the antioxidant properties of flavonoids were unknown, there are likely many other favorable components of whole foods that are yet to be discovered. Therefore, the reported health benefits of high fruit and vegetable intake may be due to known antioxidants working in synergy with one another, as well as other undiscovered compounds in the food. Whole foods may contain non-antioxidant, yet equally beneficial components that are generally not found in supplements. For example, dietary fiber in whole grains, fruits, and vegetables has independently been shown to reduce the risk of heart disease, certain types of cancer, and help control blood glucose levels.

The saying "too much of a good thing…" is probably true when it comes to consumption of antioxidant supplements. Many antioxidant supplements contain amounts of nutritive antioxidants well above the Recommended Dietary Allowance (RDA). With the belief that if "some is good, more must be better," consumers may unknowingly consume antioxidants in levels above the established tolerable upper intake levels for a nutrient, increasing risk of toxicity. For more information on Dietary Reference Intakes (DRIs), which include RDAs, estimated average requirement, adequate intake level, and tolerable upper intake levels for specific nutrients, visit the United States Department of Agriculture web-site.

Even less is known about safety of consuming large amounts of non-nutrient antioxidants, as there is insufficient information available to establish DRIs for these compounds at this time. When taken in supplement form the antioxidants may not be the appropriate type, amount, or ratio needed to yield the same advantageous results as seen with whole food consumption.

Furthermore, consumers should be cautioned to question safety of any type of dietary supplement. Currently, dietary supplements are not regulated the way that new drugs, or even the food supply is, under the Food and Drug Administration's (FDA) Federal Food, Drug, and Cosmetic Act. This is not to say that all dietary supplements are unsafe. It is merely to say that these products have not been ensured for safety and effectiveness in the same manner as drugs, even though some may contain ingredients with similar properties and functions. Some supplement manufacturers voluntarily pay an independent, not-for-profit third party to test their products for safety. These products may carry the USP verified or NSF verified symbol somewhere on the label. Learn more about the USP or NSF dietary supplement regulatory programs at US Pharmacopeia and NSF International.

The good news is, under the Dietary Supplement Health and Education Act (DSHEA), the FDA is calling for tighter regulation of dietary supplements. The FDA announced in 2007 the establishment of a final rule that will require dietary supplement companies to follow current good manufacturing practices (cGMP) to ensure that supplements are "produced in a quality manner, do not contain contaminants or impurities, and are accurately labeled." Unfortunately, regulation under the final rule is still not equivalent to rules governing drug supply, and it may be a couple of years before all manufacturers are required to abide. Please visit FDA News, the Federal Food, Drug and Cosmetic Act , and Dietary Supplement Health and Education Act of 1994 for more information regarding FDA regulation of dietary supplements.

Until more is known about the safety and efficacy of antioxidant supplements, unless recommended by a qualified health professional consumption of antioxidants in supplement form is generally not recommended. If a balanced, healthy diet is consumed, individuals should be able to get all the antioxidants they need from the foods they eat (and drink). So instead of spending money on pills, consumers should focus on deriving antioxidants from a variety of whole foods in order to reap maximum health benefits. View the USDA Food Guide Pyramid for more information on healthy, balanced eating. The following table is a short list of some known antioxidant compounds along with foods/beverages they can be found in.

What about wine, coffee, beer, and chocolate!

Many consumers have questions pertaining to health benefits of antioxidants found in beverages such as red wine, coffee, and beer. Most people want to know if they should start drinking these beverages to gain maximum health benefits. Although research in this area is still very preliminary, most healthy individuals can continue to enjoy these beverages in moderation (i.e. one alcoholic drink/day for women, 2 alcoholic drinks/day for men, and 2-3 cups regular coffee/day), and reap any potential antioxidant benefits when doing so. However, because consumption of these beverages (especially above levels established for moderation) may also have adverse health consequences and can be addictive, it is currently not recommended for individuals who do not already drink coffee or alcohol to start, in order to increase antioxidant intake. A similar point can be made about chocolate. Although there may be some antioxidant perks in this tasty treat, chocolate is also high in calories, and like any high calorie food eating too much can make it difficult to maintain a healthy weight.

Moderation and balance is the key not only when it comes to chocolate, coffee, wine, and beer, but for good nutrition in general. Antioxidants may play an important role in promoting good health, but there are many other dietary components that are equally as important. The only way to ensure you are receiving adequate nutrition for optimal health, function, and performance is to eat a balanced diet. Staying physically active, and laughing plenty, also does wonders for overall health and is highly recommended!

Getting your daily dose of antioxidants doesn't have to be boring. Try the following tasty suggestions, or be creative with your own!

Make Smoothies - Put fresh, frozen, or even canned fruits into a blender. Add a splash of juice or milk, and ice (if using frozen berries don't use ice) for desired consistency. Add yogurt, ground flaxseed, or anything else that sounds good. Blend and enjoy!

Make Salsa - Use part canned or fresh tomatoes (half and half works well), garlic, onion, cilantro, fresh squeezed lime juice, salt to taste, and any other vegetables that sound good. Blend in a food processor and enjoy!

Make a Super Antioxidant Salad - Mix together green and/or red leaf lettuce, spinach, and a variety of fresh vegetables. Add sunflower seeds and kidney beans to add a protein and antioxidant boost. Top with light dressing, olive oil and vinegar, or fresh squeezed lemon and enjoy!

Make a fun, antioxidant-rich dessert - Make, or purchase from the store, sugar cookie dough. Press into one layer on a cookie sheet. Bake according to the recipe or package instructions or until golden brown. Let cool (put in fridge for faster cooling). Once cooled, spread a layer of cream cheese frosting (make or purchase from store) on top of the cookie slab. Sprinkle with an assortment of berries (raspberries, strawberries, blackberries, blueberries, marionberries, etc…), cut and enjoy!

Resources:
American Dietetic Association
www.eatright.org
Consumer friendly, expert advice and educational handouts on a variety of nutrition topics
Advice on finding a local Registered Dietitian

American Heart Association
http://www.americanheart.org/presenter.jhtml?identifier=1200010
General healthy eating advice – consumer friendly

American Cancer Society
http://www.cancer.org/docroot/PED/ped_3.asp
BMI calculator
Calorie counter
Target heart rate calculator
Ideas for increasing fruit/vegetable intake

American Diabetes Association
http://www.diabetes.org/nutrition-and-recipes/nutrition/overview.jsp
Consumer friend advice on nutrition, guide to eating out, answer common questions, virtual grocery store

USDA Food Guide Pyramid
http://www.mypyramid.gov/
Personalized diet plans, meal tracker, portion control, balanced eating, health lifestyle

2005 Dietary Guidelines for Americans
http://www.health.gov/dietaryguidelines/

DRI charts
http://fnic.nal.usda.gov/nal_display/index.php?info_center=4&tax_level=2&tax_subject=256&topic_id=1342&placement_default=0

biography:

Stephanie received her B.S. in Nutrition from Oregon State University in 2005, and recently completed the Dietetic Internship Program at Central Washington University. She has experience working as a dietitian specializing in oncology and geriatric nutrition.

Stephanie grew up in Gresham, Oregon where she participated in gymnastics, cross-country, and track. She has been married to her high school sweetheart for seven years, and when not working enjoys running, hiking, writing, and spending time with friends and family.

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