Advertisement

Drugs & Aging

, Volume 12, Issue 3, pp 169–175 | Cite as

Should Antioxidant Vitamins be Routinely Recommended for Older People?

  • John A. Ward
Leading Article

Summary

The hypothesis that oxidative damage due to free radicals is an important cause of aging is the subject of much research and even more interest among the public and lay media. An increasing number of older people are asking whether they should be taking antioxidant vitamins, despite their considerable cost.

Epidemiological and laboratory evidence indicates that oxidative damage caused by oxygen free radicals is important in many of the major diseases of older age. It is also clear that a diet high in antioxidants protects against these diseases, including many cancers and ischaemic heart disease. However, it has not been proven whether antioxidant vitamins, taken as dietary supplements, provide the same level of protection as a diet that is rich in fruit and vegetables. Although there appears to be no reason to discourage older people from taking vitamin E (tocopherols) and ascorbic acid (vitamin C), the best advice to give them is to reduce their intake of xenobiotics, to drink tea instead of coffee, and to eat liberal amounts of fruit, vegetables, nuts, soya beans and lentils. The use of β-carotene as a dietary supplement should be discouraged.

Keywords

Adis International Limited Beta Carotene Probucol Antioxidant Vitamin Deprenyl 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Harman D. Aging — a theory based on free radical and radiation biology. J Gerontol 1956; 11: 298–300PubMedCrossRefGoogle Scholar
  2. 2.
    Esterbauer H, Wag G, Puhl H. Lipid peroxidation and its role in atherogenesis. Br Med Bull 1993; 49: 566–76PubMedGoogle Scholar
  3. 3.
    Comstock GW, Bush TL, Helzsoner K. Serum retinol, beta-carotene, vitamin E and selenium as related to subsequent cancer of specific sites. Am J Epidemiol 1992; 135: 115–21PubMedGoogle Scholar
  4. 4.
    Owen AD, Schapira AHV, Jenner P, et al. Oxidative stress and Parkinson’s disease. Ann N Y Acad Sci 1996; 786: 217–23PubMedCrossRefGoogle Scholar
  5. 5.
    Harman D. A hypothesis on the pathogenesis of Alzheimer’s disease. Ann N Y Acad Sci 1996; 786: 152–68PubMedCrossRefGoogle Scholar
  6. 6.
    Knekt P, Heliovaara M, Rissamen A, et al. Serum antioxidant vitamins and risk of cataract. BMJ 1992; 305: 1392–4PubMedCrossRefGoogle Scholar
  7. 7.
    Halliwell B, Gutteridge JM, Cross CE. Free radicals, antioxidants and human disease: where are we now? J Lab Clin Med 1992; 119: 598–620PubMedGoogle Scholar
  8. 8.
    Stanton R. Dispelling myths of nutrition: antioxidant theories create confusion. Aust Doctor 1997 Jul 11; 45–6Google Scholar
  9. 9.
    Harman D. Aging and disease: extending functional life span. Ann N Y Acad Sci 1996; 786: 321–36PubMedCrossRefGoogle Scholar
  10. 10.
    Ward JA. Free radicals, antioxidants and preventive geriatrics. Aust Fam Physician 1994; 23: 1297–305PubMedGoogle Scholar
  11. 11.
    Halliwell B, Gutteridge JM. Free radicals in biology and medicine. Oxford: Clarendon Press, 1985: 11–8Google Scholar
  12. 12.
    Bland JS. Oxidants and antioxidants in clinical medicine: past, present and future potential. J Nutr Environ Med 1995; 5: 255–80CrossRefGoogle Scholar
  13. 13.
    Halliwell B. Antioxidants and human disease: a general introduction. Nutr Rev 1997; 55 (1 Pt 2): S44–52PubMedCrossRefGoogle Scholar
  14. 14.
    Jenkins RR, Goldfarb A. Introduction: oxidant stress, aging and exercise. Med Sci Sports Exerc 1993; 25: 210–2PubMedGoogle Scholar
  15. 15.
    Pacifici RE, Davies KJ. Protein, lipid and DNA repair systems in oxidative stress: the free radical theory of aging revisited. J Gerontol 1991; 37: 166–80CrossRefGoogle Scholar
  16. 16.
    Schamberger RJ, Andercone TL, Willis CE. Antioxidants and cancer: IV. Initiating activity of malonaldehyde as a carcinogen. J Natl Cancer Inst 1974; 53: 1771–3Google Scholar
  17. 17.
    Bird RP, Draper HH. Effect of malonaldehyde and acetaldehyde on cultured mammalian cells: growth, morphology and synthesis of macromolecules. J Toxicol Environ Health 1980; 6: 811–23PubMedCrossRefGoogle Scholar
  18. 18.
    Sohal RS, editor. Age pigments. Amsterdam: Elsevier, 1981: 303–16Google Scholar
  19. 19.
    Steinberg D, Parthasarathy S, Carew TE, et al. Beyond cholesterol: modifications of low density lipoprotein that increase its atherogenicity. N Engl J Med 1989; 320: 915–23PubMedCrossRefGoogle Scholar
  20. 20.
    Diaz MN, Frei B, Vita JA, et al. Antioxidants and atherosclerotic heart disease. N Engl J Med 1997; 337: 408–15PubMedCrossRefGoogle Scholar
  21. 21.
    Gaziano JM, Manson JE, Buring JE, et al. Dietary antioxidants and cardiovascular disease. Ann N Y Acad Sci 1992; 669: 249–59PubMedCrossRefGoogle Scholar
  22. 22.
    Buring JE, Hennekens CH. Antioxidant vitamins and cardiovascular disease. Nutr Reviews 1997; 55 (1 Pt 2): S53–60CrossRefGoogle Scholar
  23. 23.
    Carew T, Schwenke D, Steinberg D. Antiatherogenic effect of probucol unrelated to its hypercholesterolemic effect: evidence that antioxidants in vivo can selectively inhibit low density lipoprotein degradation in macrophage-rich fatty streaks and slow the progression of atherosclerosis in the Watanabe heritable hypercholesterolemic rabbits. Proc Natl Acad Sci U S A 1987; 84: 7725–9PubMedCrossRefGoogle Scholar
  24. 24.
    Stampfer MJ, Hennekens CH, Manson JE, et al. Vitamin E consumption and the risk of coronary disease in women. N Engl J Med 1993; 328: 1444–9PubMedCrossRefGoogle Scholar
  25. 25.
    Rimm EB, Stampfer MJ, Ascherio A, et al. Vitamin E consumption and the risk of coronary disease in men. N Engl J Med 1993; 328: 1450–6PubMedCrossRefGoogle Scholar
  26. 26.
    Gazziano JM, Branch LG, Manson JE, et al. Aprospective study of beta-carotene in fruits and vegetables and decreased cardiovascular mortality in the elderly. Ann Epidemiol 1995; 5: 255–60CrossRefGoogle Scholar
  27. 27.
    Enstrom JE, Kanim LE, Klein MA. Vitamin C intake and mortality among a sample of the United States population. Epidemiology 1992; 3: 194–202PubMedCrossRefGoogle Scholar
  28. 28.
    Kushi LH, Folsom AR, Prineas RJ, et al. Dietary antioxidant vitamins and death from coronary heart disease in postmenopausal women. N Engl J Med 1996; 334: 1156–62PubMedCrossRefGoogle Scholar
  29. 29.
    Yu BP, Masoro EJ, Murata EJ, et al. Life span study of SPF Fischer 344 male rats fed ad libitum or restricted diets: longevity, growth, lean body mass and disease. J Gerontol 1982; 37: 130–41PubMedCrossRefGoogle Scholar
  30. 30.
    Ingram DK, Cutler RG, Weindruch R, et al. Dietary restriction and aging: the initiation of a primate study. J Gerontol 1990; 45: B148–63PubMedCrossRefGoogle Scholar
  31. 31.
    Harman D. Free radical theory of aging. Mutat Res 1992; 275: 257–66PubMedCrossRefGoogle Scholar
  32. 32.
    Blot WJ, Li J-Y, Taylor PR, et al. Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease specific mortality in the general population. J Natl Cancer Inst 1993; 85: 1483–92PubMedCrossRefGoogle Scholar
  33. 33.
    Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994; 330: 1029–35Google Scholar
  34. 34.
    Omenn GS, Goodman GE, Thornquist MD, et al. Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med 1996; 334: 1150–5PubMedCrossRefGoogle Scholar
  35. 35.
    Hennekens CH, Buring JE, Manson JE, et al. Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Engl J Med 1996; 334: 1145–9PubMedCrossRefGoogle Scholar
  36. 36.
    Stephens NG, Parsons A, Schofield PM, et al. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet 1996; 347: 781–6PubMedCrossRefGoogle Scholar
  37. 37.
    Haeger K, Long-time treatment of intermittent claudication with vitamin E. Am J Clin Nutr 1974; 27: 1179–81PubMedGoogle Scholar
  38. 38.
    Livingstone PD, Jones C. Treatment of intermittent claudication with vitamin E. Lancet 1958; II: 602–4CrossRefGoogle Scholar
  39. 39.
    Williams HTG, Fenna D, MacBeth RA. Alpha-tocopherol in the treatment of intermittent claudication. Surg Gynecol Obstet 1971; 132: 662–6PubMedGoogle Scholar
  40. 40.
    Jesberger JA, Richardson JS. Oxygen free radicals and brain dysfunction. Int J Neurochem 1991; 57: 1–17CrossRefGoogle Scholar
  41. 41.
    Loproscino G, Marder K, Cote L, et al. Dietary lipids and antioxidants in Parkinson’s disease: a population-based, case-control study. Ann Neurol 1996; 39: 89–94CrossRefGoogle Scholar
  42. 42.
    de Rijk MC, Breteler MM, den Breeijen JH, et al. Dietary antioxidants and Parkinson’s disease: the Rotterdam Study. Arch Neurol 1997; 54: 762–5PubMedCrossRefGoogle Scholar
  43. 43.
    The Parkinson’s Study Group. The effect of deprenyl on the progression of disability in early Parkinson’s disease. N Engl J Med 1989; 321: 1364–71CrossRefGoogle Scholar
  44. 44.
    Fahn S. An open trial of high dose antioxidants in early Parkinson’s disease. Am J Clin Nutr 1991; 53(1 Suppl.): 380S–2SPubMedGoogle Scholar
  45. 45.
    The Parkinson’s Study Group. Effects of tocopherol and deprenyl on the progression of disability in early Parkinson’s disease. N Engl J Med 1993; 328: 176–83CrossRefGoogle Scholar
  46. 46.
    Evans DA, Morris MC. Is a randomised trial of antioxidants in the primary prevention of Alzheimer’s disease warranted? Alz Dis Assoc Disord 1996; 10Suppl. 1: 45–9CrossRefGoogle Scholar
  47. 47.
    Chandra RK. Graying of the immune system: can nutrient supplements improve immunity in the elderly? JAMA 1997; 277: 1398–9PubMedCrossRefGoogle Scholar
  48. 48.
    Meydani SN, Meydani M, Blumberg JB, et al. Vitamin E supplementation and in-vivo immune response in healthy elderly subjects: a randomised controlled trial. JAMA 1997; 277: 1380–6PubMedCrossRefGoogle Scholar
  49. 49.
    Bendick A, Machlin LJ. Safety of oral intake of vitamin E. Am J Clin Nutr 1988; 48: 612–9Google Scholar
  50. 50.
    Combs GF. The vitamins: fundamental aspects in nutrition and health. Orlando (FL): Academic Press, 1991: 179–204Google Scholar

Copyright information

© Adis International Limited 1998

Authors and Affiliations

  • John A. Ward
    • 1
  1. 1.Royal South Sydney HospitalZetlandAustralia

Personalised recommendations