Let's Anti Our Oxidants!
Following up on our promise from last month, we will have a rant-level discussion on antioxidants. In today’s super-long, sarcastic post, we will discuss why the term antioxidant is misleading and how many commercial antioxidant supplements are kinda worthless. Yet, we’ll stress why we don’t bail on the idea of seeking out antioxidants entirely. Finally, we’ll run down a list of common antioxidant supplements and show you their true colors.
Antioxidants seem to be one of those magical, mysterious words used in the natural products industry. I mean, we all know that antioxidants are good, right? In general, yes, antioxidants in your body are good.
As usual, we will discuss what is good and what’s nonsense. In particular, I want to clear up that things “rich in antioxidants” can typically have a pro-oxidant (bad), not anti-oxidant (good) effects.
Confused yet? This is why we are talking about antioxidants. Because when it comes to your health, it’s more complicated than it seems. We’ll discuss all of this, but let’s start with what antioxidants actually are.
What Is An Antioxidant?
Normal biologic activity causes some compounds to gain or lose electrons, resulting in an imbalance of charge and electron count. These stripped away compounds are called “free radicals” and generally run amok damaging other cells in the body.
The knocking around of electrons is called oxidation. When oxidation overcomes natural cleanup mechanisms, we are said to be in "oxidative stress.” One could say our political climate is in oxidative stress.
Any compound that specifically removes oxidation and free radicals is an antioxidant. An antioxidant is a compound that rebalances the oxidative state. These are compounds like dietary Vitamin A, C, or E, or glutathione, or other internally created compounds. They’re the cleanup crew. The yin to the body’s yang.
Note that an antioxidant isn’t something magical or healthy by default; it’s just a chemical attribute of a compound. It’s like saying I’m right-handed. A compound’s ability to rebalance electrons makes it an antioxidant, and not so healthy stuff could possess that attribute.
Here’s my fatherhood analogy of oxidation and antioxidants. Oxidation is like a kid going into a public restroom with you because you can’t leave them in the airport hallway while you go to the bathroom.
Sometimes, you’re lucky, and there is no interaction between the kid and any surface. Most of the time, it’s just the natural state of things for the kids to interact with its environment. It touches something gross - the wall, the sink, whatever.
They now require hand washing. If not, the impact he could have on other systems, aka his sister’s health, could be harmful. The kid becomes oxidized and requires an antioxidant - his father sternly demanding to wash his hands now for touching the stall door or sink surface - to rebalance the oxidative damage that could be damaging to other “cells” aka his sisters and himself.
Some behaviors create MORE oxidation. Bad diet, bad habits (smoking and booze), and exposure to compounds will cause more oxidation to happen in the body. Oxidative stress, especially over a long period of time, seems to be quite a significant contributor towards disease and death. We learn more about it as time progresses and many more traditional practitioners are paying attention to these deeper level chemical states of our body.
Oxidation is a part of the natural chemical interactions in our complex biological systems. Oxidation just happens. Therefore, antioxidants need to be present, which they are. They’re often made internally or found in our diets.
The Natural Reflex - Why We Take Supplements
The natural reaction to the developing knowledge that oxidation is present and contributes to death and disease is to act - to seek out strong antioxidants.
Unfortunately, that’s the extent of the knowledge the teenage “expert” at the health food store or the internet wellness guru blogger has - that antioxidants are healthy and you need them.
It’s true though... They aren’t wrong. We know we all need more antioxidants. It’s primarily because our diets are garbage. Sweets, sugars, and in general, fun stuff can increase oxidation and free radicals formation. We’ve all heard the scientific media talk about antioxidant-rich diets improving the outcomes of specific diseases we fear the most - cancer, dementia, heart disease.
The supplement industry props up antioxidant supplements as a solution for these very large problems and the fear they instill in us. But there’s a dark secret not many people like to talk about...
The Big Secret About Antioxidants
Back to the foundation of the discussion before we pick on the natural products industry: Oxidation happens. Antioxidants clean it up. But what does this mean to us as humans? How do we know if we don’t have enough anti-oxidation going on? Are we in oxidative stress?
Here’s a bit of truth: We lack the ability to look at the individual chemical reactions in the body as they happen. Until we have nanobots that work like the Mars Rover that can patrol every aspect of our many body systems, it is difficult to know what is going on at the chemical level.
A bigger bit of truth: We don’t have a conclusive mechanism to measure oxidative stress in the body. It is much like people who attempt to measure the pH of their body. You can get measurements at certain access points, but the pH varies widely in different body systems and changes from moment to moment. We also have very effective natural mechanisms to keep our pH-regulated within a tolerable range. The same thing is true with oxidation. Can our liver accumulate oxidative byproducts to a higher degree than our muscles in our thigh, yet still work at a highly efficient level? At what point does a real problem start, and what is the range between working well and “a real problem”?
Our ability to determine if a compound is an antioxidant exists solely in test tube (in vitro) studies. We can measure a compound’s ability to reverse oxidation (be an antioxidant) and compare these compounds against other compounds with antioxidant activity. The compound is assigned a value; one measure is referred to as an ORAC value.
Many foods contain compounds called polyphenols. Examples of polyphenols are bioflavonoids. These polyphenols show strong antioxidant activity in test tube studies. Therefore, many polyphenols are called antioxidants. Other compounds found in foods, such as carotenoids, have antioxidant activity as well.
Here’s the dirty secret: There is very little evidence that antioxidant compounds found in foods do anything in the body. They may even NOT act as antioxidants. And I’m not talking about large clinical trials. I’m talking about basic evidence of their physiologic properties after we eat them. Are they absorbed?
If so, are they absorbed in digested forms that don’t have antioxidant activity? Are they metabolized and removed from the body quickly? Many antioxidant compounds found in food or supplements may not be conserved after ingestion, meaning they may have no antioxidant impact in the body.
Being an antioxidant is only the result of having antioxidant activity in a test tube, not in the body. Boom. Knowledge dropped. I’ll be outside.
I am saying that foods rich in antioxidants are healthy for you because of many reasons. We shouldn’t hang our hats on the idea that compounds found in these foods can act as antioxidants in test tubes.
There are foods SUPER rich in polyphenols and antioxidant compounds, such as nuts, beans, fruits, and vegetables. We know that diets with ample servings of varied foods rich in these components will cause people to be healthier and have better outcomes - less disease and dying too soon. The benefit of these foods may not come from a few of their key ingredients’ antioxidant activity at all, as they may not directly act as antioxidants in the body.
We suggest that you look at the term antioxidant, as it pertains to food, to mean that it is rich in healthy stuff and is good for us. But know the mechanism of why it is so healthy may not be related to the antioxidant activity at all! The health benefit of healthy foods, especially ones rich in antioxidant polyphenols, is complicated and is probably deeper than our current understanding.
Here’s a great chart of some of the most antioxidant-rich foods:
No one in their right mind would say that they shouldn’t be eaten because antioxidants refer to test tube activity. Eat these foods - lots of them!
If the above dirty secrets are ignored completely for the sake of making millions of dollars, an industry is born.
Foods that happen to be rich in polyphenols that have antioxidant activity in test tubes, when eaten in a varied, rich diet, can keep us healthy. That doesn’t mean taking a supplement with those antioxidant compounds help at all. And typically it won’t.
A Harvard review on antioxidant claims of supplements puts it very well:
“Often the claims have stretched and distorted the data: While it’s true that the package of antioxidants, minerals, fiber, and other substances found naturally in fruits, vegetables, and whole grains helps prevent a variety of chronic diseases, it is unlikely that high doses of antioxidants can accomplish the same feat.”
Do antioxidant supplements work? Yes, but no. Clear as a mud puddle on a starless night, right?
Of course these antioxidants work, but work should be in quotes. These supplements, if used in a test tube study, would reduce oxidation. Data has shown time and time again, that almost all isolated antioxidant supplements have no impact on health. The American Heart Association, for example, doesn’t approve using antioxidant supplements to improve outcomes. They argue (and there are way more experts and way more resources there than here) that there is no evidence antioxidant supplements provide cardiovascular protection.
We must understand that the clinical data is lacking. Studies of isolate antioxidant supplements such as curcumin or CoQ10 show no benefit at reducing diseases on their own. To take it further, we learned in last month’s rant that there’s ample evidence antioxidant supplements may actually be PRO-oxidants in certain situations, making them harmful to us.
And really, if you’re going to increase the oxidation levels of your body, it should be from unhealthy, fun stuff like junk food and drugs, not healthy stuff like vitamins. It’s sarcastic (I warned you this month!), but it’s honestly true. If you are taking something to be healthy, it shouldn’t have an impact on you negatively, especially to the same degree - or worse - as the very unhealthy stuff we are trying to avoid.
Famous Antioxidant Supplements
I briefly want to discuss some of the more famous antioxidant supplements, their liabilities, and options for people looking to make better decisions when it comes to using them.
We tore this guy up last month, so read that rant if you haven’t. Vitamin C is one of the few compounds that has been shown to have antioxidant activity after absorption, so we at least know it does act like one in the body. We don’t absorb much beyond what would be found in food and this has been shown to have pro-oxidant effects when mega-dosed. Look for eating foods rich in vitamin C like acerola cherries, or use a whole food Vitamin C powder or capsule when you can.
Similarly, Vitamin E retains antioxidant activity in the body. Also, it increases oxidation when dosed over 800 IU a day, and has been shown to increase stroke risk at these higher doses. People looking for Vitamin E should look to a properly made wheat germ oil.
The last of the triad of antioxidants both in the body and in test tubes. High dose synthetic Vitamin A can be harmful. In smokers, synthetic Vitamin A increases the chance of developing lung cancer, for example. Foods rich in Vitamin A are animals (fish like Cod or organ meats of cows). Beta-carotene is converted to Vitamin A as needed in the body and is found in foods like greens and carrots. Proper whole food Vitamin A/beta-carotene products will be rich in these sources.
Resveratrol is a super controversial antioxidant supplement. Foods and wines rich in resveratrol, when part of a balanced diet, seems to be beneficial to our health. When isolated (usually coming from Japanese knotweed), the data is lacking. Instead of knotweed, try properly made sour red grape pills which are a whole food source of resveratrol. Ideally, increase the foods you take in that are rich in resveratrol - but not too much, especially if you choose wine.
This is the big guy. Many people look to increase glutathione levels for numerous reasons - typically to support their liver health. What many people don’t know is glutathione has VERY poor oral absorption. There are compounds like milk thistle that some believes increase glutathione levels in the body. Some forms of glutathione such as s-acetyl-glutathione boasts better oral absorption. Some supplies of transdermal or injectable glutathione are available, typically from compounding pharmacies. But in the end, deficiency is rare and higher levels have no connection to prevention of most major diseases.
Green tea, when a part of a balanced diet, can be healthy. We’re not saying green tea is bad, but poor quality, adulterated green tea supplements cause liver damage, almost more than any other supplements out there. Most green tea is adulterated with synthetic ECGC - a liver-damaging compound. Properly made green tea supplements and teas COULD be used, but be aware of the risks of adulteration.
Misinformation and Antioxidants
“Fake news” in supplements usually follows some preliminary data showing a health benefit of a food and/or an isolation of a compound that may be responsible for some of the antioxidant benefits. Then Dr. InternetFace goes into high gear and a fad is born. False equivalence is strong with antioxidants.
This cycle just repeats ad nauseum. “A couple glasses of wine daily seems to be healthy” reports the scientific media. The supplement companies then start cranking out resveratrol only supplements, ignoring the fact that nutrition and human physiology is complex and works hand in hand with nature. It then becomes a self-serving system, framing how we think about the whole argument. It’s not any longer “what role does resveratrol rich-foods play in keeping us healthy?” but “how much/what kind/what brand of resveratrol supplement should I take?” It’s almost like they’ve done this for 70 years and made billions of dollars on it.
Here’s the most important antioxidant supplement take home for anyone that most practitioners, propaganda artists, or industry people miss: antioxidants aren’t interchangeable. Just because you take resveratrol, doesn’t mean you have the antioxidant problem under wraps. Eating blueberries for each snack every day will surely be healthy, but it may not have the same impact as mixing it up will. Just like different vitamins assist different body functions, different antioxidants will reduce oxidation in different body systems. This is why it is so important to have a varied diet rich in foods that have antioxidants.
A Reasonable Approach To Antioxidants
I really tried not to make this a semantic argument about the term antioxidants. It is important, though, to understand that foods rich in antioxidants may not be healthy because some of its compounds donate electrons in test tubes.
Know we fall firmly on the side of getting lots of antioxidants rich foods into your body, preferably from a varied diet. This is probably the number 1 intervention we all can make if we want to be healthier people.
We are more reluctant to recommend specific, synthetic isolates. Synthetic isolates rarely possess the same antioxidant properties of those compounds found in food, especially at the doses most supplements are given.
In general, as it pertains to using supplements for their antioxidant properties:
- Avoid all synthetic antioxidants - stick to foods or food powders
- Avoid single ingredient antioxidants, go for blends
- Know the tricks supplement companies use. Synthetic isolates can be added to highly processed or adulterated food powders.
- When choosing a food powder or supplement, make sure it is Vitality Approved or check with us first!
Real Food All The Way
Our bodies are complex, interwoven systems. They are a network, and as such answers about how it works are not black and white.
Understanding the relationship to oxidative stress to disease is important. A deeper knowledge of how specific interventions can help reduce oxidative stress is on the horizon. Foods rich in antioxidants carry health benefits beyond our current understanding. But besides eating better, we can also look to reducing bad habits that contribute to oxidative stress.
When it comes to nutrition and making us healthier, the supplements most people take are far inferior to food. Like night and day. People shouldn’t even bother. By taking a more skeptical look at the current state of the supplement industry, we can be better armed against the misinformation.While antioxidant rich foods are healthy, mass marketed antioxidant supplements are another in a long list of examples of broken promises from a corrupt industry.
Just trying to keep it real...
Neal Smoller, PharmD
Owner, Pharmacist, Big Mouth