Good health and wellness are processes that must be ongoing across the life span. I cannot emphasize strongly enough that this involves many life style factors, of which anti-oxidants are one important consideration.

Anti-oxidants provide benefits to virtually all the major systems of the body. Five bodily systems and processes stand out, however, as meriting lifetime protection because in those systems, disease and compromised health occur over a longer periods of time. Those systems are the cardiovascular system, the immune system, specific groups of nerve cells (neurons) in the brain, protection against cancers and slowing some steps in the aging process.

For example, a heart attack from occluded coronary arteries may occur suddenly, but probably occurred following decades of plaque formation and damage to arterial walls. In other diseases, such as Alzheimer's disease, damage occurs so gradually that it is not possible to ascertain when cognitive changes began. Damage to neurons in Alzheimer's disease may be ongoing for a decade or more before one is aware of a problem.

Anti-oxidants can make a difference in some of these processes, but are not a solution to put in place after a major health problem has occurred. Although it is never too late to obtain some health benefits from anti-oxidant supplements, it is best to start early, get into the habit of good anti-oxidant supplementation every day, and continue it throughout your life.

While scientists prefer to see controlled experimental studies that show the benefits of lifetime daily use of anti-oxidants, practically, such studies must be conducted across decades of time, involve millions of dollars and are highly unlikely to be done. Therefore, to assess the benefits of lifetime use of anti-oxidants, we must understand their benefits to each system or process.

How anti-oxidants help the cardiovascular system
In the cardiovascular system, anti-oxidants can counteract the oxidation of low density lipoproteins (LDLs), the so-called "bad" cholesterol, and help protect arteries from forming plaques that can clog arteries and deprive the heart and other organs (e.g., brain) of vitally needed blood. Anti-oxidants also can protect the walls of arteries from loss of flexibility and from damage from inflammation. A further benefit to the entire cardiovascular system is protection against platelet "stickiness," or aggregation that can lead to formation of unwanted clots. Unfortunately, the gradual build up of plaque and arterial damage is not just a process that occurs in the elderly or in someone with a genetic predisposition to lipid and cholesterol problems. It is a process that begins early, probably even in young adulthood. Prevention, starting early, makes a lot of sense. Anti-oxidants alone cannot be expected to provide singular protection in the face of other damaging process. That is why we recommend a total program of a healthy life style that involves aerobic exercise, stress management, optimal nutrition, time to enjoy music and the arts, laughter, social interactions and use of anti-oxidant supplements.

How anti-oxidants benefit the immune system
The immune system protects the body from internal and external invaders. Bacteria, viruses and parasites can gain entry into the body through the lungs and airway system, the gastrointestinal tract, the skin and the blood. The immune system has both a front line system of responses (called the innate immune response) and a reserve system with a very precise and specific attack (called the acquired immune response). Both of these systems help protect the body from damage from these organisms and help to mop up residual damage. The immune system also is engaged in ongoing surveillance and destruction of tumor cells that are not recognized as "self." Anti-oxidants provide benefits to both innate and acquired arms of the immune system. They are particularly helpful in enhancing natural killer (NK) cell activity, a part of the innate immune response that attacks some cancers and virally-infected cells, and cell-mediated responses, part of the acquired immune response that kills infected cells. The immune system must be ready to respond to the daily ongoing threat of invasion by infectious organisms and the threat of tumor cell formation. Maintenance of robust immune reactivity is a good idea to prevent problems and combat infections once they occur. As we age, this maintenance becomes even more important because some immune responses, including NK cell activity and cell mediated immune responses, generally diminish with age.

How anti-oxidants help protect the brain
In the brain, selected populations of neurons are susceptible to damage from free radicals, particularly oxygen free radicals. Unfortunately, the susceptible neurons appear to undergo destruction and damage in the neurodegenerative diseases such as Parkinson's disease (resting tremor, muscle rigidity, and difficulty initiating movements), Alzheimer's disease (memory loss, deteriorating cognitive functioning), and amyotrophic lateral sclerosis, also known as Lou Gehrig's disease (muscle paralysis). Anti-oxidants appear to provide some protection against the formation of free radicals that can damage the neurons. We have studied protective strategies to preserve the functional integrity of neurons that degenerate in Parkinson's disease. These dopamine neurons can be protected from age-related damage from free radicals by inhibiting the extent of free radical formation. However, the protective effect of limiting dopamine-related free radical formation worked far better when initiated early rather than in life. Therefore, I am convinced that anti-oxidant protection of vital groups of brain neurons should be a process that starts early and continues throughout the life span.

Protection against cancers
Cancer cells can form when the genetic machinery of a cell is altered to cause that cell to proliferate out of control. Many mechanisms contribute to the formation of cancers, including genetic predisposition, environmental toxins, radiation, long-term nutritional effects, and other factors. Each type of cancer is unique and has its own set of risk factors. This complicates the search for treatments and cures. However, it is generally accepted that free radicals can cause damage to the genetic machinery of many cells and contribute as an important risk factor to the formation of cancers. The process of counteracting cancer cells, in a preventive manner and in immune-related destruction of cancer cells already in the body, goes on throughout the life span. While the incidence of many forms of cancer increases with age, protection and prevention are ongoing processes. Protection against many cancers can benefit from optimal anti-oxidant supplementation. It seems obvious that this is best started before a cancer occurs rather than after it is discovered.

Fighting the gradual aging process
The aging process involves gradual changes in many of the important systems and process of the body. The cardiovascular system is increasingly at risk from cumulative damage of atherosclerosis. The immune system shows a diminished capacity to protect the body from invading organisms and the formation of some types of tumors. Some systems of neurons in the brain show an ongoing process of free radical-related deterioration, and cannot be replaced with new neurons. Cumulative damage from cancer-promoting insults continues across the life span. Cataracts, involving a loss of transparency in the lens of the eye, increase with age. Damage to the genetic machinery of many cell types continues in cumulative fashion into old age. All of these processes can benefit from anti-oxidant supplements. Therefore, I am convinced that the right time to provide optimal anti-oxidants to the body on a daily basis is very early in life.

Is the recommended daily intake enough?
At first glance, one could ask, "why can't I get all of the anti-oxidants I need directly from my diet?" A diet rich in fruits and vegetables appears to contain many anti-oxidants, such as vitamins C and E, beta-carotene, and even a little selenium. This may be sufficient to prevent vitamin deficiencies, but it is not sufficient to provide optimal anti-oxidant protection. The USDA minimal daily requirements represent the intake necessary to prevent deficiencies. They do not represent the optimal levels to provide the best protection for the systems discussed above. In order to obtain those optimal levels, it is necessary to take anti-oxidant supplements. Some anti-oxidants must not be taken in excessive quantities. Selenium can be highly toxic in doses exceeding 500 micrograms. It also is important to work with a knowledgeable physician or health care provider to take into account your individual physiology, weight and health, kidney function, and other factors that might influence the need and processing of anti-oxidants. The anti-oxidant regimen I have chosen for my own daily use is a combination of vitamin C, vitamin E, grape seed extract, selenium, and co-Enzyme Q10. The benefit of a water soluble (C) and a lipid soluble (E) antioxidant, in combination with highly potent anti-oxidants that can help to synergize and recycle both C and E (grape seed extract), is to provide optimal anti-oxidant protection to all the major systems and compartments of the body.

David Felten, MD, PhD, is founding Director of the Center for Neuroimmunology and Professor of Pathology and Human Anatomy and Professor of Neurology at Loma Linda University School of Medicine in Loma Linda California. He is an internationally known researcher whose contributions helped to establish the field of psychoneuroimmunology.

© 2000 David L. Felten, M.D., Ph.D.

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