Antioxidants in Nutrition, Health, and Disease

John M.C. Gutteridge, Barry Halliwell
Oxford University Press, 70 Wynford Dr, Don Mills, ON M3C 1J9
1994/143 pp

Strengths

Summarizes current thought on free radicals and antioxidants. A clear, pithy, scientific, informative text

Audience

Physicians, medical students, nurses, biologists, nutritionists, and chemists

The authors have written a short textbook introducing antioxidants to clinical practice. They also refresh readers with a review of the basic clinical sciences.

A short, informative preface asks succinct questions on using antioxidants for treating heart disease, cancer, and degenerative illnesses. The authors answer their questions with sufficient information on free radicals, cholesterol, and oxidative stress for readers to use in laboratories and practices.

A historical discussion of oxygen, oxidation-reduction definitions, and electron transport is followed by scientific information on the Krebs cycle, vitamins, and nutrients and a timely presentation of free radicals as contributing to cardiovascular and degenerative disease.

Later, epidemiologic and pathologic evidence on nutrient use is presented. This evidence allows us to understand information applicable to a scientific study of tissue damage and regeneration. Clearly, interest in the effects of nutrition and vitamins on health has increased. This short text will help practitioners upgrade current knowledge and share the information with patients.

The authors acknowledge the brevity of their text. They have challenged readers to examine modern concepts that might be discussed with our patients in the office. They also give us sufficient information to provide our patients and colleagues with current thinking on the activity of essential vitamins A, E, and C.

The style of this book flows well with diagrams, bold headings, illustrations, and informative tables. I enjoyed the quotations from The Beatles and Butch Cassidy and the Sundance Kid mixed with Paracelsus and Francis Bacon, which set the tone for the discussion in each of the seven chapters.

Appendices supplementing chapters 1, 4, and 5 provide further information on cholesterol, saturated and unsaturated fats, and their effect on the cardiovascular system. The authors raise questions not only for academics, but also for the less scientific. Skillfully, they then lead us through a historical discussion of the building blocks of life: carbon, hydrogen, oxygen, and nitrogen. Are antioxidants elixirs or media hype? Are human phagocytes useful? Does oxidative stress help or hinder our health? Should vitamins and minerals be used as supplements? What is the window of optimum activity of antioxidants?

Although the jury is still out on the results of antioxidant research, the authors present much food for thought. This book is valuable, and a few nights’ perusal should give readers sufficient vital information on antioxidant therapy to guide application.

If you anticipate feeling anxious before a test or an interview, what could you eat to help make you feel both calm and alert? Claudia Lutz, RD, MPH, whose area of expertise is nutrition education, suggests that a good combination, eaten about an hour before the event, might be nonfat yogurt with some fruit juice and fruit. The dairy provides protein and tryptophan, the amino acid that begins the production of serotonin (5-hydroxytryptamine). You may want to give yourself a good start by getting a good night’s sleep the day before, she adds, by having no caffeine eight hours before bed time and a minimal amount earlier in the day.

Dietary choices. For examples of meals that may help you feel more alert or more relaxed, refer to CyberDiet’s article on Moods and Foods. For a “feel good” treat, eat chocolate, which contains caffeine, theobromine, and phenylethylamine, which stimulate the nervous system and produce brain endorphins (“internal morphines”).

Dietary changes, as well as nutrient and herbal supplements, can be part of an approach to relieving mild to moderate depression or anxiety. However, diagnosis of deficiencies may require a nutritionally oriented doctor, and a healthcare professional knowledgeable in the field of nutrition or medicinal plants should supervise any supplementation.

The following recommendations may be helpful.

Dietary changes. If you’re depressed, it’s advised that you avoid alcohol, as it is a powerful depressant and can make you feel worse. Additionally, alcohol depletes the body of vitamins essential to good mental health. People experiencing depression may also want to avoid sugar and caffeine to see how it affects their mood. Too much of either can lead to a crash or fatigue. Because of increased susceptibility to its stimulating effect, people experiencing anxiety should also avoid all sources of caffeine, including chocolate.

Vitamins and supplements. Iron deficiency can cause fatigue and worsen depression. Good sources of dietary iron are found in oysters, meat, poultry, fish, green leafy vegetables, wine, and acidic foods cooked in an iron pan. Iron supplements should not be taken unless a deficiency has been diagnosed, because too much can cause oxidative damage.

Deficiencies in the B vitamins can create disturbances in mood and mental processes. Vitamin B folic acid, or folate, is needed to make SAMe (S-adenosyl-L-methionine), which appears to increase levels of dopamine, a neurotransmitter that affects mood. Folate is found in dried peas and beans, dark green leafy vegetables, citrus fruits, and wheat germ. Vitamin B12 is also needed for the production of SAMe and is found in dairy, eggs, poultry, fish, and meat. Oral contraceptives can deplete the body of Vitamin B6, which is needed to make serotonin, dopamine, and the hormone melatonin. Vitamin B6 supplementation may help alleviate depression related to premenstrual syndrome. Good sources of Vitamin B6 are found in turkey, tuna, lentils, potatoes, and bananas.

Herbal remedies. St. John’s wort extract, widely prescribed in Germany to treat mild to moderate depression, is noted in Phytomedicine 1995, to significantly relieve such symptoms as sadness, worthlessness, and fatigue. Recent research, reported in Pharmacopsychiatry 1997, suggests that St. John’s wort extract has an antidepressant action by inhibiting the reuptake of neurotransmitters serotonin, neorepinephrine, and dopamine, thereby making them more available to the brain. Ginkgo biloba, which has been shown (Am J Therapeutics, 1996) to increase concentration and memory, may also relieve depression in elderly people.

Extensively studied, the primary healing plant remedy used to treat anxiety is kava extract, which has active ingredients that may have antianxiety effects. Other botanicals, not well studied but safely used historically to treat anxiety, include passion flower and valerian.

Research on how to improve the brain’s functioning continues, with the aging generation of the baby boom eagerly awaiting identification of protective foods and plants. In the meantime, Lutz reminds us that we can make some improvements now in our mental health by assessing the soundness of our nutrition. Ask yourself the following questions. How much do you eat? When? What types of food? Are you getting enough water, adequate protein, lots of complex carbohydrates and fruits and vegetables? What nutrients are you sparing or restricting? How much caffeine and alcohol do you take? Let your answers guide you to make some corrective changes. If you need help, seek the counsel of a licensed, registered dietician.

Caveat. If you experience depression or anxiety that is severe, recurrent, or constant, it’s important that you seek expert medical care. Accurate diagnosis is critical to determining the appropriate treatment. Biochemical or physical causes need to be ruled out. For example, low thyroid function can cause depression that can be successfully treated with prescription thyroid medication. Additionally, the need for psychotherapeutic drugs and/or psychotherapy should be evaluated. For example, antidepressant medication may be required to relieve utter hopelessness or suicidal thoughts. Or cognitive behavior therapy may be necessary to relieve anxiety by teaching relaxation techniques and facilitating the development of better coping skills in stressful situations.