Antioxidant Supplementation Pros and Cons

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There are several misconceptions regarding the benefit of supplementing diet with pharmacologic doses of antioxidants. A common misconception is that overweight people are well fed and are not at risk for micronutrient deficiencies. The lay public is under the impression that since supplements are natural products, they must be safe, and since they are available over the

Antioxidants and Diabetes Table 3. The arguments for and against the use of antioxidant supplementation

(a) Many do not consume a balanced diet

(b) It may prevent heart disease, infection, diabetes and cancer

(c) In small amounts it is harmless

Against

(a) Supplementation will encourage consumption of a poor diet

(b) Body regulates micronutrient absorption and excretion

(c) The evidence for health benefits is small if any, and often contradictory (e.g. p-carotene and lung cancer)

(d) No long-term toxicity data counter, they must have the approval of the government agencies. Many also erroneously believe that antioxidant supplementation will achieve health benefits when conventional therapies fail. The arguments in favor of and against use of antioxidant supplementation are summarized in table 3. The fact that many, both in the industrialized world as well as in developing countries, do not consume a balanced diet that contains fresh fruits and vegetables, and the fact that antioxidants in small amounts appear to be safe, supplementation of the diet with modest amounts of conventional antioxi-dants may be justifiable. On the other hand, the fact that the body regulates the absorption and excretion of micronutrients, the concern about encouraging poor dietary habits and potential long-term toxicity and teratogenicity [3, 4], especially in certain groups of people, are arguments against routine supplementation of the diet with pharmacological doses of antioxidants.

In a recent meta-analysis of 7 randomized trials of vitamin E and 8 trials of p-carotene treatment concluded that at the present time there is no convincing evidence for any beneficial effects of vitamin E or p-carotene on cardiovascular morbidity and mortality [47]. In this analysis, p-carotene led to a small but significant increase in all-cause mortality (7.4 vs. 7.0%, p = 0.003) and a slight increase in cardiovascular death (3.4 vs. 3.1%, p = 0.003) underscoring the concerns about the indiscriminate use of antioxidants in health maintenance.

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