Conclusions and Recommendations

Diabetes mellitus is associated with increased tissue content of oxidation byproducts and reduced antioxidant defense system. Hyperglycemia appears to be a necessary and sufficient cause for inducing excessive production of ROS.

Epidemiological studies have shown a correlation between dietary or supplemental intake of antioxidants and the reduced incidence of CVD. However interventional studies using select antioxidant supplements have failed to show significant benefits from supplementation and in some studies the potential for adverse outcomes has emerged. A common limitation in all the currently available interventional trials is the lack of measurements of the oxidative load of the study population, baseline micronutrient status and the lack of a marker of oxidation that can be monitored throughout the study to ascertain the bioavailability and efficacy of the supplements tested. At the present time given the inconsistencies in the studies available, the widespread supplementation with pharmacological doses of antioxidants should be discouraged. Future studies should focus on identifying reliable markers of oxidation to incorporate these measurements in clinical interventional trials, and to further develop novel antioxidants that reduce oxidative burst instead of functioning like conventional antioxidants that scavenge ROS after they have been produced.

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