The Way of the Antioxidant

It always seemed so irresistibly simple. Oxidation = bad, therefore antioxidants = good. Free radicals(any atom or molecule that has a single unpaired electron in an outer shell, making it highly reactive and unstable) have long been seen as the “bad guys” going around our body and causing oxidative damage, by “stealing” electrons from other atoms, leading to aging and disease. This in turn can lead to a chain reaction with the atoms and molecules that had their electrons “stolen” from them becoming free radicals themselves, trying to steal electrons from other atoms.

In comes the police, uh, I mean the antioxidants to put a stop to this mayhem. Antioxidants protect the body’s tissues by donating their own electrons to the free radicals, neutralizing the threat. We actually produce our own antioxidants: glutathione peroxidase, and superoxide dismutase, among others. We also get antioxidants through our diet, such as vitamin C(ascorbic acid), vitamin E(actually a family of chemically similar fat-soluble vitamins), and beta-carotine(and other carotenoids), among so many others. Even the non-vitamin phytochemicals in many plant foods often have antioxidant effects(by definition, vitamins are absolutely essential for the body to function properly, while phytochemicals are not, though at least some of them are beneficial for health).

So taking large amounts of antioxidant supplements would obviously protect the body even more than getting smaller amounts from food, right? Wrong! Indeed, let’s look at the results of a study done on athletes who took antioxidant supplements, people whose muscles are under a great deal of oxidative stress during exercise.

Does antioxidant vitamin supplementation protect against muscle damage?
McGinley C, Shafat A, Donnelly AE.
Source

Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.

Abstract

The high forces undergone during repetitive eccentric, or lengthening, contractions place skeletal muscle under considerable stress, in particular if unaccustomed. Although muscle is highly adaptive, the responses to stress may not be optimally regulated by the body. Reactive oxygen species (ROS) are one component of the stress response that may contribute to muscle damage after eccentric exercise. Antioxidants may in turn scavenge ROS, thereby preventing or attenuating muscle damage. The antioxidant vitamins C (ascorbic acid) and E (tocopherol) are among the most commonly used sport supplements, and are often taken in large doses by athletes and other sportspersons because of their potential protective effect against muscle damage. This review assesses studies that have investigated the effects of these two antioxidants, alone or in combination, on muscle damage and oxidative stress. Studies have used a variety of supplementation strategies, with variations in dosage, timing and duration of supplementation. Although there is some evidence to show that both antioxidants can reduce indices of oxidative stress, there is little evidence to support a role for vitamin C and/or vitamin E in protecting against muscle damage. Indeed, antioxidant supplementation may actually interfere with the cellular signalling functions of ROS, thereby adversely affecting muscle performance. Furthermore, recent studies have cast doubt on the benign effects of long-term, high-dosage antioxidant supplementation. High doses of vitamin E, in particular, may increase all-cause mortality. Although some equivocation remains in the extant literature regarding the beneficial effects of antioxidant vitamin supplementation on muscle damage, there is little evidence to support such a role. Since the potential for long-term harm does exist, the casual use of high doses of antioxidants by athletes and others should perhaps be curtailed.

Okay, so they don’t prevent oxidative damage to muscles, but can vitamin C at least improve athletic performance?

Effect of vitamin C supplements on physical performance.

Braakhuis AJ.
Source

US Olympic Committee, Sport Performance, Olympic Training Center, Chula Vista, CA 91915, USA. andrea.braakhuis@usoc.org

Abstract

Vitamin C is an essential component of the diet and may reduce the adverse effects of exercise-induced reactive oxygen species, including muscle damage, immune dysfunction, and fatigue. However, reactive oxygen species may mediate beneficial training adaptations that vitamin C attenuates; indeed, from a total of 12 studies, vitamin C in doses >1 g·d(-1) impaired sport performance substantially in four of four studies, possibly by reducing mitochondrial biogenesis, while a further four studies demonstrated impairments that were not statistically significant. Doses of ∼0.2 g·d(-1) of vitamin C consumed through five or more servings of fruit and vegetables may be sufficient to reduce oxidative stress and provide other health benefits without impairing training adaptations.

It appears that supplemental vitamin C impaired performance. The general idea here for why mega-doses of vitamin C and other antioxidant supplements are not protecting tissues or enhancing performance is that not all oxidation reactions are harmful; they are used in many metabolic reactions, for cell communications and are important for the immune system. So if you effectively shut down oxidation with a flood of antioxidants, you may be interfering with some important chemical reactions in your body, and doing more harm than good. Vitamin C isn’t just an antioxidant – it is needed for collagen production and immunity and not getting enough results in a serious deficiency disease called scurvy. Scurvy is very rare in the developed world, and only a small daily dose(60mg) of vitamin C is necessary to prevent it.

The best way to get antioxidants. Source: Wikipedia

Okay, then maybe, just maybe a powerful antioxidant like beta-carotine can protect smokers, who are exposing themselves to a lot of oxidative damage through the act of smoking:

Beta-carotene in multivitamins and the possible risk of lung cancer among smokers versus former smokers: a meta-analysis and evaluation of national brands.

CONCLUSIONS:

High-dose beta-carotene supplementation appears to increase the risk of lung cancer among current smokers. Although beta-carotene was prevalent in multivitamins, high-dose beta-carotene was observed among multivitamin formulas sold to promote visual health.

So far, it doesn’t look like antioxidant supplements are beneficial for anyone’s health. Beta-carotine, in particular, may even increase lung cancer risk in smokers.

This doesn’t mean that antioxidants are themselves bad for you. It just means you are better off getting them from food, where they may interact with other chemicals in the fruits and vegetables they naturally coincide with in a manner that makes them relatively harmless and likely beneficial.

Antioxidants do provide some protection, but that’s not the whole story. It’s long been thought that fruits and vegetables are beneficial largely due to their antioxidant content. This may still be true in part, but the phytochemicals in them may have other ways of protecting our health in ways science is still trying to figure out. Antioxidant content may be a proxy measure of protective phytochemical content, since many if not most phytochemicals tend to have antioxidant effects. Blueberries, with a very high antioxidant content and some possible brain-protecting effects, are a good example of this.

Good health means having a good balance between antioxidants and oxidation reactions, which taking large doses of antioxidant supplements interferes with.

Calcium blocks lead absorption

Everyone knows about calcium. I don’t think it is really necessary to list why it is so important for human health, but I’ll say it anyway – it is needed to build strong bones, as well as for proper functioning of the heart and muscles. Lack of calcium can even lead to heart failure in the elderly. It also has many other functions, but these are its most important duties. While you can get calcium from milk, leafy green vegetables like kale and collard greens are even better sources.

What isn’t as well known is that calcium can block the absorption of lead, which is very toxic even in small doses. This is yet another reason you should make sure you are getting enough calcium. This is especially important in communities where children are exposed to lead, since it can permanently damage the brain.

According to the Ohio State University Extension Fact Sheet- Human Nutrition and Food Management:

An adequate calcium intake can protect against lead poisoning. It has been observed in animals and humans that both the absorption and retention of lead decreases as calcium intake increases. Many children at risk for exposure to excess lead are also those who live at the poverty level, and may consume a diet with insufficient calcium. Therefore, increasing consumption of low-cost calcium rich foods can reduce the severity of the effects of lead exposure.

Why lead exposure in young children is especially problematic:

Epidemiologic studies of children show that those exposed to lead, even low levels of lead, may have a lower IQ, learning disabilities, behavioral abnormalities and kidney damage. Cognitive and growth defects also may occur in infants whose mothers are exposed to lead during pregnancy. Lead intoxication is a widespread problem. One of every nine children under six years of age has blood lead levels high enough to be at risk. In 1970, an estimated 3 million children aged less than 6 years had blood lead levels associated with adverse health events. Children in older, inner-city neighborhoods are more likely to be affected, but children in suburban and rural areas are at risk too.

There are a lot of ways to ensure you are getting enough calcium, but make food your primary source. While you can get calcium from dairy, vegans or people with lactose intolerance require another source. Luckily, the bioavailability of calcium in kale is even higher than the calcium in milk. It must be noted that while spinach has a lot of calcium, spinach also has a lot of oxalic acid which can block calcium absorption. Therefore, do not rely on spinach or other high oxalic acid foods for calcium(kale is a low oxalic acid vegetable). Oxalic acid also contributes to kidney stones.

Increasingly, many foods and beverages are fortified with calcium, like orange juice and rice milk for example. Also make sure you get enough vitamin D to absorb the calcium. If you have very young children, do all you can to make their environment lead free, besides making sure they get enough calcium. Don’t forget that lead tastes sweet.

Lead poisoning in children

The vitamin K family and bone health

The holidays are that time of year for family gatherings. Some of us have big families while some of us have small families. The much ignored(until recently) vitamin K is actually a big family and not just one lonely vitamin. In this respect, it is similar to the B vitamin complex, which is made up of several distinct vitamins under the vitamin B umbrella, all of which are needed for proper energy metabolism.

So what is so special about vitamin K? Vitamin K, which is fat-soluble, is essential for blood clotting(coagulation), as well as optimal calcium metabolism. A deficiency of vitamin K can lead to excessive bleeding. Unfortunately for vampires, vitamin K deficiency is rare.

Phylloquinone chemical structure

Menaquinone chemical structure

There are two main forms of vitamin K – vitamin K1(phylloquinone), and vitamin K2(menaquinone). Vitamin K1 is found mostly in plants while vitamin K2 is found more in meat and produced in the body. This gets even more fun when you consider that there are also many sub-forms of menaquinone, which seem to have somewhat different effects. The overall effect of vitamin K is the synthesis of proteins needed for proper coagulation and the proper metabolism of calcium and bone tissue. This makes vitamin K important both for bone growth and maintenance, as well as the prevention of arterial calcification.

According to Schurgers LJ, Cranenburg EC, Vermeer C. at Maastricht University:

Among the proteins involved in vascular calcium metabolism, the vitamin K-dependent matrix Gla-protein (MGP) plays a dominant role. Although on a molecular level its mechanism of action is not completely understood, it is generally accepted that MGP is a potent inhibitor of arterial calcification. Its pivotal importance for vascular health is demonstrated by the fact that there seems to be no effective alternative mechanism for calcification inhibition in the vasculature. An optimal vitamin K intake is therefore important to maintain the risk and rate of calcification as low as possible.

So vitamin K looks very promising as a treatment for calcification of the arteries(a very common problem among the elderly). Basically, the vitamin K family ensures calcium goes where it belongs(the bones), so it doesn’t get stuck where it can cause problems(the arteries).

According to the same vitamin K researchers quoted above:

Prolonged sub-clinical vitamin K deficiency is a risk factor for osteoporosis, atherosclerosis, and cancer. Present recommendations for dietary intake are based on the daily dose required to prevent bleeding. Accumulating scientific data suggests that new, higher recommendations for vitamin K intake should be formulated.

It also appears that vitamin K may help prevent osteoporosis, and surprisingly, cancer. It also says the scientific data suggests new, higher recommendations for vitamin K intake. It doesn’t say exactly how much more, and I am not recommending we all take vitamin K pills. However, if you are at risk for osteoporosis or have atherosclerosis(of which calcification of the vessels plays an important part), it may be a good idea to talk with your doctor about vitamin K.

Vitamin K is also associated with a decreased risk of type 2 Diabetes, according to Diabetes Care:

This study shows that both phylloquinone and menaquinones intakes may be associated with a reduced risk of type 2 diabetes.

So how can you be sure you are getting enough of both forms of vitamin K? Eating a varied diet that includes a lot of green leafy vegetables can help ensure you get enough. Vitamin K is also produced by gut bacteria. So eating fermented food may ensure optimal vitamin K levels. People with chronic gastrointestinal diseases are at a much higher risk for vitamin K deficiency, according to – Am J Clin Nutr. 1985 Mar;41(3):639-43.

Here is some interesting research from Italy on the different biological effects of the various forms of vitamin K:

Vitamin K (vitamin K1 or phylloquinone and vitamin K2, a series of menaquinones [MKs]) is involved in the production of bone and matrix amino acid γ-carboxy-glutamic acid (Gla) proteins, regulating bone and vascular calcification. Low vitamin K concentrations are associated with increased risks of fractures and vascular calcification, and frequent complications in hemodialysis patients. We carried out an observational study to establish the prevalence of vitamin K deficiency and to assess the relationship between vitamin K status, vertebral fractures, vascular calcification, and survival in 387 patients on hemodialysis for ≥1 year. We determined plasma levels of vitamin K compound, bone-Gla-protein, matrix-Gla-protein, and routine biochemistry. Vertebral fractures (reduction in vertebral body height by ≥20%) and aortic and iliac calcifications were also investigated in a spine (D(5) -L(4)) radiograph. Three-year patient survival was analyzed. Important proportions of patients had deficiency of MK7 (35.4%), vitamin K1 (23.5%), and MK4 (14.5%). A total of 55.3% of patients had vertebral fractures, 80.6% had abdominal aorta calcification, and 56.1% had iliac calcification. Vitamin K1 deficiency was the strongest predictor of vertebral fractures (odds ratio [OR], 2.94; 95% confidence interval [CI], 1.38-6.26). MK4 deficiency was a predictor of aortic calcification (OR, 2.82; 95% CI, 1.14-7.01), whereas MK5 deficiency actually protected against it (OR, 0.38; 95% CI, 0.15-0.95). MK7 deficiency was a predictor of iliac calcification (OR, 1.64; 95% CI, 1.03-2.60). The presence of vertebral fractures was also a predictor of vascular calcifications (OR, 1.76; 95% CI, 1.00-3.08). Increased alkaline phosphatase and C reactive protein (CRP), age, and cerebrovascular events were predictors of mortality. Our study suggests that the vitamin K system may be important for preserving bone mass and avoiding vascular calcification in hemodialysis patients, pointing out a possible role of vitamin K in bone and vascular health. Based on our results, we suggest that the general population should also be studied for vitamin K deficiency as a possible cause of both vertebral fractures and vascular calcification.
Copyright © 2012 American Society for Bone and Mineral Research.

So, have you figured out yet which is your favorite form of vitamin K? Don’t stress yourself out over whether or not you are getting enough of the MK7 form of vitamin K or enough phylloquinone. If you don’t have liver problems, or gastrointestinal problems, or if you are not on dialysis and you are young, eat right and get plenty of exercise, you have little to worry about. But if you are at risk for diabetes, osteoporosis or atherosclerosis, speak with your doctor about vitamin K.

The effects of air pollution on exercise

How air pollution affects exercise performance doesn’t get as much attention as it deserves. It is a rather complex subject, although it seems rather intuitive that the more polluted the air, the worse it is for exercise. Although air pollution is everywhere, it is far worse in urban centers, with most of it coming from vehicle exhaust.

On this issue, it appears that science agrees with our intuition. According to this study – Subclinical Effects of Aerobic Training in Urban Environment, which compared people trying to improve their aerobic fitness in urban and rural settings, both groups became equally fit, though reaction times were better in rural settings and the urban exercisers had significantly higher levels of inflammation markers(exercise even in a non-polluted area can cause inflammation, it’s just worse in polluted areas).

I don’t believe the lesson to be learned from this is to not exercise if you live in a polluted area, unless you have respiratory disease, but rather to be more cautious or try to seek out an area with cleaner air to exercise if possible.

Also, I think it could be possible to prevent the inflammation caused by pollution by eating better. Some foods have a pro-inflammatory effect, like food with a high saturated fat content, as well as fried, roasted and overly processed foods. On the other hand, many fresh fruits and vegetables either have a neutral effect on inflammation or can help prevent it from getting out of control. Curcumin, a natural compound which is found in turmeric(an important ingredient in curry), has potent anti-inflammatory effects. Ginger, a close cousin of turmeric has similar benefits. Leafy greens may also help. Try to get all this from food, not supplements.

Besides this, if you are a runner living in an urban environment, try to stay far away from highways or areas with heavy traffic when running. In my personal experience, it seems that I’ve had to apply more effort when running in polluted areas than in non-polluted areas to achieve my usual pace. Also, the study I cited seems to suggest that air pollution would have more of an effect on jogglers than runners, since air pollution interferes with reaction rates/cognition during aerobic exercise. In my experience, I am more likely to drop the balls in polluted areas.

Do not let this discourage you from exercise, unless you have medical issues.