Antioxidants
For many years strong scientific evidence has shown that a group of nutrients known as antioxidants can inhibit the formation of cholesterol plaque in coronary arteries by their ability to neutralize free radicals (for an explanation, see the “Basic Concepts” section of this Web site). Since free radicals may also contribute to several types of cancer, as well as to other conditions such as cataracts, antioxidants are considered important nutrients for health prevention.
In the following paragraphs you will find a brief description of the most important antioxidants, minerals, and other nutrients believed to have an effect on the metabolic process of cholesterol. Following the descriptions, you will find a section titled “Nutrients Summary” with some recommendations on this important and complex subject, so we recommend that you keep reading.
Beta-carotene is an important antioxidant found in yellow-orange fruits and vegetables and in some deep-green leafy vegetables. Beta-carotene is the chemical parent of vitamin A. Supplemental vitamin A is harmful in large amounts, but it is impossible to overdose on beta-carotene. The body simply draws on this nutrient as it is needed. Researchers report that a daily intake of 25 milligrams (mg) of beta-carotene provides adequate protection. A single carrot supplies 15 to 20 mg per day. Other good sources of beta-carotene are yams, cantaloupe, broccoli, apricots, pink grapefruit, red peppers, mangoes, peaches, papayas, sweet potatoes, pumpkins, yellow squash, spinach, kale, collards, and dark green romaine lettuce. For those unable to eat fruits or vegetables, beta-carotene is also available in supplement form.
Vitamin C—laboratory tests show that vitamin C is one of the most effective antioxidants in blocking low-density lipoprotein (LDL) oxidation and therefore preventing artery plaque formation. Other tests reveal that a higher dietary intake of vitamin C is invariably associated with higher levels of high-density lipoprotein (HDL), also known as good cholesterol. Furthermore, tests have revealed that heart attack victims and people with high blood pressure almost invariably have low blood serum levels of vitamin C. Good sources of vitamin C include broccoli, Brussels sprouts, tomatoes, green peppers, cantaloupe, papayas, strawberries, kiwi, and oranges (including fresh orange juice).
Vitamin E, the principal fat-soluble antioxidant, functions wherever fat is present in the body. According to the World Health Organization, a low blood level of vitamin E is the single most important risk factor in death from ischemic heart disease (oxygen starvation of the heart muscle due to artery blockage). Based on data from a study conducted in 16 European cities, low vitamin E levels were linked to blocked coronary arteries in 62 percent of deaths from ischemic heart disease. The study’s author cited a low level of vitamin E as a greater risk factor for heart disease than high cholesterol, smoking, or high blood pressure. Additionally, vitamin E may reduce the tendency of platelets to coagulate and form blood clots, a major cause of heart attack and stroke. People who have a diet high in refined and processed foods may have a deficiency of vitamin E. Some natural foods such as wheat germ, sweet potatoes, and kale contain appreciable amounts of vitamin E, but the principal dietary sources are fatty foods like nuts, seeds, and vegetable oils. For this reason, supplements may be the preferred source. Taking 200 international units (IU) per day may be sufficient; but many people, including some cholesterol researchers, take 400 IU daily. It usually takes several weeks of daily supplementation to raise the blood level of vitamin E to an effective level.
Selenium is a mineral present in grains grown in certain areas. To ensure an adequate intake, a daily supplement of 50 to 100 micrograms should be ample to maintain antioxidant benefits.
Vitamin B6—if your regular diet is high in animal protein, especially red meat (beef), you should consider taking a multiple B vitamin tablet containing vitamin B6. Beef often contains a significant amount of methionine. Methionine is a precursor of homocysteine, which causes smooth muscle cells to multiply inside artery walls. Eventually, these surplus cells break away and become part of the debris that contributes to the formation of arterial plaque. All indications are that methionine can be metabolized and rendered harmless by a sufficiency of vitamin B6 in the diet. Also, it is important to note that recent scientific research has found that proper levels of homocysteine are associated with good heart health and that those levels can be maintained by consuming the recommended daily/dietary allowance (RDA) of vitamins B6, B12, and folic acid.
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Important Minerals
Potassium has shown its ability, in certain studies, to lower total cholesterol levels and blood pressure. Most advisory agencies recommend a daily intake of at least 2,000 mg of potassium. Bananas, potatoes, tomatoes, winter squash, spinach, and broccoli are particularly rich in potassium. Most plant-based foods provide a rich supply of potassium, and supplementation is normally unnecessary.
Chromium—a deficiency of chromium has been associated with elevated cholesterol. In developed countries, a large percentage of the population may have some degree of chromium deficiency usually due to eating refined and processed foods. Chromium works by helping to lower insulin levels, which in turn aids in lowering cholesterol and triglyceride levels. An adequate level of chromium in the bloodstream is also believed to help prevent injury to artery walls. Since chromium works synergistically with a variety of other nutrients, it should be taken in the form of a fully balanced supplement of all essential minerals. Taking a single supplement of chromium is likely to cause a deficiency of some other minerals. The RDA of chromium is 50 to 200 micrograms. As with all minerals, many chelating agents (carriers) may be used to enhance the absorption of chromium. For this reason it is available as chromium picolinate bound to picolinic acid, chelated chromium bound to glycine, glucose tolerance factor (GTF) chromium derived from yeast, and chromium polynicotinate, a niacin-bound chromium complex that usually comes in a combination of 100 mg niacin and 200 micrograms of GTF chromium. Chromium polynicotinate is usually recommended in dosages of 300 to 600 micrograms per day, and it should be taken only under medical doctor supervision.
Magnesium is a key mineral for protecting heart health. When free fatty acids increase in the bloodstream due to emotional stress, the magnesium level is reduced. Stress hormones like adrenaline also deplete magnesium, simultaneously raising blood pressure. Because magnesium protects artery walls from damage caused by sudden blood pressure increases, maintaining an adequate level of magnesium in the bloodstream is clearly important. Magnesium is also essential for regulating blood pressure. The RDA for magnesium is 400 mg.
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Other Nutrients
Omega-3—some studies have shown that the consumption of omega-3 oils, usually found in fish and seafood, lowers the liver’s production of triglyceride, reduces the risk of several cancers, and reduces the risk of heart disease (specifically the recurrence of myocardial infarction). As a supplement, omega-3 oils are commonly found in the form of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and they both should be taken especially by those people with high levels of triglyceride; the recommended daily dosages are 360 mg of EPA and 240 mg of DHA.
Pantethine is the biologically active form of pantothenic acid (vitamin B5). It is used by key enzymes involved in the transport and breakdown of triglyceride and cholesterol. The breakdown of fat into energy requires the transport of fatty acids across cellular membranes. Pantethine (as a component of coenzyme A and acyl carrier protein) is essential in this process. The recommended dosage is 900 mg a day.
CoQ10 is a vitamin-like, naturally occurring nutrient normally present in every cell in the body. It has a molecular structure similar to that of vitamin K and could be considered a relative of vitamin E. It is usually ingested through foods (especially fish and meats) and produced internally by our bodies, although many people don’t make it very well due to the highly complicated biochemical process required for its production.
CoQ10 stands for coenzyme Q10, which is the given name to this important nutrient by the scientific community and especially by the late Karl Folkers, Ph.D., considered the father of coenzyme Q10. CoQ10 is sometimes also referred to as ubiquinol, a name formed with the word ubiquitous (which means “being or seeming to be everywhere at the same time; omnipresent”), because coenzyme Q10 is found in virtually every cell in the body, and with the word quinol coming from the type of coenzyme involved (quinone).
CoQ10 plays two important roles in the body. First, it helps in the energy production needed by our organs to function properly. Second, it acts as a very powerful antioxidant against free radicals, which cause or contribute to various degenerative diseases. More than 90 percent of the energy from our cells is produced from the aerobic respiration that takes place in the mitochondria, tiny organs present in each human cell. CoQ10 facilitates the electron transfer in the mitochondria for the production of adenosine triphosphate (ATP), the usable unit of energy. ATP is the basic building block of the energy needed for the functioning of each cell and the life of the entire body. As an antioxidant, CoQ10 has been well researched and shown to be as effective as alpha-tocopherol, one of the strongest antioxidants available.
While CoQ10 is found in virtually every cell in the body, its concentration varies depending on the tissue type and location. The heart contains more CoQ10 than any other organ in the body. Other major organs such as the liver require large amounts of CoQ10 to produce the energy needed to function properly. Therefore, CoQ10 deficiencies are likely to first affect the heart and other large organs; but effects due to a lack of CoQ10 may be seen in any organ, tissue, or system in the body—the brain, kidneys, lungs, pancreas, periodontal tissues, immune system, and so forth.
Researchers have demonstrated that CoQ10 deficiencies are more prevalent with age. As we grow older, we are no longer able to produce CoQ10 from the food in our diet. This is because as we age, the body loses its efficiency in manufacturing important nutrients. Hence, even though the young may be able to get enough CoQ10 by making it and ingesting it through diet, a gradual deficiency may develop as we reach middle age and beyond. In addition, people with serious diseases (such as heart disease and cancer) tend to have low CoQ10 levels. Consumed regularly, CoQ10 fights off the aging process as it contributes to greater health and longevity.
CoQ10 provides valuable protection from oxidative damage occurring in fat-soluble media, such as cell membranes, which are composed of fatty acids. CoQ10 also works with vitamin E to prevent damage to lipid membranes and plasma lipids. Like other antioxidants, CoQ10 also offers protection against the accumulation and deposit of oxidized fats in blood vessels, which can lead to atherosclerosis. CoQ10 prevents the lipid peroxidation of lipoproteins, and that is how it protects our arteries from plaque formation and other damage.
Many doctors in Europe recommend CoQ10 to patients with Cardiovascular Disease (CVD). In Japan, since the late 1970s, CoQ10 has been widely accepted as a preventative supplement and as a treatment for those with heart-related conditions. Since 1982, CoQ10 has rivaled that country’s top five medications in consumption. For years, the Japanese have led the world in research on this amazing nutrient.
As a heart strengthener, an energy promoter, and an aging fighter, CoQ10 is just as vital to our bodies as vitamins C and E.
CoQ10 dietary supplementation must be seriously considered by those individuals who are under a cholesterol-lowering treatment or regimen that controls the amount of cholesterol produced by the enzyme HMG-CoA reductase in the liver. These treatments or regimens include, but are not limited to, the commonly used statin drugs and the dietary supplement red yeast rice.
Recent News about Antioxidants
In February 2007, the Cochrane Collaboration, a health organization based at Copenhagen University Hospital in Denmark, published a report on antioxidants and mortality. The report was compiled, using a statistical technique called meta-analysis, by Goran Bjelakovic at Serbia’s Hepato-Biliary Group. For the new report on antioxidants, the researchers first analyzed 68 studies involving 232,606 people and found no significant effect on mortality. However, when they eliminated the lower-quality studies and focused only on the higher-quality ones, researchers believe they found a higher risk of death for some people: 4 percent for those taking vitamin E, 7 percent for beta-carotene, and 16 percent for vitamin A. Dr. Christian Gluud, a spokesperson for the Copenhagen University Hospital, said, “The main message is that prevention by beta-carotene, vitamin A and vitamin E cannot be recommended. These three antioxidants may increase mortality.”
Some experts who reviewed the antioxidants mortality report were dismissive of the increased death risk and the analysis overall, saying it pooled studies that were too diverse. Meir Stampfer, professor of nutrition and epidemiology at the Harvard University School of Public health, said the new analysis hasn’t discouraged him from taking his vitamins. Stampfer stated that the studies analyzed were too diverse to pool together because they study the effects of various combinations of doses of antioxidants tested in different groups of people. The trials ranged from a three-month study of 109 elderly nursing home residents to a 12-year study of 22,071 male doctors. “This study does not advance our understanding and could easily lead to misinterpretation of the data,” Stampfer said. The complaint was backed up by Andrew Shao, a spokesperson for the Council of Responsible Nutrition, a dietary supplement trade association. “Only when they included and excluded certain trials they were able to find this alleged increase in mortality, which they cannot explain,” Shao said. “There is plenty of data out there that show regular use of antioxidant supplements help to maintain health.”
The Cochrane report on antioxidants and mortality has caused so much controversy in the nutrition and medical communities that the institution has decided to review and publish a revised report in the future at an unannounced date. Many years might pass before we have final recommendations on antioxidants. For that reason it might be best, as stated by Alice Lichtenstein, a professor of nutrition science at Tufts University who was not involved with the report, to “rely on food to get your nutrients.”
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Nutrition Summary
To promote healthy cholesterol levels, and in turn promote cardiovascular health, you should complement a healthy diet with the following antioxidants: foods containing vitamin A as beta-carotene, vitamin C, vitamin E, and selenium. You should also consider taking the recommended daily/dietary allowance (RDA) of the following minerals: chromium, magnesium, calcium, copper, and zinc. If you are not eating enough fish and seafood, you should also consider taking omega-3 oils as a dietary supplement.
Taking the RDA of nutrients is a necessary and important step that will help you promote cardiovascular health. Since our internal organs sometimes have problems absorbing one or more vitamins or minerals from the food we eat, you should consider having a reputable laboratory perform a total blood chemistry analysis and then take the results to a consultation with a licensed nutritionist, who will adapt the general suggestions outlined on this page to your particular needs.
Important hints:
- It is not recommended to take multivitamin or multimineral dietary supplements since they might contain nutrient levels that might exceed the safe limits for your particular situation. It is always better to take the individual nutrients your body requires, and only a licensed nutritionist can help you with this.
- To guarantee the safety and effectiveness of any dietary supplement, you should consider consuming only reputable brands, because such brands are more likely to follow good manufacturing practices (GMP) in their products. Some dietary supplements are manufactured by companies with low standards and therefore you might end up buying products that do not contain the indicated dosages (effectiveness problems), or worst yet, the dietary supplements can contain ingredients harmful to your health. Choose the manufacturer or supplier of your dietary supplements carefully. Do your homework and research the company and its manufacturing standards.
Source: Some of the information presented above on this page is based on information originally published in the book Natural Ways to Lower Your Cholesterol, by Norman D. Ford. The book summarizes scientific positions about the most important nutrients that promote healthy levels of cholesterol.
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