Antioxidants and Aging

Written by Dr. Steve Chaney on . Posted in current health articles, Healthy Lifestyle, Healthy Living, Supplements and Health

Author: Dr. Stephen Chaney

 

antioxidant agingModern medicine has helped mankind greatly extend our lifespan, but what about our “healthspan”? Aging is often associated with major degenerative diseases and loss of physical and mental functioning. As the saying goes: “Aging isn’t for sissies”. But, what if you could live healthy into your 80s and 90s? What if you had the health to truly enjoy the wisdom that comes with your years of experience?  In this article we will explore antioxidants and aging.

While healthy aging is a very personal issue for all of us in our golden years, it is a very important societal issue as well. The United Nations estimates that by 2050 more than 1/3 of the population of developed countries will be over 60. Unless we can find a way to preserve the health of these older adults, health care costs will bankrupt even the richest of countries.

That’s why the recently published study on the effect of antioxidant supplements on healthy aging in French adults (Assmann et al, American Journal of Epidemiology, 182: 694-704, 2015) is so interesting.

How Was The Study Designed?

studyThis study was a follow-up to the “Supplementation With Antioxidant Vitamins and Minerals” study that was conducted in France during 1994-2002. That was a double blind, placebo controlled study in which participants were given either a placebo or a supplement containing 120 mg of vitamin C, 6 mg of beta-carotene, 30 mg of vitamin E, 100 ug of selenium, and 20 mg of zinc every day for an eight-year period. These nutrient levels were designed to be equivalent to the quantities provided by a balanced diet rich in fruits and vegetables.

The follow-up study was conducted approximately 5 years later with 3,996 of the original participants. The investigators specifically selected participants who were disease free when they entered the original study. These study participants were equally divided between men and women and had an average age of 65.3 years.

The participants were put through a battery of screens and assigned a “healthy aging score” based on:

  • Absence of cancer, heart disease and diabetes
  • Good physical and cognitive function
  • No limitations in activities associated with daily living
  • No depressive symptoms
  • No health-related limitations in social life
  • Good overall perceived health
  • No function-limiting pain

In short those participants with a high healthy aging score had good health and good quality of life.

Are Antioxidants the Secret to Healthy Aging?

antioxidant nutrientsWhen the investigators looked at the group as a whole, the results were pretty discouraging:

  • Antioxidant supplementation provided no significant benefit to the population as a whole.
  • Antioxidant supplementation also provided no significant benefit to the women in the group.

However, when they looked at subgroups, the results were much more encouraging:

  • Antioxidant supplementation increased the probability of healthy aging by 18% for the men in the study.
  • For those participants with low serum vitamin C levels at the beginning of the study antioxidant supplementation increased the probability of healthy aging by 28%
  • For those participants with low serum zinc levels at the beginning of the study antioxidant supplementation increased the probability of healthy aging by 26%
  • For those participants consuming very few fruits and vegetables at the beginning of the study, antioxidant supplementation increased the probability of healthy aging by 17%

The conflicting results for men and women were puzzling, but the investigators pointed out that very few women had low serum vitamin C status at the beginning of the study, while 25% of the men had low serum vitamin C levels at the beginning of the study. The investigators speculated that supplementation may have been less effective in women simply because they had better diets than the men in the study. That certainly wouldn’t surprise me.

What Are The Strengths And Weaknesses Of This Study?

Let’s start with the strengths. This is the very first double-blind, placebo-controlled study to look at the role of antioxidant nutrients in healthy aging. A number of previous studies looking at the effect of antioxidant nutrients on individual components of aging have given conflicting results. The investigators pointed out that this study may have shown more beneficial effects of antioxidants than previous studies because:

  • Most previous studies have been relatively short in duration. This was an 8-year study with a 5-year follow-up period (total study length = 13 years).
  • Most previous studies did not measure baseline intake of the nutrients. This study shows that individuals with low baseline intake or low serum levels at the beginning of the study are significantly more likely to benefit from supplementation.
  • Most previous studies have measured the effects of single antioxidant nutrients, or at most combinations of 2 or 3 antioxidant nutrients. This study used a combination of 5 different antioxidant nutrients. The synergy between these nutrients may have increased the magnitude of the observed benefits.

The weaknesses of the study are also pretty apparent.

  • Since it is the first study of its kind, it does need to be validated by additional studies.
  • There is no universally accepted index for healthy aging (This is a problem for aging research as a whole, not just this study).
  • The participants in the study were not evaluated for healthy aging criteria at the beginning of the study so we have no idea how their healthy aging score changed over time.
  • The beneficial effect of antioxidant nutrients, while significant, were relatively small. You are obviously not going to live healthy to 100 by consuming antioxidant supplements alone.

Antioxidants and Aging:  Will Antioxidant Nutrients Help You?

aging gracefullyThis study does suggest that antioxidant supplements may help you achieve healthy aging. This study also makes three other very important points:

  • A holistic approach to supplementation – one involving multiple antioxidant nutrients – is much more likely to be beneficial than individual antioxidant supplements.
  • Supplementation is most likely to be beneficial for those individuals who are consuming a poor diet.
  • Supplementation is also most likely to be beneficial for those individuals who have low serum level of essential nutrients. This can be due to poor diet, but low serum levels of individual nutrients can also be caused by individual differences in metabolism or genetic make-up.

However, as noted above:

  • The study has some weaknesses and needs to be repeated.
  • The beneficial effects of antioxidant nutrients were relatively small.

That means that holistic approaches to healthy aging are more likely to be beneficial than individual supplements. Based on what we currently know a holistic approach to healthy aging includes:

  • Consuming a combination of a balanced diet and supplementation that provides sufficient levels of all the essential nutrients, not just the antioxidant nutrients. This would include things like omega-3 fatty acids and polyphenols.
  • Avoiding saturated and trans fats, excess sugar, red and processed meats, which may have bad effects on your health.
  • Controlling your weight.
  • Staying mentally and physically active.
  • Maintaining strong social networks.
  • Maintaining a positive outlook on life.

 

The Bottom Line

  • A recent study suggests that antioxidant supplements may help you achieve healthy aging. This study also makes two other very important points:
  • A holistic approach to supplementation – one involving multiple antioxidant nutrients – is much more likely to be beneficial than individual antioxidant supplements.
  • Supplementation is most likely to be beneficial for those individuals who are consuming a poor diet and/or have low serum levels of essential nutrients.
  • Since the beneficial effect of antioxidant nutrients on healthy aging was relatively small, this suggests the antioxidant nutrients are just one part of a holistic approach to healthy aging that includes.
  • Consuming a combination of a balanced diet and supplementation that provides sufficient levels of all the essential nutrients, not just the antioxidant nutrients. This would include things like omega-3 fatty acids and polyphenols.
  • Avoiding saturated and trans fats, excess sugar, red and processed meats, which may have bad effects on your health.
  • Controlling your weight.
  • Staying mentally and physically active.
  • Maintaining strong social networks.
  • Maintaining a positive outlook on life.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Should You Avoid Sugar Completely?

Posted October 24, 2017 by Dr. Steve Chaney

Is It The Sugar, Or Is It The Food?

Author: Dr. Stephen Chaney

 

Should we avoid sugar completely?  Almost every expert agrees that Americans should cut down on the amount of sugar we are consuming. However, for some people this has become a “sugar phobia”. They have sworn that “sugar shall never touch their lips”. Not only do they avoid sugar sweetened sodas and junk food, but they also have become avid label readers. They scour the label of every food they see and reject foods they find any form of sugar listed as an ingredient. Is this degree of sugar avoidance justified?

 

Should We Avoid Sugar to Keep it From Killing Us?

 

Let me add some perspective:

  • If you just take studies about the dangers of sugar at face value, sugar does, indeed, look dangerous. Excess sugar consumption is associated with increased risk of obesity, diabetes, and heart disease. However, when you look a little closer, you find that most of these studies have been done by looking at the correlation of each of these conditions with sugar sweetened beverage consumption (sodas and fruit juices).

A few studies have looked at the correlation of obesity and disease with total “added sugar” consumption. However, 71.6% of added sugar in the American diet comes from sugar sweetened beverages and junk food. None of the studies have looked at the sugar from healthy foods like fruits, vegetables, and whole grains. That’s because there is ample evidence that these foods decrease the risk of obesity, diabetes, and heart disease.

  • For example, if apples had a nutrition label, it would list 16 grams of sugar in a medium 80 calorie apple, which corresponds to about 80% of the calories in that apple. The sugar in an apple is about the same proportion of fructose and glucose found in high fructose corn syrup. Apples are not unique. The nutrition label would read about the same on most other fruits. Does that mean you should avoid sugar from all fruits? I think not.

Avoid Sugar or Avoid Certain Foods

 

avoid sugar from junk foodsThe obvious question is: “Why are the same sugars, in about the same amounts, unhealthy in sodas and healthy in fruits?” Let’s go back to those studies I just mentioned—the ones that are often used to vilify sugars. They are all association studies, the association of sugar intake with obesity and various diseases.

The weakness of association studies is the association could be with something else that is tightly correlated with the variable (sugar intake) that you are measuring. Could it be the food that is the problem, not the sugar?

If we look at healthy foods (fruits, vegetables, whole grains) they are chock full of vitamins, minerals, phytonutrients, fiber, and (sometimes) protein. Fiber and protein slow the absorption of sugar into the bloodstream. As a result, blood sugar levels rise slowly and are sustained at relatively low levels for a substantial period of time.

In sodas there is nothing to slow the absorption of blood sugar. You get rapid rise in blood sugar followed by an equally rapid fall. The same is true of junk foods consisting primarily of sugar, refined flour and/or fat.  Avoid sugar from those types of foods.

Another consideration is something called caloric density. Here is a simple analogy. I used to explain the concept of caloric density to medical students in my teaching days. There are about the same number of calories in a 2-ounce candy bar and a pound of apples (around 278 in the 2-ounce candy bar and 237 in a pound of apples). You can eat a 2-ounce candy bar and still be hungry. If you eat a pound of apples you are done for a while. In this example, the 2-ounce candy bar had a high caloric density (a lot of calories in a small package). Perhaps a more familiar terminology would be the candy bar was just empty calories.

Are Sodas and Junk Foods Killing Us?

avoid sugar from candyPutting all that together, you can start to understand why the foods the sugars are in are more important than the sugars themselves. When you consume sugars in the form of sugar sweetened beverages or sugary junk foods, your appetite increases. We don’t know for sure whether it is the intense sweetness of those foods, the rapid increase and fall in blood sugar, or the high caloric density (lots of calories ina small package) that makes us hungrier. It doesn’t matter. We crave more food, and it isn’t usually fruits, vegetables, and complex carbohydrates we crave. It’s more junk. That sets in motion a predictable sequence of events.

  • We overeat. Those excess calories are stored as fat and we become obese. [Note: The low carb enthusiasts will tell you our fat stores come from carbohydrates alone. That is incorrect. All excess calories, whether from protein, fat, or carbohydrate, are stored as fat.]
  • It’s not just the fat you can see (belly fat) that is the problem. Some of that fat builds up in our liver and muscles. This sets up an unfortunate sequence of metabolic events.
  • The fat stores release inflammatory cytokines into our bloodstream. That causes inflammation. Inflammation increases the risk of many diseases including heart disease and cancer.
  • The fat stores also cause our cells to become resistant to insulin. That reduces the ability of our cells to take up glucose, which leads to hyperglycemia and type 2 diabetes. [Note: The low carb enthusiasts will tell you carbohydrates cause type 2 diabetes. That is also incorrect. It is our fat stores that cause insulin resistance and type 2 diabetes. Our fat stores come from all excess calories, not just excess calories from carbohydrates.]
  • Insulin resistance also causes the liver to overproduce cholesterol and triglycerides and pump them into the bloodstream. That increases the risk of heart disease.
  • Sugar sweetened beverages and sugary junk foods also displace healthier foods from our diet. That leads to potential nutrient shortfalls that can increase our risk of many diseases.

However, none of this has to happen. The one thing that every successful diet has in common is the elimination of sodas, junk foods, fast foods and convenience foods. You should avoid sugar from those foods as much as possible. Once you eliminate those from your diet,you significantly enhance your chances of being at a healthy weight and being healthy long term.

 

What About Protein Supplements And Similar Foods?

Of course, the dilemma is what you, as an intrepid label reader, should do about protein supplements, meal replacement bars, or snack bars. They are supposed to be healthy, but the label lists one or more sugars. Even worse, the sugar content is higher than your favorite health guru recommends.  So, should you avoid sugar from supplements and the like?

In this case, a more useful concept is glycemic index, which is a measure of the effect of the food on your blood sugar levels. Healthy foods like apples may have a high sugar content, but they havea low glycemic index.

avoid sugar and consume protein to slow absorbptionThe same is true for the protein supplements and bars you are considering. Rather than looking at the sugar content, you should be looking for the term “low glycemic” on the label. That means there is enough fiber and protein in the food to slow the absorption of sugar into the bloodstream and stabilize your blood sugar levels.

What Does This Mean For You?

Don’t misunderstand me. I am not advocating for unlimited consumption of sugar. We should work on ways to avoid sugar or reduce the amount of sugar in our diet. On the other hand, we don’t need to become so strict that we and our family need to eat foods that taste like cardboard. We also don’t want to replace natural sugars with artificial sweeteners. I have warned about the dangers of artificial sweeteners previously.

We can go a long way towards reducing sugar by just eliminating sodas, other sugar sweetened beverages, junk foods, fast foods, convenience foods, and pastries from our diet. When considering fast foods and convenience foods, we should check the label for hidden sugar. For example, some Starbucks drinks are mostly sugar. When considering foods that are supposed to be healthy, we should look for the term “low glycemic” on the label.

So we don’t have to avoid sugar completely, but we should reduce sugar from sugar sweetened beverages and junk food.

 

The Bottom Line

 

We need to keep warnings about the dangers of sugar in perspective:

  • The studies showing that sugar consumption leads to obesity, diabetes, and heart disease have all been done with sodas and junk foods.
  • Many fruits have just as much sugar as a soda. They also contain about the same proportion of fructose and glucose as high fructose corn syrup. Yet we know fruits are good for us.
  • Diets rich in fruits, vegetables and whole grains decrease our risk of obesity, diabetes, and heart disease.
  • That is because the sugar in whole foods is generally present along with fiber and protein, which slows the absorption of sugar and prevents the blood sugar spikes we get with sodas and junk foods.
  • In the case of prepared foods like protein supplements, you should look for “low glycemic” on the label rather than sugar content. Low glycemic means that there is enough fiber and protein in the product to slow the absorption of sugar and prevent blood sugar spikes.
  • Don’t misunderstand me. I am not advocating for unlimited consumption of sugar. We should all work on ways to avoid sugar from junk foods or to reduce the amount of sugar in our diet. On the other hand, we don’t need to become so strict that we and our family need to eat foods that taste like cardboard. We also don’t want to replace natural sugars with artificial sweeteners.
  • We can go a long way towards reducing sugar by just eliminating sodas, other sugar sweetened beverages, junk foods, fast foods, convenience foods, and pastries from our diet. When considering fast foods and convenience foods, we should check the label for hidden sugar. When considering foods that are supposed to be healthy, we should look for the term “low glycemic” on the label.

For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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