Don’t Let the Government Ban Your Vitamins
There are literally thousands of well-documented peer-reviewed studies supporting the health benefits of taking vitamins and other dietary supplements.
Yet, this does not stop the U.S. Food and Drug Administration (FDA) and our Congress (under the strong influence of Big Pharma’s multimillion-dollar lobbying machine) from going “vigilante” from time to time.
What do I mean? Well the FDA has threatened to classify some foods you probably have in your refrigerator or pantry right now, like cherries, yogurt or Cheerios, as “unapproved drugs.” All because the FDA feels the studies strongly supporting various health-related marketing claims weren’t done to their standards.
So antioxidant-rich cherries with their anti-inflammatory properties can’t be mentioned in any way that even remotely implies that this delicious and nutritious fruit will “treat, cure, or prevent any disease or condition.”
Dannon settled a dispute with the FDA by paying $21 million for advertising that their probiotic-rich Activia yogurt “helps regulate your digestive system… naturally.” A claim backed by substantial scientific evidence.
And despite clinical studies supporting the cholesterol-lowering benefits of Cheerios, the FDA was ready to label one of the best-selling breakfast cereals of all time an unapproved drug because of the specificity of some of the language printed on the box.
The maddening irony is that at the same time the FDA is lawyering up to hassle these companies over what amounts to no more than semantics, the powerful snack food lobby has persuaded the FDA that it is fine for Frito-Lay to say:
“You might be surprised at how much good stuff goes into your favorite snack. Good stuff like potatoes, which naturally contain vitamin C and essential minerals. Or corn, one of the world’s most popular grains, packed with thiamin, vitamin B6, and phosphorous – all necessary for healthy bones, teeth, nerves and muscles.”
Give me a break.
What’s even worse is that now, nearly two decades after passage of the Dietary Supplement Health and Education Act intended to facilitate the flow of safe and beneficial supplements directly to consumers, the FDA has proposed draconian measures on any supplement ingredients introduced after the enactment of this law some 18 years ago.
In order for these ingredients to remain in use, supplement manufacturers will need to conduct extremely expensive studies that will threaten the economic viability of many of these products. So, if implemented, some very effective supplements you may currently be taking could vanish from store shelves and supplement catalogues. (Be sure to contact your U.S. representatives and let them know you are against these new regulatory barriers on the vitamin and supplement industry.)
Our mission at Peak Health Advocate isn’t to pick fights with the FDA, but to bring you well-researched information based on substantial scientific evidence that can have a positive impact on your health and well-being.
And we are firm believers that this evidence clearly demonstrates the benefits of regularly taking vitamins and other dietary supplements – especially if you are not getting a sufficient supply of these vital nutrients on a daily basis from the food you eat.
And let’s face facts: It is nearly impossible to consume the level of vitamins and minerals needed for peak health from even a reasonably healthy diet.
So here in this report, we’ll summarize why dietary supplements are so important and give you the top seven supplements necessary for lifetime vitality.
Truth #1: We Are the Masters of Our Own Fate
Believe it or not, there are two simple and undisputable reasons for the premature death of two out of every three U.S. adults each year: nutrient deficiency and inadequate physical activity.
In fact, five of the top six causes of adult deaths in the United States — heart disease, cancer, lung disease, diabetes and stroke — are strongly correlated with these two risk factors/lifestyle choices. Nutrient deficiency and physical inactivity conspire to lower our immune defenses, and that’s where the rubber meets the road in the development of chronic health conditions and premature death.
Truth be told, our immune systems spend an inordinate amount of our precious energy and resources each day in a desperate and losing battle to simply counter the effects of these two lifestyle choices. The various cells and molecules in our immune systems exert so much effort in this daily battle that eventually they are overrun and two very bad things happen:
1. The lining of our vital pathways (blood vessels, intestines, airways) are breached, and once breached, our underlying cells are exposed to dangerous toxins for which they have no natural defenses.
2. Once these toxins exact their toll on our underlying cells, these underlying cells seem to forget their original purpose and fail to perform their assigned jobs. And, voilà, the stage is set for chronic diseases to develop.
It would take pages upon pages to provide you with a comprehensive explanation of how this happens in the body, but we will offer two examples in the Appendix of this report. However, you can trust that the path to ruin is nearly identical in the five major diseases listed above, even though the specific protagonists and antagonists might be different in each disease.
The takeaway is this: We can make a meaningful difference in how we feel, how our bodies age, and how long we live by improving the quality of the nutrients we consume and the amount of daily physical activity in which we engage. And, in our opinion, dietary supplements have an important role to play in supporting both endeavors.
Truth #2: Think Robin, Not Batman
If you’re serious about reducing the risk of developing one or more of the five leading chronic diseases mentioned above, it is of high value to increase daily physical activity, substitute healthy foods for unhealthy ones, and complement both actions by adding targeted dietary supplements to provide your body with extra support.
And that’s really the purpose of dietary supplements — to complement taking the right steps to manage your health, i.e., improving diet and exercise habits. Supplements are not magic bullets, cures or substitutes for prescription drugs (at least in most cases). Alone, dietary supplements can make some difference, but to make a long-term course-correcting alteration in how you feel, it is crucial to also adopt healthier diet and exercise habits.
In other words, dietary supplements are Robin to diet and exercise’s Batman. All are caped crusaders fighting for justice in your body, but diet and exercise are the real heroes with the superpowers to fell evildoers. Dietary supplements, like Robin, are there to drive the car, send for additional help, and step in to deal with an unexpected or unseen foe while Batman has his back turned to confront the main enemies.
This is especially true if you have already been diagnosed with one or more of the five major diseases listed above. With each and every one of these conditions, changing your diet and exercise habits alone can substantially lower your mortality risk and improve your quality of life, but certain dietary supplements can make the work of diet and exercise easier to accomplish.
The seven core dietary supplements we will describe in this report are intended to do just that — act as supporting cast members for the main protagonists, diet and exercise.
Truth #3: Zero-Hour Conversions
In a popular book about the D-Day invasion, the author recounted a story that reminds me of the skepticism doctors often display toward dietary supplements. Picture this scene: A group of soldiers boarding a landing craft on their way to storm the beach. On the dock, a chaplain is bestowing God’s blessing on the troops for a successful campaign and a safe return. As one soldier bows his head to receive the blessing, he notices one of his mates doing the same. Puzzled, the soldier exclaims, “Hey, I thought you said you didn’t believe in God.” In perfect deadpan, the mate replies, “I don’t, but I figure just in case I’m wrong it can’t hurt.”
Such is the truth behind the disparity of actions and words spoken by many doctors. According to a recent research paper published in the Journal of Nutrition, approximately 70 percent of U.S. adults are at least occasional consumers of one or more dietary supplements. But despite the widespread use and growing interest in dietary supplements, many physicians and medical researchers remain skeptical of the benefits associated with supplemental vitamins, minerals, antioxidant compounds and herbal preparations.
Why the skepticism? A large dose comes from the scarce amount of independent, peer-reviewed, published studies that the scientific community deems convincing, i.e., double-blind, randomized control studies using well-characterized, large groups of live humans that prove beyond a shadow of doubt the efficacy of supplemental dietary ingredients and that have been confirmed by similarly constructed follow-on studies.
You see, most of the published dietary supplement research has been conducted on laboratory animals and human tissue samples. This is because it is easier and less expensive to control the variables that might affect the outcome of a research investigation by using a homogeneous population in a controlled environment. While the results of many of these studies have been compelling, follow-on studies using live human subjects have not consistently shown the same effects. Further, even if researchers were convinced by the results of lab animal and/or tissue studies, these studies don’t provide much in the way of guidance in terms of effective dosage recommendations for humans.
What’s more, some dietary supplement marketers do themselves further harm in physicians’ and scientists’ eyes by making wild, unfounded claims about the effectiveness of their products that are not supported by research at all be it live human, live animal, tissue or otherwise.
These are legitimate concerns, and we’re not trying to paint traditional medical practitioners as unreasonable in their reservations about the usefulness of dietary supplements. But did you know that a Nutrition Journal study found that approximately 68 percent of specialist physicians participating in their study use dietary supplements at least occasionally, with a significant majority of this group regularly consuming dietary supplements. Further, the same research team reported that 72 percent of doctors and 89 percent of nurses participating in a separate 2009 study were at least occasional consumers of dietary supplements.
The attentive reader will notice that medical practitioners therefore consume dietary supplements at nearly the same level, if not higher, than the rest of us! Now why would they do this if they thought dietary supplements offered no redeeming value?
The simple answer is this: Despite sometimes conflicting and incomplete scientific evidence in dietary supplement studies, there is enough convincing research to warrant taking them “just in case.”
Therefore, as you read this Special Report, please keep in mind that while there is an undercurrent of scientific skepticism regarding dietary supplement use and differing views on dosage recommendations, the scientific evidence for many dietary ingredients is strong enough that physicians and nurses themselves utilize supplements in much the same way as the rest of us.
Truth #4: Diet and Exercise Alone May Not be Enough
Engaging in regular physical activity and consistently consuming a nutrient-rich diet are two obvious steps any person can take to receive significant protective health benefits. Many research studies have shown that those who exercise at a moderate intensity 30 minutes per day, five days a week, have a substantially lower risk of developing chronic disease and lower mortality rates than those who exercise less than three days a week. In fact, one recent study reported finding an approximately 19 percent lower mortality risk from a moderate exercise program.
Similarly, many research studies have shown that consuming a diet high in fruits, vegetables, nuts, whole grains, fish/seafood, olive oil and red wine, commonly referred to as a “Mediterranean diet,” results in substantially lower incidences of chronic disease and a 50 percent lower mortality rate than a Western-style diet, i.e., one that consists of large amounts of red meat, sugar/salt-laden processed foods, and foods with high saturated fat content.
This Mediterranean-style diet has been linked to substantially lower incidences of heart disease, stroke, lung disease and diabetes in the populations of the southern Mediterranean countries of Spain, Portugal, Italy, Greece and France, in comparison to other developed countries including the United States. Further, these countries, with the exception of Italy and France, have slightly lower cancer incidence compared with other developed countries. Researchers point to the Mediterranean diet and declare, “Aha! Following a Mediterranean diet will help to prevent heart disease, stroke, diabetes and cancer.” And there is good reason to make this declaration when one considers that among European nations, the populations of the southern Mediterranean countries are the least physically active. For those interested, there is an interesting graphical presentation of disease risk by country as determined by the World Health Organization, which you can view by clicking here.
But are diet and exercise enough? Many physicians would say, “Yes, these two steps alone are more than adequate to protect your long-term health.” This certainly seems like a reasonable conclusion based on research evidence if you’ve followed both recommendations for most of your life. But many people (OK, most people) haven’t been so devout with their exercise and diet habits over their lifetime. For those of us in this category, adopting healthier exercise and diet habits are surely helpful, but we’ve likely already inflicted damage from unhealthy lifestyle behaviors over time that suggest we need to take some extra steps beyond dietary and exercise changes. This is especially true for those unwilling or unable to adopt and sustain healthier exercise and dietary habits, and those who’ve already developed chronic health conditions.
To wit, many research studies have found profound nutrient deficiencies among people who have already developed chronic health conditions. Take vitamin D, for example. A 2010 study of smokers and patients with chronic obstructive pulmonary disease (COPD) showed 31 percent of smokers in the study with normal lung function were considered deficient in vitamin D, and up to 77 percent of participating severe COPD patients were vitamin D deficient. In a 2011 study of patients who’d suffered heart attacks, 75 percent were found to be vitamin D deficient. Further still, 34 percent of type-2 diabetes patients participating in a separate 2011 study were shown to be vitamin D deficient. Finally, in a recent study examining vitamin D status in 224 breast cancer patients, researchers found 67 percent were deficient in this vital nutrient.
Looking at vitamin C deficiency, a 2005 study of Americans with advanced cancer showed 30 percent were deficient in vitamin C. In a 2000 study of non-smoking American adults, researchers found a 57 percent higher risk of death from heart attack and a 62 percent higher risk of death from cancer among men who had the lowest plasma concentrations of vitamin C. We could go on with more study citations detailing core nutrient deficiencies in various populations, but we think you get the point.
So while the deficiency percentages vary by nutrient for different chronic health conditions, and not all nutrients are found to be deficient in all chronic health conditions, there is enough research evidence to suggest a connection between the development of chronic disease and nutrient deficiency.
Knowing that many people will not or cannot adapt their exercise and dietary habits to address these deficiencies, scientists turned to the study of dietary supplements to help fill the gap. Many studies have shown promise in supplementing key nutrients in various chronic health conditions, although, to be fair and balanced, study results for a number of nutrients have been mixed. Yet scientists continue to invest time and energy into dietary supplement research given the intuitive link between nutritional deficiencies and the underlying mechanisms of inflammation and oxidative stress (more on these two topics later in this report). In the meantime, 70 percent-plus of practicing physicians are taking dietary supplements themselves … just in case.
Truth #5: It’s Never Too Late
Sometimes we get down on ourselves and feel like it’s too late to make a change. Maybe you’ve already developed heart disease. Maybe you’ve been overweight for so long that you can’t see yourself ever being thin again. Or maybe you’ve convinced yourself that at your age it doesn’t seem worth it to try to change.
Please don’t resign yourself to this point of view. The human body is remarkable in its innate desire to heal. If you provide the right combination of inputs, your body will perk up, take notice and respond. It doesn’t necessarily mean that disease is stopped or reversed overnight, because the health habits that lead to chronic disease don’t happen overnight either. That said, every step you take in the right direction to improve your diet and exercise habits is indeed recognized and acted upon quite quickly in your body.
For example, in studies examining the impact of exercise programs on people with severe lung disease, heart disease and cancer, multiple studies have shown pronounced improvements in basic physical functioning and reported quality of life among participants. As a case in point, a recent research study examining the effects of pulmonary rehabilitation among COPD patients with varying disease severity found that even the most severe COPD patients experienced improved respiratory symptoms and reported higher quality of life.
The same type of effect has been observed in people with chronic disease conditions who adopt healthier diets. For example, a 2010 study explored the impact of adopting a Mediterranean-style diet among patients who had survived a heart attack. The researchers found that patients who adopted more daily components of the Mediterranean-style diet saw their cardiovascular inflammation risk markers (C-reactive protein and interleukin-6) fall significantly in comparison to heart attack survivors who did not.
In our opinion, dietary supplements combined with a healthier diet and regular physical activity program can help stir these processes into action, facilitate the body’s ability to utilize higher quality nutrients, and boost the benefits of your exercise program.
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The core of our dietary supplement recommendations are based on the following philosophy:
Before any dietary nutrient can help your body, it must be absorbed.
To us, this means the first way a dietary supplement can lend assistance in your personal health program is to help clear your digestive system of built-up, non-nutritious matter, rebalance the bacterial balance of your gastric tract, and supplement the digestive enzymes that help you break down and absorb nutrients. To accomplish these tasks, we recommend adding greens/fiber and a probiotic supplement to your daily routine.
With improved digestive function, the next step is to address the deficiencies of core vitamins and minerals by adding a multi-nutrient.
We prefer a hi-potency multi-nutrient, i.e., one that goes beyond the minimum recommended dosage as promulgated by the National Academy of Sciences, for most of the ingredients included in the multi-nutrient. Why? Because the vast majority of us are already starting off in a nutrient-deficient position. Taking the bare minimum supplementation is unlikely to do more than narrow the gap. Of particular note, we will discuss vitamin D.
Finally, you can help to relieve stress on your immune system by supplementing your diet with targeted antioxidants that are inexplicably not on the government’s list of minimum nutrition requirements and, therefore, do not appear in most one-a-day type multi-nutrients.
These targeted antioxidants are used widely and effectively in your body to lower oxidative stress and inflammation. They include N-acetylcysteine (NAC), coenzyme Q10 (CoQ10), omega-3 fatty acids and resveratrol. NAC, omega-3 fatty acids and CoQ10 have also been shown to boost exercise capacity.
As you consider our recommendations, please keep in mind that it is always a prudent measure to discuss dietary supplements you’d like to try with your physician prior to taking them. Yes, you may find your doctor scoffs at the specific supplements you discuss, but it’s important to make sure there are no counter-indications with other medications you are taking and/or with specific aspects of your particular medical status.
Poor digestive health is a major problem in America. Fueled by bad diets, the side effects of prescription drugs, sedentary lifestyles, and the normal decline of digestive system efficiency associated with aging, many people suffer from uncomfortable gastric issues.
Such issues run the gamut of:
- Infrequent bowel movements
- Persistent gas buildup/bloating/constipation
- Irritable bowel syndrome
Most often, these conditions occur because either we are not clearing the food we consume through our digestive systems quickly enough, or because we have upset the proper balance of digestive bacteria in our gastric tracts. And when you are suffering from one or more of these conditions, you tend to restrict your activities, feel lethargic and irritable, and struggle to sleep. Sound familiar?
To relieve bloating or blockage, many people take laxatives. But laxatives are really just a short-term Band-Aid. They do nothing to address the core issues causing the problems. A better long-term strategy is to boost fiber-rich foods in your daily diet and engage in regular physical activity. Both actions help the body move food though the digestive tract with greater ease and speed. We recommend fiber-rich foods commonly found in a Mediterranean-style diet, including raw fruits and vegetables, nuts, beans, and whole grain breads, pasta and cereals. For people who cannot envision consistently ingesting the recommended 7-10 daily servings of the fiber-rich foods just mentioned, we suggest complementing your daily servings with a greens dietary supplement that is fortified with fiber.
A greens/fiber supplement will generally come in a powdered form that you scoop into a glass of water or fruit juice (although some greens formulas are available in capsule form). The powder contains granules of various fruits, vegetables and grasses. Typically, these products also contain a sampling of digestive enzymes. A greens/fiber supplement assists your body in three ways:
1. The fiber content and digestive enzymes aid in quicker absorption and digestion, meaning food clears your digestive tract at a faster pace.
2. The combination of the greens and fiber help create softer stool that moves through your digestive tract more easily and with less discomfort.
3. The antioxidant content of the greens help support the body’s fight against oxidative stress (we’ll explain more about this in the antioxidant section of this report).
While you will quickly notice an improvement in your digestion from adding a greens/fiber supplement to your daily routine, don’t fool yourself into thinking that you can skip eating fiber-rich foods altogether. A daily dose of a greens/fiber supplement will generally provide the equivalent nutritional content of 3-5 servings of fruits/vegetables and 2-3 grams of fiber. The National Academy of Sciences considers 30-38 grams of total dietary fiber daily adequate for men and 21-25 daily grams for women, so the fiber in most greens formulas represents a small portion of your daily needs. In other words, a greens/fiber product is not an outright substitute for raw fruits, vegetables, nuts, beans and whole grains.
Most scientists who study dietary supplements caution their findings by recommending that food sources of vital nutrients are preferred because they believe the interactions of the various elements of fiber and nutrients contained in raw foods are more effective than the extracts of these key nutrients typically found in dietary supplements. While the research evidence supporting these scientists’ position is thin (i.e., there are few studies that definitively demonstrate that food-based nutrition is more effective than concentrated extracts of the key nutrients in dietary supplements), we agree that entirely eschewing raw fruits, vegetables, etc., in favor of dietary supplements is likely not healthy for antioxidant protection and digestion.
A greens/fiber supplement is really intended to complement the raw, fiber-rich foods already in your diet and help fill the gap when you can’t reasonably eat 7-10 servings of these foods each day.
But this is only half of the solution to a healthy digestive system. The other big issue most people with gastric problems face is an imbalance of the bacteria in the intestines that assist in breaking down food and removing unfriendly toxins. These “body friendly” bacteria are known as probiotics.
Certain lifestyle behaviors, bacteria, fungi, diseases, prescription medications and other foreign substances absorbed by the body can reduce the number of “friendly” probiotic organisms or overwhelm them with higher numbers of “unfriendly” organisms. When this happens, it can slow down your system (constipation) or send food racing through partially digested (diarrhea).
So a second valuable step you can take to improve your digestive health is to add probiotic foods and/or a probiotic dietary supplement to your daily diet. By providing your body with a refreshed source of digestive system friendly bacteria, you can help offset lifestyle behaviors and other influences that disrupt how your body absorbs, processes and clears food.
Good probiotic food sources include:
- Yogurt (with live or active bacteria cultures)
- Miso soup
- Gouda cheese
In addition to their digestion-aiding properties, probiotic dietary supplements have also been studied for their antioxidant and immune-supporting properties.
For those interested in trying a probiotic dietary supplement, look for products that contain live cultures of the three most common strains of gut-friendly bacteria: lactobacillus acidophilus, bifidobacterium longum and bifidobacterium bifidum. The supplement facts box on the bottle should identify the bacteria strains in any reputable probiotic product.
We tend to prefer probiotics in “pearl” form because they are smaller and easier to swallow than coarse capsules. In addition, the protective pearl coating helps it to pass through the stomach and into the intestines before fully opening, which allows most of the live bacteria to be deposited into the intestines where they do their work (as compared to capsules or tablets, which are partially digested in the stomach). That said, some, but not all, of the capsule/tablet forms of probiotics incorporate coatings that allow more of the probiotics bacteria to be released in the intestines for those who prefer them to pearls. In addition, some greens/fiber dietary supplements also contain probiotic cultures in powder form.
Combined with a greens/fiber dietary supplement, a probiotic can make a big difference in your digestive system performance and in how you feel and live each day. A healthy digestive system that has balanced bacteria levels, and absorbs, processes and clears food quickly, can provide you with greater energy, help you sleep better, and improve your disposition — mentally, emotionally and physically!
These first two important steps also help set the stage for better nutrient absorption for key vitamins and minerals our bodies need to support and regulate a host of functions. The next step in our recommendation is to add a high-potency multi-nutrient to your daily routine.
Over the years, the National Academy of Sciences has created and refined a list of basic vitamins and minerals and their respective dosages that all adults should consume on a daily basis. These guidelines are now referred to as dietary reference intakes (DRI), but were called recommended daily allowances (RDA) in the past.
DRIs have been established for the following vitamins and minerals:
Pantothenic Acid (B5)
The adult DRI levels of these vitamins and minerals established by the NAS are considered to be “adequate” for 97 percent to 98 percent of our population. (You can view the specific recommended daily DRI dosages by clicking here.) Most one-a-day type multi-nutrients provide 70 percent to 100 percent of these DRI levels, so one would think this would be sufficient for most people when combined with additional vitamins and minerals consumed in food.
But here’s the problem: When scientists look at blood plasma levels of many of these basic vitamins and minerals in adults with chronic health conditions, they find a significant portion of the respective populations are deficient in one or more nutrients. (To be clear, these studies consider “insufficient” to mean a little lower than adequate, while “deficient” means much lower than adequate.) We noted some of these research-reported deficiencies in the introduction of this report.
We know what you’re thinking — if one consumes a diet that contains the government-recommended level of five servings of fruits and vegetables per day, and if one participates in a regular exercise program 30 minutes a day, three to five days a week, how are these deficiencies possible?
Well, for starters, a significant portion of our population does not consume an optimal diet nor exercise on a regular basis. And beyond poor exercise and dietary habits, there are other lifestyle factors that conspire to scavenge our available nutrients, leaving us in a deficit position, including:
- The existing presence of chronic health conditions
- The efficiency/effectiveness of the digestive tract
- Use of one or more prescription medication on a regular basis
- Inadequate exposure to direct sunlight
- Cigarette smoke and industrial pollution
- Excessive alcohol and/or illegal narcotics
That’s why, in our opinion, it is of value to consider taking a high-potency multi-nutrient that provides daily dosages in excess of the DRI for a number of the core vitamins and minerals categorized by the NAS.
When selecting your multi-nutrient, look for one that provides, at minimum, higher than 100 percent of the DRI for key nutrients such as vitamin C, vitamin D, vitamin E, selenium and zinc. Some formulas will also have more than 100 percent of vitamin A, folate, and other B-complex vitamins. There is no perfect combination of these higher-than-DRI dosages (at least no study has been published demonstrating such), and one should be wary of formulas with individual ingredients that are more than 1,000 percent of the DRI for that ingredient. In general, most high-potency multi-nutrients that are not targeted for a specific health condition will provide 100 percent to 500 percent of the DRI for the ingredients highlighted here.
In our opinion, the most critical vitamin found in a multi-nutrient is vitamin D. Reams of recent research reveal strong links between vitamin D deficiency and chronic health conditions (see our introductory section for study citations supporting this point). And vitamin D deficiency has become widespread as people spend less time in direct sunlight.
OK, so we’ve dealt with improving your digestive function and providing an adequate amount of supporting basic vitamins and minerals to complement your program of regular physical activity and a Mediterranean-style diet. Now it’s time to talk more in depth about oxidative stress, inflammation and antioxidants, and in particular, N-acetylcysteine (NAC), coenzyme Q10 (CoQ10), omega-3 fatty acids (sometimes referred to as fish oil or EPA/DHA fatty acids) and resveratrol. These four antioxidants are incredibly powerful, widely and easily processed/used by the human body, have significant bodies of published research showing their effectiveness, and yet, unbelievably, are not part of the current DRIs.
Before we delve into the specific antioxidant recommendations that comprise #4 through #7 on our list of top supplements, let’s first discuss why antioxidants are important to begin with.
Each act the human body engages in requires energy at a cellular level. One side effect of the cellular process to create energy is the splitting of oxygen molecules. The splitting of naturally bound oxygen molecules results in the creation of free-floating, unstable oxygen particles known as “free radicals” (also referred to as “pro-oxidants”). Free radicals are like tiny shards of glass flowing through the blood vessels, airways and other pathways of your body. As they bounce off the walls of these passageways, free radicals nick up the smooth, protective lining along the walls (known as epithelial tissue), exposing the underlying tissue to toxins being cleared by the body through circulation, respiration and digestion.
Over time, these toxins degrade the integrity and function of the underlying tissue cells exposed by free radical damage, leading them to malfunction by failing to perform their intended purposes or by over-performing them. Both outcomes lead to inflammation (buildup of fluids, proteins and white blood cells) in the underlying tissue cells. Inflammation ultimately leads to depressed immunity and premature aging of the tissues, and sets the stage for chronic disease to develop. Scientists refer to the resulting imbalance between pro-oxidative molecules (bad guys) and antioxidant molecules (good guys) as “oxidative stress.”
In fact, oxidative stress is believed by many scientists to lie at the core of nearly all major chronic health conditions, including heart disease, stroke, lung disease, cancer and diabetes. (See the Appendix of this report for two examples of how oxidative stress and inflammation create the foundation for chronic diseases to develop.)
Thankfully, our bodies can consume and produce protective molecules known as antioxidants that bind to free radicals and neutralize their ability to nick up the lining of body passageways. One way to view antioxidants is as matching puzzle pieces that turn jagged-edged free radicals into harmless, round bouncing balls.
But here’s the problem: As we discussed in the multi-nutrient section, the average American adult does not consume enough antioxidants through diet to offset the ravaging effects of pro-oxidative free radicals.
Further, as we also discussed earlier, many of the behaviors we demonstrate on a daily basis increase the number of free radicals in our bodies and/or decrease the available supply of neutralizing antioxidants (poor sleep, lack of sunlight, lack of physical activity, smoking, drinking, prescription drug consumption, and fat/sugar centric diets to name a few).
So, for the vast majority of Americans, supplementing a diet that includes antioxidant-rich foods with a high-potency multi-nutrient and additional targeted antioxidants is beneficial.
Which targeted antioxidants make the most sense?
Our first targeted antioxidant is N-acetylcysteine (NAC). NAC is an amino acid that is easily and quickly processed by the human body to produce the most abundant antioxidant found in our bodies — glutathione. You might ask, why not just take a glutathione supplement directly?
Well, as it turns out, the human body does not absorb and utilize glutathione effectively when taken directly. Our bodies are much better at producing our own glutathione when we are provided precursors of the antioxidant. According to scientists, the most effective precursor in assisting the body’s production of glutathione is NAC. As an aside, another powerful precursor of glutathione is vitamin D. As we described in the multi-nutrient section, many Americans are vitamin D deficient. Therefore, supplementing both vitamin D and NAC is helpful in boosting glutathione production.
“Cysteine” family amino acids (of which NAC belongs) are found in many high-protein foods, including:
- Meats such as poultry and pork
- Oats, wheat germ and other whole grains
- Eggs, yogurt, whey protein and other dairy products
- Vegetables such as broccoli, onions and red peppers
Careful readers will note that the Mediterranean-style diet contains many sources of cysteine-family amino acids (i.e., whole grains, poultry and vegetables).
Given that glutathione is the most abundant antioxidant in our bodies, one would think that NAC would be on the government’s list of DRIs, but it does not appear. This is especially puzzling when one considers that glutathione deficiency has been found in studies examining chronic health conditions ranging from lung disease to macular degeneration.
NAC has been shown to be helpful in reducing oxidative stress in numerous studies and has also been shown to improve exercise tolerance in both healthy adults and those with certain chronic health conditions such as lung disease. Most human studies have evaluated NAC’s effectiveness at 600 mg to 1,200 mg daily dosages.
Below is some research that details the powerful effects of NAC:
NAC reduces inflammatory response of macrophages (white blood cells) exposed to bacteria. In this human cell study, researchers exposed macrophages to lipopolysaccharide molecules (these molecules form the outside covering of bacteria cells) causing the macrophages to release proteins known as cytokines that are present in significant concentrations during inflammation. The researchers then introduced NAC into this mixture to determine whether it had any impact on the cytokine population in the mixture. They discovered NAC significantly reduced the cytokine counts leading researchers to conclude NAC has an inflammation-reducing effect.
NAC improves inspiratory capacity and forced vital lung capacity in COPD patients engaged in an exercise program. In another study, 24 subjects were divided into two groups, one receiving 1,200 mg of NAC daily and the other receiving a placebo, and participated in a six-week exercise program. Then, the two groups switched supplementation regimens and again participated in a six-week exercise program. Researchers evaluated the inspiratory capacity and forced vital capacity of the two groups at rest and immediately after exercise. They discovered higher levels of both measures in the NAC supplementation groups and further determined the NAC groups experienced longer endurance times during exercise compared to the placebo groups.
NAC reduces respiratory muscle fatigue during heavy exercise. Eight healthy adults enrolled in a study engaged in heavy bouts of cardiovascular exercise. Forty-five minutes prior to exercise, half the study subjects were provided with 1,800 mg of NAC, and the other half were given a placebo supplement. Researchers evaluated respiratory performance (inspiratory pressure, expiratory pressure) before exercise and again every five minutes during exercise. They discovered the NAC group experienced significantly higher inspiratory pressure than the placebo group at 25 minutes and 30 minutes into exercise, leading the researchers to conclude that NAC reduced respiratory muscle fatigue during exercise.
NAC reduces oxidative stress in coronary artery cells of patients with arthrosclerosis. Cells that line the coronary arteries (endothelium) were extracted from 26 human subjects with known severe arthrosclerosis. The cells from each donor were divided into two lots with one lot receiving NAC and the other lot receiving no antioxidant supplementation. Approximately 100 days after NAC supplementation commenced, researchers analyzed the cells for known markers of oxidative stress and cell damage. They found that 58% of the patient cells receiving NAC experienced significant reduction in lipid peroxidation (sign of reduced oxidative stress) and maintained or elongated telomere length (sign of reduced cell DNA damage). Researchers concluded that NAC supplementation was beneficial for reducing the impact of oxidative stress and cell damage in coronary arteries for a majority of study subjects with severe coronary artery disease. As an aside, among the arthrosclerotic patient population in the study whose cells responded favorably to NAC supplementation, 93% had high cholesterol, 67% had high blood pressure, 13% were diabetic and 73% were either current or former smokers.
NAC’s ability to help fend off chronic health conditions ranging from oxidative stress to inflammation and improve exercise tolerance is why it’s the first of the targeted antioxidants we recommend.
 Palacio JR, et al. Inflammation Research. 2011 March 20 (epub ahead of print).
 Stav D, et al. Chest. 2009 August; 136(2): 381-386.
 Kelly MK, et al. Respir Physiol Neurobiol. 2009 January 1; 165(1): 67-72.
 Voghel G, et al. Mechanisms of Aging and Development. 2008 May; 129(5): 261–270.
The next targeted antioxidant we recommend is coenzyme Q10 (CoQ10). This antioxidant molecule is found in significant concentration in the mitochondria of most cells, because CoQ10 is an essential catalyst for the production of energy within cells. Its role is so important that CoQ10 is found in highest concentrations in the cells of our most intensely used organs, including the heart, liver and kidneys. We consume CoQ10 primarily in meats like beef, chicken and pork. Additionally, monounsaturated and polyunsaturated fats such as soybean oil and olive oil contain high concentrations of CoQ10.
Like with NAC, it is puzzling that CoQ10 does not appear on the government’s DRI list given its crucial role, especially in cardiovascular health. Indeed, scientists have found in a number of studies that people with chronic heart conditions are deficient in CoQ10 and that supplementing CoQ10 in these populations has been shown to reduce oxidative stress. Much like NAC, CoQ10 has also been shown to improve exercise tolerance in healthy adults, as well as those with cardiovascular and respiratory problems. Most human studies examining the benefits of CoQ10 have used 100 mg to 300 mg daily dosages. Supplemental CoQ10 can be found in multiple forms, but the most studied form is called ubiquinone.
Here are some highlights of recent CoQ10 research results:
CoQ10 supplementation improves multiple measures of cardiovascular function in patients with chronic heart failure (CHF). In this study, 21 subjects with CHF were divided into two groups (one receiving 100 mg of CoQ10 three times daily for four weeks, and the other receiving a placebo supplement for four weeks). After the initial four-week period and a washout period, the groups reversed supplementation routines for an additional four weeks. Then researchers evaluated several measures of cardiovascular performance (peak oxygen uptake, systolic wall thickening and ventricular ejection fraction). CoQ10 supplementation improved these performance measures between 12 percent and 15 percent among the study participants.
Mediterranean diet supplemented with CoQ10 reduces oxidative stress markers more than Mediterranean diet alone. In this study, researchers examined the differences in levels of an oxidative-stress-related protein among 20 participants. Each participant followed three different diets during the study. In one diet, subjects ate a typical Western-style diet (high in saturated fats, low in unsaturated fats). In another, subjects consumed a Mediterranean diet (high in unsaturated fats, low in saturated fats). In the final diet, subjects consumed the Mediterranean diet plus 200 mg of CoQ10 daily. The researchers drew blood samples after each diet and discovered the Mediterranean diet combined with CoQ10 demonstrated the least amount of the oxidative-stress-related protein. We wrote a more extensive article on this subject that you can view by clicking here.
Anti-fatigue effects of CoQ10 during physical exertion. In this study, 17 healthy subjects participated in maximum intensity exercise tests under three conditions. In one, the subjects received a placebo supplement for eight days prior to the exercise test. After a washout period, the same group performed the exercise test after eight days of CoQ10 supplementation at 100 mg daily dosage. Finally, the same exercise test was taken after another washout period, and then eight days of preceding CoQ10 supplementation at 300 mg per day. The researchers found the CoQ10 supplementation improved maximum workout velocity and reduced the fatigue sensation experienced by the study subjects. The most pronounced effects occurred with the 300 mg daily dosage.
 Belardinelli R, et al. Biofactors. 2005;25(1-4):137-145.
 Guitterez-Meriscal FM, et al. Age. 2011 March 15 (epub ahead of print).
 Mizuno K, et al. Nutrition. 2008 April; 24(4): 293-299.
The third targeted antioxidant we recommend is omega-3 fatty acids. It is often referred to as fish oil or EPA/DHA fatty acids, as many fish and other forms of seafood contain high levels, with salmon, tuna, mackerel and sardines being particularly rich. Omega-3 fatty acids are monounsaturated fats (considered to be healthy fats) that play a crucial role in the moderation of blood glucose, triglycerides and lipids (cholesterol).
Numerous studies of people with chronic cardiovascular and diabetic conditions who received supplemental omega-3 fatty acids experienced notably improved blood sugar, triglyceride and lipid levels. Further, other studies have shown that supplementing omega-3 fatty acids reduces markers for oxidative stress. Most human studies examining omega-3 fatty acids have used a 1,000 mg to 1,800 mg daily dosage.
Here is a sampling of recent omega-3 research results:
Omega-3 fatty acids supplementation impact on inflammation after exercise in untrained men. Forty-five men were divided into three groups, one receiving 1,800 mg of omega-3 fatty acids, one group receiving placebo, and a control group receiving no supplementation. All men participated in an eccentric exercise program, and researchers measured blood plasma inflammation markers before and after exercise. The omega-3 group demonstrated significantly less elevation in inflammation markers after the exercise program than either the placebo or control group.
Low levels of omega-3 fatty acids correlated with sudden cardiac arrest. Twenty-five sudden cardiac arrest survivors had their blood drawn shortly after physicians stabilized the patients. Researchers looked at blood plasma concentrations of omega-3 fatty acids and found depressed levels in these patients compared to healthy subjects and other study subjects who experienced a myocardial infarction (heart attack) without sudden cardiac arrest. The researchers noted an earlier study, which showed that providing patients with 1,000 mg of omega-3 fatty acids shortly after a heart attack reduced the risk of sudden cardiac-related deaths by 45 percent in the 3.5-year follow-up period.
Low-dose omega-3 fatty acids supplementation improves mild to moderate depression in elderly subjects. In this study, 66 subjects with an average age of 65 who suffered from mild to moderate depression were divided into two groups — one receiving 1,000 mg of omega-3 fatty acids daily, the other receiving a placebo supplement. Before and after the six-month study, the researchers asked the participants to complete a standardized depression questionnaire. They found the omega-3 group experienced statistically significant lower depression symptoms than the placebo group.
 Tartibian B, et al. Clinical Journal of Sports Medicine. 2011 March; 21(2):131-137.
 Aarsetoey H, et al. Lipids. 2011 February; 46(2):151-161.
 Tajalizadekhoob Y, et al. European Archives of Psychiatry & Clinical Neuroscience. 2011 February 12 (epub online ahead of print).
One last antioxidant that we believe is helpful in reducing oxidative stress is the polyphenol resveratrol. This antioxidant is commonly found in the skins and seeds of red grapes, blueberries, cranberries and peanuts, and the roots and leaves of certain herbs.
Resveratrol first received attention when scientists examined the diets of the southern Mediterranean populations seeking clues as to why there is such a low incidence of cardiovascular disease in these cultures despite the fact that the people of this region consume significant amounts of bread, pasta and fats. In examining the daily diet patterns of the region’s adult population, the researchers noticed the prevalence of whole grains (versus processed grains), monounsaturated and polyunsaturated fats (versus saturated fats), and red wine. In looking more closely at the components of red wine, researchers isolated resveratrol as an antioxidant with oxidative-stress-relieving properties.
While a range of research studies have demonstrated resveratrol’s impact on oxidative stress, most of these studies have been conducted on laboratory animals and human tissue samples versus live human subjects:
Resveratrol modifies cardiovascular risk factors in porcine model. A 2011 study found that Yorkshire pigs fed a high-cholesterol diet and supplemented with 100 mg/kg/day of resveratrol over a seven-week period had lower BMI, lower cholesterol, improved glucose tolerance and lower levels of a common inflammation marker, C-reactive protein in comparison to pigs fed the same diet but without supplemental resveratrol.
Resveratrol inhibits melanoma cell growth in murine model. A 2011 study found that laboratory mice injected with cancer cells and fed 1 mg/kg/day of resveratrol had 75 percent less liver melanoma cell growth compared to laboratory mice who were injected with the metastatic cancer cells alone.
Resveratrol improves oxidative stress and inflammation markers in diabetic mice. A 2010 study examined the impact of 20 mg/kg/day of supplemental resveratrol in healthy mice and mice with type-2 diabetes compared to control mice of both populations, which received no resveratrol. Results showed diabetic mice who received resveratrol had significantly higher levels of nitric oxide (an indicator of enhanced antioxidant activity) and significantly lower levels of the inflammation marker TNF (tumor necrosis factor).
Interestingly, when researchers have tried to test resveratrol in various dosages up to 5,000 mg per day in live human studies, they have been unable to produce results that demonstrate conclusively resveratrol’s effectiveness. This is in contrast to NAC, CoQ10 and omega-3 fatty acid supplementation where there have been a number of live human studies demonstrating efficacy in different measurements.
This contrast puzzles researchers because the average glass of red wine only contains 2 mg to 3 mg of resveratrol and the average southern Mediterranean adult consumes one to two glasses of red wine per day. One school of thought among researchers as to why large doses of resveratrol don’t seem to produce the effects that they see in lab animal and human tissue studies is that the body doesn’t need massive doses of resveratrol. Instead, the body needs a regular, consistent source of the polyphenol. Put another way, the body will use resveratrol effectively and efficiently when it knows it will have a consistent source of the antioxidant rather than periodic large doses. As a case in point, one laboratory rat study examining various resveratrol dosage levels found cardiovascular-protecting effects at relatively low doses that diminish at higher dosage levels.
Therefore, we do not recommend taking massive doses of resveratrol. Resveratrol is typically sold as grape seed extract or Japanese knotweed extract. These formulas typically contain 100 mg to 200 mg daily doses, which is more than adequate for most people, but keep in mind that only a portion of the grape seed extract or Japanese knotweed contains resveratrol molecules. For example, when looking at the supplement facts box on the label of a resveratrol product, you might see that it contains 100 mg of grape seed extract with an 8 percent resveratrol concentration (meaning there is only 8 mg of resveratrol in each daily dose of the product).
In our opinion, increasing your blood serum levels of these four powerful antioxidants mentioned in this report can help reduce oxidative stress and inflammation with three of them, NAC, omega-3 fatty acids and CoQ10, also providing energy to help improve exercise performance/tolerance.
As we mentioned in relation to NAC and CoQ10, omega-3 fatty acids and resveratrol do not appear on the government’s DRI list. So if you’re only taking a one-a-day type multi-nutrient, you are not getting four of the most powerful antioxidants used in your body.
Further, if you’re not consuming a Mediterranean-style diet, you are missing out on significant sources of these powerful antioxidants. Supplementing your current diet with these four antioxidants can provide your body with significant elements of a Mediterranean-style diet, but we’d still recommend that you consider substituting foods in your current diet wherever possible to incorporate those commonly found in the southern Mediterranean diet.
 Robich MP, et al. European Journal of Pharmacology. 2011 May 7. [Epub ahead of print].
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 Zhang H, et al. Am J Physiol Heart Circ Physiol. 2010 July 30; 299: H985-H994.
 Dudley J, et al. The Journal of Nutritional Biochemistry. 2009 Jun; 20(6): 443-452.
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