The antioxidant nutrients-vitamins C and E, carotenoids, selenium, and polyphenols – do appear to have a positive correlation in chronic disease reduction and better overall health. But lifestyle factors (exercise, tobacco and alcohol use, and diet choices key among them) and genetic factors also factor heavily into disease incidence. Scientific evidence is insufficient to prove that antioxidant nutrients are the exclusive reason for benefits observed from high phytochemical intake of fruits and vegetables. Antioxidants also do not appear to be a quick fix in prevention or treatment of chronic health problems that may have taken decades to develop, despite the hopes of so many Americans.
The American National Institute of Health concluded in their 2006 State of the Science Multivitamin / Mineral Supplements and Chronic Disease conference that:
More accurate information is needed about dietary supplement use in the population and study methods need to be improved.
Dietary supplement databases need to be built with ingredient information and regular updates.
Effective communication methods to disseminate scientific information to the public is needed.
Dietary supplement and medication interactions must be studied.
Population segments, previously underrepresented and at risk for chronic disease, need to be studied.
New biomedical sciences, such as nutrigenomics, need to be studied and techniques applied to observational and randomized, controlled, clinical studies.
Efficacy and safety of individual vitamins, minerals and vitamin/mineral combinations need to be studied more rigorously.
While all of these are worthy recommendations and should be implemented, gathering information via studies and setting up informational databases takes time and utilizes scarce resources. In the meantime, the average consumer and health care professional continues to be uncertain about just what to do when it comes to antioxidants. So just what should we do about them?
The leading causes of death worldwide – coronary heart disease, cancer, stroke, and diabetes – have been associated with poor diet choices. Many positive health outcomes have been associated with increasing dietary intake of fruits, vegetables, legumes, and whole grains – all high in naturally occurring antioxidant nutrients. Combining different fruits and vegetables has also been discovered to have an even greater disease-fighting potential (for example, mixing tomatoes with broccoli instead of consuming separately has been shown to provide a much more potent combination in prostate cancer
The clearest answer about what to do when advising others about antioxidants appears to be what mothers and home economic teachers have recommended for years: eat a healthy and well-balanced diet with an emphasis on intake of fruits, vegetables, legumes, and whole grains. Obviously, exercise and lifestyle habits (avoiding tobacco, alcohol, and drug abuse) and genetic legacy factor into our prospective overall health. But controlling what we eat and making healthy, nutrient-dense food choices (not gulping down a dietary supplement pill in place of them) appears to be the best choice when trying to prevent or delay chronic illnesses and improve quality of life as we age. It should be kept in mind, however, that there is a function and role for dietary supplements.
Specific at-risk populations – such as those who live in poverty, the elderly who have changing gastric secretions that may affect how much of a nutrient is absorbed, those consuming below 1,600 calories per day, and those who suffer from diseases that affect nutrient absorption – benefit from supervised dietary supplementation. Supplements are a relatively inexpensive form of nutrients that can be administered, if taken consistently, in a more precise and reliable dose than through fruits and vegetables. As such, they may be beneficial for certain life stage groups, such as during pregnancy and the elderly years when appetite and nutrient intake or absorption are diminished.