Arterial Disease Antioxidants

We have no difficulty in recommending aggressive diet revision,  vigorous enough to prevent vascular disasters. Imagine that you live in a little cottage by the sea, think quiet thoughts, walk everywhere, tend your organic vegetable garden, cultivate fruit trees (never sprayed), and go fishing once or twice per week. Now you have a perfect setting and a perfect diet  for enduring good health. Alpha Nutrition is a versatile diet revision program that creates a  healthy approach to eating. Most if not all the dietary problems that lead to heart attacks and stroke are eliminated. The program is designed to be a quick and definitive intervention when the risk  is high and prompt action is required to avert a disaster. The program also is a preventive strategy which can be implemented years before the threat of cardiovascular disease becomes imminent and essentially removes the problem from the list of things to worry about.

Alpha Nutrition  is designed to reduce cholesterol, total fat, saturated fats, and food allergy while increasing vegetable fiber-all desirable measures in the effort to prevent blood vessel diseases, heart attacks and strokes. Increased intake of potassium, magnesium and calcium is advocated with a reduction in sodium salt intake. Increased intake of six vitamins: folic acid, pyridoxine, B12, beta carotene, ascorbic acid (vitamin C) and vitamin E-are recommended. The program can be recommended, along with exercise and relaxation, as the most important defenses against cardiovascular disease.

Alpha Nutrition  Recommendations:

These recommendations apply equally to the prevention of heart attacks and strokes.

1. Complete diet revision should be undertaken and  all active symptoms resolved. High vegetable intake with low fat is the main shift in food choices. Follow Alpha Nutrition .
2. No smoking is allowed.
3. The intake of alcoholic beverages is reduced or eliminated. A glass of purple grape juices is as effective as a cadiovascular protective agent as red wine and avoids all the alcohol problems.
4. A new food list is required with new meal plans at home and new habits eating out.
5. Increased exercise and weight loss are required.
6. Increased intake of potassium, magnesium and calcium is advocated with a reduction in sodium salt intake. Increased intake of six vitamins: folic acid, pyridoxine, B12, beta carotene, ascorbic acid (vitamin C) and vitamin E-are recommended. Vitamin E should be taken - 400 iu twice per day. Beta carotene and other carotenoids are supplied as colored vegetables and fruit, abundant in the foods of Phase 1 and 2 of Alpha Nutrition .
7. Vitamin C is recommended at 400 mg. per day in divided doses such as 100 mg tablets four times a day. Ascorbic acid crystals are the least expensive and probably the best way to take vitamin C - one teaspoon supplies about 2000 mg and a daily dose of 1/4 teaspoon is all that is required. 
8. One ASA (Aspirin)  tablet per day  is an effective anti-clotting agent.

Abstracts for review

Antioxidants:

In a review article Beamish noted the many potential benefits of taking Vitamin E.

Vitamin E was first isolated in 1923, synthesized in 1938 and made available by 1941. The Canadian Shutes' Institute claimed many cardiovascular benefits of vitamin E and in 1936 found that a man with severe angina developed complete relief with vitamin E supplementation. Vitamin E can increase "good" HDL cholesterol when it is low, inhibit platelet aggregation, modulate arachidonic acid metabolism and prostaglandin production, reduce thromboxane A2 with benefit in peripheral vascular disease. Vitamin E can prevent catecholamine toxicity and free radical formation. When deficient, the risk of cardiomyopathy associated with doxorubicin toxicity increases. Vitamin E along with vitamin C in animal and human models have shown benefit in prevention of damage from heart ischemia-reperfusion. Results from the nurses health study of over 87,000 female nurses showed that women at high intakes of vitamin E (greater than 100 mg per day) had a 36% reduction of myocardial infarction compared with those in the lowest group consuming less than 6 mgs per day. There is growing evidence vitamin E has several actions which could have importance in the prevention and treatment of heart disease.

'Vitamin E - Then and Now', Beamish, Robert, M.D., Canadian journal of Cardiology, January/February 1993;9(l):29-31.

Vitamin E

In a study by Hoffmann-La Roche, 15 men and women between 21 and 65 years of age who had elevated cholesterols greater than 240 mg/dl were evaluated for metabolites of lipid peroxidation (thiobarbituric acid substances[T'BARS] and lipid oxidation products [LOPS]) before and after consuming 800 I.U. of vitamin E for 3 months. Vitamin E normalized the byproducts of lipid peroxidation and reduced platelet aggregation, even though serum vitamin E levels did not change. In the placebo group there was an increase in the TBARS. Vitamin E may help prevent oxidation of LDL cholesterol without affecting total lipids. 17767

'Vitamin E and Heart Disease Revisited, The Nutrition Report, Jan 1993; 11(l):5 Relationship Between Serum lipid Peroxidation Products in Hypercholesterolemic Subjects and Vitamin E Status', Bierenbahm M., et at Biochemistry International 1992;28:57-66.

Another review of the benefits of Vitamin E in the prevention of atherosclerosis:

Vitamin E, a major lipid soluble antioxidant in the blood, works synergistically with other antioxidants to protect cells from oxidative damage and lysis. Most of the vitamin E in plasma is present in low density lipoprotein. There is strong evidence vitamin E prevents LDL oxidation, an initiating factor in the development of atherosclerosis. Vitamin C is known to enhance vitamin E status, by regenerating the reduced form of vitamin E. Vitamin E has shown inhibition platelet adhesion and aggregation. Vitamin E can quench free radicals and is considered the major lipid soluble peroxyl radical trapping, chain breaking antioxidant in human blood. Vitamin E deficiencies are associated with an increased generation of free radicals, and reduce superoxide dismutase activity. Vitamin E has been found to inhibit prostaglandin E2 production, and prevent against the lethal effects of intravenous arachidonic acid administration in rabbits. Vitamin E has reduced cyclooxygenase activity. Levels of vitamin C and lipid standardized vitamin E are approximately 25% higher in countries with low incidences of ischemic heart disease compared to those with a higher prevalence. Cholesterol standardized vitamin E levels between 2.0-3.75 umol/inmol may be considered a risk factor for ischemic heart disease, especially in countries like Finland and Scotland with a high incidence. In one study, 1,4001.U. of vitamin E was reported to cause side effects such as fatigue and weakness. Angina treatment studies have used 200 to 3,000 mgs of vitamin E per day for 10 weeks to 6 months with little clinical benefit. In one study, a researcher found vitamin E at 1,200 l.U., per day, reduced the requirement for nitroglycerin in patients with coronary artery disease. Vitamin E was found to reduce the re-stenosis rate in patients undergoing percutaneous transluminal coronary angioplasty. By using 400 to 800 mgs per day of vitamin E in intervention trials of intermittent claudication, there were few side effects. Exercise tolerance benefits were observed in all trials.

'Vitamin E. The Evidence For an Anti-Atherogenic Role, Ferns, Gordon A.A. " et al Artery, 1993;20(2):61-94.

Vitamin E reduction in coronary artery disease reported by Rimm, E.B. et al, New England Journal of Medicine, 1993;328:1450-6.

The first authors note numerous studies have shown a dose range of 200 I.U. to 800 l.U. per day of vitamin E is virtually nontoxic. The authors do not believe it is premature to recommend vitamin E supplementation for prevention of coronary heart disease. The use of coronary angioplasty has grown dramatically since 1977. Yet, randomized trials documenting the effectiveness of elective coronary angioplasty and prolonging life or reducing cardiac events are still not available. The authors believe vitamin E should be available to patients who have coronary heart disease or are at high risk especially with the growing number of patients who ask for permission to use it. Some physicians in the United States are sufficiently convinced of potential benefits and nontoxic nature of vitamin E to supplement their own diets with it. If vitamin E is good enough for physicians, why is not good enough for their patients? The second letter notes vitamin E may play a role in inhibiting platelet adhesion. It is not necessary that vitamin E act by its antioxidant activity. Reduction of platelet adhesiveness may play an important role in preventing cardiovascular complications

Vitamin E and the Risk of Coronary Disease, O'Keefe, James IL, Jr,M.D. and Lauie, Carl J., M.D J Steiver, Manfred M.D., Ph.D, NewEngland Journal of Medicine November 4,1993;1424.(Address: JamesO'Keefe, Jr., M.D, Mid America Heart Institute, Kansas City, MO 64111, U.S.A-Manfred Steiner, M.D., PILD, Memorial Hosp Ul at Rhode Island,Pawtucket RI 02860, U.S.A.)

Pharmacotherapy, 15: 5, 1995 Sep-Oct, 648-59

Hypercholesterolemia, cigarette smoking, hypertension, and obesity are known contributing risk factors for the development of atherosclerotic coronary artery disease (CAD). However, they account for only half of all cases of CAD, and the complete pathologic process underlying atherosclerosis remains unknown. Growing evidence suggests that oxidative modification of low-density lipoprotein (LDL) may be of particular importance in the pathogenesis. Oxidized LDL exhibits proatherogenic effects. Therefore, current research has focused on inhibiting the oxidation of LDL as a means of inhibiting the atherosclerotic process. One such approach is to enhance the endogenous antioxidant defense systems within the LDL particle with lipophilic antioxidants such as alpha-tocopherol and beta-carotene, or by supplementing the aqueous-phase antioxidant capacity with ascorbic acid. Observational data suggest a protective effect of antioxidant supplementation on the incidence of CAD; however, specific doses cannot be recommended since the data are inconclusive.

 

Am J Epidemiol, 142: 12, 1995 Dec 15, 1269-78

In the Western Electric Company Study, carried out in Chicago, Illinois, data on diet and other factors were obtained in 1958 and 1959 for a cohort of 1,556 employed, middle-aged men. Nutrients included vitamin C and beta-carotene. An index that summarized combined intake of both nutrients was constructed. Mean intakes of vitamin C in the lowest and highest tertiles of the index were 66 and 138 mg/day; corresponding values for beta-carotene were 2.3 and 5.3 mg/day. A total of 522 of 1,556 men died during 32,935 person-years of follow-up, 231 from coronary heart disease and 155 from cancer. These results support the hypothesis that consumption of foods rich in vitamin C and beta-carotene reduces risk of death in middle-aged men.

 

J Am Diet Assoc, 95: 7, 1995 Jul, 775-80

To determine whether a fat- and energy-reduced diet rich in antioxidant vitamins C and E, beta carotene, and soluble dietary fiber reduces free-radical stress and cardiac enzyme level and increases plasma ascorbic acid level 1 week after acute myocardial infarction. Subjects with definite or possible acute myocardial infarction and unstable angina (according to World Health Organization criteria) were assigned to either an intervention diet (n = 204) or a control diet (n = 202) within 48 hours of symptoms of infarction. INTERVENTIONS: Intervention and control groups were advised to consume a fat-reduced, oil-substituted diet. The intervention group was also advised to eat more fruits, vegetable soup, pulses, and crushed almonds and walnuts mixed with skim milk. : Consumption of an antioxidant-rich diet may reduce the plasma levels of lipid peroxide and cardiac enzyme and increase the plasma level of ascorbic acid. Antioxidant-rich foods may reduce myocardial necrosis and reperfusion injury induced by oxygen free radicals.

 

World J Surg, 19: 5, 1995 Sep-Oct, 738-44

The objective of this study was to evaluate the antioxidative properties of the multivitamin cocktail Omnibionta (alpha-tocopherol, ascorbic acid, retinol, vitamin B complex) in terms of diminishing lipid peroxidation with improvement of leg edema performance after limb revascularization operations in humans. Fifty-one subjects were selected; the control group contained 27 patients and the treatment group 24 patients, who received the vitamin cocktail intravenously before the start of reperfusion. All patients suffered from acute or chronic arterial occlusive disease, except two subjects with arterial trauma. The results suggest that antioxidative vitamin treatment might be valuable in preventing lipid peroxidation and decreasing extremity edema.

 

Can J Cardiol, 11 Suppl G:1995 Oct, 97G-103G

The oxidative modification of low density lipoprotein (LDL) may be an early step in atherogenesis. Furthermore, evidence of oxidized LDL has been found in vivo. The most persuasive evidence shows that supplementation of some animal models with antioxidants slows atherosclerosis. The purpose of this review is to examine the roles that vitamin E, vitamin C and beta-carotene may play in reducing LDL oxidation. Vitamin E has shown the most consistent effects with regard to LDL oxidation. Beta-carotene appears to have only a mild or no effect on oxidizability. Ascorbate, although it is not lipophilic, can also reduce LDL oxidative susceptibility.

Risk Of High Dose Antioxidants ?

Arch Intern Med, 156: 9, 1996 May 13, 925-35

 

As a result of the many scientific and popular press reports of the benefits of antioxidant vitamins (vitamin A, beta-carotene, vitamin E, and ascorbic acid), it is estimated that 40% of the US population is consuming vitamin supplements. The efficacy of these supplements is not yet proved, and some have questioned their safety. Approximately 10 to 15 cases of vitamin A toxic reactions are reported per year in the United States, usually at doses greater than 100,000 IU/d. No adverse effects have been reported for beta-carotene. The frequency of vitamin E toxic reactions is not well delineated, but case reports are few at dosages less than 3200 mg/d. Ascorbic acid toxic reactions are rare at dosages less than 4 g/d. Despite a lack of clinical trial data, it seems that antioxidant vitamins are safe, although prudence might dictate their avoidance by women of childbearing potential, persons with liver disease or renal dysfunction, and those taking certain medications or undergoing specific laboratory tests.

 

J Urol, 155: 6, 1996 Jun, 1847-51

The association between the intake of vitamins C and B6, and kidney stone formation was examined. We conducted a prospective study of the relationship between the intake of vitamins C and B6 and the risk of symptomatic kidney stones in a cohort of 45,251 men 40 to 75 years old with no history of kidney calculi. Vitamin intake from foods and supplements was assessed using a semiquantitative food frequency questionnaire completed in 1986. RESULTS: During 6 years of followup 751 incident cases of kidney stones were documented. Neither vitamin C nor vitamin B6 intake was significantly associated with the risk of stone formation. : These data do not support an association between a high daily intake of vitamin C or vitamin B6 and the risk of stone formation, even when consumed in large doses.