Antioxidants part 2: how to determine if you would benefit from targeted support.


As you saw in part one of this two-part series, maxing out on ‘healthy’ antioxidant nutrients, via foods or supplements will not always offer the health benefits you might desire.  All is not lost though, as choosing the right blend, type and dose of antioxidant nutrients, targeted to specific health needs or concerns, can still provide safe support. So, how do you choose the right antioxidant and what should be considered when choosing a product that is most likely to work for you?

In this article we’ll cover the factors to consider when choosing which nutrients are right for you, followed by my top recommendations for the safest and best antioxidant nutrients that provide targeted support.

Factors to consider when choosing antioxidant support

1: Have you done all you can to optimise your diet?

We talked a lot about this in part one but this really is the most important place to start and whilst we are all interested in quick improvements to our health, to give an easy analogy, you wouldn’t build a house without digging the proper foundations. Therefore, if you want to ensure any targeted interventions are safe you need to pay some attention to ensuring you get a broad spectrum of antioxidants from your diet, on a daily basis.  Try to eat something white (e.g. onion, cauliflower, mushrooms, garlic), something green (e.g. broccoli, leafy greens, avocado, cucumber), something red (e.g. berries, red pepper, radish, tomatoes), something yellow or orange ( e.g. carrots, sweet potato, peaches, peppers) and something purple (e.g. beetroot, aubergines, plums, dark berries) every day to ensure you have a good range of antioxidants flooding into your body. Remember, these work together to support one another and can help balance out any potential negative impact of targeted interventions you might choose.

2: What’s going on in your internal environment?

There are certain factors that, when present, can increase your risk for antioxidant interventions turning sour. An important consideration is the level of inflammation in the body. Inflammation and oxidative stress go hand in hand, with one directly triggering and exacerbating the other. As such, if you are trying to combat high levels of oxidative stress you also need to address inflammatory balance. Many antioxidants also have anti-inflammatory actions and consuming a Mediterranean-style diet that includes several portions of oily fish a week is a great way to help ensure inflammation is kept in check. You may also want to test your fatty acid levels, as an imbalance of your omega-6 arachidonic acid (AA) to your omega-3 eicosapentaenoic acid (EPA) can be a sign your body is struggling to cope with inflammation and you might benefit from some targeted omega-3 support. If inflammation is not addressed alongside oxidative stress, your efforts can end up being wasted, along with your money.

3: Does this antioxidant support my health needs?

Part one explained how antioxidants work in different ways; knowing specifically which antioxidants have been shown to offer support for your health concern will help ensure you don’t waste your time and money when choosing a safe and beneficial intervention. If, for example, you read about an antioxidant that is amazing for protecting the brain against cognitive decline but all of your family have lived until their 90s with their full wits about them, it might be that you don’t need this specific support. If you are keen on helping your cells fight premature ageing but you already eat a good (plant-rich) diet, get adequate rest and don’t work in the city, and are regularly told you look younger than your years you might just end up tipping an already perfect healthy ageing balance the wrong way and inadvertently speeding cell ageing but suppressing ROS too aggressively. If arthritis runs in your family, however, and you are starting to experience achy stiff joints then a good quality vitamin C or curcumin might just be a helpful addition to your day.

4: Is it proven to reach the target area and deliver ‘therapeutic doses’?

This is a real bee in my bonnet and one of the main reasons the supplements industry has gained such a bad reputation. Unfortunately, there are simply far too many products available  using cheap, ineffective ingredients that the body can’t use and, although huge doses may be offered in various forms to appear good value to buy, they still offer very little of their promised benefits, and at such high levels of inefficient ingredients, can actually become problematic for the body.  Choosing a product that can deliver active ingredients at levels proven to confer health benefits, without dramatically overloading the body, is vital for safe and successful antioxidant support. A highly bioavailable, but low dose antioxidant is usually much better and more beneficial than huge doses of cheap ingredients.

(Some of) My top supplement recommendations for well researched, targeted antioxidant support:

Ubiquinol – CoQ10

Coenzyme Q10 (usually shortened to CoQ10) is a vital chemical involved in the generation of energy by our mitochondria. Found in the diet in relatively small amounts,  unless we eat lots of organ meats, many of us struggle to keep up with the demand for this nutrient and as such our energy levels and cellular respiration can struggle. Another amazing benefit of the ubiquinol form of CoQ10 is that it is a potent antioxidant that is not only excellent at quenching free radicals but also recycling other antioxidants, thus helping to keep the antioxidant ‘pool’ topped up.

CoQ10 is available in supplement form as either ubiquinone or ubiquinol but only the latter is in the body-ready, active, antioxidant form; studies consistently support the superior health benefits of ubiquinol. Research suggests that ubiquinol at a dosage of 150-200mg can be hugely helpful in preventing and managing energy-related conditions, pain syndromes such as fibromyalgia, cardiovascular health and function (the heart has the highest density of mitochondria), metabolic syndrome components including diabetes, oxidative stress and fatigue associated with strenuous exercise, neurological issues such as autism, ADHD and Alzheimer’s and even fertility issues in males. It is recognised that as we age our ability to keep up with the body’s demand for CoQ10 slows down, making supplemental ubiquinol particularly beneficial in supporting the above systems, and our general health, as we age. One of the safest antioxidants to take for general oxidative stress protection, with almost no known side effects, ubiquinol (at lower doses e.g. 100mg/day) is ideal as a preventative/general health supplement. Seeking out a ubiquinol supplement that contains an optimised delivery system, such as VESIsorb, can further enhance absorption and reduce the dose needed for benefits to be seen. 

Curcumin

Curcumin is an extract of the spice turmeric, used widely in South Asian and other cuisine. Curcumin has gained a huge amount of attention over the last few years thanks to its purported wide-ranging health benefits. Multiple studies show that curcumin is a powerful antioxidant acting to quench free radicals and also upregulate our inbuilt antioxidant defences. A major benefit of curcumin in promoting health is that it also combats inflammation, making it an excellent addition to a healthy diet for helping to manage conditions with an inflammatory component to their onset and progression. Research into the therapeutic potential of curcumin shows extremely promising results when used in the protection from and management of cancer, inflammatory joint problems such as arthritis, neurological disorders (in particular Alzheimer’s, where animal models have shown it helps to prevent amyloid plaque formation) and digestive disorders such as inflammatory bowel and colorectal cancer, as well as liver and metabolic syndrome (Pulido-Moran et al., 2016).

One problem with curcumin is that the body struggles to absorb it and even when it does, it is quickly metabolised and excreted, rendering it quite useless. So unless you are happy to eat several grams, daily, if you want your curcumin to have a therapeutic benefit, it is necessary to choose one with proven ability to deliver clinically effective doses of ‘free curcumin’, the main form associated with biological activity. Longvida is a patented delivery system that does just this, and is one of the very few forms of curcumin supplement proven to reach target tissues, including crossing the blood-brain barrier to exert health benefits in the brain. The considerably increased bioavailability of Longvida curcumin, compared with other supplements, means much lower doses can be taken, making it safer and less likely to cause any imbalance or overstimulation of specific pathways.

N-Acetyl Cysteine (NAC)

NAC is the precursor nutrient in the synthesis of glutathione, one of the body’s most powerful and precious antioxidant nutrients. Unfortunately, when taken as a supplement, glutathione itself seems to have a very limited impact on raising cellular levels as it is rapidly metabolised in the intestines. NAC, however, has been shown to increase cellular glutathione levels, even in the brain, by helping to increase the amount of substrate available to make glutathione. Glutathione quenches free radicals and, provided there is enough L-cysteine available, is continuously recycled to provide ongoing antioxidant support. NAC provides a bioavailable form of L-cysteine and so helps to keep this recycling process going for as long as possible, thereby extending the antioxidant potential of the glutathione made in our cells.

Whilst research into the direct health benefits of supplementing with NAC is still quite limited, its potential for raising glutathione levels alone place it high on my list.  That said, NAC has for many years been used to prevent liver toxicity associated with paracetamol and other drug use, as well as lead toxicity and, as such, is commonly used to support general liver health and detoxification pathways., Studies have also shown that NAC may help alleviate symptoms in a number of neuropsychiatric disorders including addiction, OCD, schizophrenia, bipolar disorder, Alzheimer’s and autism, all of which are associated with low glutathione levels.. In other areas of health, NAC has been shown to positively influence many of the risk factors for cardiovascular disease, including LDL cholesterol oxidation (a key driver of atherosclerosis), blood pressure & blood vessel function, and platelets. Some research has also shown a significant positive impact of NAC on the severity of acne (Rushworth and Megson., 2014). As things stand, NAC appears to be relatively safe when taken as a low dose (up to 500mg per day seems to be ok) so this too could be a useful, general oxidative stress management strategy.

Other nutrients to consider for broad spectrum support

In addition to the above, there are a number of excellent antioxidant nutrients that may be helpful when consumed as part of a baseline anti-oxidative stress regime. Despite their emerging (in some cases huge) potential, research is still a little limited in allowing us to conclude the benefits, or safety, of their isolated (high dose) use. Therefore, if you don’t have any major health concerns and you are simply looking for some ‘foundational’ broad-spectrum antioxidant support then the following may be worth considering, via foods or a low-dose, good quality supplement.

  • Resveratrol (red grape skin) – studies show it supports the brain and healthy ageing
  • Quercetin (apples, citrus, peppers and dark cherries) – useful for general oxidative stress and inflammation, as well as promoting exercise performance
  • Lycopene (cooked/processed tomatoes) – promotes heart, gastric and prostate health
  • Alpha-Lipoic Acid (spinach, bovine organ meats, broccoli) – beneficial for diabetic neuropathy, obesity, nerve and lipid membranes, and healthy skin.
  • Astaxanthin (microalgae; also found in salmon, shrimp, krill) – helpful for cholesterol, blood pressure and glucose management as well as supporting inflammatory balance.

Final thoughts

Nutrients do not work in isolation or via one specific mechanism in the body. Unfortunately, most of the research being carried out into the benefits of specific nutrients is conducted as if they were drugs and little consideration is given for all the factors that influence their unique biological actions. As such, results are often cloudy and inaccurate and further muddy the waters of nutrition science and understanding. With this in mind, we do not currently have the ‘proof’ that many seemingly very health-supportive nutrients can directly benefit health, overall, when taken in isolation. That said, more recent research is shedding light on the potential benefits, and harms, of specific nutrients and foods when taken at the right time, in the right circumstances. It seems safe to conclude that eating a diet rich in natural antioxidants from local, seasonal, ideally organic (because they have a harder life and so produce more) plant foods is a great way to ensure you have the tools to protect your health long term. If you have a known nutrient deficiency, have (or are at high risk for) a specific health condition, adding some highly bioavailable, well researched, targeted antioxidant nutrients, at proven to be safe doses, is likely to be a helpful method to further support your health.

NB as research gets cloudier and the need for personalised intervention becomes more established we recommend working with a qualified nutrition professional to help you address which areas of your health are likely to be under strain and which safe methods you can try to better support your unique situation.

References

Ubiquinol

Liu ZX, Artmann C: Relative bioavailability comparison of different coenzyme Q10 formulations with a novel delivery system. Alternative therapies in health and medicine 2009, 15:42-46.

Maes M, Mihaylova I, Kubera M, Uytterhoeven M, Vrydags N, Bosmans E: Coenzyme Q10 deficiency in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is related to fatigue, autonomic and neurocognitive symptoms and is another risk factor explaining the early mortality in ME/CFS due to cardiovascular disorder. Neuro endocrinology letters 2009, 30:470-476.

Cordero MD, Alcocer-Gomez E, de Miguel M, Culic O, Carrion AM, Alvarez-Suarez JM, Bullon P, Battino M, Fernandez-Rodriguez A, Sanchez-Alcazar JA: Can Coenzyme Q10 improve clinical and molecular parameter in Fibromyalgia? Antioxidants & redox signaling 2013.

Lance J, McCabe S, Clancy RL, Pierce J: Coenzyme Q10–a therapeutic agent. Medsurg nursing : official journal of the Academy of Medical-Surgical Nurses 2012, 21:367-371.

Lee BJ, Lin YC, Huang YC, Ko YW, Hsia S, Lin PT: The relationship between coenzyme Q10, oxidative stress, and antioxidant enzymes activities and coronary artery disease. The Scientific World Journal 2012, 2012:792756.

Mancuso M, Orsucci D, Volpi L, Calsolaro V, Siciliano G: Coenzyme Q10 in neuromuscular and neurodegenerative disorders. Current drug targets 2010, 11:111-121.

Chai W, Cooney RV, Franke AA, Shvetsov YB, Caberto CP, Wilkens LR, Le Marchand L, Henderson BE, Kolonel LN, Goodman MT: Plasma coenzyme Q10 levels and postmenopausal breast cancer risk: the multiethnic cohort study. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 2010, 19:2351-2356.

Chai W, Cooney RV, Franke AA, Caberto CP, Wilkens LR, Le Marchand L, Goodman MT, Henderson BE, Kolonel LN: Plasma coenzyme Q10 levels and prostate cancer risk: the multiethnic cohort study. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 2011, 20:708-710.

Curcumin

Gota VS, Maru GB, Soni TG, Gandhi TR, Kochar N, Agarwal MG: Safety and pharmacokinetics of a solid lipid curcumin particle formulation in osteosarcoma patients and healthy volunteers. Journal of agricultural and food chemistry. 2010, 58:2095-2099.

Takahashi M et al., Effects of curcumin supplementation on exercise induced oxidative stress in humans. Int J Sports Med. 2014 Jun;35(6):469-75.

DiSilvestro RA, Joseph E, Zhao S, Bomser J. Diverse effects of a low dose supplement of lipidated curcumin in healthy middle aged people. Nutr J. 2012 Sep 26;11:79.

Ma QL, Zuo X, Yang F, Ubeda OJ, Gant DJ, Alaverdyan M, Teng E, Hu S, Chen PP, Maiti P, Teter B, Cole GM, Frautschy SA. Curcumin suppresses soluble tau dimers and corrects molecular chaperone, synaptic, and behavioral deficits in aged human tau transgenic mice. J Biol Chem. 2013 Feb 8;288(6):4056-65

Pulido-Moran M, Moreno-Fernandez J, Ramirez-Tortosa C, Ramirez-Tortosa M. Curcumin and Health. Molecules. 2016; 21(3):264.

NAC

Rushworth GF, Megson IL. Existing and potential therapeutic uses for N-acetylcysteine: the need for conversion to intracellular glutathione for antioxidant benefits. Pharmacol Ther. 2014 Feb;141(2):150-9.

Joshi D, Kumar MD, Kumar SA, Sangeeta S. Reversal of methylmercury-induced oxidative stress, lipid peroxidation, and DNA damage by the treatment of N-acetyl cysteine: a protective approach. J Environ Pathol Toxicol Oncol. 2014;33(2):167-82.

Karimzadeh I, Khalili H, Dashti-Khavidaki S, Sharifian R, Abdollahi A, Hasibi M, Khazaeipour Z, Farsaei S. N-acetyl cysteine in prevention of amphotericin- induced electrolytes imbalances: a randomized, double-blinded, placebo-controlled, clinical trial. Eur J Clin Pharmacol. 2014 Apr;70(4):399-408.

Liu C, Lu XZ, Shen MZ, Xing CY, Ma J, Duan YY, Yuan LJ. N-Acetyl Cysteine improves the diabetic cardiac function: possible role of fibrosis inhibition. BMC Cardiovasc Disord. 2015 Aug 6;15:84.

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Sophie Tully

About Sophie Tully BSc, MSc, DipPT

A trained pharmacologist, Sophie pursued her passion for health and nutrition by completing a master’s degree in Clinical & Public Health Nutrition at UCL, London. Sophie balances her Igennus role with her own private nutrition and health consultancy business working with elite athletes and the general public to achieve optimal health through lifestyle and dietary interventions. Sophie’s main research interests lie in the role of nutrition and lifestyle in inflammation, psychology and immunology. Sophie also lectures at the College of Naturopathic Medicine.

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