Vol. 83 February 1, 2013 Antioxidants: Miracle or Myth?

February 1, 2013

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“The hallowed notion that oxidative damage causes aging
and that vitamins might preserve our youth is now in doubt”
-M. W. Moyer, Scientific American February 2013

It was not just a humble roundworm that got us into this debate. it was a MUTANT roundworm, a worm commonly used for the study of aging.

Since the 1960’s the dominant theory of aging blamed a rising level of free radicals. Free radicals are highly reactive organic molecules produced in our bodies by oxidation. We all know that oxidation is “bad” because we learned in high school that it is oxidation that turns steel into rust. Free radicals cause “rust” in our body by mangling other cells, proteins, and even DNA. Therefore, an antioxidant that reduces free radicals will slow cell “mangling”, destruction, and aging. Having lots of antioxidants around should retard our aging process. “Drink red wine and take vitamin E.”  More than half of Americans believe in this theory and take considerable amounts of antioxidants like Vitamin E, Vitamin C,  and beta carotene (carrot juice). (JAMA 2007)

MIRACLE: “These high powered, super antioxidants fight dangerous free radicals, the source of oxidative stress and a leading cause of premature aging. CALL NOW to Receive Your FREE 30-Day Bonus Supply!” (Cape Cod Times ad January 20, 2013, E4)

This super antioxidant is an organic chemical called oligmeric proanthrocyanide, or OPC. It is found in grape seeds and certain pine bark. This particular brand of OPC’s touted by Dr. Fred Vaginini includes some other organic chemicals found in grape skins (hence the benefits of red wine) and other botanicals. It is called OPC Factor (TM);  $59.95 for a month’s supply ($35.99 on Amazon). The “landmark, double blinded research study by the prestigious National Institutes of Health” cited to support the ad’s claims was actually a small study by an NIH grantee in Philadelphia to measure changes in energy levels in 25 adult men who took OPC. The 2006 study  results were posted in 2008 as inconclusive.

In the 1990’s genetic science advanced to the point that worm and mice genes could be manipulated to block antioxidant production resulting in very high levels of free radicals. Much to the surprise of the scientists running the experiments those worms and mice with the highest levels of free radicals lived the LONGEST.

Exercise increases free radicals, but exercise is beneficial. A 2009 study of humans who exercised revealed that the ones that did NOT pop a lot of vitamins to lower their free radical levels  were physiologically healthier than those who did!   A 2010 study of mice bred to overproduce a specific “super” free radical actually lived 32% longer than the others. Free radicals rise as one ages, but it may be a result of aging and not the cause. I remember the classic graph showing the number of lung cancer deaths increasing as the number of refrigerators (or  indoor bathrooms) increased in the U.S. during the early phase of that debate.

MYTH: A 2007 systematic review of 68 clinical trials concluded that antioxidants do not reduce the risk of death. When the analysis is restricted to only the most vigorous, double-blinded studies certain antioxidants were linked to a 5% INCREASED risk of death. The American Heart Association and the American Diabetes Association now advise “that people should not take antioxidant supplements except to treat a diagnosed vitamin deficiency”.

“The literature is providing growing evidence that these supplements- in particular at high doses -do not necessarily have the beneficial effects that they have been thought to…We’ve become acutely aware of potential downsides.” -D. Albanes, Senior Investigator, National Cancer Institute

References:
“The Myth of Antioxidants”, Scientific American, Febuary 2013, 64-66, Melinda W. Moyer

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Vol. 37 January 15, 2011 Let’s Call A Quack a “Quack”

January 14, 2011

“Since the introduction of the first vaccine, there has been opposition to vaccination…Since the 18th century, fear and mistrust have arisen every time a new vaccine has been introduced.Ultimately, society must recognize that science is not a democracy in which the side with the most votesor the loudest voices gets to decide what is right.”
– The Age-Old Struggle against the Antivaccinationists, Poland and Jacobson, NEJM 1/13/11, p.97

It is time to call a Quack a Quack! Dr.. Andrew Wakefield’s bad science suggesting a link between measles vaccination and autism has been revealed to be also fraudulent! Besides faking and altering data on the 12 (yes, only twelve) patients in his original report, Dr. Wakefield received close to $643,000 for helping lawyers sue pharmaceutical companies working on rival vaccines. “Quackery” is usually defined as selling for profit a medical notion, or lotion, whose benefits are not supported by reason or knowledge.

The U.K. Grand Medical Council has “erased” his name from the medical register. This is the same as stripping him of his medical license, and don’t you just love the British for describing it as an “erasure”. In another quaint British linguistic quirk the act of actually administering the vaccine was often called a “jab”, and so the proponents of giving the vaccine were labeled as “The Jabbers”. The charges and counter charges can get a bit murky, but this several minute annotated video of Dr. Wakefield’s own statement clarifies the issues very well.  Dr. Wakefield currently resides in Texas continuing to attract desperate parents with autistic children, but does not have a U.S. medical license.

It seems incredible to me that his assertions based on 12 patients has stood up for so long in the face of several studies of thousands of children in different countries, numerous peer reviews, and, even, a U.S. federal court decision debunking the connection between measles vaccine and autism. Will this new revelation of false data and fraud quench the voices of superstition?

I doubt it. A recently published book, The Panic Virus by Seth Mnookin explores the reasons this particular superstition has persisted.  His list includes (1) :

1.the democratization of information via the Internet,
2.Americans’ negative response against anything “perceived as infringing on individual liberty”,
3. skepticism of the medical establishment,
4. shoddy shock-seeking journalism,
5. the romance of lone-wolf skeptics tilting against establishment windmills,
6. the development of a sense of community among anti-vaccine activists,
7.journalism that not only tolerated misinformation but also validated “the notion that our feelings are a more reliable barometer of reality than the facts.”

Quackery, of course, existed and thrived a long time before the Internet, before America, before journalism, and even before the establishment of a “medical establishment” though that it is what actually defined it, so this contemporary list fails to fully explain the phenomenon. Professor Michael Shermer, editor of Skeptic Magazine, lists 25 fallacies that lead us to believe weird things (2). Michael Barrett MD explains in detail how quackery sells.

People who continue to rail against MMR vaccinations due to the fear of autism are no longer quaint nor merely superstitious. They should be called “quacks”. They put hundreds of children, and themselves as young adults having their own children, needlessly at risk of a preventable disease with serious complications..

References:
1. The Panic Virus: A True Story of Medicine, Science, and Fear, Seth Mnookin, Simon & Schuster , 2010
2. Why People Believe Weird Things, Michael Shermer, 1997



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