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Antioxidants neutralise excess free radicals. Antioxidants are produced in the body endogenous or acquired from the diet exogenous. Many studies have reported a decrease in endogenous antioxidants in many disease conditions. Therefore, intake of exogenous antioxidants in the diet becomes vital to improve the dangerous effect of reduced antioxidants and increased free radicals in disease conditions.
Vitamins are groups of complex organic compounds found in foodstuffs and essential for a healthy metabolism. Their deficiency can cause disorders, whereas resupply of these nutrients can alleviate deficiency symptoms [17].
Vitamins are different from other food nutrients due to their distinct organic nature, and their classification depends on their chemical nature and function [18].
Growth, development, health, and reproduction require minute amounts of vitamins [19]. Some vitamins synthesised from other sources in the body deviate from the usual definition of vitamins. For instance, Animals integrate ascorbic acid, tryptophan an essential amino acid produce niacin, while UV radiation from sunlight synthesises vitamin D [20].
Generally, classification of Vitamins is into two groups:. Example of water-soluble vitamins is: Vitamins B complex and C and that of fat-soluble vitamins include: A, D, E, and K. Fat-soluble vitamins are associated with fats and are absorbed with dietary fats. The absorption of fat-soluble vitamins is like the absorption of fats.
Water-soluble vitamins are not associated with fats and are unaffected by alterations in fat absorption [20, 21]. Vitamin A is a fat-soluble vitamin obtained both from plant and animal sources. Vitamin A from animal sources is known as retinoid, whereas, the vitamin A from the plant source is called provitamin A carotenoids [22].
They are essential for vision, cell growth and development, antioxidant activity, and promotion of proper cell communication [23].
Vitamin D is vital for the human body health, but the exact body intake amount varies and has an inconsistent pattern because exposure to sunlight also produces vitamin D in human skin [24]. Vitamin D is vital for normal body functioning as its deficiency cause the malformation and softening of bones.
Vitamin D deficiency is associated with many disorders like osteoporosis, rickets, osteomalacia, loss of balance, diabetes, rheumatoid arthritis, asthma, depression, epilepsy, and lowered immune function.
Calcitriol is essential for the maintenance of healthy calcium homeostasis [25]. It is also involved in the maturation of white blood cells, which is a Frontline player in immunity responses [26]. Vitamin E comprises of four forms of tocopherols and tocotrienols, forming eight naturally occurring forms of vitamin E, which include alpha, beta, gamma, and delta classes of tocopherol and tocotrienol [27].
Present in the serum and red blood cells among the tocopherols are the alpha- and gamma-tocopherols, with the alpha-tocopherol present in a higher concentration [28].
Vitamin E shields the body structures from oxidative damage. A deficiency of vitamin E protects low-density lipoproteins against oxidative damage.
Dietary sources of vitamin E includes Sunflower seeds, spinach, turnip greens, asparagus, beet greens, mustard greens, chili peppers, almonds, broccoli, bell peppers, kale, tomatoes, avocado, peanut, shrimp, olives, olive oil, collard greens, cranberries, raspberries, kiwifruit, carrots, and green beans [23].
Three different types of Vitamin K are known, namely; K1 PhylloquinoneK2 Menaquinone and K3 Menadione. K1 form is most prevalent and needed for photosynthesis in plants. Synthesised from K1 is the K2 type.
Bacteria and other microorganisms form vitamin K3. In the human body, by the biological conversion of K1 and K3 produce K2.
While, K2 is not present in plants, but the fermentation of bacteria produces it through the transformation of K1 into K2 [30]. Vitamin K is essential for blood clotting activity [31, 32], helps in the maintenance of bone health by keeping demineralisation under control [32, 33].
Food sources for Vitamin K1 are dark green leafy vegetables, while sources of Vitamin K2 include: eggs, meat, fish, dairy, fermented animal foods, and fermented plant foods and vitamin K3 is not naturally present in dietary foods [31, 32].
Generally nutritional sources for vitamin K are: spinach, mustard greens, beet greens, Swiss chard, turnip greens, parsley, broccoli, Brussels sprouts, romaine lettuce, asparagus, basil, cabbage, celery, kiwifruit, green beans, cucumber, tomatoes, black pepper, green peas, blueberries, carrots, soybeans, avocado, raspberries, winter squash, pear, cranberries, bell peppers, plum, cantaloupe and eggplant [30].
Water-soluble Vitamins includes Vitamin B1, Vitamin B2, Vitamin B3, Vitamin B5, Vitamin B6, Vitamin B9, Vitamin B12, Biotin and Vitamin C [21]. Vitamin B1 belongs to the group of vitamin B complex and known as thiamin. Vitamin B1 plays essential roles in human health.
It is involved in energy production from carbohydrates and fats [34]. Vitamin B1 acts as a co-enzyme precursor of some key enzymes of carbohydrate metabolism [35]. It also helps in the structural development of brain cells [36], and it is involved in the detoxification of alcohol [35]. The dietary sources of vitamin B1 are: asparagus, sunflower seeds, green peas, flax seeds, Brussels sprouts, beet greens, spinach, cabbage, eggplant, romaine lettuce, mushrooms, navy beans, black beans, barley, dried peas, lima beans, oats, sesame seeds, kidney beans, peanuts, sweet potato, tofu, tuna, pineapple, oranges, broccoli, green beans, onions, collard greens, fortified cereals, dried beans, lean meats, soy foods and whole wheat grain.
Vitamin B2 is also known as riboflavin. It is involved in energy metabolism. Vitamin B2 recycles glutathione, which is the most crucial antioxidant which protects against free radicals in the body. It also promotes iron metabolism, and its deficiency increases the risk of anaemia as iron is an essential element for red blood cell production [37].
Vitamin B3 is also known as Niacin. Niacin is a group of compounds having vitamin activity. Vitamin B3 comprised of nicotinic acid, nicotinamide, and numerous enzymatic forms [38].
Nicotinamide adenine dinucleotide NAD and nicotinamide adenine dinucleotide phosphate NADP are two distinct forms of vitamin B3, and they are primarily involved in the production of energy from dietary proteins, carbohydrates, and fats [39]. NAD, NADP, and niacin-containing enzymes are scavengers of free radicals and protect tissues from oxidative damage [40].
Dietary sources of vitamin B3 are: mushrooms, cauliflower, sweet potato, broccoli, beet greens, asparagus, turnip greens, bell peppers, cucumber, celery, avocado, lentils, dried peas, chicken, turkey, yogurt, salmon, rye, beef, eggs, potatoes, wheat, corn, shrimps, papaya, winter squash, and cow milk.
Pantothenic acid, incorporated into Coenzyme A CoAhas a central position for energy metabolism [41].
Dietary sources of vitamin B5 are fish, cauliflower, sweet potato, broccoli, beet greens, asparagus, turnip greens, bell peppers, cucumber, celery, avocado, lentils, dried peas, chicken, turkey, yogurt, salmon, rye, beef, eggs, potatoes, wheat, corn, shrimps, papaya, winter squash, cow's milk, mustard greens, tomatoes, sea vegetables, romaine lettuce.
Vitamin B6 is involved in red blood cell production, carbohydrate metabolism, liver detoxification, brain, and nervous system health [43]. Vitamin B6 involved in the generation of neurotransmitters in the brain and nervous system Vitamin B6 helps in liver detoxification, and its deficiency causes liver dysfunction [44].
Furthermore, Vitamin B6 deficiency can cause attention deficit disorder. Dietary sources of vitamin B6 are: Tuna, spinach, cabbage, bell peppers, turnip greens, garlic, cauliflower, turkey, beef, chicken, salmon, sweet potato, potatoes, banana, winter squash, broccoli, Brussels sprouts, collard greens, beet greens, kale, carrots, swiss chard, asparagus, mustard greens, tomatoes, leeks, summer squash, chili peppers, sunflower seeds, pinto beans, avocado, lentils, green peas, lima beans, onions, shrimps, and pineapple [41].
Vitamin B9 is also known as folate. It has critical importance for human health. There are different forms of flutes present in dietary sources dihydrofolates, methyl folate, poly glutamyl folates, and mono glutamyl folates [45].
Vitamin B9 is vital for brain health and provides support for the cardiovascular and nervous system in human [45]. Folates regulate homocysteine level, which is a marker for cardiovascular diseases as a higher level of homocysteine showed an increased risk of cardiovascular diseases.
Folate is a central nutrient for cardiovascular health [45, 46]. Folate is essential in the synthesis of erythrocytes.
: Antioxidant vitamins and minerals| Antioxidant Vitamins and Trace Elements in Critical Illness | Riboflavin deficiency and the function and fluidity Natural anti-inflammatory remedies rat erythrocyte membranes J Nutr Antioxidant vitamins and minerals Antioxidants minefals able to neutralize marauders such mineals free Ahd by giving up some of their own electrons. Lycopene is in many pink and red fruits and vegetables. Oxidative stress, inflammation, and cancer: how are they linked? Some of these supplements can also interact poorly with certain medications, so it is important you always check with your medical provider before choosing a supplement. |
| Frequently bought together | Products and services. Slide show: Add antioxidants to your diet. Previous Next 1 of 5 Antioxidants: Why are they important? Thank you for subscribing! Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry. Show references Antioxidants and health. National Center for Complementary and Integrative Medicine. Accessed Nov. Antioxidants and cancer prevention. National Cancer Institute. Duyff RL. Vitamins and minerals. In: Academy of Nutrition and Dietetics Complete Food and Nutrition Guide. Houghton Mifflin Harcourt; Aune D, et al. Dietary intake and blood concentrations of antioxidants and the risk of cardiovascular disease, total cancer, and all-cause mortality: A systematic review and dose-response meta-analysis of prospective studies. American Journal of Clinical Nutrition. Carlsen MH, et al. The total antioxidant content of more than foods, beverages, spices, herbs and supplements used worldwide. Nutrition Journal. Zeratsky KA expert opinion. Mayo Clinic. Izquierdo-Vega JA, et al. Evidence of some natural products with antigenotoxic effects. Part 1: Fruits and polysaccharides. Lopez-Romero D, et al. Part 2: Plants, vegetables, and natural resin. Rusu ME, et al. Health benefits of nut consumption in middle-aged and elderly population. Antioxidants Basel. Products and Services The Mayo Clinic Diet Online A Book: The Mayo Clinic Diet Bundle A Book: Cook Smart, Eat Well. Mayo Clinic Press Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Mayo Clinic on Incontinence - Mayo Clinic Press Mayo Clinic on Incontinence The Essential Diabetes Book - Mayo Clinic Press The Essential Diabetes Book Mayo Clinic on Hearing and Balance - Mayo Clinic Press Mayo Clinic on Hearing and Balance FREE Mayo Clinic Diet Assessment - Mayo Clinic Press FREE Mayo Clinic Diet Assessment Mayo Clinic Health Letter - FREE book - Mayo Clinic Press Mayo Clinic Health Letter - FREE book. SLS Healthy Lifestyle Antioxidants. Show the heart some love! Give Today. Help us advance cardiovascular medicine. Find a doctor. Explore careers. Sign up for free e-newsletters. About Mayo Clinic. About this Site. Contact Us. Health Information Policy. Media Requests. News Network. Antioxidants are said to help neutralize free radicals in our bodies, and this is thought to boost overall health. Antioxidants can protect against the cell damage that free radicals cause, known as oxidative stress. Activities and processes that can lead to oxidative stress include :. The damage caused by oxidative stress has been linked to cancer, atherosclerosis , and vision loss. It is thought that the free radicals cause changes in the cells that lead to these and possibly other conditions. Other research has indicated that antioxidant supplements may help reduce vision loss due to age-related macular degeneration in older people. Overall, however, there is a lack of evidence that a higher intake of specific antioxidants can reduce the risk of disease. In most cases, results have tended to show no benefit, or a detrimental effect, or they have been conflicting. There are thought to be hundreds and possibly thousands of substances that can act as antioxidants. Each has its own role and can interact with others to help the body work effectively. Flavonoids, flavones, catechins, polyphenols, and phytoestrogens are all types of antioxidants and phytonutrients, and they are all found in plant-based foods. Each antioxidant serves a different function and is not interchangeable with another. This is why it is important to have a varied diet. To obtain some specific antioxidants, try to include the following in your diet:. Vitamin C : Most fruits and vegetables, especially berries, oranges, and bell peppers. Vitamin E : Nuts and seeds, sunflower and other vegetable oils, and green, leafy vegetables. Beta-carotene : Brightly colored fruits and vegetables, such as carrots, peas, spinach, and mangoes. Lutein : Green, leafy vegetables, corn, papaya , and oranges. Selenium : Rice, corn, wheat, and other whole grains, as well as nuts, eggs, cheese, and legumes. Goji berries and many other food products that contain antioxidants are available to purchase online. The following foods are good sources of antioxidants. Click on each one to find out more about their health benefits and nutritional information:. Lycopene is the antioxidant that gives tomatoes their rich red color. When tomatoes are heat-treated, the lycopene becomes more bio-available easier for our bodies to process and use. However, studies have shown that cauliflower, peas, and zucchini lose much of their antioxidant activity in the cooking process. Keep in mind that the important thing is eating a variety of antioxidant-rich foods, cooked and raw. There is no set recommended daily allowance RDA for antioxidants, but a high intake of fresh plant-based produce is considered healthful. It is worth remembering that, while studies link the consumption of fruits and vegetables with better overall health, it is not clear whether how far this is due to the activity of antioxidants. In addition, caution is needed regarding supplements. The National Institutes of Health NIH warn that high doses of antioxidant supplements can be harmful. A high intake of beta-carotene, for example, has been linked to an increased risk of lung cancer in smokers. A high dose of vitamin E has been found to increase the risk of prostate cancer , and the use of some antioxidant supplements has been linked to a greater risk of tumor growth. Antioxidant supplements may also interact with some medications. It is important to speak with a health provider before using any of these products. Overall, research has not proven that taking any particular antioxidant as a supplement or through a food can protect against a disease. There may be some benefit for people at risk of age-related macular degeneration, but it is essential to seek advice from a doctor about whether to use supplements, and which ones to use. Free radicals have been linked to a range of diseases, including heart disease, cancer, and vision loss, but this does not mean that an increased intake of antioxidants will prevent these diseases. Antioxidants from artificial sources may increase the risk of some health problems. As a result, it is important to seek out natural sources of antioxidants, in the form of a healthful diet. Consuming fruits and vegetables has been linked to a lower rate of chronic diseases, and antioxidants may play a role. However, it is unlikely that consuming added antioxidants, especially in processed foods, will provide significant benefits. In addition, anyone considering taking antioxidant supplements should speak to a health provider first. Read the article in Spanish. Free radicals are unstable atoms that can cause damage to cells and lead to illnesses and the aging process. Exactly what impact do they have on the…. Eating a balanced diet is vital for healthful living. Figs contain protein, fiber, and iron, among many other nutrients. Learn more about the…. What are micronutrients? Read on to learn more about these essential vitamins and minerals, the role they play in supporting health, as well as…. Adding saffron supplements to standard-of-care treatment for ulcerative colitis may help reduce inflammation and positively benefit patients, a new…. My podcast changed me Can 'biological race' explain disparities in health? Why Parkinson's research is zooming in on the gut Tools General Health Drugs A-Z Health Hubs Health Tools Find a Doctor BMI Calculators and Charts Blood Pressure Chart: Ranges and Guide Breast Cancer: Self-Examination Guide Sleep Calculator Quizzes RA Myths vs Facts Type 2 Diabetes: Managing Blood Sugar Ankylosing Spondylitis Pain: Fact or Fiction Connect About Medical News Today Who We Are Our Editorial Process Content Integrity Conscious Language Newsletters Sign Up Follow Us. |
| About this item | The research results were mixed, but most did not find the hoped-for benefits. Antioxidants are still added to breakfast cereals, sports bars, energy drinks, and other processed foods , and they are promoted as additives that can prevent heart disease, cancer, cataracts, memory loss, and other conditions. Randomized placebo-controlled trials, which can provide the strongest evidence, offer little support that taking vitamin C, vitamin E, beta-carotene, or other single antioxidants provides substantial protection against heart disease, cancer, or other chronic conditions. The results of the largest trials have been mostly negative. A modest effect of vitamin E has been found in some studies but more research is needed. A study from the Journal of Respiratory Research found that different isoforms of vitamin E called tocopherols had opposing effects on lung function. Lung function was tested using spirometric parameters: higher parameters are indicative of increased lung function, while lower parameters are indicative of decreased lung function. The study found that higher serum levels of alpha-tocopherol were associated with higher spirometric parameters and that high serum levels of gamma-tocopherol were associated with lower spirometric parameters. Though the study was observational in nature, it confirmed the mechanistic pathway of alpha- and gamma-tocopherol in mice studies. When it comes to cancer prevention, the picture remains inconclusive for antioxidant supplements. Few trials have gone on long enough to provide an adequate test for cancer. High-dose antioxidant supplements can also interfere with medicines. Vitamin E supplements can have a blood-thinning effect and increase the risk of bleeding in people who are already taking blood-thinning medicines. Some studies have suggested that taking antioxidant supplements during cancer treatment might interfere with the effectiveness of the treatment. Inform your doctor if starting supplements of any kind. One possible reason why many studies on antioxidant supplements do not show a health benefit is because antioxidants tend to work best in combination with other nutrients, plant chemicals, and even other antioxidants. For example, a cup of fresh strawberries contains about 80 mg of vitamin C, a nutrient classified as having high antioxidant activity. Polyphenols also have many other chemical properties besides their ability to serve as antioxidants. There is a question if a nutrient with antioxidant activity can cause the opposite effect with pro-oxidant activity if too much is taken. This is why using an antioxidant supplement with a single isolated substance may not be an effective strategy for everyone. Differences in the amount and type of antioxidants in foods versus those in supplements might also influence their effects. For example, there are eight chemical forms of vitamin E present in foods. However, vitamin E supplements typically only include one form, alpha-tocopherol. Epidemiological prospective studies show that higher intakes of antioxidant-rich fruits, vegetables, and legumes are associated with a lower risk of chronic oxidative stress-related diseases like cardiovascular diseases , cancer, and deaths from all causes. The following are nutrients with antioxidant activity and the foods in which they are found:. Excessive free radicals contribute to chronic diseases including cancer, heart disease, cognitive decline, and vision loss. Keep in mind that most of the trials conducted have had fundamental limitations due to their relatively short duration and inclusion of people with existing disease. At the same time, abundant evidence suggests that eating whole in fruits , vegetables , and whole grains —all rich in networks of naturally occurring antioxidants and their helper molecules—provides protection against many scourges of aging. The contents of this website are for educational purposes and are not intended to offer personal medical advice. You should seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The Nutrition Source does not recommend or endorse any products. Skip to content The Nutrition Source. The Nutrition Source Menu. Search for:. Home Nutrition News What Should I Eat? In , a rating tool called the Oxygen Radical Absorbance Capacity ORAC was created by scientists from the National Institute on Aging and the United States Department of Agriculture USDA. It was used to measure the antioxidant capacity of foods. The USDA provided an ORAC database on its website highlighting foods with high ORAC scores, including cocoa, berries, spices, and legumes. Blueberries and other foods topping the list were heavily promoted in the popular press as disease-fighters even if the science was weak, from cancer to brain health to heart disease. However, 20 years later the USDA retracted the information and removed the database after determining that antioxidants have many functions, not all of which are related to free radical activity. Although this was not a primary endpoint for the trial, it nevertheless represents an important outcome. In the Heart Outcomes Prevention Evaluation HOPE trial, the rates of major cardiovascular events were essentially the same in the vitamin E A recent trial of vitamin E in Israel, for example, showed a marked reduction in coronary heart disease among people with type 2 diabetes who have a common genetic predisposition for greater oxidative stress. In the Supplementation en Vitamines et Mineraux Antioxydants SU. MAX study, 13, French men and women took a single daily capsule that contained mg vitamin C, 30 mg vitamin E, 6 mg beta-carotene, mcg selenium, and 20 mg zinc, or a placebo, for seven and a half years. The vitamins had no effect on overall rates of cardiovascular disease. Lung disease A study from the Journal of Respiratory Research found that different isoforms of vitamin E called tocopherols had opposing effects on lung function. Cancer When it comes to cancer prevention, the picture remains inconclusive for antioxidant supplements. MAX randomized placebo-controlled trial showed a reduction in cancer risk and all-cause mortality among men taking an antioxidant cocktail low doses of vitamins C and E, beta-carotene, selenium, and zinc but no apparent effect in women, possibly because men tended to have low blood levels of beta-carotene and other vitamins at the beginning of the study. Age-related eye disease A six-year trial, the Age-Related Eye Disease Study AREDS , found that a combination of vitamin C, vitamin E, beta-carotene, and zinc offered some protection against the development of advanced age-related macular degeneration, but not cataracts, in people who were at high risk of the disease. However, relatively short trials of lutein supplementation for age-related macular degeneration have yielded conflicting findings. The study found that people taking the vitamins were less likely to progress to late-stage AMD and vision loss. However, the study authors noted that taking lutein and zeaxanthin alone or vitamin E alone did not have a beneficial effect on these eye conditions. The Selenium and Vitamin E Cancer Prevention Trial SELECT Eye Endpoints Study, which followed 11, men for a mean of five years, did not find that vitamin E and selenium supplements, in combination or alone, protected from age-related cataracts. It did not find that antioxidant supplements of vitamin E or selenium, alone or in combination, protected against dementia compared with a placebo. Early death A meta-analysis of 68 antioxidant supplement trials found that taking beta-carotene and vitamin A and E supplements increased the risk of dying. It was also difficult to compare interventions because the types of supplements, the dosages taken, and the length of time they were taken varied widely. The same authors conducted another systematic review of 78 randomized clinical trials on antioxidant supplements including beta-carotene, vitamin A, vitamin C, vitamin E, and selenium alone or in combination. The study found that both people who were healthy and those with diseases taking beta-carotene and vitamin E supplements had a higher rate of death. The duration of the studies varied widely from one month to 12 years, with varying dosages. The first inkling came in a large trial of beta-carotene conducted among men in Finland who were heavy smokers, and therefore at high risk for developing lung cancer. The trial was stopped early when researchers saw a significant increase in lung cancer among those taking the supplement compared to those taking the placebo. Again, an increase in lung cancer was seen in the supplement group. MAX trial, rates of skin cancer were higher in women who were assigned to take vitamin C, vitamin E, beta-carotene, selenium, and zinc. These results came from the Selenium and Vitamin E Cancer Prevention Trial SELECT that followed 35, men for up to 12 years. References National Center for Complementary and Integrative Health NCCIH. Antioxidants: In Depth. Carlsen MH, Halvorsen BL, Holte K, Bøhn SK, Dragland S, Sampson L, Willey C, Senoo H, Umezono Y, Sanada C, Barikmo I. The total antioxidant content of more than foods, beverages, spices, herbs and supplements used worldwide. Nutrition journal. Semba RD, Ferrucci L, Bartali B, Urpí-Sarda M, Zamora-Ros R, Sun K, Cherubini A, Bandinelli S, Andres-Lacueva C. Resveratrol levels and all-cause mortality in older community-dwelling adults. JAMA internal medicine. Grodstein F, Kang JH, Glynn RJ, Cook NR, Gaziano JM. Archives of internal medicine. USDA Oxygen Radical Absorbance Capacity ORAC of Selected Foods, Release 2 Lee IM, Cook NR, Gaziano JM, Gordon D, Ridker PM, Manson JE, Hennekens CH, Buring JE. Lonn E, Bosch J, Yusuf S, Sheridan P, Pogue J, Arnold JM, Ross C, Arnold A, Sleight P, Probstfield J, Dagenais GR. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. GISSI-Prevenzione Investigators. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. The Lancet. Milman U, Blum S, Shapira C, Aronson D, Miller-Lotan R, Anbinder Y, Alshiek J, Bennett L, Kostenko M, Landau M, Keidar S. Vitamin E supplementation reduces cardiovascular events in a subgroup of middle-aged individuals with both type 2 diabetes mellitus and the haptoglobin genotype: a prospective double-blinded clinical trial. Arteriosclerosis, thrombosis, and vascular biology. Hennekens CH, Buring JE, Manson JE, Stampfer M, Rosner B, Cook NR, Belanger C, LaMotte F, Gaziano JM, Ridker PM, Willett W. Furthermore, low antioxidant levels may even be beneficial as pro-oxidants are essential in bacterial killing. The reviewed studies in critically ill patients show conflicting results. This may be due to different patient populations, study designs, timing, dosing regimens, and duration of the intervention and outcome measures evaluated. Therefore, at present, it remains unclear whether supplementation of antioxidant micronutrients has any clinical benefit in critically ill patients as some studies show clear benefits, whereas others demonstrate neutral outcomes and even harm. Combination therapy of antioxidants seems logical as they work in synergy and function as elements of the human antioxidant network. Further research should focus on defining the normal antioxidant status for critically ill patients and to study optimal supplement combinations either by nutrition enrichment or by enteral or parenteral pharmacological interventions. Keywords: antioxidants; critical care; critically ill; selenium; trace elements; vitamin A; vitamin C; vitamin E; vitamins; zinc. |
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