Antioxidant

Space-filling model of the antioxidant metabolite glutathione. The yellow sphere is the redox-active sulfur atom that provides antioxidant activity, while the red, blue, white, and dark grey spheres represent oxygen, nitrogen, hydrogen, and carbon atoms, respectively.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

## Overview

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An antioxidant is a molecule capable of slowing or preventing the oxidation of other molecules. Oxidation is a chemical reaction that transfers electrons from a substance to an oxidizing agent. Oxidation reactions can produce free radicals, which start chain reactions that damage cells. Antioxidants terminate these chain reactions by removing free radical intermediates, and inhibit other oxidation reactions by being oxidized themselves. As a result, antioxidants are often reducing agents such as thiols or polyphenols.

Although oxidation reactions are crucial for life, they can also be damaging; hence, plants and animals maintain complex systems of multiple types of antioxidants, such as glutathione, vitamin C, and vitamin E as well as enzymes such as catalase, superoxide dismutase and various peroxidases. Low levels of antioxidants, or inhibition of the antioxidant enzymes, causes oxidative stress and may damage or kill cells.

As oxidative stress might be an important part of many human diseases, the use of antioxidants in pharmacology is intensively studied, particularly as treatments for stroke and neurodegenerative diseases. However, it is unknown whether oxidative stress is the cause or the consequence of disease. Antioxidants are also widely used as ingredients in dietary supplements in the hope of maintaining health and preventing diseases such as cancer and coronary heart disease. Although some studies have suggested antioxidant supplements have health benefits, other large clinical trials did not detect any benefit for the formulations tested, and excess supplementation may be harmful.[1] In addition to these uses in medicine, antioxidants have many industrial uses, such as preservatives in food and cosmetics and preventing the degradation of rubber and gasoline.

## History

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The term antioxidant originally was used to refer specifically to a chemical that prevented the consumption of oxygen. In the late 19th and early 20th century, extensive study was devoted to the uses of antioxidants in important industrial processes, such as the prevention of metal corrosion, the vulcanization of rubber, and the polymerization of fuels in the fouling of internal combustion engines.[2]

Early research on the role of antioxidants in biology focused on their use in preventing the oxidation of unsaturated fats, which is the cause of rancidity.[3] Antioxidant activity could be measured simply by placing the fat in a closed container with oxygen and measuring the rate of oxygen consumption. However, it was the identification of vitamins A, C, and E as antioxidants that revolutionized the field and led to the realization of the importance of antioxidants in biochemistry of living organisms.[4][5]

The possible mechanisms of action of antioxidants were first explored when it was recognized that a substance with anti-oxidative activity is likely to be one that is itself readily oxidized.[6] Research into how vitamin E prevents the process of lipid peroxidation led to the identification of antioxidants as reducing agents that prevent oxidative reactions, often by scavenging reactive oxygen species before they can damage cells.[7]

## The oxidative challenge in biology

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Further information: [[:Oxidative stress]]

The structure of the antioxidant vitamin ascorbic acid (vitamin C).

A paradox in metabolism is that while the vast majority of complex life requires oxygen for its existence, oxygen is a highly reactive molecule that damages living organisms by producing reactive oxygen species.[8] Consequently, organisms contain a complex network of antioxidant metabolites and enzymes that work together to prevent oxidative damage to cellular components such as DNA, proteins and lipids.[9][10] In general, antioxidant systems either prevent these reactive species from being formed, or remove them before they can damage vital components of the cell.[9][8]

The reactive oxygen species produced in cells include hydrogen peroxide (H2O2), hypochlorous acid (HClO), and free radicals such as the hydroxyl radical (·OH) and the superoxide anion (O2−).[11] The hydroxyl radical is particularly unstable and will react rapidly and non-specifically with most biological molecules. This species is produced from hydrogen peroxide in metal-catalyzed redox reactions such as the Fenton reaction.[12] These oxidants can damage cells by starting chemical chain reactions such as lipid peroxidation, or by oxidizing DNA or proteins.[9] Damage to DNA can cause mutations and possibly cancer, if not reversed by DNA repair mechanisms,[13][14] while damage to proteins causes enzyme inhibition, denaturation and protein degradation.[15]

The use of oxygen as part of the process for generating metabolic energy produces reactive oxygen species.[16] In this process, the superoxide anion is produced as a by-product of several steps in the electron transport chain.[17] Particularly important is the reduction of coenzyme Q in complex III, since a highly reactive free radical is formed as an intermediate (Q·−). This unstable intermediate can lead to electron "leakage", when electrons jump directly to oxygen and form the superoxide anion, instead of moving through the normal series of well-controlled reactions of the electron transport chain.[18] In a similar set of reactions in plants, reactive oxygen species are also produced during photosynthesis under conditions of high light intensity.[19] This effect is partly offset by the involvement of carotenoids in photoinhibition, which involves these antioxidants reacting with over-reduced forms of the photosynthetic reaction centres to prevent the production of reactive oxygen species.[20]

## Metabolites

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### Overview

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Antioxidants are classified into two broad divisions, depending on whether they are soluble in water (hydrophilic) or in lipids (hydrophobic). In general, water-soluble antioxidants react with oxidants in the cell cytoplasm and the blood plasma, while lipid-soluble antioxidants protect cell membranes from lipid peroxidation.[9] These compounds may be synthesized in the body or obtained from the diet.[10] The different antioxidants are present at a wide range of concentrations in body fluids and tissues, with some such as glutathione or ubiquinone mostly present within cells, while others such as uric acid are more evenly distributed (see table below).

The relative importance and interactions between these different antioxidants is a very complex question, with the various metabolites and enzyme systems having synergistic and interdependent effects on one another.[21][22] The action of one antioxidant may therefore depend on the proper function of other members of the antioxidant system.[10] The amount of protection provided by any one antioxidant will also depend on its concentration, its reactivity towards the particular reactive oxygen species being considered, and the status of the antioxidants with which it interacts.[10]

Some compounds contribute to antioxidant defense by chelating transition metals and preventing them from catalyzing the production of free radicals in the cell. Particularly important is the ability to sequester iron, which is the function of iron-binding proteins such as transferrin and ferritin.[23] Selenium and zinc are commonly referred to as antioxidant nutrients, but these chemical elements have no antioxidant action themselves and are instead required for the activity of some antioxidant enzymes, as is discussed below.

Antioxidant metabolite  | Solubility  | Concentration in human serum (μM)[24] | Concentration in liver tissue (μmol/kg)

|
|
|

Ascorbic acid (vitamin C)  | Water  | 50 – 60[25] | 260 (human)[26]
Glutathione | Water  | 325 – 650[27] | 6,400 (human)[26]
Lipoic acid | Water  | 0.1 – 0.7[28] | 4 – 5 (rat)[29]
Uric acid | Water  | 200 – 400[30] | 1,600 (human)[26]
Carotenes | Lipid  | β-carotene: 0.5 – 1[31]

retinol (vitamin A): 1 – 3[32]

| 5 (human, total carotenoids)[33]
α-tocopherol (vitamin E)  | Lipid  | 10 – 40[32] | 50 (human)[26]
Ubiquinol (coenzyme Q)  | Lipid  | 5[34] | 200 (human)[35]

### Ascorbic acid

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Ascorbic acid or "vitamin C" is a monosaccharide antioxidant found in both animals and plants. As it cannot be synthesised in humans and must be obtained from the diet, it is a vitamin.[36] Most other animals are able to produce this compound in their bodies and do not require it in their diets.[37] In cells, it is maintained in its reduced form by reaction with glutathione, which can be catalysed by protein disulfide isomerase and glutaredoxins.[38][39] Ascorbic acid is a reducing agent and can reduce and thereby neutralize reactive oxygen species such as hydrogen peroxide.[40] In addition to its direct antioxidant effects, ascorbic acid is also a substrate for the antioxidant enzyme ascorbate peroxidase, a function that is particularly important in stress resistance in plants.[41]

### Glutathione

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The free radical mechanism of lipid peroxidation.

Glutathione is a cysteine-containing peptide found in most forms of aerobic life.[42] It is not required in the diet and is instead synthesized in cells from its constituent amino acids.[43] Glutathione has antioxidant properties since the thiol group in its cysteine moiety is a reducing agent and can be reversibly oxidized and reduced. In cells, glutathione is maintained in the reduced form by the enzyme glutathione reductase and in turn reduces other metabolites and enzyme systems as well as reacting directly with oxidants.[38] Due to its high concentration and its central role in maintaining the cell's redox state, glutathione is one of the most important cellular antioxidants.[42]

### Melatonin

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Melatonin is a powerful antioxidant that can easily cross cell membranes and the blood-brain barrier.[44] Unlike other antioxidants, melatonin does not undergo redox cycling, which is the ability of a molecule to undergo repeated reduction and oxidation. Redox cycling may allow other antioxidants (such as vitamin C) to act as pro-oxidants and promote free radical formation. Melatonin, once oxidized, cannot be reduced to its former state because it forms several stable end-products upon reacting with free radicals. Therefore, it has been referred to as a terminal (or suicidal) antioxidant.[45]

### Tocopherols and tocotrienols (vitamin E)

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Vitamin E is the collective name for a set of eight related tocopherols and tocotrienols, which are fat-soluble vitamins with antioxidant properties.[46][47] Of these, α-tocopherol has been most studied as it has the highest bioavailability, with the body preferentially absorbing and metabolising this form.[48]

It has been claimed that the α-tocopherol form is the most important lipid-soluble antioxidant, and that it protects membranes from oxidation by reacting with lipid radicals produced in the lipid peroxidation chain reaction.[46][49] This removes the free radical intermediates and prevents the propagation reaction from continuing. This reaction produces oxidised α-tocopheroxyl radicals that can be recycled back to the active reduced form through reduction by other antioxidants, such as ascorbate, retinol or ubiquinol.[50]

However, the roles and importance of the various forms of vitamin E are presently unclear,[51][52] and it has even been suggested that the most important function of α-tocopherol is as a signaling molecule, with this molecule having no significant role in antioxidant metabolism.[53][54] The functions of the other forms of vitamin E are even less well-understood, although γ-tocopherol is a nucleophile that may react with electrophilic mutagens,[48] and tocotrienols may be important in protecting neurons from damage.[55]

## Pro-oxidant activities

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Further information: [[:Pro-oxidant]]

Antioxidants that are reducing agents can also act as pro-oxidants. For example, vitamin C has antioxidant activity when it reduces oxidizing substances such as hydrogen peroxide,[56] however, it will also reduce metal ions that generate free radicals through the Fenton reaction.[57][58]

2 Fe3+ \+ Ascorbate → 2 Fe2+ \+ Dehydroascorbate

2 Fe2+ \+ 2 H2O2 → 2 Fe3+ \+ 2 OH· \+ 2 OH−

The relative importance of the antioxidant and pro-oxidant activities of antioxidants are an area of current research, but vitamin C, for example, appears to have a mostly antioxidant action in the body.[59][57] However, fewer data are available for other dietary antioxidants, such as vitamin E.[60]

## Enzyme systems

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Enzymatic pathway for detoxification of reactive oxygen species.

### Overview

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As with the chemical antioxidants, cells are protected against oxidative stress by an interacting network of antioxidant enzymes.[9][8] Here, the superoxide released by processes such as oxidative phosphorylation is first converted to hydrogen peroxide and then further reduced to give water. This detoxification pathway is the result of multiple enzymes, with superoxide dismutases catalysing the first step and then catalases and various peroxidases removing hydrogen peroxide. As with antioxidant metabolites, the contributions of these enzymes to the antioxidant defenses of a cell can be hard to separate from one another, but the generation of transgenic mice lacking just one antioxidant enzyme can be informative.[61]

### Superoxide dismutase, catalase and peroxiredoxins

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Superoxide dismutases (SODs) are a class of closely related enzymes that catalyse the breakdown of the superoxide anion into oxygen and hydrogen peroxide.[62][63] SOD enzymes are present in almost all aerobic cells and in extracellular fluids.[64] Superoxide dismutase enzymes contain metal ion cofactors that, depending on the isozyme, can be copper, zinc, manganese or iron. In humans, the copper/zinc SOD is present in the cytosol, while manganese SOD is present in the mitochondrion.[63] There also exists a third form of SOD in extracellular fluids, which contains copper and zinc in its active sites.[65] The mitochondrial isozyme seems to be the most biologically important of these three, since mice lacking this enzyme die soon after birth.[66] In contrast, the mice lacking copper/zinc SOD are viable but have lowered fertility, while mice without the extracellular SOD have minimal defects.[61][67] In plants, SOD isozymes are present in the cytosol and mitochondria, with an iron SOD found in chloroplasts that is absent from vertebrates and yeast.[68]

Catalases are enzymes that catalyse the conversion of hydrogen peroxide to water and oxygen, using either an iron or manganese cofactor.[69][70] This protein is localized to peroxisomes in most eukaryotic cells.[71] Catalase is an unusual enzyme since, although hydrogen peroxide is its only substrate, it follows a ping-pong mechanism. Here, its cofactor is oxidised by one molecule of hydrogen peroxide and then regenerated by transferring the bound oxygen to a second molecule of substrate.[72] Despite its apparent importance in hydrogen peroxide removal, humans with genetic deficiency of catalase — "acatalasemia" — or mice genetically engineered to lack catalase completely, suffer few ill effects.[73][74]

Decameric structure of AhpC, a bacterial 2-cysteine peroxiredoxin from Salmonella typhimurium.[75]

Peroxiredoxins are peroxidases that catalyze the reduction of hydrogen peroxide, organic hydroperoxides, as well as peroxynitrite.[76] They are divided into three classes: typical 2-cysteine peroxiredoxins; atypical 2-cysteine peroxiredoxins; and 1-cysteine peroxiredoxins.[77] These enzymes share the same basic catalytic mechanism, in which a redox-active cysteine (the peroxidatic cysteine) in the active site is oxidized to a sulfenic acid by the peroxide substrate.[78] Peroxiredoxins seem to be important in antioxidant metabolism, as mice lacking peroxiredoxin 1 or 2 have shortened lifespan and suffer from hemolytic anaemia, while plants use peroxiredoxins to remove hydrogen peroxide generated in chloroplasts.[79][80][81]

### Thioredoxin and glutathione systems

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The thioredoxin system contains the 12-kDa protein thioredoxin and its companion thioredoxin reductase.[82] Proteins related to thioredoxin are present in all sequenced organisms, with plants such as Arabidopsis thaliana having a particularly great diversity of isoforms.[83] The active site of thioredoxin consists of two neighboring cysteines, as part of a highly-conserved CXXC motif, that can cycle between an active dithiol form (reduced) and an oxidized disulfide form. In its active state, thioredoxin acts as an efficient reducing agent, scavenging reactive oxygen species and maintaining other proteins in their reduced state.[84] After being oxidized, the active thioredoxin is regenerated by the action of thioredoxin reductase, using NADPH as an electron donor.[85]

The glutathione system includes glutathione, glutathione reductase, glutathione peroxidases and glutathione S-transferases.[42] This system is found in animals, plants and microorganisms.[86][42] Glutathione peroxidase is an enzyme containing four selenium-cofactors that catalyzes the breakdown of hydrogen peroxide and organic hydroperoxides. There are at least four different glutathione peroxidase isozymes in animals.[87] Glutathione peroxidase 1 is the most abundant and is a very efficient scavenger of hydrogen peroxide, while glutathione peroxidase 4 is most active with lipid hydroperoxides. Surprisingly, glutathione peroxidase 1 is dispensable, as mice lacking this enzyme have normal lifespans,[88] but they are hypersensitive to induced oxidative stress.[89] In addition, the glutathione S-transferases are another class of glutathione-dependent antioxidant enzymes that show high activity with lipid peroxides.[90] These enzymes are at particularly high levels in the liver and also serve in detoxification metabolism.[91]

## Oxidative stress in disease

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Further information: [[:Pathology, Free-radical theory of aging]]

Oxidative stress is thought to contribute to the development of a wide range of diseases including Alzheimer's disease,[92][93] Parkinson's disease,[94] the pathologies caused by diabetes,[95][96] rheumatoid arthritis,[97] and neurodegeneration in motor neurone diseases.[98] In many of these cases, it is unclear if oxidants trigger the disease, or if they are produced as a consequence of the disease and cause the disease symptoms;[11] as a plausible alternative, a neurodegenerative disease might result from defective axonal transport of mitochondria, which carry out oxidation reactions. One case in which this link is particularly well-understood is the role of oxidative stress in cardiovascular disease. Here, low density lipoprotein (LDL) oxidation appears to trigger the process of atherogenesis, which results in atherosclerosis, and finally cardiovascular disease.[99][100]

A low calorie diet extends median and maximum lifespan in many animals. This effect may involve a reduction in oxidative stress.[101] While there is good evidence to support the role of oxidative stress in aging in model organisms such as Drosophila melanogaster and Caenorhabditis elegans,[102][103] the evidence in mammals is less clear.[104][105][106] Diets high in fruit and vegetables, which are high in antioxidants, promote health and reduce the effects of aging, however antioxidant vitamin supplementation has no detectable effect on the aging process, so the effects of fruit and vegetables may be unrelated to their antioxidant contents.[107][108] One reason for this might be the fact that consuming antioxidant molecules such as polyphenols and vitamin E will produce changes in other parts of metabolism, so it may be these other non-antioxidant effects that are the real reason they are important in human nutrition.[109][53]

## Health effects

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### Disease treatment

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The brain is uniquely vulnerable to oxidative injury, due to its high metabolic rate and elevated levels of polyunsaturated lipids, the target of lipid peroxidation.[110] Consequently, antioxidants are commonly used as medications to treat various forms of brain injury. Here, superoxide dismutase mimetics,[111] sodium thiopental and propofol are used to treat reperfusion injury and traumatic brain injury,[112] while the experimental drug NXY-059[113][114] and ebselen[115] are being applied in the treatment of stroke. These compounds appear to prevent oxidative stress in neurons and prevent apoptosis and neurological damage. Antioxidants are also being investigated as possible treatments for neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis,[116][117] and as a way to prevent noise-induced hearing loss.[118]

### Disease prevention

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Error creating thumbnail: File missingStructure of the polyphenol antioxidant resveratrol.

Antioxidants can cancel out the cell-damaging effects of free radicals.[9] Furthermore, people who eat fruits and vegetables, which are good sources of antioxidants, have a lower risk of heart disease and some neurological diseases,[119] and there is evidence that some types of vegetables, and fruits in general, probably protect against a number of cancers.[120] These observations suggested that antioxidants might help prevent these conditions. There is some evidence that antioxidants might help prevent diseases such as macular degeneration,[121] suppressed immunity due to poor nutrition,[122] and neurodegeneration.[123] However, despite the clear role of oxidative stress in cardiovascular disease, controlled studies using antioxidant vitamins have observed no reduction in either the risk of developing heart disease, or the rate of progression of existing disease.[124][125] This suggests that other substances in fruit and vegetables (possibly flavonoids), or a complex mix of substances, may contribute to the better cardiovascular health of those who consume more fruit and vegetables.[126][127]

It is thought that oxidation of low density lipoprotein in the blood contributes to heart disease, and initial observational studies found that people taking Vitamin E supplements had a lower risk of developing heart disease.[128] Consequently, at least seven large clinical trials were conducted to test the effects of antioxidant supplement with Vitamin E, in doses ranging from 50 to 600 mg per day. However, none of these trials found a statistically significant effect of Vitamin E on overall number of deaths or on deaths due to heart disease.[129] It is not clear if the doses used in these trials or in most dietary supplements are capable of producing any significant decrease in oxidative stress.[130]

While several trials have investigated supplements with high doses of antioxidants, the "Supplémentation en Vitamines et Mineraux Antioxydants" (SU.VI.MAX) study tested the effect of supplementation with doses comparable to those in a healthy diet.[131] Over 12,500 French men and women took either low-dose antioxidants (120 mg of ascorbic acid, 30 mg of vitamin E, 6 mg of beta carotene, 100 <math>\mu</math>g of selenium, and 20 mg of zinc) or placebo pills for an average of 7.5 years. The investigators found there was no statistically significant effect of the antioxidants on overall survival, cancer, or heart disease. However, a subgroup analysis showed a 31% reduction in the risk of cancer in men, but not women.

Many nutraceutical and health food companies now sell formulations of antioxidants as dietary supplements and these are widely used in industrialized countries.[132] These supplements may include specific antioxidant chemicals, like resveratrol (from grape seeds), combinations of antioxidants, like the "ACES" products that contain beta carotene (provitamin A), vitamin C, vitamin E and Selenium, or herbs that contain antioxidants - such as green tea and jiaogulan. Although some levels of antioxidant vitamins and minerals in the diet are required for good health, there is considerable doubt as to whether antioxidant supplementation is beneficial, and if so, which antioxidant(s) are beneficial and in what amounts.[133][134][119]

It has been suggested that moderate levels of oxidative stress may increase life expectancy of in the worm Caenorhabditis elegans, by inducing a protective response to increased levels of reactive oxygen species.[135] However, the suggestion that increased life expectancy comes from increased oxidative stress conflicts with results seen in the yeast Saccharomyces cerevisiae,[136] and the situation in mammals is even less clear.[104][137][138]

### Physical exercise

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During exercise, oxygen consumption can increase by a factor of more than 10.[139] This leads to a large increase in the production of oxidants and results in damage that contributes to muscular fatigue during and after exercise. The inflammatory response that occurs after strenuous exercise is also associated with oxidative stress, especially in the 24 hours after an exercise session. The immune system response to damage done by exercise peaks 2 to 7 days after exercise, the period during which adaptation resulting in greater fitness is greatest. During this process, free radicals are produced by neutrophils to remove damaged tissue. As a result, excessive antioxidant levels have the potential to inhibit recovery and adaptation mechanisms.[140]

The evidence for benefits from antioxidant supplementation in vigorous exercise is mixed. There is strong evidence that one of the adaptations resulting from exercise is a strengthening of the body's antioxidant defenses, particularly the glutathione system, to deal with the increased oxidative stress.[141] It is possible that this effect may be to some extent protective against diseases which are associated with oxidative stress, which would provide a partial explanation for the lower incidence of major diseases and better health of those who undertake regular exercise.[142]

However, no benefits to athletes are seen with vitamin A or E supplementation.[143] For example, despite its key role in preventing lipid membrane peroxidation, 6 weeks of vitamin E supplementation had no effect on muscle damage in ultramarathon runners.[144] Although there appears to be no increased requirement for vitamin C in athletes, there is some evidence that vitamin C supplementation increased the amount of intense exercise that can be done and vitamin C supplementation before strenuous exercise may reduce the amount of muscle damage.[145][146] However, other studies found no such effects, and some research suggests that supplementation with amounts as high as 1000 mg inhibits recovery.[147]

### Adverse effects

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Further information: [[:Micronutrients]]

Structure of the metal chelator phytic acid.

Relatively strong reducing acids can have anti-nutritional effects by binding to dietary minerals such as iron and zinc in the gastrointestinal tract and preventing them from being absorbed.[148] Notable examples are oxalic acid, tannins and phytic acid, which are high in plant-based diets.[149] Calcium and iron deficiencies are not uncommon in diets in developing countries where less meat is eaten and there is high consumption of phytic acid from beans and unleavened whole grain bread.[150]

Foods  | Reducing acid present

|

Cocoa and chocolate, spinach, turnip and rhubarb.[151] | Oxalic acid
Whole grains, maize, legumes.[152] | Phytic acid
Tea, beans, cabbage.[153][151] | Tannins

Nonpolar antioxidants such as eugenol, a major component of oil of cloves have toxicity limits that can be exceeded with the misuse of undiluted essential oils.[154] Toxicity associated with high doses of water-soluble antioxidants such as ascorbic acid are less of a concern, as these compounds can be excreted rapidly in urine.[155] More seriously, very high doses of some antioxidants may have harmful long-term effects. The beta-Carotene and Retinol Efficacy Trial (CARET) study of lung cancer patients found that smokers given supplements containing beta-carotene and vitamin A had increased rates of lung cancer.[156] Subsequent studies confirmed these adverse effects.[157]

These harmful effects may also be seen in non-smokers, as a recent meta-analysis including data from approximately 230,000 patients showed that β-carotene, vitamin A or vitamin E supplementation is associated with increased mortality but saw no significant effect from vitamin C.[158] No health risk was seen when all the randomized controlled studies were examined together, but an increase in mortality was detected only when the high-quality and low-bias risk trials were examined separately. However, as the majority of these low-bias trials dealt with either elderly people, or people already suffering disease, these results may not apply to the general population.[159] This meta-analysis was later repeated and extended by the same authors, with the new analysis published by the Cochrane Collaboration; confirming the previous results.[160] These two publications are consistent with some previous meta-analyzes that also suggested that Vitamin E supplementation increased mortality,[161] and that antioxidant supplements increased the risk of colon cancer.[162] However, the results of this meta-analysis are inconsistent with other studies such as the SU.VI.MAX trial, which suggested that antioxidants have no effect on cause-all mortality.[131][163][164][165] Overall, the large number of clinical trials carried out on antioxidant supplements suggest that either these products have no effect on health, or that they cause a small increase in mortality in elderly or vulnerable populations.[133][119][158]

While antioxidant supplementation is widely used in attempts to prevent the development of cancer, it has been proposed that antioxidants may, paradoxically, interfere with cancer treatments.[166] This was thought to occur since the environment of cancer cells causes high levels of oxidative stress, making these cells more susceptible to the further oxidative stress induced by treatments. As a result, by reducing the redox stress in cancer cells, antioxidant supplements were thought to decrease the effectiveness of radiotherapy and chemotherapy.[167] However, this concern appears not to be valid, as it has been addressed by multiple clinical trials that indicate that antioxidants are either neutral or beneficial in cancer therapy.[168][169]

## Measurement and levels in food

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Further information: [[:List of antioxidants in food, Polyphenol antioxidants]]

File:Vegetarian diet.jpgFruits and vegetables are good sources of antioxidants.

Measurement of antioxidants is not a straightforward process, as this is a diverse group of compounds with different reactivities to different reactive oxygen species. In food science, the oxygen radical absorbance capacity (ORAC) has become the current industry standard for assessing antioxidant strength of whole foods, juices and food additives.[170][171] Other measurement tests include the Folin-Ciocalteu reagent, and the trolox equivalent antioxidant capacity assay.[172] In medicine, a range of different assays are used to assess the antioxidant capability of blood plasma and of these, the ORAC assay may be the most reliable.[173]

Antioxidants are found in varying amounts in foods such as vegetables, fruits, grain cereals, legumes and nuts. Some antioxidants such as lycopene and ascorbic acid can be destroyed by long-term storage or prolonged cooking.[174][175] Other antioxidant compounds are more stable, such as the polyphenolic antioxidants in foods such as whole-wheat cereals and tea.[176][177] In general, processed foods contain less antioxidants than fresh and uncooked foods, since the preparation processes may expose the food to oxygen.[178]

Antioxidant compounds  | Foods containing high levels of these antioxidants[179][153][180]

|

Vitamin C (ascorbic acid)  | Fruits and vegetables
Vitamin E (tocopherols, tocotrienols)  | Vegetable oils
Polyphenolic antioxidants (resveratrol, flavonoids)  | Tea, coffee, soy, fruit, olive oil, chocolate, oregano and red wine.
Carotenoids (lycopene, carotenes)  | Fruit and vegetables

Some antioxidants are made in the body and are not absorbed from the intestine. One example is glutathione, which is made from amino acids. As any glutathione in the gut is broken down to free cysteine, glycine and glutamic acid before being absorbed, even large oral doses have little effect on the concentration of glutathione in the body.[181] Ubiquinol (coenzyme Q) is also poorly absorbed from the gut and is made in humans through the mevalonate pathway.[35]

## Uses in technology

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### Food preservatives

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Antioxidants are used as food additives to help guard against food deterioration. Exposure to oxygen and sunlight are the two main factors in the oxidation of food, so food is preserved by keeping in the dark and sealing it in containers or even coating it in wax, as with cucumbers. However, as oxygen is also important for plant respiration, storing plant materials in anaerobic conditions produces unpleasant flavors and unappealing colors.[182] Consequently, packaging of fresh fruits and vegetables contains an ~8% oxygen atmosphere. Antioxidants are an especially important class of preservatives as, unlike bacterial or fungal spoilage, oxidation reactions still occur relatively rapidly in frozen or refrigerated food.[183] These preservatives include ascorbic acid (AA, E300), propyl gallate (PG, E310), tocopherols (E306), tertiary butylhydroquinone (TBHQ), butylated hydroxyanisole (BHA, E320) and butylated hydroxytoluene (BHT, E321).[184][185]

The most common molecules attacked by oxidation are unsaturated fats; oxidation causes them to turn rancid.[186] Since oxidized lipids are often discolored and usually have unpleasant tastes such as metallic or sulfurous flavors, it is important to avoid oxidation in fat-rich foods. Thus, these foods are rarely preserved by drying; instead, they are preserved by smoking, salting or fermenting. Even less fatty foods such as fruits are sprayed with sulfurous antioxidants prior to air drying. Oxidation is often catalyzed by metals, which is why fats such as butter should never be wrapped in aluminium foil or kept in metal containers. Some fatty foods such as olive oil are partially protected from oxidation by their natural content of antioxidants, but remain sensitive to photooxidation.[187]

### Industrial uses

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Some antioxidants are added to industrial products. A common use is as stabilizers in fuels and lubricants to prevent oxidation, and in gasolines to prevent the polymerization that leads to the formation of engine-fouling residues.[188] They are also used to prevent the oxidative degradation of rubber, plastics and adhesives that causes a loss of strength and flexibility in these materials.[189] Antioxidant preservatives are also added to fat-based cosmetics such as lipstick and moisturizers to prevent rancidity.

Fuel additive  | Components[190] | Applications[190]

|
|

AO-22  | N,N'-di-2-butyl-1,4-phenylenediamine | Turbine oils, transformer oils, hydraulic fluids, waxes, and greases
AO-24  | N,N'-di-2-butyl-1,4-phenylenediamine  | Low-temperature oils
AO-29  | 2,6-di-tert-butyl-4-methylphenol | Turbine oils, transformer oils, hydraulic fluids, waxes, greases, and gasolines
AO-30  | 2,4-dimethyl-6-tert-butylphenol | Jet fuels and gasolines, including aviation gasolines
AO-31  | 2,4-dimethyl-6-tert-butylphenol  | Jet fuels and gasolines, including aviation gasolines
AO-32  | 2,4-dimethyl-6-tert-butylphenol and 2,6-di-tert-butyl-4-methylphenol  | Jet fuels and gasolines, including aviation gasolines
AO-37  | 2,6-di-tert-butylphenol | Jet fuels and gasolines, widely approved for aviation fuels

## See also

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* Evolution of dietary antioxidants
* Free radical theory
* Life extension
* Nootropics
* Nutrition
* Phytochemical
* Mitohormesis
* List of phytochemicals and foods in which they are prominent
* Polymer degradation
* Forensic polymer engineering

## Further reading

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* Nick Lane Oxygen: The Molecule That Made the World (Oxford University Press, 2003) ISBN 0-198-60783-0
* Barry Halliwell and John M.C. Gutteridge Free Radicals in Biology and Medicine(Oxford University Press, 2007) ISBN 0-198-56869-X
* Jan Pokorny, Nelly Yanishlieva and Michael H. Gordon Antioxidants in Food: Practical Applications (CRC Press Inc, 2001) ISBN 0-849-31222-1

## External links

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* Foods that are rich in antioxidants
* U.S. National Institute Health, Office on Dietary Supplements
* List of antioxidants, food sources, and Potential Benefits
* MedlinePlus: Antioxidants.

## References

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1. ↑ Bjelakovic G; et al. (2007). "Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis". JAMA. 297 (8): 842–57. PMID 17327526.CS1 maint: Explicit use of et al. (link)
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120. ↑ Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. World Cancer Research Fund (2007). ISBN 978-0-9722522-2-5.
121. ↑ Bartlett H, Eperjesi F (2003). "Age-related macular degeneration and nutritional supplementation: a review of randomised controlled trials". Ophthalmic Physiol Opt. 23 (5): 383–99. PMID 12950886.
122. ↑ Wintergerst E, Maggini S, Hornig D (2006). "Immune-enhancing role of vitamin C and zinc and effect on clinical conditions". Ann Nutr Metab. 50 (2): 85–94. PMID 16373990.CS1 maint: Multiple names: authors list (link)
123. ↑ Wang J, Wen L, Huang Y, Chen Y, Ku M (2006). "Dual effects of antioxidants in neurodegeneration: direct neuroprotection against oxidative stress and indirect protection via suppression of glia-mediated inflammation". Curr Pharm Des. 12 (27): 3521–33. PMID 17017945.CS1 maint: Multiple names: authors list (link)
124. ↑ Bleys J, Miller E, Pastor-Barriuso R, Appel L, Guallar E (2006). "Vitamin-mineral supplementation and the progression of atherosclerosis: a meta-analysis of randomized controlled trials". Am. J. Clin. Nutr. 84 (4): 880–7, quiz 954-5. PMID 17023716.CS1 maint: Multiple names: authors list (link)
125. ↑ Cook NR, Albert CM, Gaziano JM; et al. (2007). "A randomized factorial trial of vitamins C and E and beta carotene in the secondary prevention of cardiovascular events in women: results from the Women's Antioxidant Cardiovascular Study". Arch. Intern. Med. 167 (15): 1610–8. PMID 17698683.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
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127. ↑ Lotito SB, Frei B (2006). "Consumption of flavonoid-rich foods and increased plasma antioxidant capacity in humans: cause, consequence, or epiphenomenon?". Free Radic. Biol. Med. 41 (12): 1727–46. PMID 17157175.
128. ↑ Rimm EB, Stampfer MJ, Ascherio A, Giovannucci E, Colditz GA, Willett WC (1993). "Vitamin E consumption and the risk of coronary heart disease in men". N Engl J Med. 328 (20): 1450–6. PMID 8479464.CS1 maint: Multiple names: authors list (link)
129. ↑ Vivekananthan DP, Penn MS, Sapp SK, Hsu A, Topol EJ (2003). "Use of antioxidant vitamins for the prevention of cardiovascular disease: meta-analysis of randomised trials". Lancet. 361 (9374): 2017–23. PMID 12814711.CS1 maint: Multiple names: authors list (link)
130. ↑ Roberts LJ, Oates JA, Linton MF; et al. (2007). "The relationship between dose of vitamin E and suppression of oxidative stress in humans". Free Radic. Biol. Med. 43 (10): 1388–93. PMID 17936185.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
131. ↑ 131.0 131.1 Hercberg S, Galan P, Preziosi P, Bertrais S, Mennen L, Malvy D, Roussel AM, Favier A, Briancon S (2004). "The SU.VI.MAX Study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals". Arch Intern Med. 164 (21): 2335–42. PMID 15557412.CS1 maint: Multiple names: authors list (link)
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135. ↑ Schulz TJ, Zarse K, Voigt A, Urban N, Birringer M, Ristow M (2007). "Glucose Restriction Extends Caenorhabditis elegans Life Span by Inducing Mitochondrial Respiration and Increasing Oxidative Stress". Cell Metab. 6 (4): 280–93. PMID 17908557.CS1 maint: Multiple names: authors list (link)
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137. ↑ Sohal R (2002). "Role of oxidative stress and protein oxidation in the aging process". Free Radic Biol Med. 33 (1): 37–44. PMID 12086680.
138. ↑ Rattan S (2006). "Theories of biological aging: genes, proteins, and free radicals". Free Radic Res. 40 (12): 1230–8. PMID 17090411.
139. ↑ Dekkers J, van Doornen L, Kemper H (1996). "The role of antioxidant vitamins and enzymes in the prevention of exercise-induced muscle damage". Sports Med. 21 (3): 213–38. PMID 8776010.CS1 maint: Multiple names: authors list (link)
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142. ↑ Leeuwenburgh C, Heinecke J (2001). "Oxidative stress and antioxidants in exercise". Curr Med Chem. 8 (7): 829–38. PMID 11375753.
143. ↑ Takanami Y, Iwane H, Kawai Y, Shimomitsu T (2000). "Vitamin E supplementation and endurance exercise: are there benefits?". Sports Med. 29 (2): 73–83. PMID 10701711.CS1 maint: Multiple names: authors list (link)
144. ↑ Mastaloudis A, Traber M, Carstensen K, Widrick J (2006). "Antioxidants did not prevent muscle damage in response to an ultramarathon run". Med Sci Sports Exerc. 38 (1): 72–80. PMID 16394956.CS1 maint: Multiple names: authors list (link)
145. ↑ Peake J (2003). "Vitamin C: effects of exercise and requirements with training". Int J Sport Nutr Exerc Metab. 13 (2): 125–51. PMID 12945825.
146. ↑ Jakeman P, Maxwell S (1993). "Effect of antioxidant vitamin supplementation on muscle function after eccentric exercise". Eur J Appl Physiol Occup Physiol. 67 (5): 426–30. PMID 8299614.
147. ↑ Close G, Ashton T, Cable T, Doran D, Holloway C, McArdle F, MacLaren D (2006). "Ascorbic acid supplementation does not attenuate post-exercise muscle soreness following muscle-damaging exercise but may delay the recovery process". Br J Nutr. 95 (5): 976–81. PMID 16611389.CS1 maint: Multiple names: authors list (link)
148. ↑ Hurrell R (2003). "Influence of vegetable protein sources on trace element and mineral bioavailability". J Nutr. 133 (9): 2973S–7S. PMID 12949395.
149. ↑ Hunt J (2003). "Bioavailability of iron, zinc, and other trace minerals from vegetarian diets". Am J Clin Nutr. 78 (3 Suppl): 633S–639S. PMID 12936958.
150. ↑ Gibson R, Perlas L, Hotz C (2006). "Improving the bioavailability of nutrients in plant foods at the household level". Proc Nutr Soc. 65 (2): 160–8. PMID 16672077.CS1 maint: Multiple names: authors list (link)
151. ↑ 151.0 151.1 Mosha T, Gaga H, Pace R, Laswai H, Mtebe K (1995). "Effect of blanching on the content of antinutritional factors in selected vegetables". Plant Foods Hum Nutr. 47 (4): 361–7. PMID 8577655.CS1 maint: Multiple names: authors list (link)
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154. ↑ Prashar A, Locke I, Evans C (2006). "Cytotoxicity of clove (Syzygium aromaticum) oil and its major components to human skin cells". Cell Prolif. 39 (4): 241–8. PMID 16872360.CS1 maint: Multiple names: authors list (link)
155. ↑ Hornig D, Vuilleumier J, Hartmann D (1980). "Absorption of large, single, oral intakes of ascorbic acid". Int J Vitam Nutr Res. 50 (3): 309–14. PMID 7429760.CS1 maint: Multiple names: authors list (link)
156. ↑ Omenn G, Goodman G, Thornquist M, Balmes J, Cullen M, Glass A, Keogh J, Meyskens F, Valanis B, Williams J, Barnhart S, Cherniack M, Brodkin C, Hammar S (1996). "Risk factors for lung cancer and for intervention effects in CARET, the Beta-Carotene and Retinol Efficacy Trial". J Natl Cancer Inst. 88 (21): 1550–9. PMID 8901853.CS1 maint: Multiple names: authors list (link)
157. ↑ Albanes D (1999). "Beta-carotene and lung cancer: a case study". Am J Clin Nutr. 69 (6): 1345S–1350S. PMID 10359235.
158. ↑ 158.0 158.1 Bjelakovic G, Nikolova D, Gluud L, Simonetti R, Gluud C (2007). "Mortality in Randomized Trials of Antioxidant Supplements for Primary and Secondary Prevention: Systematic Review and Meta-analysis". JAMA. 297 (8): 842–57. PMID 17327526.CS1 maint: Multiple names: authors list (link)
159. ↑ Study Citing Antioxidant Vitamin Risks Based On Flawed Methodology, Experts Argue News release from Oregon State University published on ScienceDaily, Accessed 19 April 2007
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161. ↑ Miller E, Pastor-Barriuso R, Dalal D, Riemersma R, Appel L, Guallar E (2005). "Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality". Ann Intern Med. 142 (1): 37–46. PMID 15537682.CS1 maint: Multiple names: authors list (link)
162. ↑ Bjelakovic G, Nagorni A, Nikolova D, Simonetti R, Bjelakovic M, Gluud C (2006). "Meta-analysis: antioxidant supplements for primary and secondary prevention of colorectal adenoma". Aliment Pharmacol Ther. 24 (2): 281–91. PMID 16842454.CS1 maint: Multiple names: authors list (link)
163. ↑ Caraballoso M, Sacristan M, Serra C, Bonfill X (2003). "Drugs for preventing lung cancer in healthy people". Cochrane Database Syst Rev: CD002141. PMID 12804424.CS1 maint: Multiple names: authors list (link)
164. ↑ Bjelakovic G, Nagorni A, Nikolova D, Simonetti R, Bjelakovic M, Gluud C (2006). "Meta-analysis: antioxidant supplements for primary and secondary prevention of colorectal adenoma". Aliment. Pharmacol. Ther. 24 (2): 281–91. PMID 16842454.CS1 maint: Multiple names: authors list (link)
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168. ↑ Simone C, Simone N, Simone V, Simone C (2007). "Antioxidants and other nutrients do not interfere with chemotherapy or radiation therapy and can increase kill and increase survival, part 1". Alternative therapies in health and medicine. 13 (1): 22–8. PMID 17283738.CS1 maint: Multiple names: authors list (link)
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170. ↑ Cao G, Alessio H, Cutler R (1993). "Oxygen-radical absorbance capacity assay for antioxidants". Free Radic Biol Med. 14 (3): 303–11. PMID 8458588.CS1 maint: Multiple names: authors list (link)
171. ↑ Ou B, Hampsch-Woodill M, Prior R (2001). "Development and validation of an improved oxygen radical absorbance capacity assay using fluorescein as the fluorescent probe". J Agric Food Chem. 49 (10): 4619–26. PMID 11599998.CS1 maint: Multiple names: authors list (link)
172. ↑ Prior R, Wu X, Schaich K (2005). "Standardized methods for the determination of antioxidant capacity and phenolics in foods and dietary supplements". J Agric Food Chem. 53 (10): 4290–302. PMID 15884874.CS1 maint: Multiple names: authors list (link)
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174. ↑ Xianquan S, Shi J, Kakuda Y, Yueming J (2005). "Stability of lycopene during food processing and storage". J Med Food. 8 (4): 413–22. PMID 16379550.CS1 maint: Multiple names: authors list (link)
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178. ↑ Henry C, Heppell N (2002). "Nutritional losses and gains during processing: future problems and issues" (PDF). Proc Nutr Soc. 61 (1): 145–8. PMID 12002789.
179. ↑ "Antioxidants and Cancer Prevention: Fact Sheet". National Cancer Institute. Retrieved 2007-02-27.
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