a special program of the National Emergency Medicine Association (NEMA)
Transcripts: 494.1 to 494.5
Week: 494.1 Guest: Joanne Hattner Topic: Antioxidant Vitamins Part One Host: Richard Roeder Producer: Ed Graham
NEMA: This is a five part series on antioxidant vitamins and disease prevention. My guest is clinical nutritionist Joanne Hattner from Palo Alto, California.
NEMA: Ms. Hattner, considering the term antioxidant vitamin shows up nowadays on everything from cereal to frozen yogurt, it's still a class of nutrients that are little understood by the general public. Would you lay a little foundation for our discussion by explaining what a vitamin is, first, and what an antioxidant vitamin is.
Hattner: Yes. Well, you're probably familiar, for example, on the labels where in the past they had recommended dietary allowances and now they have daily values, for example, and this is a compilation of nutrients primarily established by the National Research Council in which they actually give recommendations for daily vitamins, mineral intake as well as calories and proteins so I think we're all familiar with those from our labels. Now when it comes to antioxidants and their particular role and there are really three of those that we're looking at which is beta carotene which is actually a precursor for vitamin A. In other words, when you eat a carrot you're eating beta carotene but it actually acts as vitamin A in the body, vitamin E and vitamin C and those we consider the antioxidant vitamins.
NEMA: There was a recent study that came out that had some rather disturbingly high increases in birth defects in the babies of women who early on in their pregnancy were on vitamin A. Now does this not apply to beta carotene, just the pure vitamin A itself?
Hattner: No. They actually stated that that did not apply to beta carotene and you will notice for example that if you pick vitamin A up and you need to be careful when you do this, for example, if you go to the store and you want to buy beta carotene, that is not the same as buying vitamin A supplement so you need to be careful about that and vitamin A supplements very often when you turn it around to see what the source is, it might for example be coming from fish liver. Liver is a very high source of vitamin A so be sure and notice that on the bottle that you're getting beta carotene and not vitamin A because the warning is that anything over 10,000 international units of vitamin A in pregnancy may well be harmful to the fetus. So there is a warning out about that so you do need to be careful.
NEMA: The term that is most often associated with antioxidant vitamins is something called "free radicals" in the body. Would you explain what free radicals are.
Hattner: It's not easy to explain but I think we have to realize that any kind of metabolism has cost. In other words, as we live and breathe, there are some trade offs and oxidants are really by products of normal energy metabolism. As we exercise, as we walk and breathe, we do have oxidant by products and it is thought that they do damage to DNA which is a familiar term to us as well as proteins and other molecules in the cells.
NEMA: Join me for part two on antioxidants with Joanne Hattner.
Week: 494.2 Guest: Joanne Hattner Topic: Antioxidant Vitamins Part Two Host: Richard Roeder Producer: Ed Graham
NEMA: This is part two in a five part series on antioxidant vitamins and disease prevention. My guest is clinical nutritionist Joanne Hattner from Palo Alto, California. I asked Ms. Hattner to explain oxidation and free radicals.
Hattner: As we exercise, as we walk and breathe, we do have oxidant by products and it is thought that they do damage to DNA which is a familiar term to us as well as proteins and other molecules in the cell and one of the things that happens is we get these free radicals and antioxidants are thought to protect and although it is a trade off to life itself, it is thought to perhaps increase with aging and is responsible for perhaps some of our degenerative diseases.
NEMA: Actually I'd like to touch on some of them specifically. Obviously the mechanisms would be quite different under which these antioxidants worked on different diseases but talk about heart disease and plaque build up and the theory that the antioxidants may help in that problem.
Hattner: Degenerative diseases of aging really include cancer, cardiovascular disease, some immune system decline, even cataracts and in the cardiovascular disease area, I think most people are familiar that we have various types of cholesterol, for example, and the LDL cholesterol we know can actually go through oxidation and that perhaps vitamin E and beta carotene will block oxidation to such an extent that it will be beneficial in the prevention of coronary artery lesions which lead to coronary heart disease.
NEMA: The main three that you mention were beta carotene, vitamin C and vitamin E. What are the most common natural sources of those substances?
Hattner: The most common natural sources certainly of beta carotene and vitamin C are fruits and vegetables and we always look to diet as the source of those nutrients. Now vitamin E can also be found in some fruits and vegetables but it's primarily found in our vegetable oils. Now you can also get vitamin E through such things as wheat germ. For example, it has the natural oil in it, the wheat germ oil. Sunflower seeds, vegetable oils, nuts are good sources of vitamin E. And the vitamin C I think you're pretty familiar with but that's going to be your citrus fruits and many of your fruits and vegetables and then your beta carotene is normally in your deep yellow, making it yellow to the eye as well as deep green and remember it's high in those deep green vegetables. For example, in spinach it's just masked by the green color of the chlorophyll but very high in vitamin A or beta carotene.
NEMA: The debate that's been going on for as many years as I remember studying this subject is the debate between synthetic vitamins or vitamins from natural sources. It's a war I haven't heard as much of lately but it certainly was a big topic of discussion quite a while back. What is the cutting edge view of that right now?
Hattner: To my knowledge when you buy beta carotene and you buy a synthetic form of beta carotene, you may have better quality control.
NEMA: Join me for part three on antioxidants with Joanne Hattner.
Week: 494.3 Guest: Joanne Hattner Topic: Antioxidant Vitamins Part Three Host: Richard Roeder Producer: Ed Graham
NEMA: This is part three in a five part series on antioxidant vitamins and disease prevention. My guest is clinical nutritionist Joanne Hattner from Palo Alto, California. I asked Ms. Hattner how she would compare the effectiveness of synthetic compared to natural source vitamins?
Hattner: To my knowledge, when you buy beta carotene and you buy a synthetic form of beta carotene, you may have better quality control. In other words, those vitamins are going to have a particular level that is contained in that capsule. When you go in for some of the natural sources, it may not have, for example, the same level of quality control.
NEMA: But do you believe that there's any inherent difference in the benefit from a synthetic vitamin C versus vitamin C from rose hips or some kind of natural source?
Hattner: I've really not seen a comparison of whether or not there's any difference in the effectiveness of it. I think you're just assured that you may be getting the same level or quality control in those in which it is a synthetic form. When you buy the rose hips as a source of vitamin C, I cannot assure you that each of those is going to contain the same amount.
NEMA: Sure. There have been some relatively new entrants into that broad category called antioxidants in the form pygnoginol and another thing called melatonin. Do you know what these are and can you explain a little bit about what they are and are they like vitamin C and vitamin E?
Hattner: I think you're going to see that you're talking about melatonin for example?
Hattner: ....and the anti aging aspects. I think you're going to see what we sometimes call a little bit of science in the media which doesn't have full explanation, for example, and melatonin as you know was originally researched as part of overcoming jet lag. It has a response to light so I have not seen in the literature real documentation that it's going to have an antioxidant role or an anti aging role. But there are many substances which are coming into the literature which you may also be reading about, for example, those substances that are in red wine which are thought to have antioxidant properties and yet are not vitamin C or vitamin E or vitamin A so you're going to be seeing I think a lot more in the literature where they talk about antioxidant properties.
NEMA: Do you believe that the average healthy American now this is no doubt to you and many others open to interpretation, what I mean by that but just sort of the average American, healthy, no obvious health problem would this person be wise to be taking some sort of antioxidant dosages every day?
Hattner: I think it is primarily determined by your age, your health status and also your history, your family history, what particular diseases are you at risk for and I cannot emphasize enough how important it is to know your individual history. As you age, it's thought that you may well need greater antioxidant intake in those vitamins and when you talk about antioxidants, the vitamin E, the beta carotene and the vitamin C, they're very available. They are in great quantities in many of our fruits and vegetables.
NEMA: Join me for part four on antioxidant vitamins with Joanne Hattner.
Week: 494.4 Guest: Joanne Hattner Topic: Antioxidant Vitamins Part Four Host: Richard Roeder Producer: Ed Graham
NEMA: This is part four in a five part series on antioxidant vitamins and disease prevention. My guest is clinical nutritionist Joanne Hattner from Palo Alto, California.
Hattner: As you age and as you become perhaps more susceptible to those degenerative diseases, we may find that you will certainly benefit by additional antioxidants.
NEMA: Do you recommend vitamins for children?
Hattner: Vitamins for children are not normally necessary in that children do have good appetites, eat a variety of foods and are generally in good health. If a child is ill or has a chronic illness, we may well recommend that they do get vitamin supplementation in order to give more support to the immune system or help them overcome perhaps a diet which is not as varied as we would like for it to be because of a chronic illness.
NEMA: Something you touched on earlier in our conversation about the idea of vitamin E being available in oils. There are a lot of people nowadays on either extremely low fat diets or even non fat diets. What does the non fat diet do to a person's ability to handle certain vitamins like the A and E?
Hattner: You have to get very low in your fat intake in order to interfere with the fat soluble vitamin absorption's. I've actually looked at this because we see many women who are going into low levels of dietary fat so you have to get pretty low before you actually interfere with the absorption but vitamin E as a nutrient is associated somewhat with fat intake so if you're taking in vegetable oils, you're getting vitamin E but if you're also limiting your total fat, your vitamin E intake may be low.
NEMA: I have heard through the years from people who sometimes don't feel good when they take vitamins. They will talk about feeling lethargic or they'll feel this or that. How common is this and is it usually a problem with the vitamins themselves or is it in the formulation or is it just that the person needs time to adapt?
Hattner: I think very often they are taking them at the wrong time of day. For example, many people will get up in the morning and take their vitamins on an empty stomach and you may find that you tolerate them much better later in the day and perhaps after you've had something to eat. Very often, if you're using multi vitamins or very high doses of vitamins in the morning, you do get some nausea associated with those and remember that there are some vitamins which are associated with a little bit of what we call gastro intestinal upset so it may well be better to take those with food.
NEMA: Are prescription medications and vitamin supplements ever a dangerous mixture?
Hattner: Not to my knowledge. There are some cases of course where you want to be assured that you're not taking very high doses, particularly if you're on some type of blood thinner where you have cardiovascular concerns so it's always good when you're taking supplements to check those with a physician so they can look at the dosage. Now there are some dosages that get into what we call pharmacological dosages. In other words, you're using them more as a pharmacological substance rather than a nutritional supplement.
NEMA: Join me for part five on antioxidants with Joanne Hattner.
Week: 494.5 Guest: Joanne Hattner Topic: Antioxidant Vitamins Part Five Host: Richard Roeder Producer: Ed Graham
NEMA: One of the hottest topics in health and nutrition today is antioxidant nutritional supplements. This is part five in a five part series on antioxidant vitamins and disease prevention. My guest is clinical nutritionist Joanne Hattner from Palo Alto, California.
NEMA: If we had had this conversation 15 or 20 years ago, we wouldn't have had anything to talk about. There was so little mention and literature of that vintage about antioxidants. Where do you see this going in terms of antioxidant supplements for the average person and how likely do you think that this field is going to get broader and broader as more substances are discovered?
Hattner: I think this is a wide open field and actually a very exciting field for researchers. The one association we have had in the past has been people who live in very polluted areas. I can recall very early on where vitamin E was being recommended in those areas in which people lived in a great deal of pollution and we certainly know that pollutants and smoke can have damaging effects. Now we also are aware of other substances which may well have damaging effects and also are contributing to the degenerative diseases so antioxidants as a potential protector against those diseases is wide open as far as research and as far as being able to apply that in nutrition.
NEMA: Now there certainly are an overwhelming number of resources for this information in health food stores and in libraries, lots and lots, hundreds, thousands of books on vitamins. To someone listening to us right now who thinks this sounds like a good idea maybe antioxidants, at least some belong in my diet how would you recommend they even go about introducing this into their diet?
Hattner: You can start with the recommendation of the five fruits and vegetables a day. I think everybody in the country by now has heard about the five a day program and that means a total serving number of five servings including fruits and vegetables. Many people are going higher than that and going into nine servings a day of fruits and vegetables. It really depends upon your individual profile. If you need to go beyond that and you're looking at supplementation, then you can look at some supplementation values I think that have been recommended, for example, the 400 international units of vitamin E and the 25,000 international units of beta carotene and vitamin C about 250 milligrams. I would always check those out with my physician, particularly. Those have been recommended mainly to reduce the cardiac risk so you may see that being recommended by your physician.
NEMA: And as far as the best time for a person to figure they should probably be doing some supplementation, is there a certain age or a certain set of conditions that somebody should doubly consider this?
Hattner: I think as you get into your adult years, you really need to be in touch with your physician about your personal history as well as your family history, knowing what you may be at risk for and whether or not antioxidants as a supplement in your diet might be beneficial and again I would discuss that with my primary physician and I would certainly look at my diet as the natural sources. Remember that it has been in the studies where people have greater intake of fruits and vegetables that have been associated with lower incidences of certain forms of cancer.