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Antioxidants increasingly have been praised for their benefits against disease and aging, but recent studies at Kansas State University show that they also can cause harm.

Researchers in K-State's Cardiorespiratory Exercise Laboratory have been studying how to improve oxygen delivery to the skeletal muscle during physical activity by using antioxidants, which are nutrients in foods that can prevent or slow the oxidative damage to the body. Their findings show that sometimes antioxidants can impair muscle function.

Antioxidant

"Antioxidant is one of those buzz words right now," said Steven Copp, a doctoral student in anatomy and physiology from Manhattan and a researcher in the lab. "Walking around grocery stores you see things advertised that are loaded with antioxidants.

I think what a lot of people don't realize is that the antioxidant and pro-oxidant balance is really delicate.

One of the things we've seen in our research is that you can't just give a larger dose of antioxidants and presume that there will be some sort of beneficial effect. In fact, you can actually make a problem worse."

David C. Poole and Timothy I. Musch, K-State professors from both the departments of kinesiology and anatomy and physiology, direct the Cardiorespiratory Exercise Laboratory, located in the College of Veterinary Medicine complex. Researchers in the lab study the physiology of physical activity in health and disease through animal models. Copp and Daniel Hirai, an anatomy and physiology doctoral student from Manhattan working in the lab, have conducted various studies associated with how muscles control blood flow and the effects of different doses and types of antioxidants.

Abnormalities in the circulatory system

Abnormalities in the circulatory system, such as those that result from aging or a disease like chronic heart failure, can impair oxygen delivery to the skeletal muscle and increase fatigability during physical activity, Copp said. The researchers are studying the effects antioxidants could have in the process.

"If you have a person trying to recover from a heart attack and you put them in cardiac rehab, when they walk on a treadmill they might say it's difficult," Poole said. "Their muscles get sore and stiff. We try to understand why the blood cells aren't flowing properly and why they can't get oxygen to the muscles, as happens in healthy individuals."

Some of the oxidants in our body, such as hydrogen peroxide, are helpful to increase blood flow.

Copp said there is a potential for antioxidants to reverse or partially reverse some of those changes that result from aging or disease. However, K-State's studies have shown that some of the oxidants in our body, such as hydrogen peroxide, are helpful to increase blood flow.

"We're now learning that if antioxidant therapy takes away hydrogen peroxide - or other naturally occurring vasodilators, which are compounds that help open blood vessels - you impair the body's ability to deliver oxygen to the muscle so that it doesn't work properly," Poole said.

Antioxidants can actually suppress key signaling mechanisms that are necessary for muscle to function effectively.

Poole said antioxidants are largely thought to produce better health, but their studies have shown that antioxidants can actually suppress key signaling mechanisms that are necessary for muscle to function effectively.

"It's really a cautionary note that before we start recommending people get more antioxidants, we need to understand more about how they function in physiological systems and circumstances like exercise," Poole said.

Mobility for advancing age and diseases like heart failure

Hirai said the researchers will continue to explore antioxidants and the effects of exercise training. Their studies are looking at how these can help individuals combat the decreased mobility and muscle function that comes with advancing age and diseases like heart failure.

"The research we do here is very mechanistic in nature, and down the road our aim is to take our findings and make recommendations for diseased and aging populations," Copp said.

The researchers have published their recent findings in several journals, including the Journal of Applied Physiology, Respiratory Physiology and Neurobiology, Microvascular Research, The American Journal of Physiology and Experimental Physiology.

The Cardiorespiratory Exercise Laboratory has been funded by grants from the National Institutes of Health, American Heart Association and intramural awards from the College of Veterinary Medicine.

Despite a general belief among physicians that extreme obesity is too difficult to treat, except with bariatric surgery, researchers at the Pennington Biomedical Research Center have learned a substantial proportion of individuals with extreme obesity can lose 10-percent or more of their body weight through medical treatment that does not include surgery.

10% Loss Improves Risk Factors and Health

Furthermore, even though those individuals are still obese, they have improvements in risk factors and other health markers.

Weight Loss Surgery Not Often Affordable or Reimbursed by Insurance

"This is important, because surgery is not often affordable or reimbursed by insurance," said leading scientist Dr. Donna Ryan. "In fact, many medical treatments are frequently not reimbursed by insurance if they are for obesity. So this research is needed to show that primary care doctors are capable of helping obese patients lose weight to improve health, even those with extreme obesity. "

Ryan said losing only five-percent of body weight can reap healthy benefits for the extremely obese, and nearly 61-percent of those in her clinical trial achieved that. More than 40-percent lost 10-percent body weight or more.

Physicians Trained in Intensive Medical Intervention

Ryan and her team spread out across Louisiana to recruit and train practicing physicians and their office staffs in eight cities in what she called "intensive medical intervention," in which physicians used a combination of medication, low-calorie diets and behavior changes. All of the techniques were endorsed by national guidelines for obesity management. Training of physicians and their staffs took about a day and a half.

Funded by the Louisiana Office of Group Benefits, which provides health coverage for state employees, the research team contacted state employees, seeking participants to screen for and enroll in the trial. Nearly 400 participants enrolled in the two-year trial, called LOSS, using the nearest trained physicians.

About half of the participants received the intensive medical intervention, the other half received what Ryan called "usual care." 

Program Starts with Low-calorie Liquid Diet

Those in the intense intervention group were immediately placed on a low-calorie liquid diet. They gradually moved to a low calorie, highly controlled diet using meal replacements, and received weight loss medication and group behavioral therapy that included lessons in exercise, activity, self-monitoring and recommendations for walking, water exercise and weight training. The group sessions were supervised by office staff.

Recommended Activities

  • exercise
  • activity
  • self-monitoring
  • recommendations for walking
  • water exercise
  • weight training

Success in Daily Routine of Doctor's Practice

"We conducted this trial as close to the reality of a typical clinic setting as we could," Ryan said, "We didn't want to learn just if these strategies worked, but if they would work in the daily routine of a doctor's practice."

Challenge of Keeping Weight Off

Ryan noted that the continual challenge in weight loss is keeping weight off, and that means sticking with a routine.

More than 50% of the LOSS participants stuck with it for two years or more, keeping much of the weight off, but Ryan said that does leave room for improving weight loss maintenance.

The LOSS trial results were published in the current issue of the Archives of Internal Medicine.

The Pennington Biomedical Research Center is a campus of the Louisiana State University System and conducts basic, clinical and population research.

Dietary Reference Intakes:

The Essential Guide to Nutrient Requirements


The Dietary Reference Intakes: The Essential Guide to Nutrient Requirements is sold only as a printed book; the PDF offered free of charge for download contains only the references.

Dietitians, community nutritionists, nutrition educators, nutritionists working in government agencies, and nutrition students at the postsecondary level, as well as other health professionals, will find Dietary Reference Intakes: The Essential Reference for Dietary Planning and Assessment an invaluable resource.

Widely regarded as the classic reference work for the nutrition, dietetic, and allied health professions since its introduction in 1943, Recommended Dietary Allowances has been the accepted source in nutrient allowances for healthy people. Responding to the expansion of scientific knowledge about the roles of nutrients in human health, the Food and Nutrition Board of the Institute of Medicine, in partnership with Health Canada, has updated what used to be known as Recommended Dietary Allowances (RDAs) and renamed their new approach to these guidelines Dietary Reference Intakes (DRIs). Since 1998, the Institute of Medicine has issued eight exhaustive volumes of DRIs that offer quantitative estimates of nutrient intakes to be used for planning and assessing diets applicable to healthy individuals in the United States and Canada. Now, for the first time, all eight volumes are summarized in one easy-to-use reference volume, Dietary Reference Intakes: The Essential Reference for Dietary Planning and Assessment. Organized by nutrient for ready use, this popular reference volume reviews the function of each nutrient in the human body, food sources, usual dietary intakes, and effects of deficiencies and excessive intakes. For each nutrient of food component, information includes:

  • Estimated average requirement and its standard deviation by age and gender.
  • Recommended dietary allowance, based on the estimated average requirement and deviation.
  • Adequate intake level, where a recommended dietary allowance cannot be based on an estimated average requirement.
  • Tolerable upper intake levels above which risk of toxicity would increase. Along with dietary reference values for the intakes of nutrients by Americans and Canadians, this book presents recommendations for health maintenance and the reduction of chronic disease risk. Also included is a Summary Table of Dietary Reference Intakes, an updated practical summary of the recommendations. In addition, Dietary Reference Intakes: The Essential Reference for Dietary Planning and Assessment provides information about:
  • Guiding principles for nutrition labeling and fortification
  • Applications in dietary planning
  • Proposed definition of dietary fiber
  • A risk assessment model for establishing upper intake levels for nutrients
  • Proposed definition and plan for review of dietary antioxidants and related compounds
  • A free PDF download of an errata page to Dietary Reference Intakes: The Essential Guide to Nutrient Requirements is available from: http://books.nap.edu/html/11537/dri_errata.pdf.

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