title: Lipoprotein oxidation, antioxidants and cardiovascular risk: epidemiologic evidence.
abstract: This review summarizes the scientific evidence for a possible role of antioxidants in the prevention of coronary heart disease (CHD). Dietary antioxidants include vitamin E, vitamin C and beta-carotene, whereas selenium is an integral part of the antioxidant enzyme glutathione peroxidase. Experimental studies suggest that the oxidation of low-density lipoproteins (LDL) in the vessel wall plays an important role in the development of atherosclerotic lesions. The resistance of LDL to oxidation is increased by antioxidant supplementation, at least in vitro. Epidemiological studies have not demonstrated unequivocally that a high intake of antioxidants leads to a decreased risk of CHD. Studies on dietary intake and serum levels of antioxidants do point in the direction of a preventive effect of antioxidants, whereas the results of intervention studies are less conclusive. Beta-carotene supplementation is not associated with any decrease in CHD; high doses of vitamin E may be beneficial, but results from large trials are to be awaited. General preventive measures based on antioxidant supplementation are not yet justifiable.
authors.affiliation: Department of Epidemiology, TNO Nutrition and Food Research Institute, Zeist, The Netherlands. vandeVijver@Voeding.TNO.NL
authors.forename: L P
authors.initials: LP
authors.lastname: van de Vijver
authors.forename: A F
authors.initials: AF
authors.lastname: Kardinaal
authors.forename: D E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: H M
authors.initials: HM
authors.lastname: Princen
authors.forename: G
authors.initials: G
authors.lastname: van Poppel
mesh_terms: D000818:Animals; D000975:Antioxidants / Q000494:pharmacology*; D001205:Ascorbic Acid / Q000494:pharmacology; D002318:Cardiovascular Diseases / Q000178:diet therapy / Q000401:mortality / Q000517:prevention & control; D003327:Coronary Disease / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D004032:Diet; D005260:Female; D005609:Free Radicals / Q000737:chemistry; D006801:Humans; D008077:Lipoproteins, LDL / Q000737:chemistry* / Q000187:drug effects / Q000378:metabolism*; D008297:Male; D010084:Oxidation-Reduction / Q000187:drug effects; D011446:Prospective Studies; D012307:Risk Factors; D012643:Selenium / Q000494:pharmacology; D014810:Vitamin E / Q000494:pharmacology; D019207:beta Carotene / Q000494:pharmacology
chemical_list: D000975:Antioxidants; D005609:Free Radicals; D008077:Lipoproteins, LDL; D019207:beta Carotene; D014810:Vitamin E; D012643:Selenium; D001205:Ascorbic Acid