Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
The Fifteen Supernutrients Steven G. Pratt, MD, FACS, ABHM Vision Institute of Canada Nutrition and Vision Conference Calgary, Alberta May 31 & June 1, 2008 Supernutrients • Found in abundance in SuperFoods 1 Supernutrients • Vitamin C • Lutein • Vitamin D • Zeaxanthin • Folic Acid • Lycopene • Selenium • Beta Carotene • Glutathione • Alpha Carotene • Resveratrol • Beta Cryptozanthin • Polyphenols • Fiber Index for Biological Aging (IBA) • Biological age is a measure of how well the body is aging • Key = biological age < chronological age • ↓ Morbidity in later life • 4 plasma antioxidants inversely associated with IBA – – – – Alpha-carotene Lycopene Alpha tocopherol Lutein / zeaxanthin • n-3’s Vitamin D Index for Biological Aging (IBA) • 4 plasma nutrients associated with a poor health outlook if low concentration – – – – Vitamin C Beta carotene Selenium Folate • NAS - 15-50 yrs = 200 IU - 51-70 yrs = 400 IU - 71 and above = 600 IU • SuperHealth Recommended /d - 800-2000 IU???? 2 Food Sources of Vitamin D Vitamin D per 3.53 oz Food Alaskan Sockeye Salmon 687 IU Alaskan Albacore Tuna 544 IU Alaskan Silver Salmon Alaskan King Salmon Alaskan Sardines 236 IU 222 IU Alaskan Halibut 162 IU 1 TBS 1360 3 oz 360 Sardines, canned 3 oz 250 Mackerel, canned 3 oz 214 Tuna, canned 3 oz 200 Milk, fortified 1 cup 100 Orange juice, fortified 1 cup 100 Margarine, fortified 2 tsp 50 Cereal, fortified 1 cup 40 Liver, beef, cooked * Superfoods HealthStyle: Proven Strategies for Lifelong Health, 2006 Egg Vitamin D • Deficiency is widespread in all age groups • Deficiency associated with ↑ risk for cancer (breast, prostate, colon, NHL, pancreas), ↓ survival from melanoma, Rheumatoid arthritis, T1DM, macular degeneration, degeneration frailty (falls), MS, fibromyalgia, gingivitis, muscle aches and pains, osteoporosis, HTN • AntiAnti-inflammatory effect • ↓ Angiogeneis • Immune system booster • Regulate cell growth Vitamin D IU Salmon, canned, pink Cod liver oil 439 IU Serving 3.5 oz 30 1 whole 20 Vitamin D • • • • ↑ Vitamin A can ↓ vitamin D absorption Sunscreen ↓’s vitamin D skin production ↓ skin production of vitamin D as go “North” Little to no winter production north of a line between San Francisco & Philadelphia – 12 mo/yr in San Diego • ↓ skin production with age and ↑ skin melanin • 15 minutes sun exposure 3-4x weekly adequate (in SD) – Pale white skin can produce 20,000 IU vitamin D in 20 minutes (full sunlight) – Tan white skin ≅10,000 IU in 20 minutes – Dark brown skin ≅ 5,000 IU in 20 minutes 3 Vitamin D • Vitamin D3 vs. vitamin D2 – Summer sunlight can produce D3 from 0700 1700 with a peak synthesis of pre-vitamin D at 1230 • Conversion of 25 hydroxyvitamin D to active hormone; kidney > immune cells, colon cells, placenta, breast, prostate, and pancreas “An estimated 30 people may die of cancers related to vitamin D deficiency for every person who dies from skin cancers caused by excessive sun exposure.” --Edward Giovannucci Vitamin D & the Metabolic Syndrome “ I would challenge anyone to find an area or nutrient or any factor that has such consistent anti-cancer benefits as vitamin D” --Edward Giovannucci • Metabolic syndrome – – – – – – – – – Abdominal obesity Atherogenic dyslipidemia ↑ BP Insulin resistance Proinflammatory state Prothomotic state 23.1% of adults in NHANE III >2 million adolescents in U.S. Low serum 25 hydroxyvitamin D is associated with an ↑ risk of metabolic syndrome 4 Vitamin D and Melanoma • Every 10% ↑ in residential UVB – 19% ↑ risk in males – 16% ↑ risk in females Vitamin D and Cancer • Lower limit for any benefit of Vitamin D – 1000 I.U.’s D3 for colorectal cancer – 2000 I.U.’s D3 for breast cancer Obesity & Vitamin D Status Vitamin C • Daily goal from foods 350-400 mg • Vitamin D plays a role in glucose metabolism and insulin sensitivity • The hormonal form of vitamin D can inhibit the production of proinflammatory cytokines * Check Your Serum 25 Hydroxyvitamin D Level !! - 1 large yellow bell pepper = 341 mg 1 large red bell pepper = 312 mg 1 common guava = 165 mg 1 large green bell pepper = 132 mg 1 cup fresh orange juice = 124 mg 1 cup orange juice from frozen concentrate = 97 mg 1 cup fresh sliced strawberries = 97 mg 1 cup fresh broccoli (chopped) = 79 mg - “Graze” all day long - Early AM for first “dose” 5 Vitamin C • • • • • • • • • The master antioxidant Cellular concentration important (<400mg) “Gone in 12 hours” ↓ Risk for cancer, CVD, cataracts, mortality, Alzheimer's (AZ) Vitamin C = Ascorbic acid High serum vitamin C levels associated with ↓ all course mortality Some studies show vitamin C may ↓ the duration and severity of colds Supplements = ideal 250 mg QID TUL 2000 mg per day Folic Acid • Daily goal from foods 400 mcg - 1 cup cooked spinach = 263 mcg 1 cup boiled kidney beans = 230 mcg 2 cup boiled green soybeans = 200 mcg ½ cup soy nuts = 177 mcg 1 cup orange juice from frozen concentrate = 110 mcg 4 cooked asparagus spears with ½ in. base = 89 mcg 1 cup (frozen) chopped cooked broccoli = 103 mcg Selenium Folic Acid • • • • • Folic acid is folate (food) ≈10 folates in food → 5-methyltetrahydrofolate ↓ Risk for cancer, CVD, AD, birth defects Folic acid and homocysteine Folic acid and B12 – May need 300-1000 mcg to prevent B-12 deficiency • High folic acid intake can mask B12 deficiency • Homocysteine and folic acid, B6, B12, betaine (spinach) • > 400 mcg supplemental • Daily goal from foods 70-100 mcg - 3 oz cooked Pacific oysters = 131 mcg 1 cup whole grain wheat flour = 85 mcg 1 dried Brazil nut = 68-91 mcg ½ can Pacific sardines = 75 mcg 3 oz of canned white tuna = 56 mcg 3 oz cooked clams = 54 mcg 6 farmed oysters = 54 mcg 3 oz roasted skinless turkey breast = 27 mcg – ? ↑ Risk for breast and colon cancer 6 Vitamin E Selenium • • • • An essential component of the GSH peroxidase enzyme ↓ Risk for multiple cancers, CHD Toxicity issues Supplemental form – Bioavailability of selenomethionine (90%) twice selenium selenite (50%) – Max ≅100 mcg supplemental /d? – To ↓ cancer may need 200 mcg/d? • Relation to GSH • > 25 selenoproteins • Daily goal from foods 16 mg - Vitamin E • • • • • • • • • Essential to have all 8 forms in a supplement “Synergy of 8” ↓ Risk for CVD, cancer, AD, degenerative eye disease Immune system booster Safety issues?? Bioavailability issues in 10-15% of the population N-3’s and vitamin E Gamma tocopherol and inflammation Don’t forget your tocotrienols 2 tablespoons wheat germ oil = 41 mg 2 tablespoons soybean oil = 2.6 mg 2 tablespoons canola oil = 13.6 mg 2 tablespoons peanut oil = 9.2 mg 2 tablespoons flaxseed oil = 4.8 mg 2 tablespoons olive oil = 4 mg 1 oz raw (23-24 whole kernels) almonds = 7.7 mg ¼ cup hulled dry-roasted sunflower seeds = 6.8 mg 2 tablespoons raw (untoasted) wheat germ = 5 mg 1 medium orange bell pepper = 4.3 mg 1 oz hazelnuts (20-21 kernels) = 4.3 mg 2 tablespoons peanut butter = 3.2 mg 1 cup blueberries = 2.8 mg * Kiwis also a good source Gamma Tocopherol • Best sources – – – – – – – – Perilla seed Pistachios Pecans Walnuts Pumpkin seeds Pine nuts Cashews Peanuts • A potent anti-inflammatory • Primary form in skin “oil” 7 Serum Carotenoids • ↑ Serum carotenoids associated with… – – – – – – – ↓ Risk for type II DM ↓ Risk for breast cancer ↑ Grip strength ↑ “Quad” strength ↓ Risk for falls ↓ Risk for osteoporosis ↓ Risk for sarcopenia Lycopene • #1 in American’s serum • Lutein “protector” • Bioavailabilty issues – Heat – Oils – Avocado Lycopene • Daily goal from foods 22 mg - 1 cup tomato sauce (canned) = 37 mg - 2 cup R.W.Knudsen Very Veggie vegetable cocktail from concentrate = 22 mg - 1 cup tomato juice = 22 mg - 1 watermelon wedge (1/16 of a melon 15 inches long, 7 ½ inches in diameter) = 13 mg - 1 cup canned stewed tomatoes = 10.3 mg - 1 tablespoon tomato paste = 4.6 mg - 1 tablespoon ketchup = 2.9 mg - ½ pink grapefruit = 1.8 mg Lycopene • Oxidative metabolites identified • ↓ Risk for multiple cancers (prostate, lung, digestive tract, breast), CVD, AMD • Relationship with GSH • Gap junctions • SPF nutrient • Plasma ½ life 12-30 days – High concentrations in testes, adrenal gland, liver, kidney, lung, cervix, prostate 8 Lutein/Zeaxanthin • Daily goal from foods 12 mg - 1 cup cooked kale (chopped) = 23.7 mg 1 cup cooked spinach = 20.4 mg 1 cup cooked collard greens (chopped) = 14.6 mg 1 cup cooked turnip greens = 12.1 mg 1 large sweet orange bell pepper = 9.2 mg 1 cup cooked green peas = 4.2 mg 1 cup cooked broccoli = 2.4 mg Lutein/Zeaxanthin • ↓ Risk for CVD, cancer, AMD, cataracts • Obesity and L&Z bioavailability • Bioavailability – Oil – Raw vs. cooked – Love that egg yolk • Oxidative metabolites • Macular pigment – Blue Light filter Spinach contains: Zeaxanthin Superfood • • • • * 1 large orange bell pepper 1 cup canned yellow corn 1 raw Japanese persimmon 1 cup degermed cornmeal Gogi Berry 8.0 mg 0.9 0.8 0.7 • A synergy of multiple nutrients & phytonutrients • B vitamins (thiamine, riboflavin, B6, folate) • Low in calories • Alpha lipoic acid • Lutein / zeaxanthin • Vitamins C & E • Plant-derived omega-3 fatty acids • Minerals (calcium, iron, magnesium, manganese, and zinc • Beta-carotene • Polyphenols • Glutathione • Betaine • Potassium 9 Alpha-carotene • Daily goal from foods 2.4 mg - 1 cup canned pumpkin = 11.7 mg 1 cup cooked carrots (slices) = 6.6 mg 10 raw medium baby carrots = 3.8 mg 1 cup cooked butternut squash (cubes) = 2.3 mg 1 large sweet orange bell pepper = .3 mg 1 cup cooked collard greens (chopped) = .2 mg Beta-carotene • Daily goal from foods 6 mg - 1 cup cooked sweet potato = 23 mg 1 cup canned pumpkin = 17 mg 1 cup cooked carrots (slices) = 13 mg 1 cup cooked spinach = 11.3 mg 1 cup cooked chopped kale = 10.6 mg 1 cup cooked butternut squash (cubes) = 9.4 mg 1 cup cooked collard greens (chopped) = 9.2 mg Alpha-carotene • • • • • Keeps “cropping up” A pro-Vitamin A carotenoid ? Better tumor suppressor than BC ↓ Risk for cataracts, cancers (skin, lung) ↓ Activity of C-450 an activator of pro-carcinogens Beta-carotene • Synergy of multiple carotenoids and multiple antioxidants, phytonutrients • Beware of supplemental and cigarettes, asbestos, alcohol • Bioavailability – Raw carrots vs. cooked – Carrots vs. supplements • Degenerative eye disease and BC • Pro-Vitamin A carotenoid – Veggies vs. fruit • Anti-inflammatory effect 10 Beta Cryptoxanthin • Daily goal from foods 1 mg - 1 cup cooked butternut squash (cubes) = 6.4 mg 1 cup cooked red bell pepper (strips) = 2.8 mg 1 Japanese persimmon (2 ½ in. diameter) = 2.4 mg 1 cup mashed papaya = 1.8 mg 1 large sweet red bell pepper (raw) = .8 mg 1 cup fresh tangerine juice = .5 mg 1 medium tangerine = .3 mg Glutathione • Daily goal from foods is not yet known - Asparagus Watermelon Avocado Walnuts Grapefruit Peanut butter Oatmeal Broccoli Oranges Spinach Beta Cryptoxanthin • • • • Pro-Vitamin A carotenoid One of the “big six” ↓ Risk for polyarthritis ↓ Risk for multiple cancers Glutathione • The master intra-cellular antioxidant • Relationship to vitamin C, A-Lipoic acid, selenium, and others • Poorly absorbed in GI tract • Role of protein & NAC • DNA protector, immune system booster, detoxifier, ↓ chronic inflammation • Early AM boost a great anti-aging strategy • Go for the cysteine 11 Resveratrol • Daily goal from foods is not yet known - Blueberries Peanuts Purple grape skins Red wine Purple grape juice Cranberries/cranberry juice Mulberries Red wine contains 1.2 mg/L Resveratrol • Readily absorbed in the gut • Biological activities include antibacterial, antifungal, antioxidant, free radical scavenging, vasorelaxation, chemopreventive, anti-inflammatory • Role in ↓ risk for cancer and heart disease • Produced by plants in response to injury, UV-light, bacteria, fungi • Role in cell cycle arrest and induction of apoptosis • Neuroprotective * Synthesized by >70 edible plants Resveratrol • Anti-inflammatory properties – Suppresses COX-2 expression • Influence on sirtuin enzymes which slow down the aging process and extend lifespans – mimic caloric restrictions • Biological effect at very low dose • Promising research but many questions remain Potassium NAS • 4700 mg daily SuperHealth Recommendation • 8000 mg daily Sources Odwalla Blackberry Fruit Shake 1060 mg/8 oz Medium potato 926 mg Sweet potato 950 mg Naked Just Carrot Juice 620 mg/cup Sunsweet Prune Juice 540 mg/8 oz R.W. Knudsen Very Veggie Vegetable Cocktail (Low sodium) 520 mg/cup Cantaloupe 494 mg/cup Orange Juice 473 mg/cup Avocado (1/2) 439 mg Banana 422 mg/cup 12 Potassium Fiber • Daily goal from foods: • Helps decrease risk for hypertension, stroke, cardiac dysfunction, arrhythmias, kidney damage, osteoporosis. Females Males 19-50 51-70 19-50 51-70 25 g 21 g 38 g 30 g • Fiber power the Superfoods Way = 45 g/d for adult males; 32 gd adult females – – – – – 1 cup cooked black beans = 15 g ¼ cup dry pinto beans = 14 g 1 cup cooked garbanzo beans = 13 g ¼ cup dry lentils 9 g 1 cup fresh raspberries = 8 g Fiber • Role in preventing – – – – – – – T2DM Obesity CVD / Atherosclerosis Cancer Oxidative stress Constipation Hemorrhoids • • • • Synergy of different types Loaded with phytonutrients Helps prevent recurrent breast cancer 3 to 4 grams whole grain bran ↓ carotid artery atherosclerosis • Weight control • Anti-inflammatory - ↓ CRP 13 Omega-3 Fatty Acids Omega-3 Fatty Acids • Food and Nutrition Board – – – – 1.6 g/d ALA for men 1.1 g/d ALA for women 160 mg/d EPA/DHA for men 110 mg/d EPA/DHA for women • My goal – – – – – – – – – 3 oz cooked Chinook (king) salmon = 1.5 g 3 oz sockeye salmon = 1 g 3 oz farmed Rainbow trout = 1 g 1 can sardines = .9 g 3 oz canned white tuna in water = .7 g 1 g/d EPA/DHA for men 0.7 g/d EPA/DHA for women 1-2 TBSP/d ground flaxseed meal n-3/n-6 ratio between 1/1 → 1/3 Omega-3 Fatty Acids • ALA – – – – – – – – – – – • EPA/DHA 1 tablespoon canola oil = 1.3 g 1 tablespoon soybean oil = .7 g 1 tablespoon walnut oil = 1.4 g 1 tablespoon flaxseed oil = 7.3 g 1 cup cooked spinach = .2 g 1 cup cooked collard greens = .2 g ½ cup dry roasted soy nuts = 1.2 g 1 tablespoon flaxseed = 2.2 g ½ cup wheat germ = .5 g 1 oz (14 halves) English walnuts = 2.6 g 1 omega-3 “vegetarian” hen egg = amounts vary Omega-3 Fatty Acids • EPA/DHA vs. ALA • ↓ Risk for “everything” • The easiest way to ↓ risk for sudden cardiac death = 1 gram fish oil/d • Healthy heart, brain, eyes • Roll in ↓ Atrial Fibrillation (25% of adults) • A major anti-inflammatory • ↓ Triglycerides • ↓ BP • ↓ Heart rate 14 Omega-3 Fatty Acids • • • • • • A major human deficiency state exists DHA concentrated in the brain, retina, cardiac muscle EPA/DHA supplements “work” Fish protein + EPA/DHA “best” Safety Immune system function – No adverse parameters with 3 or less grams/d • Risk for hemorrhagic stroke with 10-12g/d • Omega-3 intake-hypothalamus-obesity Polyphenols • Daily goal from foods is not yet known Whole Foods – – – – – – – – – Berries Dates and figs Prunes Kale, spinach Parsley, dried parsley Apples with skin Citrus Grapes Cherries Polyphenols • A great 21st century Phytonutrient • Multiple functions – – – – – • • • • • Anti-oxidant Anti-mutagenic Anti-inflammatory Cell signaling Metal chelation – Anti-platlet – Synergy – Phytoestrogen – Vasodilators – Nutrigenomics Intake/d Bioavailability Safety Cancer, CVD, neuro-degenerative disorders AntiAnti-inflammatory!! Polyphenols Jams • Trader Joe’s Organic Blueberry Fruit Spread • Knott’s Pure Boysenberry Preserves • Trader Joe’s Organic Blackberry Fruit Spread Beverages • Green, black, oolong, white, Rooibus tea • Soymilk • 100 percent fruit juices (berry, pomegranate, Concord grape, cherry, apple, citrus, prune) 15 Polyphenols Polyphenols Juices Mg of polyphenols per 8 oz serving Jams Mg of polyphenols per 20 g—a trace over 1 Tablespoon Odwalla C Monster 845 Trader Joe’s Organic Blueberry Fruit Spread 400 Trader Joe’s 100% Unfiltered Concord Grape Juice 670 Knott’s Pure Boysenberry Preserves 300 Trader Joe’s Organic Blackberry Fruit Spread 280 Trader Joe’s Organic Strawberry Fruit Spread 120 Trader Joe’s Organic Morello Cherry Fruit Spread 120 Sorrell Ridge Wild Blueberry Spreadable Fruit 100 R.W.Knudsen 100% Pomegranate Juice 639 R.W.Knudsen 100% Cranberry Juice 587 R.W.Knudsen Just Blueberry 425 L&A Black Cherry Juice 345 27% cranberry juice cocktail 137 Knott’s Bing Cherry Pure Preserves 100 100% apple juice 61 Welch’s Concord Grape Jam 60 * Superfoods Rx: Fourteen Foods That Will Change Your Life * Superfoods Rx: Fourteen Foods That Will Change Your Life Polyphenol Content of 40g’s Dark Chocolate • Newman’s Own Sweet Dark Dark Chocolate 955mg • Dove Silky Dark Chocolate 811mg • Endangered Species Chocolate Company Wolf Bar 811mg • Cadbury Royal Dark Indulgent Dark Chocolate 765mg • Hershey’s Special Dark Mildly Sweet Chocolate 739mg * Superfoods Health Style: Proven Strategies for Lifelong Health The Ideal Supplement • Lutein / Zeaxanthin • Lycopene, Alpha / Beta carotene, others • B-complex • Vitamins D, K, A • Glutathione • N-acetyl-L-cysteine • Alpha lipoic acid • CoQ10 • n-3’s • • • • • Polyphenols Zn, Mn, Se (others) Vitamin C Vitamin E (All 8 forms) Betane Synergy Balance Long-term use (>10 yr) • A supplement to whole foods * One a Day is NOT the answer 16 Supplements Compliment but Don’t Replace Healthy Diet “The whole of the plant is greater than the sum of its individual parts. The combinations of nutrients as contained in whole foods seem more effective for reducing the risk of various chronic diseases. So maybe Mother Nature does know best. The numerous other phytochemicals found in foods rich in antioxidant nutrients may be necessary to act synergistically to provide effect against chronic disease.” Susan F. Clark, RD, Ph.D Sources • Murakoshi M, Nishino H, et al. Potent preventive action of alphacarotene against carcinogenesis: spontaneous liver carcinogenesis and promoting stage of lung and skin carcinogenesis in mice are suppressed more effectively by alpha-carotene than by beta-carotene. Cancer Res 1992; 52:6583-7. • Thompson H, Heimendinger J, et al. In vivo investigation of changes in biomarkers of oxidative stress induced by plant food rich diets. J Agric Food Chem, 2005; 53:6126-32. • Astley S, Elliott R, et al. Evidence that dietary supplementation with carotenoids and carotenoid-rich foods modulates the DNA damage: repair balance in human lymphocytes. Br J Nutr, 2004; 91:63-72. • Pratt S, Matthews K. SuperFoods HealthStyle: Proven Strategies for Lifelong Health. Harper Collins, New York; 2006. • Pratt S, Greenway H, Naugle C. Nutrition and Skin Cancer Risk Prevention. In: Functional Foods & Nutraceuticals in Cancer Prevention. Watson, Ronald R. ed., Iowa State Press, Ames, Iowa, 2003; 105-20. 17 Sources Sources • Pratt S, Greenway H, Harris G, Twersky J. Superfoods and Supernutrients in Nutrition of the Skin. Watson, Ronald R. ed., going to Press. • Kune, G.A. et al. Diet, alcohol, smoking, serum beta-carotene, and vitamin A in male nonmelanocytic skin cancer patients and controls. Nutrition and Cancer, 1992; 18(3):237-44. • Black, H.S. Pro-carcinogenic activity of beta-carotene, a putative systemic photoprotectant. Photochemical and Photobiological Sciences, 2004; 3(8):753-8. • Lee EH, et al. Dietary lutein reduces ultraviolet radiation-induced inflammation and immunosuppression. J Invest Dermatol 2005;122:510-7. • Fuchs, J.et al. HPLC analysis of vitamin E isoforms in human epidermis: correlation with minimal erythema dose and free radical scavenging activity. Free Radical Biology and Medicine, 2003; 34(3): 330-6. • Kuchide M, et al. Cancer chemopreventive effects of oral feeding alpha-tocopherol on ultraviolet light B induced photocarcinogenesis of hairless mouse. Cancer Lett 2003;196;169-77. • • Gonzalez, S. et al. Dietary lutein/zeaxanthin decreases ultraviolet Binduced epidermal hyperproliferation and acute inflammation in hairless mice. Journal of Investigative Dermatology, 2003; 121(2):399-405. Sies H, Stahl W. Nutritional protection against skin damage from sunlight. Annu Rev Nutr 2004;24:173-200. • Greenway, H.T. and Pratt, S.G. Vitamins and micronutrients in aging and photoaging skin. In: Watson, R.R. (ed.) Vegetables, Fruits, and Herbs in Health Promotion. CRC Press LLC, 2001; 109-116. Pence BC, et al. Effects of dietary selenium on UVB-induced skin carcinogenesis and epidermal antioxidant status. J Invest Dermatol 1994;102:759-61. • Black HS, Rhodes LE. The potential of omega-e fatty acids in the prevention of non-melanoma skin cancer. Cancer Detect Prev 2006;30:224-32. • Sources • McNaughton S, et al. Role of dietary factors in the development of basal cell cancer and squamous cell cancer of the skin. Cancer Epid Biomarkers Prev 2005;14:1596-607. • Hughes MC, et al. Food intake and risk of squamous cell carcinoma of the skin in a community: the Nabour Skin Cancer Cohort Study. Int J Cancer 2006;119:1953-60. • Moller P, Loft S. Dietary antioxidants and beneficial effect on oxidatively damaged DNA. Free Rad Biol Med 2006;41:388-415. 18