The first part of this series looked at the origin story of vitamins—and how they rose to dizzying popularity. Today, we explore the trickier questions about everyone’s fave version of vitamins—antioxidants. What is an antioxidant? Do they work at all? And what’s their link with cancer?
Antioxidants? Like the ones in the anti-ageing stuff?
We’ve all been subjected to great gyaan from beauty gurus about the mighty antioxidants that destroy nasty free radicals—the well-established ‘anti-nationals’ of skincare. But how many of us even understand wtf any of that means? Let us explain.
First, meet the free radical: In the mitochondria within our cells, food is converted to energy. The process requires oxygen and hence its name: oxidation. The process requires a free flow of electrons (which are negatively charged particles)—some of which leak. These react with nearby oxygen molecules and turn into those dreaded things called free radicals—“a radically reactive molecule with a free electron”:
In order to regain stability, free radicals wreak havoc on the structures around them, ripping electrons from vital molecules such as DNA and proteins in order to balance its own charge. Although inconceivably small in scale, the production of free radicals.. would gradually take its toll on our entire bodies, causing mutations that can lead to ageing and age-related diseases such as cancer.
Eeks! Hence, the advice to stock up on your antioxidants—that can slay this dreaded beast.
Meet the antioxidant: Antioxidants calm those out-of-control free radicals down by taking away that rogue free electron. Our body produces its own antioxidants—but also gets them from fruits and vegetables—specifically, selenium, beta-carotene, and vitamins A, C, and E. Plants produce their own vitamins—which act as antioxidants—during the course of photosynthesis. The more photosynthesis that happens, the greater the amount of vitamins. That’s why dark green leafy vegetables contain more antioxidants. That’s also why doctors are always on about eating more of them.
The anti-ageing boom: In the 1970s, “shortly after free radicals were linked to ageing and disease, they were seen as enemies that should be purged from our bodies.” Hence, our love affair with the mighty antioxidants as an anti-ageing elixir.
Fascinating point to note: Unlike antioxidants in our diet, the vitamins in our tablets are made in a lab—not from plants but artificially synthesised from chemicals. For example, the ingredients of synthetic Vitamin A include acetone and formaldehyde. Our Vitamin D tablets are made from lanolin—found in sheep’s wool. To be clear, this doesn’t make them bad for you. These vitamins are identical to the ones found in nature. But it’s a bit ironic given all those vitamin ads drowning in colourful fruits and veggies.
Ok, now you’re going to tell me they’re useless…
Lol, that’s sorta true. Given the many claims about vitamins, it isn’t surprising that there have been countless trials studying their effects. And not one of them bears out the grand claims. Tamar Haspel reporting for the Washington Post found that the dietary supplements industry group couldn’t point her to a single independent scientist who’s on their side. In 2022, a US government task force looked at 84 studies and concluded this:
Vitamin and mineral supplementation was associated with little or no benefit in preventing cancer, cardiovascular disease, and death, with the exception of a small benefit for cancer incidence with multivitamin use. Beta carotene was associated with an increased risk of lung cancer and other harmful outcomes in persons at high risk of lung cancer.
Read that line again. There is no definitive proof that vitamin supplements are good for you. But there is alarming evidence that antioxidants can actually be bad for you.
The scary studies from hell: In 1994, a double-blind control trial—the gold standard of medical testing—showed that participants “taking vitamins and supplements were more likely to die from lung cancer or heart disease than those who didn’t take them.” A later study showed that post-menopausal women who took folic acid (a variety of Vitamin B) every day for ten years were 20% more likely to get breast cancer. A 2007 study showed that men that took multivitamins were twice as likely to die from prostate cancer.
One study of more than 1,000 heavy smokers published in 1996 had to be terminated nearly two years early. After just four years of beta-carotene and vitamin A supplementation, there was a 28% increase in lung cancer rates and a 17% increase in those who died.
The four-year trials resulted in 80 more deaths because of these two supplements.
As for those free radicals: Turns out they are critical to our immune system:
Inside the immune cell, they are used for what they are infamous for: to damage and to kill. The intruder is torn apart. From start to finish, a healthy immune response depends on free radicals being there for us, within us.
Exterminating them by blanketing our bodies with antioxidants leaves us vulnerable to infections.
Whoa! Multivitamins can kill me?
No, no, no. As one doctor puts it: “The reassurance, such as it is, comes from the fact that the products are mostly ineffective.” Unless you are poor and malnourished, most of us get enough vitamins from our daily diet. They’re called micronutrients precisely because we need very tiny amounts. Supplements essentially overload our system with too much of the good stuff. But our body is very good at maintaining a balance—and flushes out the excess.
But, but, but: There’s a critical difference between water soluble and fat soluble vitamins.
Water-soluble vitamins, which include vitamin C and all eight B vitamins, are dissolved, processed, and metabolised quickly in the body, and are not stored for later use. "Excess amounts of water-soluble vitamins are excreted in the urine," explains [cardiovascular nutritionist] Alice Lichtenstein.
But fat soluble vitamins like Vitamins A, D, E, and K. We store these in our liver and fatty tissue for the future. Take too much and they can turn toxic. Doctors suggest exercising the greatest caution with Vitamins A and E.
Too much of Vitamin A, for example, can cause foetal damage—or liver damage in adults. Even in modest amounts, "Vitamin A supplements have been linked to skin irritation and an increased risk of bone fractures.” Too much Vitamin E, OTOH, can cause lung cancer and/or interfere with blood clotting—leading to haemorrhaging.
Vitamins, vitamins everywhere: The real problem is that most of us don't know how much vitamins we are consuming on a daily basis. Everything is fortified with vitamin—from food to beauty creams—and even water:
The other thing that concerns me is that we have so many products that have so many extra vitamins. If you have a Vitaminwater, and a sports bar, plus your breakfast cereal, plus all these other things you can get — often at the gym — that have many times your required amounts of daily vitamins, then you start getting into this situation where you have really high doses of vitamins, far beyond what you can get from food, and far beyond what need to prevent deficiency. We don’t really know what the long-term effect of this is.
A good example: That perilous Vitamin A—which is also an ingredient in the very common skincare ingredient retinol—commonly used to treat acne. It’s easy to zip past the limit:
The maximum daily upper intake limit for vitamin A is set at 3,000 micrograms, though it's important to note that such allowances include consumption or absorption of all sources of vitamin A including from foods, supplements, and creams/lotions that contain retinol… Research published earlier this year shows that vitamin A toxicity can also result from topical vitamin A (retinol) which is used to treat acne and psoriasis.
Yikes! So should I junk my multivitamins?
Vitamins are meant to treat deficiency. You should only take a specific vitamin if you’re diagnosed with one. In other words, vitamins ought to be part of medical treatments—not used as an everyday health aid. So if you’re going to take a vitamin, consult your doctor so you will know if the dosage is too high. This is especially true of multivitamins—which can be especially confusing.
Irony alert: People who are most susceptible to the hype are often the most health-conscious:
She has found that people who use supplements more frequently are also more likely to have a higher level of education and income, a healthier lifestyle, and a greater likelihood to eat a healthy diet and exercise. “So those who are taking supplements are more health-conscious overall,” she says.
And every doctor agrees that healthy people do not need to take vitamins, period.
Vitamins on your plate: That’s where vitamins belong—in your food not your medicine cabinet. Doctors emphasise balanced diets for a surprising reason: We don’t know enough about how vitamins and minerals work. One reason they are more effective in a dish is because you eat them along with other stuff:
[A] good example of this effect is olive oil. It increases the amount of a carotenoid called lycopene that we absorb when we eat tomatoes, because carotenoids must be dissolved in fat to be transported into the blood. A similar principle applies to the fat-soluble vitamins A, D, E and K.
To put it more simply: “We don’t eat a single nutrient; we eat a food. That’s why a lot of supplements don’t achieve the same effect as the natural nutrients coming from food sources.”
The bottomline: The best take on the vitamin diet is this:
And that’s the dietary supplement conundrum. Most of them do nothing, so you shouldn’t take those. But the ones that actually do something are the ones that pose danger, so you shouldn’t take those either. If something really can enlarge your penis, imagine the havoc it can wreak in your liver.
Reading list
The best read on this is a book titled ‘Vitamania’ by Catherine Price. Get a taste of it here—or buy it here. If not, then read BBC Future’s exhaustive piece on the science on vitamins. The Atlantic has revisited this subject multiple times—like this piece on the vitamin myth—and the role of Linus Pauling in building it. More alarming: This investigation into what is in a multivitamin pill. TIME and New Scientist offer a good balanced piece on when you should consider supplements—the Washington Post veers toward scepticism.
