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Health maintenance

Last Updated on May 19, 2021 by MyFormulary

Related Terms

  • Aerobics, antioxidants, ashwagandha, Atkins diet™, black currant, blackberry, carbohydrates, carrot, cranberry, dandelion, DASH diet, diet, electrolytes, exercise, fats, food groups, fruits, globe artichoke, grains, grape seed, kidney function, lifestyle, lutein, lycopene, melatonin, milk, muscle-strengthening activity, noni, nutrition, physical fitness, physical inactivity, prayer, protein, pycnogenol, raspberry, rose hip, seaweed, selenium, South Beach diet™, strawberry, vegetables, vitamin A, vitamin E, weight loss.

Background

  • Maintaining a healthy lifestyle through diet and exercise may help prevent certain diseases and enhance quality of life.
  • Antioxidants are the subject of increasing research because of the possible role they play in preventing disease. Antioxidants are molecules that work to prevent damage that occurs in cells and body tissues due to both normal bodily processes and exposure to some chemicals. The potential medical benefit of antioxidants may reside in their ability to prevent or slow the oxidation of molecules. However, there is some debate as to whether antioxidants have health benefits, as clinical trials have produced mixed results.
  • Research has recently focused on how antioxidant vitamins may reduce cardiovascular disease risk. In addition to being available in a variety of fruits and vegetables, antioxidants are available as supplements. Antioxidant vitamins, including vitamin E and C, and beta-carotene (a form of vitamin A), may have potential health benefits. According to the American Heart Association, approximately 30% of Americans are taking some form of antioxidant supplement.
  • Exercise is any form of physical activity that helps to promote overall health and decrease the risk of developing illnesses, such as heart disease. Most movement of the body is considered beneficial, as long as it is done in moderation and at the skill level of the person. There are many ways for people to exercise, including gardening, walking, sports activities, and dancing.
  • Patients beginning an exercise program should choose activities that fit their levels of strength and endurance. Exercise that causes extreme pain or discomfort is considered by many experts as unhealthy, and it may even cause permanent damage to the body.
    Based on expert opinion, most regular exercise plans adjusted for the abilities and goals of the patient are about equally beneficial.
  • The American Academy of Family Physicians recommends that patients choose exercise programs they will carry out consistently. They also recommend lower-impact forms of exercise, such as walking or swimming, for pregnant patients and patients unable to handle more intense forms of exercise. The American Heart Association recommends that adults aged 18-65 years participate in moderate-intensity aerobic physical activity for a minimum of 30 minutes at least five days each week. Another option is vigorous-intensity aerobic activity for a minimum of 20 minutes at least three days each week.
    The U.S. Centers for Disease Control and Prevention (CDC) recommends 30 minutes of moderate activity on all or most days of the week. Finally, the
    World Health Organization (WHO) suggests 30 minutes of moderate activity every day.
  • According to the U.S. Department of Health and Human Services and the U.S. Department of Agriculture, poor diet and physical inactivity may be associated with a variety of conditions, including cardiovascular disease, type 2 diabetes, hypertension, osteoporosis, and certain cancers.

Integrative Therapies

B

Good scientific evidence

  • Rose hip
    : The evidence currently available supports the use of a rose hip fruit juice extract to support antioxidant status in healthy young adults. Some very preliminary data indicate that CiLi, an oral liquid prepared from the constituents of rose hips, may have immune-boosting properties.

  • Use cautiously in patients taking agents that affect the immune system, anticoagulant or anti-platelet aggregating agents, aluminum-containing antacids, salicylates, or laxatives. Avoid in patients who are allergic to rose hips, rose pollen, its constituents, or members of the Rosaceae family.
  • Selenium
    : Selenium is a component of glutathione peroxidase, which possesses antioxidant activity and demonstrates antioxidant properties in humans. Long-term clinical benefits remain unknown.

  • Use cautiously at doses from 27-2,310 milligrams daily, as well as in patients on hemodialysis, in patients with iodine deficiency, high cholesterol, or immune disorders, and in those using immunosuppressants, corticosteroids, antacids, erythropoietin (EPO), cholesterol-lowering medications, oral contraceptives, astragalus, or iron supplements. Avoid in patients at high risk of nonmelanoma skin cancers or at risk for developing diabetes. Avoid in patients with known allergy or hypersensitivity to products containing selenium; however, selenium is a trace element, and hypersensitivity is unlikely.
  • Strawberry
    : Laboratory studies suggest that strawberry has antioxidant properties. However, the effect in humans is unclear. Further study is needed to define strawberry’s effectiveness in humans.

  • Use cautiously with hematological (blood) disorders or if taking anticoagulants or blood thinners. Use cautiously with iron-absorption disorder. Use cautiously if pregnant or breastfeeding. Avoid if allergic or hypersensitive to strawberry or members of the Rosaceae family.

C

Unclear or conflicting scientific evidence

  • Amaranth
    : Limited evidence suggests that amaranth may have antioxidant properties when combined with a heart-healthy diet. Additional studies are needed before conclusions can be drawn.

  • Amaranth is generally considered safe. Avoid if allergic or sensitive to amaranth. Use cautiously with diabetes, low blood sugar, low blood pressure, immune system disorders, or kidney disorders. Use cautiously if pregnant or breastfeeding.
  • Ashwagandha
    : The use of ashwagandha as an antiaging agent is based on traditional use in Indian Ayurvedic medicine to promote physical and mental health, improve resistance to disease, and promote longevity. Preliminary research suggests antioxidant properties, which has been proposed by some as a possible mechanism of ashwagandha for promoting longevity. Human research is scant in this area, and currently there is insufficient evidence to draw a firm conclusion.

  • Avoid if allergic or hypersensitive to ashwagandha products or any of their ingredients. Dermatitis (allergic skin rash) was reported in three of 42 patients in one ashwagandha trial.
    There are few reports of adverse effects associated with ashwagandha, but there are few human trials using ashwagandha, and most do not report the doses or standardization/preparation used.
    Avoid with peptic ulcer disease. Ashwagandha may have cause abortions based on anecdotal reports. Avoid if pregnant or breastfeeding.
  • Beta-glucan
    : In patients with high blood pressure, foods containing oat beta-glucan did not appear to have antioxidant effects. More research is needed before a conclusion can be made.

  • Avoid if allergic or hypersensitive to beta-glucan. When taken by mouth, beta-glucan is generally considered safe. Use cautiously with AIDS or AIDS-related complex (ARC). Avoid using particulate beta-glucan. Avoid if pregnant or breastfeeding.
  • Bitter orange
    : A low quality study indicates that a combination product including immature bitter orange may improve symptoms of aging. More, higher-quality studies are needed.

  • Avoid if allergic or hypersensitive to bitter orange or any members of the Rutaceae family. Avoid with preexisting cardiovascular (heart) disease, narrow-angle glaucoma, and intestinal colic. Avoid using if taking anti-adrenergic agents, beta-blockers, or QT-interval prolonging drugs or with long QT interval syndrome. Avoid if taking antidepressants, with drugs or dietary supplements with stimulant properties, and with honey. Use bitter orange preparations that are applied to the skin cautiously with fair skin. Use cautiously with headache and hyperthyroidism (too much thyroid hormone). Avoid if pregnant or breastfeeding.
  • Black currant
    : Preliminary study investigated the effects of black currant juice (and black currant anthocyanins in particular) on the steady state level of oxidative DNA damage in mononuclear blood cells. The antioxidant amount in the treatment dose was roughly equivalent to 10 servings of fruits and vegetables that have demonstrated antioxidant properties. The 22 elderly patients were dosed with black currant juice for only two weeks, a timeframe that other researchers determined to be inadequate to determine changes in antioxidant and oxidative status.

  • Avoid if allergic or hypersensitive to black currant, its constituents, or plants in the Saxifragaceae family. Avoid with hemophilia or those on blood thinners unless otherwise recommended by a qualified healthcare provider. Use cautiously with venous disorders or gastrointestinal disorders. Avoid if pregnant or breastfeeding.
  • Blackberry
    : Several in vitro studies indicate that blackberry fruit is high in antioxidants, which may be due to the berries’ anthocyanin content, such as cyanidin-3-O-glucoside. However, its antioxidant properties in the laboratory did not translate to antioxidant properties in elderly humans when a mixed-fruit food was ingested for two weeks. The authors state that two weeks may not have been enough time for the fruit to change serum antioxidant levels. More research using blackberry as a monotherapy is needed to determine its effects on antioxidant levels in humans.

  • Avoid if allergic or hypersensitive to blackberry (Rubus fructicosus), its constituents, or members of the Rosaecae family. Based on traditional use, blackberry is likely safe in food amounts in pregnant or breastfeeding patients. Other uses are not recommended in pregnant or breastfeeding women due to lack of sufficient data.
  • Carrot
    : Several preliminary clinical studies indicate that carrot ingestion may have only slight antioxidant activity. Clinical study of smokers eating a controlled diet high in polyunsaturated fatty acids and ingestion of a combination of orange juice and carrot juice significantly reduced malondialdehyde levels, but did not affect LDL oxidation. More high-quality studies using carrot as a monotherapy are needed to define carrot’s antioxidant activity in humans.

  • Avoid if allergic or hypersensitive to carrot, birch pollen-related allergens, or members of the Apiaceae family. Use cautiously in patients with low blood sugar or diabetes. Use cautiously in patients with bowel obstruction, hormone-sensitive conditions, or in children. Use cautiously and only in food amounts in pregnant and breastfeeding women.
  • Chocolate
    : Cocoa can be a rich source of flavonoids. These compounds may protect the body from the damaging effects of chemicals known as free radicals. More high-quality studies are needed before a conclusion can be made on the antioxidant effects of chocolate in humans.

  • Chocolate contains relatively high levels of caffeine. Use with caution in patients with addictive tendencies, anemia, cardiovascular disease, endocrine disorders, gastrointestinal disorders, kidney stones, migraine headaches, nervous disorders, respiratory disorders, or skin disorders. Use with caution in those who are overweight or obese or who are pregnant, breastfeeding, or trying to become pregnant. Use with caution in patients using agents that affect blood pressure, agents that affect blood sugar, antimicrobials, birth control pills, blood thinners, ergot derivatives, painkillers, sedatives, and stimulants. Use with caution in children. Avoid with known allergy or sensitivity to chocolate, cocoa, any of its components (including caffeine), or members of the Sterculiaceae family.
  • Cinnamon
    : Based on human study, a dried water-based extract of cinnamon (Cinnulin PF®) may improve the antioxidant status of overweight or obese individuals with impaired fasting glucose. More well-designed trials are needed before a firm conclusion can be made.

  • Avoid if allergic or hypersensitive to cinnamon, its constituents, members of the Lauraceae family, or Balsam of Peru. High levels of cinnamon may contain coumarin. Use cautiously if prone to atopic reactions or if taking cytochrome P450 metabolized agents, anticoagulants (blood thinners), insulin or blood sugar-altering medications, antibiotics, medications that affect the immune system, medications that lower cholesterol, agents toxic to the liver, or cardiovascular agents. Avoid if pregnant or breastfeeding.
  • Cordyceps
    : Cordyceps may improve various symptoms related to aging. However, higher quality studies testing specific symptoms of aging are needed before the specific effects of cordyceps can be determined.

  • Avoid if allergic or hypersensitive to cordyceps, mold or fungi. Use cautiously with diabetes, bleeding disorders or taking anticoagulant medications, with prostate conditions, if taking immunosuppressive medications, or if on hormonal replacement therapy or oral contraceptives. Avoid with myelogenous-type cancers. Avoid if pregnant or breastfeeding.
  • Cranberry
    : Based on laboratory study, cranberry may have antioxidant properties. However, human study is lacking. Further research is needed before a recommendation can be made.

  • Avoid if allergic to cranberries, blueberries or other plants of the Vaccinium species. Sweetened cranberry juice can affect blood sugar levels. Use cautiously with history of kidney stones. Avoid more than the amount usually found in foods if pregnant or breastfeeding.
  • Dandelion
    : Several laboratory studies report antioxidant properties for dandelion flower extract, although this research is preliminary, and effects in humans are not known.

  • Avoid if allergic to chamomile, feverfew, honey, yarrow, or any related plants such as aster, daisies, sunflower, chrysanthemum, mugwort, ragweed, or ragwort. Use cautiously with diabetes or bleeding disorders, gastroesophageal reflux disease (GERD), kidney or liver diseases, or a history of stroke or electrolyte disorders. Monitor potassium blood levels. Stop use two weeks before surgery/dental/diagnostic procedures with bleeding risk and do not use immediately after these procedures. Avoid if pregnant or breastfeeding.
  • Globe artichoke
    : Antioxidant properties of artichoke have been noted in multiple preclinical studies, although long-term clinical effects in humans are not known.

  • Use cautiously if allergic/hypersensitive to members of the Asteraceae or Compositae family (e.g., chrysanthemums, daisies, marigolds, ragweed, arnica), due to possible cross-reactivity. Use cautiously with cholelithiasis or biliary/bile duct obstruction or kidney disease. Avoid if pregnant or breastfeeding.
  • Grape seed
    : Studies have found grape seed to be an antioxidant that may help prevent or relieve symptoms of certain conditions, such as wound healing and vision problems associated with diabetes. The safety of long-term use of grape seed is unknown, and more studies are needed to provide definitive answers.

  • Avoid if allergic or hypersensitive to grapes or other grape compounds. Use cautiously if taking blood thinners such as warfarin, aspirin, non-steroidal anti-inflammatory drugs (NSAIDS), or anti-platelet agents. Use cautiously with bleeding disorders or if taking drugs that may increase the risk of bleeding. Use cautiously with drugs processed using the liver’s “cytochrome P450” enzyme system. Use cautiously with blood pressure disorders or if taking ACE inhibitors. Avoid with disorders that increase their risk of bleeding or with active bleeding disorders (stomach ulcers, bleeding into the brain, etc.). Avoid if pregnant or breastfeeding.
  • Lignans
    : Lignans are thought to reduce blood lipid concentrations and improve antioxidant capacity. However, available research results are conflicting. Further studies are needed to confirm these results.

  • Use cautiously in patients with prostate abnormalities, clotting disorders, glucose or insulin disorders (including diabetes), low blood pressure, compromised immune systems, or in patients taking medications for these disorders. Use cautiously in patients taking CNS depressants, cytochrome P450 metabolized agents, diuretics, estrogens, or antibiotics. Use cautiously in pregnant or lactating women. Avoid in patients with known allergy/hypersensitivity to lignans, flaxseed, sesame seeds, or any plants that produce them.
  • Lutein
    : Numerous studies have shown the antioxidant effect of lutein in vitro. Epidemiological evidence suggests that consumption of additional lutein-rich foods has no effect on LDL oxidation. Results from clinical trials indicate that lutein has no effect on biochemical indices of oxidant status, reduced oxidative lymphocyte DNA damage, or oxidative stress. No firm conclusions can be drawn as to the ability of lutein to alter the antioxidant status of plasma at this time.

  • Avoid if allergic or hypersensitive to lutein or zeaxanthin. Use cautiously if at risk for cardiovascular disease or cancer. Avoid if pregnant or breastfeeding.
  • Lycopene
    : Like other carotenoids, lycopene is purported to possess antioxidant, antiradical, singlet oxygen quenching, and gap-junction communication enhancement activities. Multiple in vitro studies have demonstrated antioxidant properties, while a limited number of others have suggested a lack of these effects. Overall, lycopene does appear to exert antioxidant properties in vitro. In human studies, however, there have been mixed results in this area. Most trials have focused on serum lycopene levels or consumption of tomatoes or tomato-based products rather than intake of lycopene supplements. Therefore, it remains unclear to what extent lycopene supplements exert clinically relevant antioxidant effects in humans, or whether these potential effects alter the progression of any disease.

  • Avoid if allergic to tomatoes or to lycopene. Due to a lack of conclusive data, avoid if pregnant or breastfeeding.
  • Melatonin
    : There are well over 100 laboratory and animal studies of the antioxidant (free-radical scavenging) properties of melatonin. As a result, melatonin has been proposed as a supplement to prevent or treat many conditions that are associated with oxidative damage. However, well-designed trials in humans that demonstrate the benefits of melatonin as an antioxidant for any health problem are currently lacking.

  • Melatonin is generally considered safe in recommended doses for short-term use. Use cautiously with seizures, underlying major depression or psychotic disorders, high cholesterol, diabetes, blood sugar disorders, glaucoma, blood pressure disorders, bleeding disorders, or in patients using medications for any of these conditions. Use cautiously in patients using anesthetics, cytochrome P450 inhibitors, methamphetamine, nifedipine (a calcium channel blocker), or in children with a history of enuresis. Avoid in patients using CNS depressants, including benzodiazepines and alcohol. Avoid in women who are pregnant or are attempting to become pregnant. Avoid with known allergies to melatonin or related products.
  • Monterey pine
    : Antioxidant-rich plants such as Monterey pine (Pinus radiata) may offer protection against degenerative diseases and aging. Early studies showed that a combination of Monterey pine and vitamin C decreased cell damage from oxidation. Additional research is needed.

  • Use cautiously in patients taking blood pressure-lowering agents or those with blood pressure disorders, and in patients with high blood levels of fats or cholesterol. Avoid with known allergy or hypersensitivity to Monterey pine, its components (such as pollen), airborne allergens, or members of the Pinaceae family. Avoid during pregnancy or breastfeeding.
  • Noni
    : Laboratory studies indicated that Tahitian Noni® juice (TNJ) may have greater antioxidant activity than some commonly-used antioxidants. A human placebo controlled trial was conducted to determine any protective effects of TNJ on oxidative damage in smokers. Although the results suggest that TNJ does have antioxidant effects, whether TNJ protects smokers from oxidative damage is yet to be proven. More high-quality studies are needed in this area.

  • Avoid if allergic/hypersensitive to noni or any plants in the Rubiaceae family. Use cautiously with if taking warfarin or other blood “thinners.” Use cautiously in patients with diabetes, low blood pressure, HIV/AIDS, compromised liver function, gastrointestinal disorders and blockages, or compromised kidney function. Avoid if pregnant or breastfeeding.
  • Palm oil
    : Palm oil and palm oil extracts have exhibited antioxidant properties in early research. In humans, palm oil has been reported to increase the resistance of VLDL (very low density lipoprotein) to oxidation when compared to sunflower oil. However, high-quality human studies in this area are lacking.

  • Use cautiously in patients with blood pressure disorders, abnormal cholesterol levels, gastrointestinal sensitivities, liver disorders, heart disease, bleeding disorders, or blood sugar disorders, or in patients taking medications for any of these disorders. Avoid oxidized palm oil. Avoid with known allergy or hypersensitivity to Elaeis guineensis, its constituents, or members of the Arecaceae family. Avoid in patients allergic to coconut, due to similarities in allergens. Avoid the use of large doses of palm oil in pregnant women, due to the risk of birth defects when vitamin A is consumed in doses greater than the recommend dietary allowance guidelines.
  • Papaya
    : Papaya has been shown to have potent antioxidant properties. Although early research results are encouraging, further studies are required before any conclusion can be made.

  • Papaya is likely safe when consumed in food amounts. Fermented papaya is possibly safe when used medicinally for up to three months. Use with caution in patients with bleeding disorders or those taking agents that may increase the risk of bleeding, in patients with diabetes or hypoglycemia or those taking agents that affect blood sugar, and in patients with autoimmune disorders or those using agents that affect the immune system. Use papaya seed extract and the papaya enzyme papain with caution. Use cautiously with vitamin A or retinoids, beta-carotene or carotene-containing foods, iron or iron-rich foods, sodium, potassium supplements, or agents that alter potassium levels. Avoid in patients with a known allergy or hypersensitivity to papaya, its components (including papaya juice, papaya flower pollen, papain, and chymopapain), members of the Caricaceae family, or latex. Cross sensitivity between kiwi and papaya, as well as papain, has been reported. Severe life-threatening allergic reactions to papain have been reported in approximately 1% of children receiving papain for burn treatment. Avoid high amounts of papaya seeds in women who are pregnant, breastfeeding, or trying to become pregnant.
  • Paprika
    : Based on human study, a mixture containing paprika reduced oxidative stress. Additional study is needed to better determine the potential antioxidant effects of paprika.

  • Sweet peppers, such as paprika, are likely safe in amounts normally found in the diet. Avoid if allergic or hypersensitive to paprika, Capsicum annuum, other peppers, or plants related to these, or to latex. Sweet peppers should be washed before use and only purchased from trusted sources.
  • Parsley
    : A small clinical trial noted that parsley reduced oxidative stress. More research is needed to better determine the potential antioxidant effects of parsley.

  • Use cautiously with history of bleeding disorders, diabetes, hypotension, or digestive disorders. Avoid if allergic or sensitive to parsley, carrots, fennel, or celery. Skin rashes and hives have been reported. Pregnant women should avoid parsley oil. It is stronger than other forms of parsley and may cause miscarriage. Wash fresh parsley with water before use to remove bacteria.
  • Peony
    : Peony root may have antioxidant effects. More research is needed to better understand the antioxidant potential of peony.

  • Avoid if allergic or sensitive to peony. Avoid with bleeding disorders or if taking drugs, herbs, or supplements that increase bleeding risk. Use cautiously with estrogen-sensitive cancers or if taking drugs, herbs, or supplements with hormonal activity. Avoid if pregnant or breastfeeding.
  • Pomegranate
    : Early studies suggest that pomegranate juice may have antioxidant properties, but the effects in humans are still unclear. Additional studies, including those in specific disease states in which free radical oxidation is prominent (such as diabetes and cancer), are warranted.

  • Avoid if allergic or hypersensitive to pomegranate. Avoid with diarrhea or high or low blood pressure. Avoid taking pomegranate fruit husk with oil or fats to treat parasites. Pomegranate root/stem bark should only be used under supervision of a qualified healthcare professional. Use cautiously with liver damage or disease. Pomegranate supplementation can be unsafe during pregnancy when taken by mouth. The bark, root and fruit rind can cause menstruation or uterine contractions. Avoid if breastfeeding due to a lack of scientific data.
  • Pycnogenol®
    : Due to conflicting study results, it is unclear if Pycnogenol® has significant antioxidant effects in humans. Further research is necessary.

  • Avoid if allergic/hypersensitive to Pycnogenol®, its components, or members of the Pinaceae family. Use cautiously with diabetes, hypoglycemia, bleeding disorders. Use cautiously if taking hypolipidemics, medications that may increase the risk of bleeding, hypertensive medications, or immune stimulating or inhibiting drugs. Avoid if pregnant or breastfeeding, or in young children.
  • Raspberry
    : Several laboratory studies have shown that raspberry contains antioxidants and has antioxidant activity. Preliminary study indicates that a beverage containing several juices, including raspberry, has postexercise antioxidant effects. However, larger studies using raspberry alone are needed.

  • Avoid if allergic or hypersensitive to raspberry (Rubus idaeus ), its constituents, or any members of the Rosaceae family. Use cautiously with asthma or if taking Clotrimoxazole, antibiotics (especially clarithromycin), antispasmodic agents or muscle relaxants, diuretics, salicylates, or laxatives, sedatives or operating heavy machinery. Use cautiously if pregnant or breastfeeding as raspberry may theoretically induce labor. Cyclosporiasis associated with contaminated fresh raspberries has been reported. Always thoroughly wash raspberries before ingestion.
  • Resveratrol
    : Resveratrol has been included in herbal products that are marketed to increase lifespan and prevent aging. Limited evidence shows a possible benefit for this use. More studies are needed in this area.

  • Avoid if allergic or hypersensitive to resveratrol, grapes, red wine or polyphenols. Resveratrol is generally considered safe. It is commonly found in food and beverages. Use cautiously with bleeding disorders, abnormal blood pressure. Use cautiously with drugs that are broken down by the body’s cytochrome P450 system. Avoid if pregnant or breastfeeding.
  • Sea buckthorn
    : Sea buckthorn extract taken with blueberry extract may have antioxidant properties. More study is needed in this area before a conclusion can be made.

  • Avoid if allergic or hypersensitive to sea buckthorn, its constituents, or members of the Elaeagnaceae family. Use cautiously in patients with cancer, hypertension or bleeding disorders. Avoid higher doses than food amounts if pregnant or breastfeeding.
  • Seaweed
    : Fucoidans from some brown algae, including bladderwrack (F. vesiculosus),
    exhibit some antioxidant activity in vitro. Human research is lacking.

  • Avoid if allergic or hypersensitive to Fucus vesiculosus and iodine. Avoid with history of thyroid disease, bleeding, acne, kidney disease, blood clots, nerve disorders, high blood pressure, stroke, or diabetes. Avoid if pregnant or breastfeeding.
  • Selenium
    : It has been proposed that selenium supplementation may help people live longer. However, results from clinical trials are mixed, and it is still unclear whether selenium supplementation can increase lifespan in healthy individuals. More research is needed to better determine the effects of selenium on aging.

  • Use cautiously at doses from 27-2,310 milligrams daily, as well as in patients on hemodialysis, in patients with iodine deficiency, high cholesterol, or immune disorders, and in those using immunosuppressants, corticosteroids, antacids, erythropoietin (EPO), cholesterol-lowering medications, oral contraceptives, astragalus, or iron supplements. Avoid in patients at high risk of nonmelanoma skin cancers or at risk for developing diabetes. Avoid in patients with known allergy or hypersensitivity to products containing selenium; however, selenium is a trace element, and hypersensitivity is unlikely.
  • Soy
    : There is some evidence in support of soy increasing antioxidant status in humans. In general, diets high in plant foods may offer antioxidant benefits. Further research is required in this field before a conclusion can be made.

  • Avoid if allergic to soy. Breathing problems and rash may occur in sensitive people. Soy, as a part of the regular diet, is traditionally considered to be safe during pregnancy and breastfeeding, but there is limited scientific data. The effects of high doses of soy or soy isoflavones in humans are not clear, and therefore are not recommended. There has been a case report of vitamin D deficiency rickets in an infant nursed with soybean milk (not specifically designed for infants). People who experience intestinal irritation (colitis) from cow’s milk may experience intestinal damage or diarrhea from soy. It is not known if soy or soy isoflavones share the same side effects as estrogens, such as an increased risk of blood clots. The use of soy is often discouraged in patients with hormone-sensitive cancers, such as breast, ovarian or uterine cancer. Other hormone-sensitive conditions such as endometriosis may also be worsened. Patients taking blood-thinning drugs like warfarin should check with a doctor and pharmacist before taking soy.
  • Tocotrienols
    : Tocotrienols have been studied for their antioxidant properties in preliminary studies. However, few clinical trials exist. Based on a case series, PalmVitee®, a tocotrienol enriched fraction of palm oil, demonstrated antioxidant properties in patients with cerebrovascular disease. Additional high-quality clinical studies are needed before a firm conclusion can be made.

  • Use doses higher than 400 IU daily cautiously. Use cautiously in individuals with diabetes or those using hypoglycemic agents. Use cautiously in individuals with bleeding disorders or those using anticoagulant or antiplatelet agents. Use medicinal amounts cautiously in pregnant and lactating individuals. Avoid with known allergy/hypersensitivity to sources of vitamin E, tocopherols, and tocotrienols. Tocotrienols are a type of vitamin E. Skin reactions such as contact dermatitis and eczema have been reported with topical vitamin E preparations, such as ointments or vitamin E containing-deodorants. Individuals with known or suspected hypersensitivity to vitamin E should avoid these products.
  • Vitamin A
    : In humans, the benefits of vitamin A for potential antioxidant activity are not clear. Additional research is needed in this area.

  • Avoid if allergic or hypersensitive to vitamin A. Vitamin A toxicity can occur if taken at high dosages. Use cautiously with liver disease or alcoholism. Smokers who consume alcohol and beta-carotene may be at an increased risk for lung cancer or heart disease. Vitamin A appears safe in pregnant women if taken at recommended doses; however, vitamin A excess, as well as deficiency, has been associated with birth defects. Excessive doses of vitamin A have been associated with central nervous system malformations. Use cautiously if breastfeeding because the benefits or dangers to nursing infants are not clearly established.
  • Vitamin E
    : Vitamin E possesses antioxidant activity, but it is not clear if there is any benefit in humans. The American Heart Association has recommended obtaining antioxidants such as vitamin E by eating a well-balanced diet high in fruits, vegetables, and whole grains, rather than from supplements, until further scientific evidence is available.

  • Avoid if allergic or hypersensitive to vitamin E. Avoid with retinitis pigmentosa (loss of peripheral vision). Use cautiously with bleeding disorders or if taking blood thinners. Avoid above the recommended daily level in pregnant women and breastfeeding women.
  • Yoga
    : Yoga may have antioxidant properties. More, higher quality evidence is needed to confirm available study results.

  • Yoga is generally considered to be safe in healthy individuals when practiced appropriately. Avoid some inverted poses with disc disease of the spine, fragile or atherosclerotic neck arteries, risk for blood clots, extremely high or low blood pressure, glaucoma, detachment of the retina, ear problems, severe osteoporosis, or cervical spondylitis. Yoga should not be used as a substitute for standard care, especially for potentially dangerous ailments such as asthma. Patients should seek the guidance of a qualified healthcare provider before starting any regimen of treatment. Certain yoga breathing techniques should be avoided in people with heart or lung disease. Use cautiously with a history of psychotic disorders. Yoga techniques are believed to be safe during pregnancy and breastfeeding when practiced under the guidance of expert instruction (the popular Lamaze techniques are based on yogic breathing). However, poses that put pressure on the uterus, such as abdominal twists, should be avoided in pregnancy.

Author Information

  • This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration ().

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. American Heart Association. .
  2. American Dietetic Association. .
  3. Centers for Disease Control and Prevention. .
  4. Fogli-Cawley JJ, Dwyer JT, Saltzman E, et al. The 2005 dietary guidelines for Americans adherence index: Development and application. J Nutr. 2006 Nov;136(11):2908-15.
    View Abstract
  5. Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007 Aug 28;116(9):1081-93. Epub 2007 Aug 1.
    View Abstract
  6. Karasek M. Does melatonin play a role in aging processes? J Physiol Pharmacol. 2007 Dec;58 Suppl 6:105-13.
    View Abstract
  7. Moats C, Rimm EB. Vitamin intake and risk of coronary disease: observation versus intervention. Curr Atheroscler Rep. 2007 Dec;9(6):508-14.
    View Abstract
  8. Natural Standard: The Authority on Integrative Medicine. .
  9. United States Department of Agriculture. .
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