Vitamin C + E (AMD)

BACKGROUND: There is inconclusive evidence from observational studies to suggest that people who eat a diet rich in antioxidant vitamins (carotenoids, vitamins C, and E) or minerals (selenium and zinc) may be less likely to develop age-related macular degeneration (AMD). OBJECTIVES: To determine whether or not taking antioxidant vitamin or mineral supplements, or both, prevent the development of AMD. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 2), MEDLINE Ovid (1946 to 29 March 2017), Embase Ovid (1947 to 29 March 2017), AMED (Allied and Complementary Medicine Database) (1985 to 29 March 2017), OpenGrey (System for Information on Grey Literature in Europe) (www.opengrey.eu/); searched 29 March 2017, the ISRCTN registry (www.isrctn.com/editAdvancedSearch); searched 29 March 2017, ClinicalTrials.gov (www.clinicaltrials.gov); searched 29 March 2017 and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 29 March 2017. We did not use any date or language restrictions in the electronic searches for trials. SELECTION CRITERIA: We included all randomised controlled trials (RCTs) comparing an antioxidant vitamin or mineral supplement (alone or in combination) to control. DATA COLLECTION AND ANALYSIS: Both review authors independently assessed risk of bias in the included studies and extracted data. One author entered data into RevMan 5; the other author checked the data entry. We pooled data using a fixed-effect model. We graded the certainty of the evidence using GRADE. MAIN RESULTS: We included a total of five RCTs in this review with data available for 76,756 people. The trials were conducted in Australia, Finland, and the USA, and investigated vitamin C, vitamin E, beta-carotene, and multivitamin supplements. All trials were judged to be at low risk of bias.Four studies reported the comparison of vitamin E with placebo. Average treatment and follow-up duration ranged from 4 to 10 years. Data were available for a total of 55,614 participants. There was evidence that vitamin E supplements do not pre

BACKGROUND: It has been proposed that antioxidants may prevent cellular damage in the retina by reacting with free radicals that are produced in the process of light absorption. Higher dietary levels of antioxidant vitamins and minerals may reduce the risk of progression of age-related macular degeneration (AMD). OBJECTIVES: The objective of this review was to assess the effects of antioxidant vitamin or mineral supplementation on the progression of AMD in people with AMD. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 8), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to August 2012), EMBASE (January 1980 to August 2012), Allied and Complementary Medicine Database (AMED) (January 1985 to August 2012), OpenGrey (System for Information on Grey Literature in Europe) (www.opengrey.eu/), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 20 August 2012. We searched the reference lists of identified reports and the Science Citation Index. We contacted investigators and experts in the field for details of unpublished studies. We also searched for systematic reviews of harms of vitamin supplements. SELECTION CRITERIA: We included randomised trials comparing antioxidant vitamin or mineral supplementation (alone or in combination) to placebo or no intervention in people with AMD. DATA COLLECTION AND ANALYSIS: Two authors assessed risk of bias and extracted data from the included trials. Where appropriate, we pooled data using a random-effects model unless three or fewer trials were available in which case we used a fixed-effect model. MAIN RESULTS: Thirteen trials (6150 participants) were included in this review. Over half the participants (3640) were randomised in one trial (AREDS in the USA), which found a benefic

BACKGROUND: There is inconclusive evidence from observational studies to suggest that people who eat a diet rich in antioxidant vitamins (carotenoids, vitamins C and E) or minerals (selenium and zinc) may be less likely to develop age-related macular degeneration (AMD). OBJECTIVES: To examine the evidence as to whether or not taking antioxidant vitamin or mineral supplements prevents the development of AMD. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2011, Issue 12), MEDLINE (January 1950 to January 2012), EMBASE (January 1980 to January 2012), Open Grey (System for Information on Grey Literature in Europe) (www.opengrey.eu/), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). There were no date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 26 January 2012. SELECTION CRITERIA: We included all randomised controlled trials (RCTs) comparing an antioxidant vitamin and/or mineral supplement (alone or in combination) to control. DATA COLLECTION AND ANALYSIS: Both review authors independently assessed risk of bias in the included studies and extracted data. One author entered data into RevMan 5 and the other author checked the data entry. We pooled data using a fixed-effect model. MAIN RESULTS: We included four RCTs in this review; 62,520 people were included in the analyses. The trials were conducted in Australia, Finland and the USA and investigated vitamin E and beta-carotene supplements. Overall the quality of the evidence was high. People who took these supplements were not at decreased (or increased) risk of developing AMD. The pooled risk ratio for any antioxidant supplement in the prevention of any AMD was 0.98 (95% confidence interval 0.89 to 1.08) and for advanced AMD was 1.05 (95% CI 0.80 to 1.39). Similar results were seen when the analyses were restricted to beta-carotene and alpha-tocopherol alone. AUTHORS' CONCLUSIONS: There is accumulating eviden

INTRODUCTION: The aim of this review was to examine the evidence as to whether antioxidant vitamin or mineral supplements prevent the development of AMD or slow down its progression. METHODS: Randomised trials comparing antioxidant vitamin and/or mineral supplement to control were identified by systematic electronic searches (updated August 2007) and contact with investigators. Data were pooled after investigating clinical and statistical heterogeneity. RESULTS: There was no evidence that antioxidant (vitamin E or beta-carotene) supplementation prevented AMD. A total of 23 099 people were randomised in three trials with treatment duration of 4-12 years; pooled risk ratio=1.03 (95% CI, 0.74-1.43). There was evidence that antioxidant (beta-carotene, vitamin C, and vitamin E) and zinc supplementation slowed down the progression to advanced AMD and visual acuity loss in people with signs of the disease (adjusted odds ratio=0.68, 95% CI, 0.53-0.87 and 0.77, 95% CI, 0.62-0.96, respectively). The majority of people were randomised in one trial (AREDS, 3640 people randomised). There were seven other small trials (total randomised 525). CONCLUSIONS: Current evidence does not support the use of antioxidant vitamin supplements to prevent AMD. People with AMD, or early signs of the disease, may experience some benefit from taking supplements as used in the AREDS trial. Potential harms of high-dose antioxidant supplementation must be considered. These may include an increased risk of lung cancer in smokers (beta-carotene), heart failure in people with vascular disease or diabetes (vitamin E) and hospitalisation for genitourinary conditions (zinc).

OBJECTIVE: To evaluate the effectiveness of dietary antioxidants in the primary prevention of age related macular degeneration (AMD). DESIGN: Systematic review and meta-analysis. DATA SOURCES: Search of seven databases without limits on year or language of publication, and retrieval of references in pertinent reviews and articles. METHODS: Two reviewers independently searched the databases and selected the studies, using standardised criteria. Randomised clinical trials and prospective cohort studies were included. Of the 4192 abstracts initially identified, 12 studies (nine prospective cohort studies and three randomised clinical trials) met the selection criteria and were included. Data extraction and study quality evaluation were independently reviewed, using standardised criteria. Results were pooled quantitatively using meta-analytic methods. RESULTS: The nine prospective cohort studies included 149 203 people, with 1878 incident cases of early AMD. The antioxidants investigated differed across studies, and not all studies contributed to the meta-analysis of each antioxidant. Pooled results from prospective cohort studies indicated that vitamin A, vitamin C, vitamin E, zinc, lutein, zeaxanthin, alpha carotene, beta carotene, beta cryptoxanthin, and lycopene have little or no effect in the primary prevention of early AMD. The three randomised clinical trials did not show that antioxidant supplements prevented early AMD. CONCLUSIONS: There is insufficient evidence to support the role of dietary antioxidants, including the use of dietary antioxidant supplements, for the primary prevention of early AMD.

6. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD000254. doi: 10.1002/14651858.CD000254.pub2. Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration. Evans JR(1). Author information: (1)London School of Hygiene & Tropical Medicine, Internatio

PURPOSE: To determine whether oral micronutrient supplementation slows geographic atrophy (GA) progression in age-related macular degeneration (AMD). DESIGN: Post hoc analysis of Age-Related Eye Disease Study (AREDS) and AREDS2, multicenter randomized placebo-controlled trials of oral micronutrient supplementation, each with 2 × 2 factorial design. PARTICIPANTS: A total of 392 eyes (318 participants) with GA in AREDS and 1210 eyes (891 participants) with GA in AREDS2. METHODS: The AREDS participants were randomly assigned to oral antioxidants (500 mg vitamin C, 400 IU vitamin E, 15 mg β-carotene), 80 mg zinc, combination, or placebo. The AREDS2 participants were randomly assigned to 10 mg lutein/2 mg zeaxanthin, 350 mg docosahexaenoic acid/650 mg eicosapentaenoic acid, combination, or placebo. Consenting AREDS2 participants were also randomly assigned to alternative AREDS formulations: original; no beta-carotene; 25 mg zinc instead of 80 mg; both. MAIN OUTCOME MEASURES: (1) Change in GA proximity to central macula over time and (2) change in square root GA area over time, each measured from color fundus photographs at annual visits and analyzed by mixed-model regression according to randomized assignments. RESULTS: In AREDS eyes with noncentral GA (n = 208), proximity-based progression toward the central macula was significantly slower with randomization to antioxidants versus none, at 50.7 μm/year (95% confidence interval [CI], 38.0-63.4 μm/year) versus 72.9 μm/year (95% CI, 61.3-84.5 μm/year; P = 0.012), respectively. In AREDS2 eyes with noncentral GA, in participants assigned to AREDS antioxidants without β-carotene (n = 325 eyes), proximity-based progression was significantly slower with randomization to lutein/zeaxanthin versus none, at 80.1 μm/year (95% CI, 60.9-99.3 μm/year) versus 114.4 μm/year (95% CI, 96.2-132.7 μm/year; P = 0.011), respectively. In AREDS eyes with any GA (n = 392), area-based progression was not significantly different with randomization to antioxidants versus none (P = 0.63). In AREDS2 eyes with any GA, in participants assigned to AREDS antioxidants without β-carotene (n = 505 eyes), area-based progression was not significantly diffe

BACKGROUND: Age-related macular degeneration (AMD) is a degenerative condition of the back of the eye that occurs in people over the age of 50 years. Antioxidants may prevent cellular damage in the retina by reacting with free radicals that are produced in the process of light absorption. Higher dietary levels of antioxidant vitamins and minerals may reduce the risk of progression of AMD. This is the third update of the review. OBJECTIVES: To assess the effects of antioxidant vitamin and mineral supplements on the progression of AMD in people with AMD. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, one other database, and three trials registers, most recently on 29 November 2022. SELECTION CRITERIA: We included randomised controlled trials (RCTs) that compared antioxidant vitamin or mineral supplementation to placebo or no intervention, in people with AMD. DATA COLLECTION AND ANALYSIS: We used standard methods expected by Cochrane. MAIN RESULTS: We included 26 studies conducted in the USA, Europe, China, and Australia. These studies enroled 11,952 people aged 65 to 75 years and included slightly more women (on average 56% women). We judged the studies that contributed data to the review to be at low or unclear risk of bias. Thirteen studies compared multivitamins with control in people with early and intermediate AMD. Most evidence came from the Age-Related Eye Disease Study (AREDS) in the USA. People taking antioxidant vitamins were less likely to progress to late AMD (odds ratio (OR) 0.72, 95% confidence interval (CI) 0.58 to 0.90; 3 studies, 2445 participants; moderate-certainty evidence). In people with early AMD, who are at low risk of progression, this means there would be approximately four fewer cases of progression to late AMD for every 1000 people taking vitamins (one fewer to six fewer cases). In people with intermediate AMD at higher risk of progression, this corresponds to approximately 78 fewer cases of progression for every 1000 people taking vitamins (26 fewer to 126 fewer). AREDS also provided evidence of a lower risk of progression for both neovascular AMD (OR 0.62, 95% CI 0.47 to 0.82; moderate-certainty evidence) and geographic atrophy

The aim of this paper is to summarize all available evidence from systematic reviews, randomized controlled trials (RCTs) and comparative nonrandomized studies (NRS) on the association between nutrition and antioxidant, vitamin, and mineral supplements and the development or progression of age-related macular degeneration (AMD). The Cochrane Database of Systematic Reviews, Cochrane register CENTRAL, MEDLINE and Embase were searched and studies published between January 2015 and May 2021 were included. The certainty of evidence was assessed according to the GRADE methodology. The main outcome measures were development of AMD, progression of AMD, and side effects. We included 7 systematic reviews, 7 RCTs, and 13 NRS. A high consumption of specific nutrients, i.e. β-carotene, lutein and zeaxanthin, copper, folate, magnesium, vitamin A, niacin, vitamin B6, vitamin C, docosahexaenoic acid, and eicosapentaenoic acid, was associated with a lower risk of progression of early to late AMD (high certainty of evidence). Use of antioxidant supplements and adherence to a Mediterranean diet, characterized by a high consumption of vegetables, whole grains, and nuts and a low consumption of red meat, were associated with a decreased risk of progression of early to late AMD (moderate certainty of evidence). A high consumption of alcohol was associated with a higher risk of developing AMD (moderate certainty of evidence). Supplementary vitamin C, vitamin E, or β-carotene were not associated with the development of AMD, and supplementary omega-3 fatty acids were not associated with progression to late AMD (high certainty of evidence). Research in the last 35 years included in our overview supports that a high intake of specific nutrients, the use of antioxidant supplements and adherence to a Mediterranean diet decrease the risk of progression of early to late AMD. © 2022 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.

Background: There is a growing number of studies suggesting the effectiveness of dietary supplements in preventing and treating endometriosis. It has been suggested that deficiencies in vitamins D and E as well as zinc are associated with the increased risk of endometriosis development. Beneficial effects of magnesium, curcumin, resveratrol and epigallocatechin-3-gallate were found in experimental animal studies. A reduction in pain related to endometriosis was shown in women using omega-3 and alpha-lipoic acid. Meanwhile, decreasing endometriotic lesion size after the supplementation of omega-3, N-acetylcysteine, vitamin C and epigallocatechin-3-gallate was observed in animal and human studies. Thus, the aim of this critical review was to summarize the available data describing the effects of dietary supplements used in the treatment of endometriosis. Material and Methods: The PubMed, Embase, Cochrane, and Web of Science databases were searched for related studies until 15 December 2025. Finally, 34 studies were included in the synthesis. Results: Of these 34 studies, only 23 were randomized, placebo-controlled trials. There have been no RCTs evaluating the effectiveness of vitamin E, zinc, alpha-LA, EGCG and DIM in the treatment of endometriosis. Single studies evaluating the effectiveness of vitamin C, magnesium, resveratrol, NAC and PEA with PLD have not confirmed it. Meanwhile single studies evaluating the effectiveness of selenium, propolis and quercetin have confirmed it. Of the four studies assessing the effectiveness of vitamin D, two confirmed it and two did not; of the two studies assessing probiotics, one confirmed its effectiveness and one did not; of the two studies assessing curcumin, one confirmed its effectiveness and one did not; and of the three studies assessing omega-3, two confirmed its effectiveness and one did not. All four RCTs assessing the combination of vitamins C and E confirmed their effectiveness. Conclusions: Despite encouraging observations from experimental studies, the results of RCTs are less encouraging and do not allow for the formulation of recommendations concerning the use of supplements in the treatment of endometriosis

AIM: This study aimed to examine the trends and determinants of dietary supplement use and to assess the prevalence and predictors of potential drug-supplement interactions among older adults over a 16-year follow-up. METHODS: This repeated cross-sectional study included adults aged ≥ 50 years who participated in the third (2006–2008; n = 3,484), fourth (2009–2011; n = 4,020), fifth (2012–2014; n = 4,342), sixth (2015–2017; n = 4,598), and seventh (2018–2022; n = 4,750) examinations of the Tehran Lipid and Glucose Study (TLGS). Information on dietary supplement use, including individual vitamin supplements and prescription medication use was collected using standardized questionnaires. Trends in supplement use and participant characteristics were evaluated across study phases. Clinically relevant mild-to-moderate potential drug-supplement interactions were defined as the concurrent use of specific dietary supplements and commonly prescribed medications and were classified according to Stockley’s framework. Multivariable logistic regression models were used to identify factors associated with dietary supplement use and potential drug-supplement interactions in the 2018–2022 examination. RESULTS: Over 16 years, dietary supplement use increased more than 2-fold from 10.4% to 21.1%, mainly from increases in thiamin (2.2% to 13.4%), cobalamin (1.8% to 9.8%), vitamin C (1.3% to 7.9%), vitamin E (1.8% to 8.7%), and zinc (0.2% to 3.3%). Female sex, higher education, and diabetes were associated with higher likelihood of supplement use. In 2018–2022, 4.8% of participants had potential drug-supplement interactions, most commonly vitamin E with aspirin (2.3%) and magnesium or potassium with antihypertensive medications. The likelihood of potential drug-supplement interactions was higher in women (OR = 2.03, 95%CI = 1.61–2.56), participants with primary education (OR = 1.45, 95% CI = 1.09–1.96), smokers (OR = 1.50, 95%CI = 1.07–2.12), and individuals with diabetes (OR = 2.80, 95%CI = 2.13–3.68), hypertension (OR = 2.20, 95%CI = 1.78–2.73), chronic kidney disease (OR = 2.35, 95%CI = 1.88–2.94), or multimorbidity (OR = 2.46, 95%CI = 1.85–3.26). CONCLUSION: Over 16 years, supp

Endometriosis is a chronic, estrogen-dependent inflammatory condition affecting approximately 10% of women of reproductive age worldwide. It is characterized by the presence of endometrial-like tissue outside the uterine cavity, which frequently results in dysmenorrhea, chronic pelvic pain, dyspareunia, and infertility. While hormonal medications and surgical procedures are common treatments, they are often constrained by adverse effects and high recurrence rates. The aim was to systematically identify, critically appraise, and synthesize randomized controlled trials evaluating vitamin D, C, and E supplementation in women with endometriosis, focusing on their effects on pelvic pain, dysmenorrhea, dyspareunia, quality of life, oxidative and inflammatory biomarkers, and fertility-related outcomes, and to highlight methodological gaps that can inform future research and integrated therapeutic strategies. Following PRISMA guidelines, seven eligible RCTs were identified from databases including PubMed, Scopus, and ScienceDirect. The quality of these studies was assessed using the Jadad Scoring System and Cochrane RoB 2 tool. High-dose supplementation of vitamin D (50,000 IU) was found to significantly reduce pelvic pain and improve biochemical markers such as hs-CRP and total antioxidant capacity (TAC). Vitamin D appears to modulate endometrial pathways by reducing active β-catenin protein activity, which may disrupt signaling associated with lesion invasion and survival. Additionally, combined Vitamin C and E therapy (typically 1000 mg/day of Vitamin C and 800 IU/day of Vitamin E) acts synergistically to scavenge free radicals. This intervention significantly decreased oxidative stress markers, including malondialdehyde (MDA) and reactive oxygen species (ROS). Patients reported significant improvements in symptoms, including a 43% reduction in daily pelvic pain and a 37% reduction in dysmenorrhea. Despite physiological improvements, there was no statistically significant increase in pregnancy rates observed across the trials. Vitamin supplementation with D, C, and E represents a safe, low-cost adjunct therapy that can effectively mitigate endometriosis-related oxida

CONTEXT: Type 2 diabetes (T2D) is one of the fastest-growing global health emergencies of the 21st century. However, high antioxidant capacity of supplementation of vitamin C and/or E was inversely associated with insulin resistance. However, each antioxidant possesses a distinct biological function that may be influenced by both dosage and duration of supplementation, potentially resulting in significantly different effects. OBJECTIVE: This meta-analysis aimed to evaluate whether vitamin C, vitamin E, or their combination is more effective in improving glycemic control, blood lipids, and blood pressure in individuals with T2D. DATA SOURCES AND DATA EXTRACTION: A systematic search was conducted in PubMed, Scopus, and Web of Science databases for randomized clinical trials, identifying 52 studies (n = 1425 participants). DATA ANALYSIS: Random-effects models were used to assess the effects of vitamin C and/or E supplementation on glycemic control, blood lipid levels, and blood pressure. These findings indicate that supplementation with vitamin C, vitamin E, or their combination has a comparable effect on glycemic index values, systolic blood pressure, and blood lipid profiles. However, a significant reduction in systolic blood pressure was observed only with vitamin C and combined vitamin C + E supplementation. Additionally, a significant increase in high-density-lipoprotein (HDL) levels was noted exclusively with the combined vitamin C + E supplementation. CONCLUSION: Consequently, supplementation with vitamin C, vitamin E, and their combination (C + E) exhibited differing effects on HDL levels and systolic blood pressure. However, their effects on glycemic control, diastolic blood pressure, and blood lipids other than HDL were comparable. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42023399366. © The Author(s) 2025. Published by Oxford University Press on behalf of the International Life Sciences Institute.

BACKGROUND: Oxidative stress (OS) accelerates the pathogenesis of coronary artery disease (CAD) by contributing to atherosclerotic plaque formation. Current research indicates that antioxidants can mitigate OS by reducing the production of free radicals. Despite many studies that have tested the effects of antioxidants on oxidative stress in patients with CAD, the literature still lacks an updated and comprehensive systematic review. The aim of this study was to identify the effects of administering exogenous antioxidants on OS levels among adult patients with CAD. METHODS: A systematic review searched PubMed, Medline, and CINAHL for randomized controlled trials (RCTs) published between January 2013 and May 2025, which examined antioxidants to lower OS in adult participants with CAD. Studies were excluded if participants had chronic or acute inflammatory conditions, renal failure, liver failure, or had undergone major operations before being enrolled. RESULTS: Among 2338 studies reviewed, 15 RCTs met the inclusion criteria. Out of the 15 RCTs, nine reported on supplemental antioxidants (i.e., L-carnitine and melatonin), and two reported on dietary antioxidants (Khorasan wheat diet and wine) that were effective at lowering OS (P < 0.05). One study found Brazil nuts (dietary antioxidants) ineffective at lowering OS. The three remaining RTCs reported that intravenously administered antioxidants, including alpha-lipoic acid, vitamin C, or N-acetylcysteine, significantly lowered OS. CONCLUSIONS: The reviewed RTCs provide evidence that antioxidants may lower OS in patients with CAD. The utility of this conclusion is limited by the studies' methodologies that examine various antioxidants and measure OS through a variety of biomarkers. This heterogeneity in methodologies between studies indicates that further research is needed with standardized interventions and outcomes.

BACKGROUND: Resistance training (RT) is a fundamental sarcopenia treatment, but its efficacy may be enhanced by nutritional strategies. This study investigated whether combining RT with vitamins C and E supplementation yields additive benefits in sarcopenia patients. METHODS: Sixty older women with sarcopenia (60-75 years) were randomized to an antioxidant supplementation group (AS; 1000 mg/d vitamin C and 335 mg/d vitamin E) or a placebo group (PLA) following the same elastic-band RT program. Muscle mass, muscle strength, physical performance, oxidative stress-related indices (reduced glutathione [GSH] and oxidized glutathione [GSSG], GSH/GSSG ratio, malondialdehyde, and protein carbonyl), and pro-inflammatory factors (interleukin-6 [IL-6] and tumor necrosis factor-alpha) were evaluated at baseline and after the 12-week intervention. RESULTS: After 12 weeks, muscle mass, strength, and physical performance significantly increased (P < .05) in both the AS and PLA groups. However, the AS group had higher increases in arm lean mass (Δ = 0.96 vs 0.59 kg; P = .003, d = 0.74), skeletal muscle mass index (Δ = 0.71 vs 0.42 kg/m²; P = .004, d = 0.71), handgrip strength (Δ = 3.66 vs 1.16 kg; P = .047, d = 0.51), and knee extension strength (Δ = 2.28 vs 1.02 kg; P < .001, d = 0.89) than the PLA group. There were no differences in physical performance between the RT conditions over time. Regarding blood parameters, the AS group had increased GSH (P < .001, d = 1.52) and GSH/GSSG ratio (P < .001, d = 1.52), and reduced GSSG (P < .001, d = 0.96) and malondialdehyde (P < .001, d = 1.65) compared to the PLA group. The serum levels of IL-6 and tumor necrosis factor-alpha significantly decreased in the PLA and AS groups, but IL-6 was lower in the AS group than in the PLA group (P < .001, d = 1.16). CONCLUSION: Vitamins C and E supplementation combined with RT for 12 weeks resulted in superior adaptations in muscle mass and strength compared with RT with placebo, and the underlying mechanism could be related to the alleviation of oxidative stress and inflammation.

BACKGROUND: There is no conclusion on the effect of vitamins E and C on plasma biomarkers of oxidative stress and antioxidant status. We conducted this meta-analysis to gain a clearer view of this area. METHODS: We performed a systematic search in online databases using the relevant keyword combination. Randomized controlled trials that investigated the effect of vitamins E and C simultaneously, compared with control, on oxidative stress and antioxidant status biomarkers were included in the analyses. RESULTS: A total of 17 trials were included in the meta-analysis, building a total sample size of 965. The dosage of vitamin E and C supplements varied from 54 to 536 and 250 to 1000 mg/d, respectively, across included studies. We found significant results for MDA [WMD: -0.38, 95% CI: -0.48, -0.28 µg/L, P <0.001], LP [WMD: -1.01, 95% CI: -1.49, -0.54 µg/L, P <0.001], TAC [WMD: 0.09, 95% CI: 0.05, 0.13 mmol/L, P <0.001], and GPx [WMD: 1251.74, 95% CI: 258.92, 2244.56 U/L, P = 0.013], but not for SOD [WMD: 16.69, 95% CI: -29.40, 62.78 U/L, P = 0.278]. Regarding subgroup analysis, only studies on unhealthy participants showed a significant effect on MDA [WMD: -1.62, 95% CI: -2.08, -1.15 µg/L, P <0.001] and TAC [WMD: 0.08, 95% CI: 0.03, 0.14 mmol/L, P <0.001], unlike LP, where significance was only observed in healthy adults [WMD: -0.41, 95% CI: -0.45, -0.37 µg/L, P <0.001]. Moreover, only studies in which a placebo was administered, supplementation of vitamins showed significant effects on MDA [WMD: -0.47, 95% CI: -0.58, -0.35 µg/L, P <0.001], LP [WMD: -1.28, 95% CI: -1.85, -0.72 µg/L, P <0.001], and TAC [WMD: 0.10, 95% CI: 0.05, 0.15 mmol/L, P <0.001]. CONCLUSION: Our review and analyses revealed that a combination of vitamin C and E has a beneficial effect on oxidative stress biomarkers and antioxidant status. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024590197, identifier CRD42024590197.

BACKGROUND: Nutrition is vital for preterm infant development. Vitamins play key roles as cofactors and gene regulators for metabolic and immune functions and are common added components of preterm infant nutrition. However, information on how vitamins impact in-hospital and neurodevelopmental outcomes is sparse. We aimed to determine the effect of fat- and water-soluble vitamin supplementation on clinical outcomes during neonatal care and later neurodevelopment of very preterm (≤32 weeks' gestation) and very low birth weight (≤1500 g) infants. METHODS AND FINDINGS: 4 databases and 3 clinical trial registries were systematically searched for randomised controlled trials (RCTs). Two reviewers independently extracted data and assessed quality using the Cochrane Risk of Bias tool. Meta-analyses were conducted using a random-effect model for each vitamin subgroup. Data are presented as risk ratios [95% confidence intervals]. Of 4074 references identified, 43 studies were included in the review. Only 2 reported neurodevelopment at 2 years, and only 4 were studies of water-soluble vitamins (vitamin C, 3 studies; B12 and folate, 1 study). Survival free from neurodisability was not affected by supplementation of vitamin A (0.89 [0.74-1.08], n = 538, very low certainty of evidence) or vitamin D (0.76 [0.46-1.27], n = 78, very low certainty of evidence). The incidence of bronchopulmonary dysplasia was decreased by vitamins D (0.58 [0.41-0.83]) and C (0.59 [0.37-0.93]), very low certainty of evidence), retinopathy of prematurity was decreased by vitamins A (0.77 [0.61-0.98]) and E (0.10 [0.01-0.80]), very low to low certainty of evidence) and intraventricular haemorrhage was decreased by vitamin E (0.70 [0.52-0.92], moderate certainty of evidence). Culture-proven sepsis was decreased by vitamin A (0.88 [0.77-0.99], moderate certainty of evidence). CONCLUSIONS: There are few and inconclusive data on the effect of vitamin supplementation in preterm infants on later neurodevelopment. Evidence for shorter-term outcomes is mostly of low certainty. Together with substantial heterogeneity in trial design, it therefore is difficult to recommend a specific supplementation regimen.

OBJECTIVE: Preterm birth is a leading global cause of neonatal mortality and morbidity, with oxidative stress playing a role in its pathogenesis. Vitamin C, a powerful antioxidant, may help reduce this risk. This study assessed the effectiveness of vitamin C supplementation, both alone and with vitamin E, in preventing preterm birth compared to a placebo. DATA SOURCE: Databases were systematically searched in PubMed, Cochrane and Embase in December 2023 and updated in May 2024. STUDY SELECTION: Included RCTs evaluated vitamin C's effect on preterm birth and related neonatal outcomes. DATA COLLECT: Statistical analyses used a random-effects model for pooled risk ratios (RR) and 95% confidence intervals (CI). Heterogeneity was assessed with the I² statistic. DATA SYNTHESIS: Seventeen RCTs (21,567 patients) were analyzed. Vitamin C supplementation showed no significant difference compared to placebo for preterm birth (RR 1.04; 95% CI 0.96, 1.14). No significant differences were observed for neonatal death (RR 0.77; 95% CI 0.55, 1.08), NICU admission (RR 1.03; 95% CI 0.95, 1.13), preterm PROM (RR 1.04; 95% CI 0.63, 1.71), or birth weight (MD 52.41; 95% CI -19.65, 124.47). A slight decrease in gestational age was observed (MD 0.26; 95% CI -0.02, 0.55). CONCLUSION: Vitamin C supplementation alone or in combination with vitamin E does not significantly prevent preterm birth or improve related neonatal outcomes.

Respiratory viruses continue to present serious health challenges to human wellness. Growing evidence suggests that the more severe and damaging effects and symptoms of influenza, rhinovirus (RV), respiratory syncytial virus (RSV), and COVID-19 may primarily result from their common ability to disorganize the body's healthy immune response. The simultaneous over-stimulation of several reactive oxygen species (ROS) pathways and concurrent suppression of bioavailable Nitic Oxide (NO) contribute to an immune disbalance that can lead to cellular oxidative distress and an excessive inflammatory response. This study evaluated the real-time, acute ability of a single, orally administered 50 mg encapsulated dose of a plant-based dietary supplement ("PB-Blend"), compared to 1000 mg of Vitamin C as a positive control, to modulate multiple ROS associated with a dampened immune response, as well as NO and other markers of inflammation, in a cohort recovering from a moderate course of COVID-19. This randomized, double-blind study was performed on 28 individuals 18-24 days after a moderate COVID-19 infection. Participants were orally supplemented with a single encapsulated dose of either 50 mg of PB-Blend or 1000 mg Vitamin C as a positive control. Changes in the levels of bioavailable NO (measured as circulating NOHb) were assessed, as well as the ex vivo cellular formation of mitochondrial, NOX2-, iNOS-, and TNFα-dependent ROS. All parameters were measured in real time before ingestion (baseline), and then at 30, 60, 120, and 180 min after administration. ROS were measured using a portable electron paramagnetic resonance (EPR) spectrometer. Inflammatory, immunity (hsCRP and TNFα plasma levels), interleukin (IL1, IL6, IL8, and IL10), cytokine (IFNγ, TNFα, and NF-κB), and immunoglobulin (IgA, IgM, IgG, and IgE) profiles were also followed. In addition to laboratory and cell function investigations, we performed clinical cardio ergometry, blood O2 saturation, and respirometry examinations. As hypothesized, the collected baseline data from this study group confirmed that mitochondrial, NOX2, and iNOS enzymatic systems were strongly involved in the generation of ROS at 18-24 day

Diets high in red and processed meat and low in plant-based foods are associated with an increased risk of colorectal cancer. We investigated whether berry supplementation can impact gut metabolism to counteract the presumably cancer promoting luminal environment sustained by high red and processed meat consumption. Altogether 43 healthy adults were randomized either into Meat group (150 g/d red and processed pork meat) or Meat & Berries group (150 g/d red and processed meat and 200 g/d of mixed berries). Fecal samples and 3-d food records were collected at baseline and at the end of the four-week intervention. Intakes of vitamin C, vitamin E, manganese, insoluble fiber, and the polyphenols available in the database were significantly higher in the Meat & Berries than Meat group. While between-group comparisons found no significant differences in the gut microbiota, the within-group analyses showed that the relative abundances of beneficial Roseburia and Faecalibacterium were decreased and an unclassified group of Peptostreptococcaceae increased significantly in the Meat group. In comparison to the Meat group, berry consumption resulted in higher fecal concentrations of p-coumaric and protocatechuic acids and lower viability of fecal water (FW) -treated CV1-P fibroblastoma and human colon adenocarcinoma HCA-7 and Caco-2 cells (P<.05 with 30% FW). Berry consumption provided protective nutrients and mitigated potentially unfavourable gut microbiota changes seen in the Meat group, increased fecal polyphenol metabolites, and reduced viability of FW-treated colon adenocarcinoma cells, collectively suggesting that berries may protect against colorectal cancer development.

Adiponectin is a hormone that modulates glucose regulation and fatty acid oxidation. Low adiponectin concentration has been associated with increased insulin resistance. Studies show a beneficial effect of vitamin E supplementation on insulin sensitivity. We aimed to investigate the association of prenatal antioxidant supplementation with increased adiponectin concentrations in pregnant participants and their newborn infants.Secondary analysis of a randomized control trial of prenatal vitamin C and E supplementation to prevent preeclampsia in low-risk nulliparous participants. Plasma of participants at time of randomization (9-16 weeks gestation) and delivery, and neonatal cord blood were analyzed by specific enzyme-linked immunosorbent assay for adiponectin concentration. Multivariable analysis was adjusted for confounders.A total of 198 (98 vitamin, 100 placebo) maternal-neonatal dyad samples were analyzed. Maternal and neonatal characteristics were similar between the vitamin and placebo groups, with the exception of race/ethnicity, with Whites more common in the placebo group (80 vs. 66.3%, p = 0.02). In bivariable analyses, adiponectin concentrations at delivery were higher in the vitamin group compared with the placebo group (29.4 vs. 27.5 µg/mL, p = 0.04), whereas cord blood adiponectin concentrations were similar (26.6 . vs. 27.4 µg/mL, p = 0.47) between the two groups. There was a significant interaction between treatment group and maternal baseline adiponectin level on the adiponectin concentrations at delivery (p = 0.04) and cord blood adiponectin (p < 0.05). For participants whose baseline adiponectin concentrations were in the highest tertile, vitamin supplementation was associated with higher adiponectin concentrations at delivery. However, for participants whose baseline adiponectin concentration were in the lowest tertile, vitamin supplementation was associated with lower cord blood adiponectin concentrations.For participants with high baseline adiponectin concentration, vitamin C and E supplementation is associated with higher adiponectin concentration at delivery. Conversely, vitamin supplementation is associated with lower cord adiponectin con

There has been increasing interest in the role of micronutrient supplementation in critical care. This narrative review summarizes the recent studies on micronutrients in critically ill patients. We searched two databases for primary randomized controlled trials that investigated the effects of micronutrient supplementation in patients with critical illness published from January 2021 to August 2023. Personal files, reference lists of included studies, and previous reviews were also screened. Twelve studies reported on vitamin C, four studies on vitamin D, three studies on thiamin, two studies on multivitamins, and one study on cobalamin. The therapeutic effects of vitamin C appear mixed, although vitamin C monotherapy appears more promising than vitamin C combination therapy. Intramuscular administration of vitamin D appeared to lower mortality, mechanical ventilation duration, and intensive care unit stay, whereas enteral administration showed limited clinical benefits. Intravenous thiamin was not associated with improved outcomes in patients with septic shock or hypophosphatemia. Preliminary evidence suggests reduced vasopressor dose with cobalamin. Decreased disease severity and hospital stay in patients with COVID-19 with vitamins A-E requires further investigation, whereas providing solely B-group vitamins did not demonstrate therapeutic effects. It is currently premature to endorse the provision of high-dose micronutrients in critical illness to improve clinical outcomes. This review may help to inform the design of future trials that will help better elucidate the optimal dosage and form of micronutrients, methods of administration, and subgroups of patients with critical illness who may most benefit. © 2024 American Society for Parenteral and Enteral Nutrition.

BACKGROUND: There is a consistent association between exposure to air pollution and elevated rates of cardiopulmonary illnesses. As public health activities emphasize the paramount need to reduce exposure, it is crucial to examine strategies like the antioxidant diet that could potentially protect individuals who are unavoidably exposed. METHODS: A systematic search was performed in PubMed/Medline, EMBASE, CENTRAL, and ClinicalTrials.gov up to March 31, 2023, for clinical trials assessing dietary supplements against cardiovascular (blood pressure, heart rate, heart rate variability, brachial artery diameter, flow-mediated dilation, and lipid profile) or pulmonary outcomes (pulmonary function and airway inflammation) attributed to air pollution exposure. RESULTS: After reviewing 4681 records, 18 studies were included. There were contradictory findings on the effects of fish oil and olive oil supplementations on cardiovascular outcomes. Although with limited evidence, fish oil offered protection against pulmonary dysfunction induced by pollutants. Most studies on vitamin C did not find protective cardiovascular effects; however, the combination of vitamin C and E offered protective effects against pulmonary dysfunction but showed conflicting results for cardiovascular outcomes. Other supplements like sulforaphane, L-arginine, n-acetylcysteine, and B vitamins showed potential beneficial effects but need further research due to the limited number of existing trials. CONCLUSIONS: Although more research is needed to determine the efficacy and optimal dose of anti-inflammatory and antioxidant dietary supplements against air pollution toxicity, this low-cost preventative strategy has the potential to offer protection against outcomes of air pollution exposure. Copyright: © 2024 Ilaghi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.