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Q J Med 1999; 92: 527-530
© 1999 Association of Physicians


Commentary papers

Interaction of dietary antioxidants in vivo: how fruit and vegetables prevent disease?

M.A. Eastwood

From the Gastrointestinal Unit, Department of Medicine, University of Edinburgh, Western General Hospital Trust, Edinburgh, UK

Dr M.A. Eastwood, Hill House, North Queensferry, Fife KY11 1JJ

Summary

Epidemiological studies indicate that fruit and vegetables are health-promoting and protective against disease, particularly cardiovascular disease and cancer. Possible plant nutrients providing this protection include antioxidants and dietary fibre. Clinical trials with antioxidant supplements give inconsistent results for protection against lung cancer in smokers, invasive cervical cancer, oesophageal and gastric cancers, colorectal polyps and coronary heart disease. The antioxidants used in trials may be contributing to a more complex system. Antioxidants have differing solubilities which partition across the phases of tissues, cells and macromolecular structures: water-soluble ascorbate, glutathione and urate; lipid-soluble tocopherols and carotenoids, and intermediatory-soluble flavonoids and hydroxycinnamic acids. The health protection provided by fruit and vegetables could arise through an integrated reductive environment delivered by plant antioxidants of differing solubility in each of the tissue, cellular and macromolecular phases.


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