Seventy percent of all Americans use vitamin supplements every day. Thirty million Americans have joined this group of daily pill poppers only during the past 12 months. And these include some of the most renowned clinicians and scientists who had historically been a critic of vitamin therapy. Why? The new discoveries now tell that the modern role of vitamins is not in preventing the classical diseases associated with their deficiency but in preventing many dread diseases. The clinical trials begun 20-30 years ago in major health centers like Harvard have begun to yield convincing conclusions. One such conclusion is that a special group of vitamins can prevent cancer, heart disease and other chronic ailments. The new theory now medically proven is called The Antioxidant Connection--a scenario no less exciting than Ian Fleming's thrillers. So read on and enjoy the unfolding of a medical thriller.

Vitamins, a long stay of health and perceived well being for millions, have conjured chronic debates in the medical and popular press for decades. The conservative conformists held the opinion that vitamins are amply provided in our diet; taking vitamin pills only makes our urine expensive. Health conscious group of clinicians and scientists including such revered name as the two-time Nobel Laureate Linus Pauling believed that we must supplement to reap their full benefit. Diets alone can not do. What made these controversies worse were the vested interests of drug companies selling vitamins. Since the regulatory authorities considered them food supplements, the laws controlling safety and efficacy claims did not govern them; the marketers ran amok with claims, fads grew and sales of vitamins worldwide soared. This created much concern not only by the regulatory authorities like the US Food and Drug Administration and the ethical pharmaceutical companies provided large funding to independent researchers to resolve conflicting claims about the utility of vitamin supplements. The studies required were difficult and expensive, for example, take the study reported in May 1993 by Dr. Willet of Harvard. A group of 120,000 men and women were followed for a period of over eight years. Those taking 100 units of vitamin E reduced their risk of heart disease by 40%; that's much more than what had been achieved by diet modification and exercise. Other recent studies show that B vitamins prevent birth defects and vitamin D prevents breast cancer. Though many claims remain to be validated, most major issues have been resolved.

Vitamins are chemicals used by our body in small amounts to build, maintain and repair tissues. In the early part of the century, it was discovered that certain foods protected people from diseases like rickets, pellagra and beriberi, which had once been deemed infectious. The acute deficiency diseases were mostly eradicated by 1930s when vitamins were chemically synthesized and fortified in foods. The milk sold today still contains A & D added to it.

The recommended daily allowance of vitamins (RDAs), based on their ability to prevent specific diseases have been questioned by many scientists since disease states, environmental exposure, pregnancy, lactation, old age, use of some drugs, all alter our daily requirements. Evidence now suggests that while the recommended daily allowances are fine for warding off acute deficiencies, higher intakes are needed to help combat every thing from broken bones to blocked arteries.

How vitamins can prevent diseases is amply evident in their role as antioxidants. It is a new twist in the utility of vitamins, specially the ACE group--vitamin A, vitamin C and vitamin E. Together they comprise the new battle tool against a common mechanism involved in many diseases: presence of free radicals in body. A radical running rampant can destroy any society; body produces many radicals of its own and gets attacked by many from environment; they are just as harmful. The chemical molecules and atoms exist in a peaceful state when the configuration of their electronic structure is stabilized. For example, a normal oxygen atom has four pairs of electrons. Body's natural metabolism routinely robs the oxygen atoms off their electrons rendering them a free radical (a chemical term but with great connotation for the bravery of radicals) which immediately attacks atoms around it to rob them off electrons; this begins a chain reaction of robbing, eroding cell membranes, leading to disintegration of the cell and opening the door to many diseases including cancer and heart disease. Free radicals occur naturally in the body via the respiration process but the levels may be boosted significantly by external "stress" caused by our modern life style that alters metabolic process. Environmental exposure adds a load of these free radicals also.

Free radicals play significant role in Alzheimer's and Parkinson's disease, atherosclerosis (plaque formation), autoimmune diseases (arthritis, diabetes, kidney and brain disorders), metal poisoning, malaria, blood disorders, cancer, alcoholism, drug toxicity, exposure to toxins, body tissue damage, smoking, radiation, aging, smoke inhalation, stroke, skin disorders, eye diseases, gastrointestinal lesions and a host of other common ailments.

The body has its own in-built defense system of antioxidants which "mop up" and neutralize these harmful free radicals. Antioxidants like the ACE group of vitamins can give up electrons to free radicals without becoming harmful, heading off the dangerous chain reaction. The discovery that the ACE group can act as antioxidants is relatively new and serendipitous. In the 1970s it was observed that the population groups with lowest cancer incidence consumed most fruits and vegetables; those consuming large vitamin C had only one-half incidence of mouth, throat and stomach cancer. The reduced incidence of cancer of lung and other tissues was related to consumption of Beta Carotene. Since then hundreds of well-designed clinical studies have confirmed the hunch that lead to the title "chemoprevention" to the ACE vitamins.

What makes this group of vitamins so hot is their scavenger properties. They limit the spread of degenerative illnesses like cancer and premature aging and may ward off heart disease by preventing the buildup of cholesterol in arterial walls. Excess fats floating in blood get oxidized making them more liable to deposit in plaques responsible for heart attacks and strokes.

The ACE group includes the newest entry of vitamin A : Beta Carotene, a form of vitamin A with its own properties. In US, E and beta-carotene alone raked up sales of half a billion dollars last year. Vitamin C probably did much better than that.

Heart disease progression is specially altered by the antioxidants. Besides the established factors such as high cholesterol levels, hypertension and smoking, now we identify diet as a significant factor. According to the WHO, almost 50% of deaths in the developed countries are due to cardiovascular diseases (CVDs). By the end of this century, almost one-third deaths in the developing countries will be due to CVDs. The countries topping the list of CVDs are Northers Ireland, Scotland and Finland. A surprising element is the lowest incidence of disease in Japan but look at how there diet is different from the staple diet of the West.

Dietary factors include high level of saturated fat that produces excess fat in blood; unable to breakdown this excess fat in the liver, body keeps these floating fats circulating in the blood. Not unlike the oils going rancid in an open pan, the floating blood fats undergo oxidation and become more actively involved in plaque formation because they attach to things to rid themselves of the electron-deficient state.

The ACE group of vitamins provides the antioxidant function, relieve the charges on oxidized fats in the blood and thus keep them from depositing as plaques in arteries. For example, one molecule of vitamin E protects about 200 molecules of polyunsaturated fatty acids against oxidation. The use of vitamin E at 100-400 IU per day can reduce the risk of CVD by as much as 50%.

Vitamin C acts by regenerating body's supply of reduced vitamin E (the form when vitamin E donates its electrons to fat molecules) and by affecting cholesterol metabolism. Vitamin C also reduced platelet aggregation and adhesiveness, which is one of the first critical stages in the development of plaques. Oxidation also makes cholesterol "bad." Vitamin C taken at 300 mg per day or Beta Carotene at 50 mg per day reduces the risk of coronary heart disease by one half. They just keep the arteries open longer not to speak of noses: studies show that use of megadoses of vitamin C reduced the number and duration of colds by as much as 70%.

Vitamin C is found in raw fruits and vegetables, particularly citrus fruits. It is also found in potatoes, parsnips, strawberries and blackcurrants. Food over cooked or stored for too long can quickly lose their vitamin C content so be careful when storing and cooking. A minimum daily dose of about 150 mg is required to elicit the effects of vitamin C. Many studies recommend much higher doses.

Beta-carotene is fat soluble itself ad finds its way into fat deposits including plaques. It prevents oxidation of blood fats, converts blood lipids into "good" lipids, the HDLs and complements the action of vitamin E by being able to work at very low concentration of oxygen. Beta Carotene represents the most important dietary source of vitamin A in man. Part of it converts to vitamin A and the rest keeps circulating with other carotenoides. The protective effect of Beta Carotene is totally independent of its conversion to vitamin A, which in itself has protective effect against cancer.

Cancer of mouth is one type of cancer affected by intake of Beta Carotene. This type of cancer is very common in this part of the world due mainly to use of betel nuts wrapped in tobacco leaves. Studies in Indian fisherman showed that a 9-week treatment with 150 mg Beta Carotene per day reduced the number of precancer cells in mouth by 98%. Generally, however, a daily dose of 6 mg per day will be sufficient to achieve optimal effect. Within the past 12 months many drinks around the world have begun to include Beta Carotene in their formulations.

Beta Carotene, Vitamin C and E are found in many fruits and vegetables. Beta Carotene is found in the natural pigment in brightly colored fruits and vegetables such as broccoli, peppers, spinach, carrots, mangoes and apricots. Vitamin E is found in many vegetable oils, including olive oil, nuts, seeds, egg yolks and brown rice. Vegetables rich in vitamin C include spinach, green cabbage, peppers and broccoli.

Over dosing with these vitamins is not a major health hazard; taking too much of vitamin C will cause diarrhea and E and Beta Carotene may at worse cause stomachache or a reversible yellowing of the skin. However, care must be exercised in not over doing. Taking high doses of vitamin C over long time can damage kidneys specially if water intake is reduced, a common problem in Pakistan where dehydration is routinely observed. Similarly, fat soluble E and Beta Carotene may deposit in the body and show effects not yet discovered.

Armed with this new knowledge, we can plan to reduce risk of many diseases first by paying attention to what we eat. The rule of thumb is: if it is bright colored vegetable or fruit--eat it. But for millions of wizards, who can not tell the difference between a fruit and a berry, supplement it. In this case a pill a day will keep your doctor away. However, do it in moderation.