Combined vitamin C and E supplementation for disease risk reduction

Authors

  • Isaac Dias Bezerra Instituto Federal de Educação Goiano. Endereço: Rodovia Sul Goiana, Km 01, Zona Rural | Rio Verde - Go | CEP: 75.901-970 – Brasil. E-mail: rioverde@ifgoiano. Telefone 55 (64) 3620-5600. https://orcid.org/0000-0002-9484-5447
  • Raissa de Melo Matos Ferreira Instituto Federal de Educação Goiano. Endereço: Rodovia Sul Goiana, Km 01, Zona Rural | Rio Verde - Go | CEP: 75.901-970 – Brasil. E-mail: rioverde@ifgoiano. Telefone 55 (64) 3620-5600.
  • Mayra Conceição Martins Peixoto Instituto Federal de Educação Goiano. Endereço: Rodovia Sul Goiana, Km 01, Zona Rural | Rio Verde - Go | CEP: 75.901-970 – Brasil. E-mail: rioverde@ifgoiano. Telefone 55 (64) 3620-5600.
  • Geovana Rocha Plácido Instituto Federal de Educação Goiano. Endereço: Rodovia Sul Goiana, Km 01, Zona Rural | Rio Verde - Go | CEP: 75.901-970 – Brasil. E-mail: rioverde@ifgoiano. Telefone 55 (64) 3620-5600. https://orcid.org/0000-0002-3028-7191
  • Rogério Favareto Instituto Federal de Educação Goiano. Endereço: Rodovia Sul Goiana, Km 01, Zona Rural | Rio Verde - Go | CEP: 75.901-970 – Brasil. E-mail: rioverde@ifgoiano. Telefone 55 (64) 3620-5600. https://orcid.org/0000-0001-5293-0451
  • Lilianne Baldoino Monteiro Instituto Federal de Educação Goiano. Endereço: Rodovia Sul Goiana, Km 01, Zona Rural | Rio Verde - Go | CEP: 75.901-970 – Brasil. E-mail: rioverde@ifgoiano. Telefone 55 (64) 3620-5600. https://orcid.org/0000-0001-8672-9270
  • Erica de Freitas Cabral Instituto Federal de Educação Goiano. Endereço: Rodovia Sul Goiana, Km 01, Zona Rural | Rio Verde - Go | CEP: 75.901-970 – Brasil. E-mail: rioverde@ifgoiano. Telefone 55 (64) 3620-5600. https://orcid.org/0000-0002-9116-4531
  • Itatiane Catarina Guerra Instituto Federal de Educação Goiano. Endereço: Rodovia Sul Goiana, Km 01, Zona Rural | Rio Verde - Go | CEP: 75.901-970 – Brasil. E-mail: rioverde@ifgoiano. Telefone 55 (64) 3620-5600.

DOI:

https://doi.org/10.33448/rsd-v9i9.6088

Keywords:

Antioxidant; Bioactive substances; National Health Surveillance Agency.

Abstract

This review aimed to compile the results of combined use of vitamin C and E supplementation, their antioxidant effects applied in general diseases, researched in the past years and compare such dosages with the ones separately recommended in Normative Instruction nº 28 published on June of 2018 by the Brazilian National Health Surveillance Agency (ANVISA). Bibliographic research was performed in three databases on combined supplementation and the synergistic relationship between vitamins C and E. The dosages used by the researchers were tabulated for better understanding and the results were discussed and compared against the recommendations established by ANVISA low. In conclusion, when the maximum and minimum daily intake levels of vitamins C and E was drafted in the legislation, according to the population subgroups, ANVISA defined criteria for the designation of antioxidant bioactive compounds and regulated the possibility of combined supplementation of these compounds in reducing the risk of disease through oxidative stress. On the other hand, on the researcher and / or health professional falls the responsibility to previously define the supplementation protocol, considering the synergistic relationship of the constituents and avoiding the generation of pro-oxidant effects, which possibly tends to result in an adverse effect to the desired one.

Author Biographies

Isaac Dias Bezerra, Instituto Federal de Educação Goiano. Endereço: Rodovia Sul Goiana, Km 01, Zona Rural | Rio Verde - Go | CEP: 75.901-970 – Brasil. E-mail: rioverde@ifgoiano. Telefone 55 (64) 3620-5600.

Mestrado em Tecnologia de Alimentos 

Instituto Federal de Educação Goiano. Endereço: Rodovia Sul Goiana, Km 01, Zona Rural | Rio Verde - Go | CEP: 75.901-970 – Brasil. E-mail: rioverde@ifgoiano. Telefone 55 (64) 3620-5600.

Raissa de Melo Matos Ferreira, Instituto Federal de Educação Goiano. Endereço: Rodovia Sul Goiana, Km 01, Zona Rural | Rio Verde - Go | CEP: 75.901-970 – Brasil. E-mail: rioverde@ifgoiano. Telefone 55 (64) 3620-5600.

Aluno

Mayra Conceição Martins Peixoto, Instituto Federal de Educação Goiano. Endereço: Rodovia Sul Goiana, Km 01, Zona Rural | Rio Verde - Go | CEP: 75.901-970 – Brasil. E-mail: rioverde@ifgoiano. Telefone 55 (64) 3620-5600.

Professora

Geovana Rocha Plácido, Instituto Federal de Educação Goiano. Endereço: Rodovia Sul Goiana, Km 01, Zona Rural | Rio Verde - Go | CEP: 75.901-970 – Brasil. E-mail: rioverde@ifgoiano. Telefone 55 (64) 3620-5600.

Professora

Rogério Favareto, Instituto Federal de Educação Goiano. Endereço: Rodovia Sul Goiana, Km 01, Zona Rural | Rio Verde - Go | CEP: 75.901-970 – Brasil. E-mail: rioverde@ifgoiano. Telefone 55 (64) 3620-5600.

Professor

Lilianne Baldoino Monteiro, Instituto Federal de Educação Goiano. Endereço: Rodovia Sul Goiana, Km 01, Zona Rural | Rio Verde - Go | CEP: 75.901-970 – Brasil. E-mail: rioverde@ifgoiano. Telefone 55 (64) 3620-5600.

Aluno

Erica de Freitas Cabral, Instituto Federal de Educação Goiano. Endereço: Rodovia Sul Goiana, Km 01, Zona Rural | Rio Verde - Go | CEP: 75.901-970 – Brasil. E-mail: rioverde@ifgoiano. Telefone 55 (64) 3620-5600.

Aluna

Itatiane Catarina Guerra, Instituto Federal de Educação Goiano. Endereço: Rodovia Sul Goiana, Km 01, Zona Rural | Rio Verde - Go | CEP: 75.901-970 – Brasil. E-mail: rioverde@ifgoiano. Telefone 55 (64) 3620-5600.

Aluna

References

Allagui, M. S., Feriani, A., Bouoni, Z., Alimi, H., Murat, J. C., & El Feki, A. (2014). Protective effects of vitamins (C and E) and melatonin co-administration on hematological and hepatic functions and oxidative stress in alloxan-induced diabetic rats. Journal of physiology and biochemistry, 70(3), 713-723.

Ashor, A. W., Siervo, M., Lara, J., Oggioni, C., Afshar, S., & Mathers, J. C. (2015). Effect of vitamin C and vitamin E supplementation on endothelial function: a systematic review and meta-analysis of randomised controlled trials. British Journal of Nutrition, 113(8), 1182-1194.

Asleh, R., & Levy, A. P. (2010). Divergent effects of α-tocopherol and vitamin C on the generation of dysfunctional HDL associated with diabetes and the Hp 2-2 genotype. Antioxidants & redox signaling, 12(2), 209-217.

Barbosa, J. L., Thiers, C. A., de Bragança Pereira, B., do Nascimento, E. M., Ribeiro Frazon, C. M., Budni, P., ... & Pedrosa, R. C. (2016). Impact of the use of benznidazole followed by antioxidant supplementation in the prevalence of ventricular arrhythmias in patients with chronic Chagas disease: pilot study. American journal of therapeutics, 23(6), e1474-e1483.

Betancor, M. B., Caballero, M. J., Terova, G., Cora, S., Saleh, R., Benitez-Santana, T., ... & Izquierdo, M. (2012). Vitamin C enhances vitamin E status and reduces oxidative stress indicators in sea bass larvae fed high DHA microdiets. Lipids, 47(12), 1193-1207.

Basambombo, L. L., Carmichael, P. H., Côté, S., & Laurin, D. (2017). Use of vitamin E and C supplements for the prevention of cognitive decline. Annals of Pharmacotherapy, 51(2), 118-124.

Böhm, F., Edge, R., McGarvey, D. J., & Truscott, T. G. (1998). β‐Carotene with vitamins E and C offers synergistic cell protection against NOx. FEBS letters, 436(3), 387-389.

BRASIL. Guia alimentar para a população brasileira. Ministério da Saúde, 2014. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/guia_alimentar_populacao_brasileira_2ed.pdf . Acessado em 10/11/2019.

Brasil. Suplementos alimentares: Documento Base para discussão regulatória. Junho de 2017. Disponível em: http://portal.anvisa.gov.br/documents/3845226/0/Documento+Base.pdf/8a931dd3-6de7-4bd7-8546-23e91f73f331 . Acessado em 05/10/2019.

Brasil. RDC Nº 243, DE 26 DE JULHO DE 2018. Dispõe sobre os requisitos sanitários dos suplementos alimentares. Publicada no DOU nº 144, de 27 de julho de 2018. Disponível em: http://portal.anvisa.gov.br/documents/10181/3898888/RDC_243_2018_.pdf/0e39ed31-1da2-4456-8f4a-afb7a6340c15. Acessada em 18/11/2019.

Brasil. INSTRUÇÃO NORMATIVA nº 28, DE 26 DE JULHO DE 2018. Estabelece as listas de constituintes, de limites de uso, de alegações e de rotulagem complementar dos suplementos alimentares. Publicada no DOU nº 144, de 27 de julho de 2018. Disponível em: http://portal.anvisa.gov.br/documents/10181/3898888/IN_28_2018_COMP.pdf/db9c7460-ae66-4f78-8576-dfd019bc9fa1. Acessado em 20/11/2019.

Brasil. MINISTÉRIO DA SAÚDE. Perguntas e Respostas - Suplementos Alimentares, 4ª edição Brasília, 4 de fevereiro de 2019. Disponível em: http://portal.anvisa.gov.br/documents/33916/2810640/Suplementos+Alimentares/a6fd2839-6d80-496a-becb-8b2122eff409 . Acessado em 15/11/2019.

Budni, P., Pedrosa, R. C., Dalmarco, E. M., Dalmarco, J. B., Frode, T. S., & Wilhelm Filho, D. (2013). O carvedilol potencializa o efeito antioxidante das vitaminas E e C na cardiopatia chagásica crônica. Arquivos Brasileiros de Cardiologia, 101(4), 304-310.

COREN, Célia. Fascículo Vitamina E (1). International Life Sciences Institute. 2018, Brasil. Disponível em https://ilsibrasil.org/wp-content/uploads/sites/9/2018/10/Fasc%C3%ADculo-VITAMINA-E-1.pdf Acessado em 10/10/2019.

Coulter, I. D., Hardy, M. L., Morton, S. C., Hilton, L. G., Tu, W., Valentine, D., & Shekelle, P. G. (2006). Antioxidants vitamin C and vitamin E for the prevention and treatment of cancer. Journal of general internal medicine, 21(7), 735-744.

Abd El-Aal, A., Abd El-Ghffar, E. A., Ghali, A. A., Zughbur, M. R., & Sirdah, M. M. (2018). The effect of vitamin C and/or E supplementations on type 2 diabetic adult males under metformin treatment: a single-blinded randomized controlled clinical trial. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 12(4), 483-489.

Edge, R., & Truscott, T. G. (1997). Prooxidant and antioxidant reaction mechanisms of carotene and radical interactions with vitamins E and C. Nutrition, 13(11-12), 992-994.

EFSA Panel on Additives and Products or Substances used in Animal Feed (FEEDAP). (2010). Scientific Opinion on the safety and efficacy of vitamin E as a feed additive for all animal species. EFSA Journal, 8(6), 1635.

Fabre, G., Bayach, I., Berka, K., Paloncýová, M., Starok, M., Rossi, C., ... & Trouillas, P. (2015). Synergism of antioxidant action of vitamins E, C and quercetin is related to formation of molecular associations in biomembranes. Chemical Communications, 51(36), 7713-7716.

Frei, B., & Traber, M. G. (2001). The new US Dietary Reference Intakes for vitamins C and E. Redox report, 6(1), 5-9.

Hamilton, I. M., Gilmore, W. S., Benzie, I. F., Mulholland, C. W., & Strain, J. J. (2000). Interactions between vitamins C and E in human subjects. British Journal of Nutrition, 84(3), 261-267.

Hadzi-Petrushev, N., Dimovska, K., Jankulovski, N., Mitrov, D., & Mladenov, M. (2018). Supplementation with Alpha-Tocopherol and Ascorbic Acid to Nonalcoholic Fatty Liver Disease’s Statin Therapy in Men. Advances in pharmacological sciences, 2018.

Harats, D., Chevion, S., Nahir, M., Norman, Y., Sagee, O., & Berry, E. M. (1998). Citrus fruit supplementation reduces lipoprotein oxidation in young men ingesting a diet high in saturated fat: presumptive evidence for an interaction between vitamins C and E in vivo. The American journal of clinical nutrition, 67(2), 240-245.

Hosseini, B., Saedisomeolia, A., & Allman-Farinelli, M. (2017). Association between antioxidant intake/status and obesity: a systematic review of observational studies. Biological trace element research, 175(2), 287-297.

Huang, J., & May, J. M. (2003). Ascorbic acid spares α-tocopherol and prevents lipid peroxidation in cultured H4IIE liver cells. Molecular and cellular biochemistry, 247(1-2), 171-176.

Hughes, K. C., Gao, X., Kim, I. Y., Rimm, E. B., Wang, M., Weisskopf, M. G., ... & Ascherio, A. (2016). Intake of antioxidant vitamins and risk of Parkinson's disease. Movement Disorders, 31(12), 1909-1914.

Monsen, E. R. (2000). Dietary reference intakes for the antioxidant nutrients: vitamin C, vitamin E, selenium, and carotenoids. Journal of the Academy of Nutrition and Dietetics, 100(6), 637.

Nikolaidis, M. G., Kerksick, C. M., Lamprecht, M., & McAnulty, S. R. (2012). Does vitamin C and E supplementation impair the favorable adaptations of regular exercise?. Oxidative medicine and cellular longevity, 2012.

Nku-Ekpang, O. A. T., Ofem, O. E., Oka, V. O., & Jaja, S. I. (2016). Impact of Vitamins C and E supplement on anti-oxidant enzymes (catalase, superoxide dismutase, and glutathione peroxidase) and lipid peroxidation product (malondialdehyde levels) in sickle subjects. Tropical Journal of Medical Research, 19(2), 100.

Ogli, S. A., Enyikwola, O., & Odeh, S. O. (2009). Evaluation of the efficacy of separate oral supplements compared with the combined oral supplements of vitamins C and E on sperm motility in Wistar rats. Nigerian Journal of Physiological Sciences, 24(2).

Rietjens, I. M., Boersma, M. G., de Haan, L., Spenkelink, B., Awad, H. M., Cnubben, N. H., ... & Koeman, J. H. (2002). The pro-oxidant chemistry of the natural antioxidants vitamin C, vitamin E, carotenoids and flavonoids. Environmental toxicology and pharmacology, 11(3-4), 321-333.

Rumbold, A. R., Crowther, C. A., Haslam, R. R., Dekker, G. A., & Robinson, J. S. (2006). Vitamins C and E and the risks of preeclampsia and perinatal complications. New England Journal of Medicine, 354(17), 1796-1806.

Salonen, J. T., Nyyssönen, K., Salonen, R., Lakka, H. M., Kaikkonen, J., Porkkala‐Sarataho, E., ... & Tuomainen, T. P. (2000). Antioxidant Supplementation in Atherosclerosis Prevention (ASAP) study: a randomized trial of the effect of vitamins E and C on 3‐year progression of carotid atherosclerosis. Journal of internal medicine, 248(5), 377-386.

Sevanian, A., & Ursini, F. (2000). Lipid peroxidation in membranes and low-density lipoproteins: similarities and differences. Free Radical Biology and Medicine, 29(3-4), 306-311.

Sirmali, R., ARMAĞAN, A., ÖKTEM, F., Uz, E., KIRBAŞ, A., DÖNMEZ, S., ... & Sirmali, M. (2015). Protective effects of erdosteine, vitamin E, and vitamin C on renal injury induced by the ischemia-reperfusion of the hind limbs in rats. Turkish Journal of Medical Sciences, 45(1), 33-37.

Tashima, C. M., Hermes-Uliana, C., Perles, J. V. C. M., de Miranda Neto, M. H., & Zanoni, J. N. (2015). Vitamins C and E (ascorbate/α-tocopherol) provide synergistic neuroprotection in the jejunum in experimental diabetes. Pathophysiology, 22(4), 241-248.

Torkzahrani, S., Heidari, A., Mostafavi-pour, Z., Ahmadi, M., & Zal, F. (2014). Amelioration of lipid abnormalities by vitamin therapy in women using oral contraceptives. Clinical and experimental reproductive medicine, 41(1), 15.

US. Food and Drug Administration. Recommended Daily Allowances- 1968. Amendments in May 2016. Disponível em: https://dietarysupplementdatabase.usda.nih.gov/Conversions.php . Acessado em 05/12/2019.

Zervos, I. A., Nikolaidis, E., Lavrentiadou, S. N., Tsantarliotou, M. P., Eleftheriadou, E. K., Papapanagiotou, E. P., ... & Taitzoglou, I. A. (2011). Endosulfan-induced lipid peroxidation in rat brain and its effect on t-PA and PAI-1: ameliorating effect of vitamins C and E. The Journal of toxicological sciences, 36(4), 423-433.

Published

31/08/2020

How to Cite

BEZERRA, I. D.; FERREIRA, R. de M. M.; PEIXOTO, M. C. M.; PLÁCIDO, G. R.; FAVARETO, R.; MONTEIRO, L. B.; CABRAL, E. de F.; GUERRA, I. C. Combined vitamin C and E supplementation for disease risk reduction. Research, Society and Development, [S. l.], v. 9, n. 9, p. e603996088, 2020. DOI: 10.33448/rsd-v9i9.6088. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/6088. Acesso em: 16 apr. 2024.

Issue

Section

Review Article