Lucid Scientific Analysis

Good Stress, Bad Stress—The Delicate Balance in the Vasculature by Dr. rer. nat. Kirstin Wingler, Prof. Dr. med. Harald H. H. W. Schmidt in volume 42/2009

This lucid scientific analysis (1) confirms that antioxidants do not have the effects that are often attributed to them. Because of possible negative effects, the current study situation should be considered before initiating regular intake of antioxidant supplements. The multivitamin study of the Association of Retired People on prostate cancer is an example for harmful effects: of the 295 344 men who underwent regular examinations for a mean period of 5 years, 10 241 developed prostate cancer; 1476 developed advanced stage cancers. If more than 7 multivitamin tablets were taken per week, the relative risk of advanced prostate cancer rose by 32%, but no relation was found for local prostate cancer. An intake of >7 multivitamin tablets per week increased the incidence of prostate cancer compared with abstinence from multivitamin preparations from 113.4 to 143.8 per 100 000 person years.

If 200 µg selenium was taken in addition to more than 7 multivitamin tablets per week then the RR of prostate cancer rose in a linear fashion: 1.01 for 1–6 days’, 1.23 for 7 days’, and 1.39 for >7 days’ intake.. It is possible that one of the functions of reactive oxygen species (ROS) is to reduce damaged—even precancerous—cells. Prevention of prostate cancer is possible neither by using selenium (200 µg/day) nor in combination with vitamin D (400 IU/d). This was shown in the prospective, randomized SELECT study in 35 533 men (3).

What is remarkable is the health effect of red wine—beyond the “French paradox.” One of its bioactive substances is the stilbene resveratrol (red wine contains about 30 times the concentration of peanuts), which stimulates NO production, which in turn inhibits NADPH oxidase and the important transcription factor NF-kappa B. The result is a down-regulation of prostate specific antigen (PSA) (4). Accordingly, a case-control study has shown that red wine itself is suitable for primary prevention.
DOI: 10.3238/arztebl.2010.0225a

Prof. Dr. Jens E. Altwein
Urologische Abteilung
Chirurgische Klinik München – Bogenhausen
Denninger Str. 44
81679 München, Germany
[e-mail]

Conflict of interest statement
The author declares that no conflict of interest exists according to the guidelines of the International Committee of Medical Journal Editors.

References

1. Wingler K, Schmidt H: Good stress, bad stress—the delicate balance in the vasculature [Guter Stress, schlechter Stress: Die feine Balance in Blutgefäßen]. Dtsch Arztebl Int 2009; 106(42): 677–84.

2. Lawson KA, Wright ME, Subar A, et al.: Multivitamin use and risk of prostate cancer in the NIH-AARP Diet and Health Study. J Natl Cancer Inst 2007; 16: 754–64.

3. Lippman SA, Klein EA, Goodman PJ, et al.: Effect of selenium and vitamin E on risk of prostate cancer and other cancers: The Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA 2009; 301: 39–51.

4. Aggarwal BB, Bhardiway A, Aggarwal RS, et al.: Role of resveratrol in prevention and therapy of cancer: preclinical and clinical studies. Anticancer Res 2004; 24: 2783–840.