The Daily Basics:Vitamins C and E

The two most important Age Reducing vitamins are C and E. These vitamins exert powerful antioxidant activity. Taken together, they help keep your cardiovascular system healthy by reducing the amount of harmful buildup on the walls of your arteries. In addition, vitamin C strengthens the immune system, improves both eye and lung function, and helps the body heal. Vitamins E and C, taken in combination, help keep the arteries relaxed and elastic. Taking 600 mg or more (up to 2,000 mg) of vitamin C a day as supplements (in divided doses of no more than 500 mg in any six hours) and 400 IU of vitamin E a day, in addition to eating a balanced diet with lots of fresh fruits and vegetables, can reduce your RealAge by more than six years! What could be easier?

Vitamin C and vitamin E are powerful antioxidants that complement one another. Vitamin C is water soluble, whereas vitamin E is fat soluble. What does that mean? Your cells are made up of two components: the cell membrane and the cell interior. The cell membrane, the outer casing of the cell, consists of lipids, or fats. Since vitamin E dissolves in fat, it works to prevent oxidant-induced ageing in the membrane. It is in the cell membrane that you see the buildup of lipofuscins, those brown spots. In contrast, the inside of the cell is made up mostly of water. Since vitamin C dissolves in water, it can enter the center of the cell and collect the free-radical oxidants lurking there. Together, these two vitamins keep oxidants from damageing your cells, both inside and out (see Table 7.1).

Table 7.1

The RealAge Benefit of Vitamins C &E

For Men

Of getting the RAO" dose of vitamin C:

At age 55: 2.8 years younger At age 70: 3.2 years younger

Of getting the RAO dose of vitamin E:

Age 55: 2.5 years younger Age 70: 2.8 years younger

For Women

Of getting the RAO dose of vitamin C:

Age 55: 2.2 years younger Age 70: 2.6 years younger

Of getting the RAO dose of vitamin E:

Age 55: 1.5 years younger Age 70: 2.2 years younger

The Daily Dose, at the RAO Level

Vitamin C:

600 mg or more as a supplement, plus five servings of fruits and vegetables, to total 1,200 mg/day, in divided doses, separated by at least 6 hours (not to exceed 2,000 mg a day)

Vitamin E:

400IU (international units)

*The RealAge optimum, the dose recommended for the greatest Age Reduction.

Vitamin E

As mentioned, vitamin E is fat soluble. That makes it an especially vigorous antioxidant. Vitamin E goes right to work on oxidized lipids that clog the arteries, shrinking their size and preventing the initial buildup in the first place. It hampers the attachment of dangerous LDL cholesterol along the arterial walls.

Vitamin E can lower the risk of heart attack in women by as much as 40 percent and in men, by about 35 percent. If a person already has arterial disease, but not fibrotic or permanently hardened arteries, vitamin E can decrease the risk of heart attack by as much as 75 percent. That's an astounding impact! Something as simple as taking 400 IU of vitamin E a day will give you a younger, healthier cardiovascular system and all the vigor and energy that goes along with it. Moreover, like aspirin, vitamin E thins your blood, making clots less likely to form. The quinone in vitamin E has powerful anticlotting powers.....

Recent claims have also been made for vitamin E as a preventive against lung and prostate cancer and other cancers as well. The antioxidant properties of vitamin E are believed to help stop the immune system from ageing. Further studies still need to be done on the exact details of the cancer-vitamin E connection, but the evidence appears promising. Vitamin E may also help the body build muscle strength. Finally, as I mentioned, vitamin E has been shown to help prevent cataracts, and preliminary studies suggest it might help prevent macular degeneration, the leading cause of visual impairment associated with ageing.

There are several caveats you should be aware of before taking vitamin E. This vitamin therapy works only to reduce the size of fatty buildup before the arteries have become fibrotic, or permanently hardened (that is, when there is fat buildup but no irreversible changes). Vitamin E seems to help reduce the size of small or medium-sized lesions in your arteries but not severe ones. That is why you want to start taking these vitamins as soon as possible—to foil ageing before it begins.

How much vitamin E should you take, and where is it found? Vitamin E is found in fatty vegetables, such as avocados, and in some vegetable oils. It is also found in nuts, leafy green vegetables, and some grains. It is virtually impossible to get the necessary antiageing dose of vitamin E from foods. The RDA is only 12 to 15 IU a day; that is, 12 to 15 IU are all you need to survive without showing signs of deficiency disease. But the RAO—the RealAge optimum—is 400 IU. To prevent ageing, you need 400 IU daily. Since most multivitamins tend to follow RDA recommendations and contain only 15 to 30 IU, do not rely on multivitamins to get your vitamin E; the level of vitamin E in most multivitamins is usually 370 IU short of the anti-ageing optimum.

How often do you need to take vitamin E? Since vitamin E is fat soluble, it resides in your body for quite a while. One tablet a day is just the right dose. There is little risk of a vitamin E overdose unless you ingest more than 1,200 IU a day, and vitamin E is probably safe up to 3,000 IU a day. If you have high blood pressure, get the high blood pressure treated, and start slowly with 200 IU of vitamin E a day. After a week or so, increase the dose to the 400 IU level. One additional note: Several studies have noticed an increase in bleeding when vitamin E and aspirin are used in combination, a condition implicated in both ulcers and strokes. It is rare, but discuss this risk with your physician, especially if you have a history of ulcers or other blood-clotting problems.

Vitamin C

Have you ever noticed that the minute you get a cold, everyone from the checkout man at the grocery store to your mother starts telling you to take vitamin C? That is the legacy of Nobel Laureate Linus Pauling. All of us know that vitamin C is good for us, but most of us probably couldn't say why.

What exactly does vitamin C do? Like vitamin E, vitamin C helps to keep the arteries clear by inhibiting the oxidation of fat in the walls of your blood vessels. It converts cholesterol to bioacids, so they can be washed out of the body easily and not add to the problem of lipid buildup. Since vitamin C is water soluble, it enters the cells that make up the wall of the vessels themselves, binding to free radicals lurking inside the cell, precisely in the place where those free radicals are likely to cause DNA damage. Because of its healing capabilities, vitamin C helps maintain a healthy matrix in the blood vessels, repairing the vessel walls when they become damaged. When it comes to keeping the cardiovascular system healthy, vitamin C seems to help men more than women, and vitamin E helps women more than men. Regardless of your gender, you should take both vitamins (see Table 7.1).

In addition, vitamin C helps reduce high blood pressure, prevents cataracts, and promotes healing. It improves lung function, preventing ageing of the respiratory system. And it really does keep your immune system young. Linus Pauling thought vitamin C helped cure colds. We now know it decreases our risk of the one ager we all want to avoid—cancer!

Since vitamin C is water soluble, it washes out of your body when you urinate. It is important to get several doses of vitamin C a day. I recommend at least two, usually three, doses daily. I do this by combining food and supplements. In the morning, I drink a big glass of orange juice, I take a multivitamin with 200 mg of vitamin C in it, have an orange or a grapefruit at lunch, and then take a 500-mg supplement at night, just to make sure I'm getting enough. I also get vitamin C from other things I eat, just in smaller amounts, such as tomatoes or salads. The RAO for vitamin C is about 1,200 mg a day from food and supplements, taken in smaller amounts spread throughout the day. The RDA is just 60 mg, way short of the antiageing optimum. Vitamin C tends to leach out of packaged or cut vegetables. Moreover, cooking reduces vitamin C levels even more. It is important to make sure you eat plenty of fresh fruits and vegetables every day. Eat some fruit or take some of your vitamin C one to two hours before you exercise. Exercise causes the buildup of oxidants.

It doesn't matter what kind of vitamin C you take, either natural or synthetic. Your body can't tell the difference. Personally, I stay away from chew-ables because they are hard on the teeth. Although it costs a little more, I prefer taking vitamin C that contains calcium ascorbate, which helps prevent the stomachaches that straight ascorbic acid (vitamin C) can cause. If you have a sensitive stomach, take the calcium ascorbate form of vitamin C. Besides, it's another source of calcium, and, as you will see in the next section, you want to get as much calcium as you can!

Two more comments on vitamin C. A recent headline said that vitamin C caused cancer by causing breaks in DNA. What the headline didn't say was that at the 500-mg dose, vitamin C appeared to prevent, or be associated with repair of, far more DNA damage than it caused. If you take 500-mg pills, take them no more frequently than one every six hours to get the optimum balance.

Finally, I have to respond to the question, Does vitamin C prevent colds? The answer is no. But it does lessen their effect. To get this effect, when you begin to show signs of a cold, increase your dosage of vitamin C to as much as 4 grams (4,000 mg) a day, taken with plenty of water (eight glasses for 4 grams). Although this amount won't cure your cold—Linus Pauling wasn't exactly right—it will lessen the severity of the symptoms. For example, when I have a cold and take my C, I find I can keep exercising.

Now, let's consider the last big antioxidant vitamin, vitamin A. What is it about A that makes it an ageing vitamin, not an antiageing one?

Vitamin A

In 1988 Americans spent less than $8 million a year on vitamin A supplements. Now they spend $80 million on vitamin A, often sold in the form of beta carotene. They may be doing themselves more harm than good.

This is an example of too much of a good thing. In the late 1980s, a study came out showing that people who ate foods with lots of vitamin A in them tended to have lower rates of cancer. People interpreted this result to mean not that they should be eating more fruits and vegetables, but that they should be taking vitamin A supplements. The market boomed. Sales of vitamin A and beta carotene, a substance the body breaks down into vitamin A, went through the roof.

More recent studies have found that we jumped the gun. First, the correlation between vitamin A and the prevention of cancer is not as strong as was once thought. Second, too much vitamin A can actually be harmful. Although it is important to get sufficient vitamin A, you should do this by eating well, not by taking supplements. Especially avoid megadosing. Do not take more than 8,000 IU a day, which is a standard dosage in many vitamin supplements. In choosing a supplement, try to find one that has the vitamin A in the form of beta carotene because the body will not convert beta carotene into vitamin A if it has no need for it.

Vitamin A is a necessary and important nutrient, but taking large doses of it can be dangerous. Why? Because vitamin A is a nutrient that is 'level sensitive.' When levels of vitamin A are moderate, it works as an antioxidant and is important to the functioning of your body. However, when you megadose, the surplus vitamin A does the opposite. Rather than functioning as an antioxidant, high doses of vitamin A work to oxidize tissues. So taking too much vitamin A makes you age faster.

A 1993 study in Finland showed that people who took vitamin A had an increased risk of lung cancer; atherosclerosis; and, for smokers, stroke. Several other studies have confirmed these findings. Excessive amounts of vitamin A may cause liver damage. Smokers need to be especially careful about taking any kind of vitamin A, even the beta carotene form; when combined with smoke, vitamin A can be toxic.   

Although health-food stores still push vitamin A and beta carotene, remember that you probably get enough in a multivitamin and in your daily diet. For basic antioxidation, rely on vitamin C and vitamin E. Carotenoids (such as lycopene found in tomatoes) and flavonoids (found in onions, garlic, and grape products such as wine) also seem to have antioxidant power. Likewise, they help decrease ageing of the arterial and immune systems. We discuss them in Chapter 8. As good as vitamins E and C are, remember this: When it comes to vitamins, antioxidants are just the opening act. Another great duo is calcium and vitamin D.



Bone weakening, or osteoporosis, affects more than 25 million Americans. It is the major underlying cause of hip fractures and bone breaks in the elderly— about 1.25 million bone fractures, including 300,000 hip fractures, are caused annually by osteoporosis. Although osteoporosis affects women disproportionately, especially small-boned women of northern European or Asian descent, we are all at risk. Twenty million women suffer from the disease, but so do 5 million men. As more men live longer, they, too, will be at increased risk of osteoporosis.

We often forget that our bones are living tissues that need proper care. After we have completed our growth cycles, it is easy to forget about them. Just as we can make our arterial and immune systems younger, we can make our bones younger as well. Doing so protects us for the long term, reducing our overall RealAge. How do we make our bones younger? By making them stronger. We can do that by taking 1,000 to 1,200 mg of calcium a day.

Osteoporosis is a condition involving the loss of bone density. As you age, your bones lose calcium, becoming progressively weaker. Why? Your body stores excess calcium until you reach your early thirties, at which time you reach your peak level of bone density. After that, your body stops storing extra calcium. You must then get all the calcium you need from your daily diet, or you will begin to deplete the calcium stores in your bones. Just imagine your skeleton as the structure of a house. Your bones are the beams that buttress your body. In a house, you have to worry about termites: they hollow out the beams from within until the beams become so weak they collapse. As your body depletes the calcium stored in your bones, they become weaker and weaker, until, finally, like termite-eaten beams, they are almost hollow. Then, snap. They break. And a broken bone, especially a broken hip, is one of the things that can age you the fastest. Just six months of immobility can reverse all your RealAge progress by a third or more. Each day you go without activity, you get older.

Why is breaking a hip so bad? It's not the fracture itself that ages a person but, rather, the complications that stem from such an injury. A hip fracture may be the beginning of a downward spiral, triggering a chain of ageing events. When a person is bedridden, the body weakens, becoming susceptible to pneumonia and other infections that can often be fatal. With less exercise and movement, arteries start showing signs of ageing, becoming less elastic and more prone to disease or failure. Also, the immune system becomes more vulnerable. For older people, the mortality rate from hip fractures is as high as 20 percent (12-20 percent of older women who have had hip fractures die within six months). Furthermore, 40 percent of those who survive that initial six months require long-term nursing care. More than half never regain their former quality of life.

Hip fractures are astoundingly common. Thirty to forty percent of women over calendar age sixty-five have fractured their spine or vertebrae, and twenty-five percent of such women will suffer a fractured hip. Doing what you can to prevent a fracture is one of your best protections against ageing. Remember, it's not just women, either.

Men traditionally have been much less susceptible to bone fractures than women. Just 5-10 percent of men over age sixty-five have these kinds of debilitating fractures. Since historically men have not lived as long as women, however, we know less about the strength of men's bones as they age. It appears that men also suffer bone loss as they get older, although they start out with higher bone density than women. I predict that as more men live longer, bone loss and severe fractures will become an increasing problem for them, too.

If you are working to make all the rest of you younger, you should make sure that your bones also stay young. For the best RealAge advantage, men and women should make sure to get enough calcium—that is, 1,000 to 1,200 mg a day for men and 1,200 mg for most women over thirty (pregnancy and other conditions may change the requirements slightly). Take 500 or 600 mg twice a day. (This refers to the amount of actual calcium, not calcium in combination with citrate or carbonate. If the label reads 1,000 mg of calcium citrate, read on to find the amount of calcium by itself.) Any kind of calcium supplement, even over-the-counter antacid tablets, should fit the bill, just as long as you are getting the right milligram amount. I advise against taking calcium supplements that contain bone meal, dolomite, and/or oyster shells, as these can contain lead or other heavy metals that may be toxic. Calcium carbonate is best absorbed when taken with food. Calcium citrate may be taken at any time (either by itself or with food). Both forms can cause constipation. If you notice this side effect, eat more fruits and vegetables or rely on that old standby, a prune a day. Some recommend taking about 300 mg of magnesium in conjunction with the calcium (see the section on magnesium later in this chapter).

Although calcium is plentiful in dairy foods (milk, cheese, and yogurt), most people do not eat enough dairy products to get adequate amounts of calcium from diet alone. Eat dairy foods for extra calcium, but do not rely on them as your only source of calcium unless you eat and drink a lot of dairy products (and, of course, remember to eat low-fat versions). If you consistently drink three or four glasses of milk a day (most adults do not drink anywhere near that amount), then you can modify the amount you take in supplemental form accordingly. But be very careful to make the 1,000- or 1,200-mg marker daily. And a reminder to anyone under thirty, or even thirty-five, who's reading this: You should get lots of calcium to build bone strength for the future because the calcium the body stores in bone then becomes the surplus stores for the rest of your life.

Not only does calcium help your bones, it may also help lower your blood pressure. A recent study showed that men who took 1,000 mg of calcium a day had a 12 percent reduction in blood pressure. This evidence remains controversial, as other studies have reported no such lowering of blood pressure. Although there is as yet no consensus on this finding, lower blood pressure may be just one added benefit of taking calcium, which is something you should be doing anyway. Another side note for people with high blood pressure: A common treatment for high blood pressure is the administration of calcium channel-blocking drugs. These drugs have nothing to do with calcium supplements, so don't be concerned. Go ahead and take calcium supplements.