Review: The Antioxidant Network

A brief review of The Antioxidant Miracle, by Lester Packer, PhD and Carol Coleman.

by Ivy Greenwell

"How come everything does everything?" This is the question that plagues nutrition research. If a particular vitamin or flavonoid helps keep the arteries clean of plaque, it is also likely to be effective against cancer, arthritis, inflammation in general, and quite likely will help protect against and help ameliorate diabetes; it will enhance the immune function, lower high blood pressure, possibly improve mood and memory, and may help you preserve smooth skin and delay the graying of hair. If something works for the arteries and the heart, it will also work for the brain, the joints, the lungs, the pancreas, the liver, the kidneys. This multiplicity of effects has raised many eyebrows. After all, we are still imprinted on the "one drug/one disease" model-never mind the multiple benefits of aspirin. Lester Packer, PhD, director of the Packer Lab at the University of California, Berkeley, famous for its pioneering research on lipoic acid and vitamin E, has finally proposed an explanation of this "everything does everything" phenomenon so often found in alternative medicine. He presents it in his ground-breaking book, The Antioxidant Miracle (with Carol Colman).

The title may be ill-conceived, belying the scientific merit of the book. In fact, this is required reading for anyone seriously interested in anti-aging medicine. It presents cutting-edge information about how antioxidants work as a team, affecting every system and every cell in the body, including even our DNA-why "everything does everything."

Dr. Packer has been dubbed by his colleagues "Dr. Antioxidant" because of his dedication to the field, as attested by nearly five decades of research into the biochemistry of antioxidants and hundreds of scientific papers. Packer proposes that antioxidants work in the body not singly, but as a network, and that "the sum is greater than its parts." Antioxidants synergize with each other and, even more important, recycle each other.

"What makes network antioxidants so special is that they can greatly enhance the power of one another," Packer explains. Coenzyme Q10, for instance, enhances the action of vitamin E. Packer suspects that some of the effects ascribed to CoQ10 are due primarily to its potentiation of vitamin E. Thus, it is very difficult to study the effects of a single antioxidant; the whole network is affected, and it is the whole network that produces the manifold effects that we see. Forget the idea of a single antioxidant; it takes the network.

True, Packer is not the first expert to recommend taking many antioxidants together. But while others have been recommending taking a wide range of antioxidants, since they "work together," and thus may have hinted at the network effect, Packer deserves the credit for crystallizing the concept of "network antioxidants." He is emphatic and uncompromising about the importance of synergy among various antioxidants. In vivo, a single antioxidant does not act alone; the whole network becomes involved. The whole network is the "antioxidant miracle" that protects us against disease and slows down aging.

Packer is convinced that his lab's discovery of how antioxidants work as a network will have far-reaching consequences. He even states, "Just as the discovery of penicillin changed the practice of medicine earlier in this century, the antioxidant network has the potential to create a new paradigm for health." I applaud the uncompromising spirit of this statement. Far from merely rehashing well-known facts, this is in fact a pioneering book.

Network antioxidants:
a mutually recycling "juggernaut" against the lethal forces of oxidation

Packer shows this particularly in regard to the five pivotal antioxidants that he calls "network antioxidants": lipoic acid, coenzyme Q10, vitamin C, vitamin E (all natural varieties of it, not just alpha tocopherol), and glutathione. To see why these work together as a network, let's review the basics.

A free radical is a molecule with an unpaired electron, seeking to strip an electron from another molecule, and thus having the capacity to damage vital compounds such as lipids and proteins. An antioxidant is basically an electron donor: it can quickly "disarm" a free radical by easily giving up one of its electrons. But in the process, the antioxidant itself becomes a weak free radical. Fortunately, if other antioxidants are present, the original electron donor can be "regenerated," or restored to its antioxidant status.

This point is crucial to understanding Packer's thesis. In the course of its normal activity, an antioxidant becomes a pro-oxidant, i.e. a free radical (although a less destructive one than whatever free radical it has just disarmed); it must be recycled to its antioxidant state by other antioxidants. Hence the idea of a self-recycling network of antioxidants, rather than antioxidants working individually. Hence also the practical implication: in order to maintain the high levels of antioxidants necessary for health and longevity, it is necessary to ensure optimal recycling of the key antioxidants. How? By taking the whole range of certain crucial antioxidants.

Packer states that the network antioxidants include lipoic acid, Coenzyme Q10, vitamin E, vitamin C and glutathione. These work as a team, constantly regenerating each other from the oxidized state back to the antioxidant status. The pivotal antioxidant is lipoic acid. It not only recycles all the other network antioxidants, but it also regenerates itself. Although it is produced in the body, the production declines with age, and becomes insufficient to provide full benefits. Adding lipoic acid to one's supplement regimen means boosting the levels of all the other network antioxidants.

This is particularly important in the case of glutathione, since most experts agree that oral glutathione does not get absorbed through the intestines. Unfortunately Packer does not comment on the idea that taking glutathione with sufficient anthocyanins, for instance a high-potency bilberry extract, would protect it from oxidation in the gastrointestinal tract and thus make it available to various tissues. Even so, only some types of tissue can absorb preformed glutathione-most cells must synthesize it. Packer's lab discovered that lipoic acid can boost the levels of glutathione by up to 30%. Thus, in Packer's view, it is necessary to take only four network antioxidants: lipoic acid, CoQ10, vitamin E (including tocotrienols) and vitamin C. It might also be desirable to include mixed carotenoids and various mixed polyphenols.

One reason why it is so important to maintain high levels of glutathione is that it is crucial for the detoxification of carcinogens. Packer states that most people do not inherit "cancer genes"; rather, they have a genetic weakness in their detoxification system. Glutathione is an extremely important part of the detoxification system, and thus of our defenses against cancer. Lipoic acid in particular, as well as various other antioxidants including N-acetyl-cysteine (NAC), can raise glutathione levels, making cancer less likely, even if it happens to run in the family. Interestingly, whey protein has also been found to raise glutathione levels. Certain flavonoids, including grape seed extract and bilberry, likewise boost glutathione levels; silymarin, a flavonoid found in milk-thistle, is valued for its ability to raise glutathione levels in the liver. It is too bad that Packer does not discuss the glutathione-flavonoid sub-network.

Glutathione may also be one of the most important keys to longevity. Centenarians have been found to have higher levels of glutathione than would be expected for their age. Boosting one's glutathione levels with lipoic acid, NAC and flavonoids should be one of the first items on anyone's anti-aging agenda.

When all the network antioxidants are present in sufficient concentrations, the result is a marvelous synergy in the body's unceasing battle against the forces of destruction represented by excess free radicals. In Packer's and Colman's words, "when combined, [the network antioxidants] create a juggernaut against the lethal forces of oxidation."

Besides championing the use of lipoic acid as the pivotal network antioxidant, Packer also stresses the importance of gamma tocopherol, and particularly of tocotrienols. Found naturally in cereal bran and tropical oils, tocotrienols are chemically very similar to tocopherols, except for a difference that gives them special powers. They are more mobile and distribute evenly throughout membranes; tocopherols tend to cluster. They also have much greater "staying power," since they are 40 to 60 times more readily recycled. Tocotrienols are also more unsaturated, which makes them more powerful antioxidants. We are now discovering their special ability to prevent cancer and clean the arteries of plaque.

Likewise, Packer points out the newly discovered importance of gamma tocopherol. It is gamma tocopherol, not alpha tocopherol, that is depleted in AIDS patients, cardiovascular patients and smokers. This situation is particularly disastrous for smokers, since gamma tocopherol shifts the metabolism of nitrogen dioxide into the production of non-carcinogenic compounds. Gamma tocopherol also protects against high blood pressure, and thus lowers the risk of heart attack and stroke. It turns out that one of its metabolites, LLU-alpha, is a natural diuretic.

The vitamin E family has been receiving more and more "rave reviews." The crucial anti-aging question is, "Do people who take vitamin E live longer?" Packer replies, "All signs point to a resounding yes." In Packer's words, we have "wonderful evidence" that vitamin E slows down the accumulation of the age-pigment lipofuscin, a waste product of lipid peroxidation, and can in fact dramatically extend the number of times cells can divide before they die-the so-called Hayflick limit.

How is this possible? In-vitro studies have shown that the telomere ends of chromosome are especially vulnerable to damage by free radicals. This is at least one cause of their shortening during cell division. By lessening the degree of free-radical damage, antioxidants can keep the telomeres relatively long for a longer period of time. This implies that far from being an absolute, the Hayflick limit is subject to anti-aging manipulation. The implications for life extension are enormous.

Mixed carotenoids: the synergistic effect

Carotenoids also constitute their own network, working synergistically with one another. For example, mixed carotenoids enhance immune function better than beta carotene alone. The antioxidant power of mixed carotenoids is enhanced particularly when lycopene and lutein are included. One of the most interesting sections here is "The rise and fall of beta carotene," in which Packer explains the disastrous results of unbalanced supplementation, at least in smokers, who are under a particularly heavy barrage of free radicals. He points out that mixed carotenoids, the way they are naturally found in vegetables and fruit, have been consistently found to protect against lung cancer, as well as many other types of cancer.

While beta carotene has fallen into relative disfavor, lycopene has emerged as a very potent antioxidant, if not quite yet a rising star on the health food store shelves. It is too bad that Packer does not discuss lycopene in greater detail. He does point out that in vitro it is a stronger antioxidant than beta carotene, and that it inhibits the growth of various cancers. But why is lycopene so important, and how do carotenoids synergize as a network? Is it really the metabolites, such as apo-carotenoids and retinoids, that should be studied? And under what conditions do carotenoids become pro-oxidants capable of promoting cancer-only in those who smoke more than 20 cigarettes a day, or should the average person be concerned? This is perhaps the least satisfying chapter in the whole book, which is understandable, since Packer's main area of study has been lipoic acid and vitamin E, and the main network antioxidants in general. That's where he shines.

Packer also singles out flavonoids as important "boosters" of the main network antioxidants. Again, a more extensive review of flavonoids would have been preferable, since there is potentially a bigger story here than simply playing a supportive, "boosting" role. Flavonoids are extremely powerful antioxidants in their own right; some are capable of quenching the hydroxyl radical. Packer acknowledges that this is extremely important, since the hydroxyl radical is the most dangerous, capable of directly damaging DNA.

Are flavonoids merely "boosters?"

Flavonoids' boosting role certainly deserves attention: proanthocyanidins and anthocyanidins in particular-Pycnogenol and grape seed extract, bilberry-boost the levels of vitamin C, vitamin E and glutathione. Fortunately Packer does provide some intriguing information that goes far beyond that. For instance, one of the most important functions of flavonoids is their ability to control the levels of nitric oxide, which turns extremely harmful and pro-aging when present in excess. In fact, there even exists a "nitric oxide hypothesis of aging." Again, complex mixtures of flavonoids, such as are naturally present in ginkgo, for example, turn out to have synergistic power, beyond that of the individual components.

Still, both experimental studies done on animals and human epidemiological studies hint at a truly starring role for flavonoids. These weak plant estrogens happen to be ferocious phenolic antioxidants. There are very good reasons to think that a sufficiently high daily dose of flavonoids-from berries, apples (quercetin), onions, tea, wine, chocolate, miso, even coffee, and/or from supplements (bilberry, grape seed extract)-might give us lifelong freedom from heart disease, cancer, cataracts, and the nightmarish neurodegenerative diseases such as Alzheimer's and Parkinson's disease. Epidemiological studies confirm, or at least suggest, that the higher the flavonoid consumption, the lower the rates of cardiovascular disease and cancer, and the higher the life expectancy (this shows even for moderate wine drinkers as opposed to tee-totalers). As Packer himself states in a no-doubts-about-it section heading, "Flavonoids slow down aging." The public urgently needs to be made aware of this. And of course no life extension regimen makes any sense without including generous doses of flavonoids.

Since the supplement industry has given us " B Complex," I hope that soon we will also have "E Complex," "Carotene Complex" and perhaps "Flavonoid Complex." Once the network concept takes hold, I think it should be only a matter of time.

Fascinating cutting-edge findings

If you are thinking, "What's there to say about antioxidants? They protect us against free radicals, that's all," this is precisely the book you should read. Antioxidants have a surprising range of functions, including regulating the expression of genes. One of the greatest merits of Packer's book is that it presents little-known recent findings about antioxidants. Packer's recurrent message is that antioxidants do a great more than control free radicals; in his view, they virtually control our physiology. Among the new findings are the following:

• Tocotrienols can actually clean plaque out of the arteries and reduce serum glucose. They are also more easily recycled to the antioxidant state than tocopherols, and thus have more "staying power."
  
• A combination of lipoic acid and the amino acid carnitine can rejuvenate mitochondria, restoring youthful function (the research of Dr. Bruce Ames). This has tremendous implications for anti-aging.
  
• Glutathione is the most important antioxidant inside the cell. Among its many functions, it primes DNA synthesis for cell division, and switches on the enzymes that repair DNA. Glutathione also regulates the genes involved in producing chronic inflammation that can lead to arthritis, autoimmune diseases and cancer.
  
• Glutathione helps control the levels of steroid hormones and prostaglandins by sulfating them in the liver, thus making them water-soluble for easier excretion.
  
• Glutathione can rejuvenate immune function. It stimulates the production of interleukin-1 and interleukin 2, and increases the proliferation of lymphocytes.
  
• The best way to raise one's levels of glutathione is by taking lipoic acid. Lipoic acid is more effective at raising glutathione than N-acetyl-cysteine (NAC).
  
• Maintaining high levels of glutathione and vitamin E could be particularly important for athletes, maintaining their immune function in spite of high oxidative stress.
  
• Lipoic acid may be more potent than either ginkgo or vitamin E in protecting the brain.
  
• CoQ10 is likewise enormously protective for the brain, and might prove an important treatment for Lou Gehrig's disease (amyotrophic lateral sclerosis, or ALS).
  
• CoQ10 recycles vitamin E. In the bloodstream, it rides on lipoproteins with vitamin E, and the two protect lipids from oxidation. CoQ10 also works together with vitamin E in the skin, protecting against UV radiation.
  
• All the network antioxidants appear to be involved in preventing and combatting gum disease, not only CoQ10.
  
• Lipoic acid and other antioxidants can slow down glycation, the cross-linking of proteins with simple sugars such as glucose, fructose and galactose. Cataracts are largely the result of glycation.
  
• Antioxidants in general, and lipoic acid in particular, inhibit excess Nuclear Factor Kappa B (NFkB), a protein that can activate hundreds of genes. If produced in excess, NFkB leads to many problems. Free radicals turn on NFkB.
  
• People who take vitamin E are 40 to 50% less likely to die of cancer or heart disease; men who take vitamin E are also 42% less likely to die of prostate cancer.
  
• Besides working synergistically with vitamin E, selenium is necessary for the synthesis of enzymes that recycle glutathione and vitamin C.
  
• In vitro, antioxidants can increase (even double, in the case of vitamin E) the life span of normal cells and the number of times they can divide.
  
• Antioxidants can keep cells youthful by preventing the accumulation of lipofuscin, a waste product composed of peroxided lipids and proteins ("age spots" are one manifestation of lipofuscin).
  
• The antiviral activity of antioxidants may stem from the fact that antioxidants may be able to block the activation of viral genes, keeping various viruses dormant.
  
• Polyphenols found in wine protect not only against heart disease, but also against certain cancers, Alzheimer's disease and macular degeneration. Moderate wine drinkers tend to live longer than tee-totalers.
  
• It is men consuming the most strawberries who have been found to have the lowest rate of prostate cancer, not the ones who eat the most pizza, though pizza is indeed more effective than tomatoes and tomato sauce. The reason might be ellagic acid (a polyphenol), found in abundance in strawberries, cherries, walnuts and grapes.
  
• AIDS patients are extremely deficient in both glutathione and selenium. The ones with the lowest glutathione levels have the highest mortality. Selenium is required for the production of a vital antioxidant enzyme, glutathione peroxidase.
  
• Lipoic acid shows promise as another weapon against AIDS, perhaps in part because it boosts glutathione levels.
  
• Vitamin C and lipoic acid need to be frequently replenished, and thus it is best to take them at frequent intervals (every few hours). Since lipoic acid is similar in molecular structure to biotin, and may compete with it. If one takes more than 100 mg of lipoic acid a day, it might be desirable (or possibly even necessary) to supplement with biotin.
  
• Vitamin C "works through vitamin E." It is the best regenerator of vitamin E.
  
• While currently seen as "the cure for the common wrinkle" more so than the cure for the common cold, vitamin C's ability to stimulate collagen production and thus strengthen connective tissue is a vital part of the body's defenses against viruses.
  
• Men can cut their risk of a heart attack by 45% simply by taking 300mg of vitamin C a day, according to a UCLA study.
  
• Ginkgo has been found to inhibit excess production of cell adhesion molecule proteins, a contributing factor to inflammatory diseases and cancer.
  
• Alpha carotene appears to be more protective against cancer than beta carotene. The richest source is cooked carrots and pumpkin. Carrots also lower cholesterol and protect against stroke.
  
• Antioxidants have a profound role in preventing cancer because they can switch on and off the genes that control cell growth. Packer states, "I foresee a new generation of cancer treatments that will harness the power of antioxidants to control cancer at its most fundamental level."

A new health paradigm:
The role of network antioxidants and their boosters in anti-aging medicine

The implications of antioxidants for anti-aging medicine are enormous. As Packer states, the free radical theory of aging could also be called "the antioxidant theory of longevity." He points out that among mammals, humans and elephants are at the top of the list both in terms of antioxidant activity and life span. Presumably by keeping up high levels of antioxidants we could slow down aging considerably, and enhance quality of life in terms of freedom from disease and preserving mental sharpness well into the nineties and hundreds, possibly up to 120. Arm your body with the all the network antioxidants and their boosters, and chances are that you will live to your maximum life span free from the typical infirmities of old age.

While Packer suggests taking various antioxidant supplements, since in his view one can't get enough antioxidants from the diet (he points out the sheer absurdity of how much you'd have to eat to get adequate CoQ10, lipoic acid, or vitamin E), he also stresses that one can't get the full variety of antioxidants by taking supplements alone. Eating seven to ten servings of vegetables and antioxidant-rich fruit such as berries daily is still crucial. Packer is no minimalist when it comes to recommending vegetables-not instead of, but in addition to, one's basic network supplement regimen. Why? Vegetables and fruit provide the mixtures of phytochemicals that work together in a network fashion, synergistically enhancing one another. Eventually our still mostly simplistic and poorly absorbed supplements may become more sophisticated and more complex, but for now we better religiously eat our carrots and spinach, berries, grapefruit, tomatoes and kale. Carrots five times a week? You bet-especially if you are a woman who wants to avoid the trauma of breast cancer.

In particular, Packer encourages readers to consume a lot of berries: blueberries, strawberries, raspberries, blackberries. Berries, and blueberries in particular, top the list of all fruits and vegetables for antioxidant power, and may constitute the most potent dietary prevention of cancer, heart disease and neurodegenerative diseases there is. A daily serving of berries could go a long way toward preventing cancer and slowing down aging. So perhaps we should start thinking in terms of a daily bowl of berries, and a generous use of spices such as garlic, ginger and turmeric, providing a powerhouse of curcuminoids. Note the ancient-and valid, it turns out-belief that spices had a miraculous power to prevent diseases, and the enormous price that people were willing to pay. The reason some spices were worth their price in gold was not because people were so fond of their taste, but because they knew that these spices could save lives, especially with Black Death going around.

A case could also be made for daily tea, both green and black, and red wine with the heaviest meal. I think Packer could stress more emphatically the benefits of these life-extending beverages. It is striking that many centenarians favor a daily drink, and that Jeanne Calment, who lived until 122, was extremely devoted to chocolate, an even richer source of polyphenols than red wine. But then a whole book should probably be written on polyphenols alone, and I don't blame Packer for not being able to write about everything in detail. My slight objection is to the "booster" label; it just does not do justice to the very impressive antioxidant powers of polyphenols.

As for doses, this is an area where disagreement among experts is particularly evident. Packer is not a minimalist, though I think his CoQ10 recommendation should be much higher for people past midlife. What is of special interest is that he recommends taking supplements with food, for better absorption, and small but more frequent doses of vitamin C and lipoic acid, which need to be frequently replenished.

He is also a pioneer in recommending a large dose of tocotrienols-200 mg/day-for postmenopausal women, together with the complete antioxidant regimen, in order to prevent breast cancer. He does not see having "cancer genes" in the family as equivalent to being doomed to developing cancer; antioxidants can inhibit the expression of "bad genes" while free radicals can turn them on. In addition, 200 mg of tocotrienols sounds like a very good cardioprotective dose for everyone, since studies have shown this is the dose that can reduce cholesterol up to 30%, and thromboxane, a compound that stimulates clotting and inflammation, by up to 20%.

Network antioxidants and ageless beauty

Also of special interest to both men and women is Packer's plan for beautiful, "ageless" skin. In addition to taking oral antioxidants, Packer recommends using topical anitoxidants: creams containing vitamin C, vitamin E (including tocotrienols, which are readily taken up by the skin) and pycnogenol. Packer cites a colorful study that shows pycnogenol can indeed rejuvenate collagen (too bad pycnogenol is so expensive; let us hope that grape seed extract can accomplish just as much).

Elsewhere Packer mentions that topical vitamin A is also an excellent protector against wrinkles and age spots. It is a little odd that Packer does not mention the new generation of creams that contain lipoic acid in addition to other antioxidants. His thesis would imply that it is best to provide, orally as well as topically, at least four of the network antioxidants, and that lipoic acid is pivotal, since it regenerates the rest. To be sure, this is a small point. The big point is that there is at present little doubt that skin stays less wrinkled and more youthful when supplied with antioxidants both from the inside-supplements and diet, and outside-antioxidant creams.

His championing of tocotrienols for youthful skin seems well-taken; tocotrienols tend to concentrate in the skin. If we start supplementing with tocotrienols and use tocotrienol-containing creams (not yet on the market), hopefully our skin will be as lovely as that of Malaysians, famous for their lovely complexion. The Malaysian beauty secret seems to be palm oil, the richest natural source of tocotrienols.

What Packer does not seem to realize is that sex hormones play a huge role in maintaining youthful skin, as any menopausal woman quickly discovers. This is an area where antioxidants alone can do only so much. Likewise, essential fatty acids are extremely important for the skin-that's why people on low-fat diets have problems with their skin and hair. This chapter more than any other appears to show the limitations of concentrating on only one area of physiology and nutrition, or, as an ancient Roman proverb warned us, "Beware of the man of one book." It is up to the reader to find the books that deal with other areas, such as hormone replacement or optimal fatty-acid ratios, and try to piece together a coherent picture.

Returning to the general picture, it is somewhat disappointing to me that Packer does not go into the antioxidant properties of vitamin A, beyond mentioning that in the body it is converted to retinoic acid, which is important for activating genes that control cell growth. The implication for cancer prevention here is enormous. He doesn't discuss the antioxidant properties of certain B vitamins, fatty acids or amino acids. I stress that these are minor complaints, since obviously there is only so much one can discuss in a single volume, particularly one built around a particular theme, in this case the network aspect of antioxidant action. Even more information would be welcome, however, so that we could get a more complete picture of various antioxidants and their interactions.

Do we finally have the answer here to why "everything does everything"? Barry Sears, in his recent The Anti-Aging Zone, tries to provide the answer in terms of good vs bad eicosanoids (local hormones that include prostaglandins). Practically everything in some way affects the production of eicosanoids. Sears is also a pioneer in pointing out that it is not enough to take antioxidants to mop up free radicals. We must also stop producing so many free radicals, by reducing both calorie intake and mental and physical stress. Other authors point to methylation or other important factors. Indeed, books like The Antioxidant Miracle may repel some readers with their exclusive focus. Someone acquainted with the previous "miracle" books is tempted to ask, "But what about the other 'miracles'-the hormone replacement miracle, the omega-3 miracle, the carnitine miracle, the methylation miracle, the calorie-restriction miracle, and who knows what other 'miracles' yet to be discovered-how do they all fit together into an effective anti-aging program?"

A single book is not likely to provide any definitive answers. Nor, for that matter, can any number of books, since we do not yet have any definitive answers, only strong emerging clues about the various "miracles." Scientists are still busy trying to find the individual pieces of the whole picture rather than investigating complex interactions. Just the fact that someone of the stature of Dr. Lester Packer, head of the prestigious Packer Lab at UC Berkeley, is interested in the interactions among various antioxidants, and has advanced the concept of network antioxidants, is a sign of tremendous progress. After all, the whole body is a "network," and eventually we will have to come to grips with this. Everything affects everything: one antioxidant affects the levels of other antioxidants, one hormone affects the actions ofother hormones. Medicine must learn to think in terms of networks, not single agents.

Most of us would agree that aging is multi-causal, and that the struggle against it requires the integration of many approaches. Thus, Packer's book, like all the others, provides a partial answer at best. It does not even give us a full picture of all the vital antioxidants. But let us not be over demanding. The book does give a fuller and more up-to-date picture of how antioxidants work than any other. It is achievement enough that Packer introduces and explains the concept of "network antioxidants," and champions the need for taking and consuming a great variety of antioxidants, including the tremendously important yet still little-known lipoic acid and tocotrienols.

While many others have been saying all along that we need to supplement with a large variety of antioxidants, only Packer has finally clearly explained why this should be done-the need to recycle "used-up" antioxidants from the pro-oxidant back to the antioxidant state. And he has provided extensive scientific documentation to back up this view. The main antioxidant network and the various supportive networks may ultimately turn out to be more complex than Packer proposes, but here at least is an important shift in thinking, a scaffolding for the future. Packer's well-grounded promotion of lipoic acid, and of course his putting forth of the antioxidant network concept, are reason enough to give him very high marks as a public-health educator, a quantum level above most others. The Antioxidant Miracle is a big step in the right direction, and a must reading for anyone seriously interested in slowing down aging.

~Special thanks to Tom Matthews for providing comments and important information on how antioxidants protect the telomeric tails of chromosomes.