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(Circulation. 2003;108:24.)
© 2003 American Heart Association, Inc.

Clinical Investigation and Reports

Timing of Antioxidant Vitamin Ingestion Alters Postprandial Proatherogenic Serum Markers

From the University of New Mexico School of Medicine, Albuquerque.

Correspondence to Mary F. Carroll, MD, Internal Medicine/Endocrinology, MSC10 5550, 1 University of New Mexico, Albuquerque, NM 87131. E-mail mcarroll{at}salud.unm.edu

Background— This study was designed to determine the optimal timing of vitamins E and C to prevent oxidative stress induced by a high-fat evening meal in type 2 diabetes.

Methods and Results— Eleven subjects were admitted on 4 occasions. Euglycemia was maintained for 24 hours by insulin infusion. Participants were fed a high-fat test supper equivalent to a McDonald’s Big Mac Meal. Blood was drawn for measurement of C-reactive protein (CRP), interleukin 6 (IL-6), plasminogen activator inhibitor-1 (PAI-1), malonyldialdehyde (MDA), and total radical antioxidant parameter (TRAP) before and during the 4 hours after the test meal. Studies were performed in random sequence with vitamin E 800 IU and vitamin C 1 g given either before breakfast or before supper in a double-blind manner on the day of the test meal. Control studies were performed with no vitamins and no test meal administered. There was a significant rise in CRP and PAI-1 after the test supper (P<0.05 compared with "no meal"). Either presupper or prebreakfast vitamins E and C prevented the meal-induced rise in CRP (P=0.03), although presupper vitamins were more effective (P=0.03 compared with prebreakfast vitamins). Only prebreakfast vitamins prevented the meal-induced rise in PAI-1 (P=0.006). There were no significant meal-related changes in the concentrations of IL-6, MDA, or TRAP.

Conclusions— The timing of administration of antioxidant vitamins has variable effects on markers of meal-induced inflammation and fibrinolysis. This observation may be one reason why cardiovascular disease prevention trials using these vitamins have reported conflicting results.

Key Words: antioxidants • plasminogen activator inhibitor • protein, C reactive

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