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Antioxidant Vitamins A, C, and E May Benefit COPD Patients


Updated November 29, 2012



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Although the beneficial relationship between antioxidants and COPD remains unclear, there is some clinical evidence to support that they may have important health benefits.

What are Antioxidants?

Antioxidants are naturally occurring or synthetic substances that help protect cells from the damaging effects of free radicals, highly reactive compounds created during normal cell metabolism.

Antioxidants absorb or attach to free radicals preventing them from attacking normal, healthy tissue, thus reducing the damage that free radicals cause.

What Are Oxidants and Oxidative Stress?

An oxidant is a substance capable of causing oxidation (an interaction between oxygen molecules and other substances). For example, oxidation occurs when you peel an apple and it starts to turn brown or when the fender of your bicycle begins to rust. Oxidation occurs in everything from metal to living tissue. The lungs are continuously exposed to oxidants, generated from either inside the body (released from the cells), or outside the body (e.g. cigarette smoke or air pollution).

Oxidative stress occurs when the balance between oxidants and antioxidants shifts in the direction of oxidants, caused by either an excess of oxidants or a deficiency of antioxidants.

How Does Oxidative Stress Relate to COPD?

Cigarette smoke, the primary cause of COPD, increases the level of oxidants in the lungs, resulting in a decrease of antioxidants. This promotes oxidative stress and the destruction of alveoli, the tiny air sacs in the lungs where oxygen and carbon dioxide are exchanged. Oxidative stress has also been linked to inflammation of the airways of the lungs, a common finding among COPD patients.

What Does the Research Say?

The use of antioxidants to prevent and treat disease is controversial. The following are examples of what some of the research is saying about antioxidants and lung health:

  • Low levels of the antioxidant vitamin C, among other contributing factors, have been found to possibly increase the amount of oxidative stress within the body. In contrast, other investigators found that vitamin C was linked to an increase in oxidative stress and therefore, not recommended.
  • Higher levels of antioxidant vitamins A, C, E and beta-cryptoxanthin along with selenium and several other elements, were independently associated with better lung function and higher levels of FEV1. This, however, may be purely coincidental and not causal.
  • An increase of 40 mg/day in vitamin C intake per day led to an approximate 20 milliliter increase in FEV1.
  • When comparing standard treatment of COPD (inhaled bronchodilators and corticosteroids), to standard treatment plus an 8 week course of vitamin E supplementation, no additional clinical benefit was found in COPD patients, although vitamin E supplementation did help patients produce more of their own endogenous antioxidants.

Antioxidant-Rich Food Sources

Consuming foods from a wide variety of sources is part of a healthy, well-balanced diet. If your dietary goal is to include plenty of antioxidant-rich food sources in your diet, the U.S. Department of Agriculture has provided a ranking of the top 20 food sources of antioxidants to include on your shopping list:

  1. Small red beans, dry, 1/2 cup
  2. Wild blueberries, 1 cup
  3. Red kidney beans, 1/2 cup
  4. Pinto beans, dry, 1/2 cup
  5. Cultured blueberries, 1 cup
  6. Cranberries, 1 cup
  7. Artichoke hearts, 1 cup
  8. Blackberries, 1 cup
  9. Prunes, 1/2 cup
  10. Raspberries, 1 cup
  11. Strawberries, 1 cup
  12. Red delicious apples, 1
  13. Granny Smith apples, 1
  14. Pecans, 1 ounce
  15. Sweet cherries, 1 cup
  16. Black plums, 1
  17. Russet potatoes, cooked, 1
  18. Black beans, dried, 1/2 cup
  19. Plums, 1
  20. Gala apples, 1

While the list above contains some excellent sources for antioxidants-rich foods, the following foods, loaded with powerful antioxidants, should also be considered:

  • Green tea
  • Cruciferous vegetables
  • Fish
  • Tomato products
  • Flax
  • Olive oil
  • Kelp/seaweed
  • Collard greens, spinach and kale
  • Broccoli sprouts
  • Pomegranates
  • Pineapple
  • Avocado
  • Carrots
  • Exotic Mushrooms
  • Dark chocolate and hot cocoa
  • Turmeric
  • Garlic
  • Ginger

The Bottom Line

In light of the controversy surrounding antioxidants and COPD, further evidence is needed to support claims that they are beneficial for lung health. Until then, be sure to talk with your primary care provider or nutritionist regarding a diet plan to suit your individual needs.

To learn more about what to eat for a COPD diet, visit the following links:

Nutritional Guidelines for a COPD Diet

Healthy Eating Tips for the COPD Patient


Blake DJ, Singh A, Kombairaju P, Malhotra D, Mariani TJ, Tuder RM, Gabrielson E, Biswal S. Deletion of Keap1 in the Lung Attenuates Acute Cigarette Smoke-induced Oxidative Stress and Inflammation. Am J Respir Cell Mol Biol. 2009 Jun 11.

Eldridge, Lynne, M.D., Borgeson, David, MS, MPT. Avoiding Cancer One Day at a Time - Practical Advice for Preventing Cancer. Beavers Bond Press. November, 2006.

Hu G, Cassano PA. Antioxidant nutrients and pulmonary function: the Third National Health and Nutrition Examination Survey (NHANES III). Am J Epidemiol. 2000 May 15;151(10):975-81.

MacNee, W. Treatment of stable COPD: Antioxidants. European Respiratory Review. 2005;14: 12-22.

McKeever TM, Lewis SA, Smit HA, Burney P, Cassano PA, Britton J. A multivariate analysis of serum nutrient levels and lung function. Respir Res. 2008 Sep 29;9:67.

Romieu I, Trenga C. Diet and obstructive lung diseases.. Epidemiol Rev. 2001;23(2):268-87.

Siedlinski M, Postma DS, van Diemen CC, Blokstra A, Smit HA, Boezen HM. Lung function loss, smoking, vitamin C intake, and polymorphisms of the glutamate-cysteine ligase genes. Am J Respir Crit Care Med. 2008 Jul 1;178(1):13-9. Epub 2008 Apr 17.

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