Health Information For You!


I’ve posted some handouts below that you may find interesting. Please check back, because I plan to post all my handouts. You may also want to follow my posts on facebook. Here’s the link to Facebook.

Vaccine information A link to the Vaccine Information Statements by the CDC and to the AAP information site on immunizations, as well as a number of interesting articles.

Unvaccinated vs vaccinated children have been compared in a large study in Germany. The study found that the only difference between the two groups was that unvaccinated children had a higher rate of vaccine-preventable disease. There was no difference in other infectious diseases nor in allergic or autoimmune diseases.

Here’s the link to the study.

Integrative Health

Probiotics and Your Child’s Health

Antioxidants and Health

Natural remedies for colic


Breastfeeding medical protocols: Including information on mastitis, meds to increase milk and more

General Pediatrics Topics

Babyproofing tips, including list of poisonous plants

Calorie Boosters for kids who aren’t gaining weight well

Colic information — babies who cry over 3 hours a day

Cough and Cold instructions


  • Hungarian baby-nose-vacuum: This device attaches to your vacuum cleaner and sucks snot out of a baby’s nose. There are videos to watch of it in use on this site.
  • Nosefrida The Snot Sucker: This one uses your own mouth to suck. There’s a filter in-between the baby’s nose and your mouth.
  • Baby Comfy Nose: This one also uses your own mouth to suck. You put a tissue in the plastic egg to act as a filter.

New Information about Acetaminophen, the medication found in Tylenol This very interesting article from the American Academy of Pediatrics questions the safety of acetaminophen. Worth reading before giving your child this common, OTC medication!

DERMATOLOGY: Here’s a link to a dermatology diagnostic tool that may help you: Dermatology Diagnostic Tool

Diarrhea instructions

Drowning Prevention Class

Fever instructions:
When a fever is serious:
1. Fever should start the first day of an illness. If a fever comes later in an illness, it’s a sign of a bacterial infection and the child needs to be seen. Schedule on the website please.
2. Fever should last no more than 5 days. If it lasts more than 5 days, it’s a sign of a more serious illness and the child should be seen. Schedule on the website please.
3. Fever should get hotter through the first day, stay high the second day, be lower the third day (but back up at night), be even lower the fourth day (normal during the day and up at night) and be gone the 5th day. If it doesn’t follow this pattern, it’s a sign of a more serious infection and the child should be seen. Schedule on the website please.

4. Under two months of age, with a  temp of 100.4 rectally, go to the ER right away.
5. Unvaccinated child under 3 years old, with a temp of 103 or higher, go to the ER (why? the vaccines prevent serious bacterial infections. Without the vaccinations, the child is more likely to have a serious infection.) Be sure to ask the ER doctor for a complete blood count, since they may not be familiar with managing unvaccinated children.
7. If a child or baby won’t play at all, if s/he stays in the same position if you put them down, has a stiff neck, a scary purple rash, small purple marks in the skin, all red skin, seizure, or has immune system problems, or just looks very bad to you, go to the ER. If s/he will play a little, if s/he is happy and alert in your lap, if s/he will hold the cup or bottle to drink, these are good signs.
Tips on caring for your child while they have a fever which you believe is normal — due to a virus.
1. Give plenty of fluids.
2. Keep the child comfortable. You can give Motrin/ Advil (ibuprofen) every 6 hours to keep the child feeling okay. A warm (not cold) bath will help the fever come down.

FOOD ALLERGY PREVENTION: More and more studies suggest that LATE introduction of solids may lead to an INCREASED risk of food allergies, while EARLY (4-6 months) introduction may lead to a DECREASED risk. Here are some articles on this topic:

High blood pressure information

Prevent Iron Deficiency: AAP Guidelines say, start iron supplements in breastfed babies at 4 months

Measles Information

Measles — Many parents are calling me to ask about the recent measles outbreak and the measles vaccine. Measles vaccine is given as the MMR vaccine, which combines measles, mumps and rubella protection. Just measles alone is not available as a vaccine. The MMR is well-tested and is safe. It can cause one or two days of fever and rash in about one in six children who receive it, about 1-2 weeks after receiving the vaccine — this does not need treatment and goes away by itself. The rash and fever are not contagious. The vaccine is given at age one year old and again at 4 years old, at the well-visits. If your child had his or her one year old visit and you did not decline a vaccine, then your child has had the MMR vaccine. One shot of MMR makes 93% of the population completely immune to measles for life. Two shots makes 97% of the population completely immune. A blood test after the first shot does not indicate in a reliable way if you can skip the second shot, so this is not recommended.

If you are traveling out of the country, and your child is between 6 months and 12 months of age, it is recommended to get an early MMR. There is no risk from an early MMR. Early vaccines are never dangerous but may be ineffective. You don’t know if your child is able to develop immunity from the vaccine. Since most of the measles outbreaks have occurred in Europe, any international travel could put your child at risk for measles, so the early MMR may offer some protection. Similarly, if your child is between 1 year old and 4 years old, and you are leaving the US, you should get an early MMR booster for your child. The MMR given under the age of 1 does not “count” toward the recommended two shots. An early MMR booster does count. For people staying in the US, the CDC does not, at this time, suggest an early MMR.

Measles itself is a very serious disease. Some people may suffer from severe complications, such as pneumonia (infection of the lungs) and encephalitis (swelling of the brain). They may need to be hospitalized and could die.

  • As many as one out of every 20 children with measles gets pneumonia, the most common cause of death from measles in young children.
  • About one child out of every 1,000 who get measles will develop encephalitis (swelling of the brain) that can lead to convulsions and can leave the child deaf or mentally retarded.
  • For every 1,000 children who get measles, one or two will die from it.

Some parents are asking if their child could be exposed to measles in my office. It is true that some of my patients have not received all of the recommended vaccines. Very few have not received the measles vaccine. Because the office is small, and because we run as close to on-time as possible, it is never likely that you will be in the waiting room with any sick child. Measles, however, can linger in the air. So, if either of the doctors ever suspected measles in a patient in the office, we would cancel anyone who is not immune (either too young for the vaccine or not vaccinated) for the rest of the day. We would work closely with the health department to minimize any risk. It is true that your child could be exposed to measles in any doctor’s office, even one that refuses care to families who do not vaccinate. A child in one of those practices with measles might be under the age of one, or might be a new patient to the practice. Fortunately, there has not been a case of measles in Philadelphia so far.

There is lots more information on measles on the CDC website.

Migraine Information

Nanny hiring: If you are hiring a nanny, please pay for him or her to be tested for Hepatitis B and tuberculosis to see if she has them, and to be checked for immunity against measles, mumps and chicken pox, before starting. Also, provide for the nanny to receive a flu vaccine each fall, and a Tdap (against whooping cough) vaccine within 2 years of starting with a newborn, as well as give proof of a hepatitis B and hepatitis A vaccine at some point in the past.

Overweight: How to prevent it in young children

Overweight: how to lose weight

Ringworm information

Sleep: Article from Sleep Journal on Methods of Sleep Training for Babies and Young Children

Sleep: Article on long-term effects of Sleep Training at age 6 years old (no long-term effects are seen)

Smoking: How to stop

Talking about violence with children

Thrush instructions

Tick Information — If you find a tick on your child, please put it in a small jar with rubbing alcohol and bring it to the office. We will send it to the lab to be checked for Lyme Disease.

Tuna Fish – how much is safe?

Tylenol May Not Be Safe  and concerns re ibuprofen in infants are probably overstated. That said, do be careful with ibuprofen if your infant or child is dehydrated, and give Tylenol until they are better hydrated.

Vomiting instructions

Yeast diaper rash instructions Symptom Checker: This is good, reliable information from the American Academy of Pediatrics.


What are probiotics?
Beneficial bacteria, and sometimes beneficial yeast, that live in the gut. The common ones fall into two groups, Lactobacillus or Bifidobacterium. Additionally, Saccharomyces boulardii, yeasts, are considered probiotics.
They can be taken in foods, such as yoghurt, sauerkraut, miso, and tempeh. They can also be taken, in larger doses, in supplement.s
What do they do?
A number of studies have shown that they can improve allergies, eczema, diarrhea from viruses, diarrhea from antibiotics, inflammatory bowel disease, and possibly chronic sinusitis.
How do they work?
There are a number of theories. Since there are immune cells in the gut, it is possible that the friendly bacteria modulate those immune cells somehow. Another possibility is that having friendly bacteria in the gut makes it harder for unfriendly bacteria to get a foothold. A third possibility is that the friendly bacteria produce substances that improve health.
Tell me more about the studies.
Viral Diarrhea:
• Overall, there is the most research support for L. rhamnosus GG and B. lactis BB-12 for prevention, and L. reuteri SD2222 for treatment of viral diarrhea.

• 286 children in daycare in Taiwan took 5 capsules a day, 5 days a week, for 7 months, of a multi-probiotic preparation (12 types of beneficial bacterial strains for the large and small intestines, including 7 different species of Lactobacilli (Neoangelac® 12A Lactobacilli, Multipower Enterprise Corp, Taipei, Taiwan). One capsule of the Neoangelac 12A Lactobacilli series contained 3 types of Bifidobacteria (2.4×109 cfu B. bifidum, 2.4×109 cfu B. infantis, 2.4×109 cfu B. longum); 7 types of Lactobacilli (2×109 cfu L. casei, 1.2×109 cfu L. salivarius, 1.6×109 cfu L. brevis, 2×109 cfu L. plantarum, 1.2×109 cfu L. acidophilus, 8×108 cfu L. helveticus, 2×109 cfu L. rhamnosus); 1 type of Streptococcus (1×109 cfu S. thermophilus) and 1 type of Enterococcus (1×109 cfu E. faecium). (cfu: colony forming units, a measure of the dose of the probiotic) Compared to those who took a single strain of probiotics and those who took nothing (all together, over 500 other children), these children had less diarrhea and vomiting illnesses during the time they took the probiotics.

• 40 babies aged 6 to 36 months of age hospitalized with diarrhea were given L. reuteri (1010 to 1011 CFU) for up to 5 days or placebo. Those who took the probiotic had a shorter illness (1.6 versus 2.9 days in the placebo group). (Placebo: sugar pill or false treatment) In a related study, another group was given a lower dose of the same probiotic (107 CFU of L. reuteri SD2222). These children had shorter illnesses than those on placebo, but longer than those with the higher dose.
Diarrhea from Antibiotics or other causes:
• Overall, there is the most research support for Lactobacillus GG, Lactobacillus sporogenes, Saccharomyces boulardii at 5 to 40 billion colony forming units/day for preventing or treating diarrhea from antibiotics.
• Lactobacillus GG prevented antibiotic-associated and traveler’s diarrhea in adults.
• Undernourished, non-breast-fed, Peruvian children, aged 18-29 months, who took Lactobacillus rhamnosus strain GG preventively had fewer episodes of diarrhea than those who did not.
• Lactobacillus GG was shown to significantly reduce stool frequency and increase stool consistency during oral antibiotic therapy by the 10th day of antibiotic therapy compared with a placebo group.

Constipation and Irritable Bowel Syndrome:
44 infants aged 6-14 months with functional constipation were given lactobacillus reuteri or placebo. Those with the probiotics had increased frequency of stools, though no improvement in consistency of stool or amount of crying.

In a review of studies on children, it was found that L. casei rhamnosus Lcr35, but not L. rhamnosus GG, showed a beneficial effect.

203 children aged 4-18 with IBS were given probiotics; 82% reported improvement in symptoms after 40-50 days.

Necrotizing Enterocolitis in Premature Infants
• 180 preemies were given either placebo or lactobacillus acidophilus. Those with the probiotics had an 18% reduction in incidence of NEC, a severe gut problem common to preemies.
• 434 very low birth weight preemies were given either lactobacillus acidophilus and bifidobacterium bifidum or nothing. 4 of those who received the probiotics and 14 of those with nothing developed NEC.
• A combined analysis of all studies on NEC and preemies included 2176 participants, and showed a 30% reduction in the incidence of NEC in those receiving probiotics. Further, no significant adverse events were reported in any of these studies.
Inflammatory bowel disease:
In children and adults, a combined probiotic preparation has been used to maintain remission in ulcerative colitis and to prevent the onset of certain surgical complications. No such effect is seen in Crohn’s disease.

Peptic Ulcer disease with Helicobacter Pylori:
In adults, 991 patients with ulcer disease and infection with helicobacter pylori were given antibiotics to eradicate the infection. 1/3 were also given Saccaromyces boulardi. 72% of those just given antibiotics and 80% of those with the probiotics were cleared of infection.
• 230 infants with eczema were given Lactobacillus GG or a placebo. At 4 weeks, those infants with positive skin or blood tests for allergy-associated eczema who took the probiotic were improved, compared to the others.
• 62 pregnant and lactating mothers were given probiotics or placebo. Children of those who took the probiotic were less likely to develop eczema during the first two years of life.

• 132 pregnant mothers with a relative with allergies or asthma, and their babies, after birth until 6 months of age, were given either two capsules containing 1010 Lactobacillus sp. strain GG or placebo. The babies who took the probiotic were much less likely to develop eczema.
Respiratory infections:
• Over 250 pre-schoolers who took L. casei rhamnosus containing 1×108 cfu twice a day, five days a week, for 3 months over the winter, had fewer doctor-diagnosed viral infections and fewer respiratory infections than those who took nothing.

• 479 healthy adults were supplemented daily with vitamins plus minerals with or without probiotic lactobacilli and Bifidobacteria. There was no effect on how often they got the common cold but those on probiotics had shorter and less severe colds.

• 281 daycare attenders were randomized to receive either Lactobacillus GG or placebo; Those who took probiotics had nearly half the number of upper respiratory infections as the placebo group.
Other infections:
• Over 1000 Finnish children under age 6 were put in two groups, with one group taking Lactobacillus rhamnosus strain GG three times a day, five days a week, with snacks for 7 months, over the winter . The group with the probiotic had no fewer days spent with diarrhea or respiratory symptoms, but did have fewer numbers of days absent from day care, and fewer complications such as otitis media, and fewer antibiotic prescriptions.
• Over 250 pre-schoolers who took L. casei rhamnosus containing 1×108 cfu /g twice a day, five days a week, for 3 months over the winter, had fewer doctor-diagnosed bacterial infections (such as ear infections) than those who took nothing.

Bacterial vaginosis and UTI in adult women:
• Daily oral intake of 109 to 1010 L. rhamnosus GR-1 and L. fermentum RC-14 leads to transfer of the organisms from the rectum to the vagina as well as an overall decrease of unfriendly organisms (coliforms and yeasts) in the vagina
• Once-weekly vaginal administration of a suppository containing 109 L. rhamnosus GR-1 and L. fermentum B-54 for 1 year lowered women’s rate of UTI compared to their own rate the year before.
• Daily ingestion of capsules containing L. rhamnosus GR-1 and L. fermentum RC-14 by 19 women with a bacterial vaginosis led to normalization in 81% of cases, compared to 50% in women given placebo
Future areas:
A study was recently completed evaluating the L.rhamnosus R0011 strain in treating patients with chronic sinusitis. Results are pending.
Probiotics have been proposed as possible treatments or preventive measures for dental cavities, chronic diarrhea, Chrohn’s disease, and other diseases.

Is this a sure thing?
No. Many of the studies are too small to be definite. Many of the studies use different doses, and are conducted in different ways, so combining them (to get a larger number) isn’t possible. Very few of the studies were done in children. There are strong placebo effects in many of the studies. More research is needed!
Are probiotics safe to use?
Probably, for most people. When you take in bacteria, you do have a theoretical risk of getting infected by the bacteria, rather than having it live happily in your gut helping you out. There have been 2 cases of babies getting badly infected by probiotics, and 2 cases of adults getting infected as well. In each case, the person who got infected was already immunocompromised, meaning their immune systems were not working, or debilitated in some way. There have been no cases of healthy people getting sick from probiotics. So, if a child has HIV, or gets recurrent bacterial infections (meaning, perhaps, they have an undiagnosed immune deficiency), it would be wise to be cautious about using probiotics. On the other hand, probiotics have been given to people with HIV without problems.
Another theoretical risk: Probiotics could possibly cause unhealthy metabolic activities, too much stimulation of the immune system, or gene transfer (insertion of genetic material into a cell). This has not been proven.
What about side effects?
The most common are gas and bloating. Most people have no side effects.
If I want to give probiotics to my child, which ones should I give and how much?
Since there are no studies that test the dose needed for children to get a beneficial effect, to some extent, this answer has to be a guess. Most clinicians, when giving probiotics to children, give half an adult dose, and when giving to infants, give a quarter of the adult dose. But, since there aren’t dose studies in adults either, this, too, is a guess. (Again, more research is needed!)
As far as which to give, certain strains have been shown to help with certain disease states, while other strains have been shown to have no effect. So, check the strains used in the studies listed above, whether in a supplement or yoghurt, depending on the effect you hope to have.
What if my child isn’t sick, but I want to promote health with probiotics?
Using a low dose, such as that found in yoghurt, is certainly safe. Using a supplement on a weekly or twice weekly basis is probably also safe, and, perhaps, would be beneficial.


Cabana MD, Shane AL, Chao C, et al. Probiotics in primary care pediatrics. Clin Pediatr (Phila) 2006 Jun; 45(5):405-10.
Reid G, Jass J, Sebulsky MT, et al. Potential uses of probiotics in clinical practice. Clin Microbiol Rev 2003 Oct; 16(4):658-72.
Boyle RJ, Robins-Browne RM, Tang ML Probiotic use in clinical practice: what are the risks? Am J Clin Nutr 2006 Jun; 83(6):1256-64; quiz 1446-7.
Reid G The potential role of probiotics in pediatric urology. J Urol 2002 Oct; 168(4 Pt 1):1512-7.
Johnston BC, Supina AL, Ospina M, et al. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev 2007; (2):CD004827.
Jun-Song Lina,1, Yi-Han Chiub,d,1, Nien-Tsung Linc, Chia-Hsiang Chua, Kuo-Chin Huangb,Kuang-Wen Liaob, Kou-Cheng Pengd ,Different effects of probiotic species/strains on infections in preschool children: A double-blind, randomized, controlled study, , Vaccine 27 (2009) 1073–1079

Michael de Vresea, Petra Winklera, Peter Rautenbergb, Timm Harderc, Christian Noahb, Christiane Lauea, d, Stephan Otte, Jochen Hampee, Stefan Schreibere, Knut Hellerf and Jürgen Schrezenmeira, Probiotic bacteria reduced duration and severity but not the incidence of common cold episodes in a double blind, randomized, controlled trial , Vaccine, Volume 24, Issues 44-46, 10 November 2006, Pages 6670-6674

Helicobacter pylori therapy in children: overview and challenges.Chiesa C, Pacifico L, Anania C, Poggiogalle E, Chiarelli F, Osborn JF.
Int J Immunopathol Pharmacol. 2010 Apr-Jun;23(2):405-16. Review.
Lactobacillus reuteri (DSM 17938) in infants with functional chronic constipation: a double-blind, randomized, placebo-controlled study.Coccorullo P, Strisciuglio C, Martinelli M, Miele E, Greco L, Staiano A.J Pediatr. 2010 Oct;157(4):598-602. Epub 2010 Jun 12.
Comparison between killed and living probiotic usage versus placebo for the prevention of necrotizing enterocolitis and sepsis in neonates.Awad H, Mokhtar H, Imam SS, Gad GI, Hafez H, Aboushady N.Pak J Biol Sci. 2010 Mar 15;13(6):253-62
Updated meta-analysis of probiotics for preventing necrotizing enterocolitis in preterm neonates.Deshpande G, Rao S, Patole S, Bulsara M. Pediatrics. 2010 May;125(5):921-30. Epub 2010 Apr 19.
Update on the role of probiotics in the therapy of pediatric inflammatory bowel disease.Guandalini S.
Expert Rev Clin Immunol. 2010 Jan;6(1):47-54. Review.
Probiotics: preventing antibiotic-associated diarrhea.Jones K.J Spec Pediatr Nurs. 2010 Apr;15(2):160-2.
Probiotic treatment of irritable bowel syndrome in children.Martens U, Enck P, Zieseniss E.Ger Med Sci. 2010 Mar 2;8:Doc07.
Role of Lactobacillus in the prevention of antibiotic-associated diarrhea: a meta-analysis.Kale-Pradhan PB, Jassal HK, Wilhelm SM.
Pharmacotherapy. 2010 Feb;30(2):119-26.
Systematic review of randomised controlled trials: probiotics for functional constipation.Chmielewska A, Szajewska H.
World J Gastroenterol. 2010 Jan 7;16(1):69-75. Review.
Lactobacillus GG in the prevention of gastrointestinal and respiratory tract infections in children who attend day care centers: a randomized, double-blind, placebo-controlled trial.Hojsak I, Snovak N, Abdović S, Szajewska H, Misak Z, Kolacek S.
Clin Nutr. 2010 Jun;29(3):312-6. Epub 2009 Nov 5.
Hung-Chih Lin, Chyong-Hsin Hsu, Hsiu-Lin Chen, Mei-Yung Chung, Jen-Fu Hsu, Rey-in Lien, Lon-Yen Tsao, Chao-Huei Chen, and Bai-Horng Su Oral Probiotics Prevent Necrotizing Enterocolitis in Very Low Birth Weight Preterm Infants: A Multicenter, Randomized, Controlled Trial Pediatrics, Oct 2008; 122: 693 – 700.
Girish Deshpande, Shripada Rao, Sanjay Patole, and Max Bulsara
Updated Meta-analysis of Probiotics for Preventing Necrotizing Enterocolitis in Preterm Neonates
Pediatrics, May 2010; 125: 921 – 930.



Presented by Alexis Lieberman, M.D.

Fairmount Pediatrics and Adolescent Medicine

What are Free Radicals?

A byproduct of cellular metabolism are free radicals. These are molecules with only one electron, not two. The most common form of free radical is oxygen with only one electron, not with two electrons that are bonded together which is the normal form of oxygen.

Free radicals scavenge for other molecules to bond with. In the process, they damage cells. They can destroy cellular compounds and damage proteins, lipids, and DNA, and lead to cell death – especially in the brain which generates more oxidative by products than other organs of the body. This process is called oxidative stress.

What kind of damage can be done by free radicals?

The following diseases are caused or aggravated by free radicals:

  • Alcoholic liver and heart conditions
  • Arteriosclerosis
  • Arthritis
  • Autoimmune diseases
  • Cancer
  • Cataracts
  • Circulation disturbances
  • Coronary heart disease
  • Diabetes
  • Emphysema of the lung
  • Inflammatory reactions
  • Liver Cirrhosis
  • Malaria
  • Multiple Sclerosis (MS)
  • Neuronal Lipofuscinosis
  • Parkinson’s Disease
  • Porphyria
  • Premature Ageing
  • Retinal Diseases
  • Rheumatoid diseases
  • Senile Dementia
  • Side-effects of medicines

What are antioxidants?

Antioxidants are substances that may protect cells from the damage caused by unstable molecules known as free radicals. Antioxidants interact with and stabilize free radicals and may prevent some of the damage free radicals might otherwise cause.

What are examples of antioxidants?

L-Carnosine   L-Carnosine is a multi-potent super-antioxidant which stabilizes and protects the cell membrane. Specifically, as a water-soluble free radical scavenger it prevents lipid peroxidation within the cell membrane.
Carotenoids/  Beta-carotene Carotenoids are perhaps best known for their ability to be converted to vitamin A, which is essential for healthy vision and reproduction, and for maintaining body tissues. Carotenoids are also powerful antioxidants on their own right.They are found in many foods that are orange in color, including sweet potatoes, carrots, cantaloupe, squash, apricots, pumpkin, and mangos. Some green, leafy vegetables, including collard greens, spinach, and kale, are also rich in beta-carotene.
Co-Enzyme Q10 Co Q10 is involved in the body’s metabolic processes, particularly in the release of energy from food, and is a potent antioxidant.
  Lutein Lycopene best known for its association with healthy eyes, is abundant in green, leafy vegetables such as collard greens, spinach, and kale.A potent antioxidant found in tomatoes, watermelon, guava, papaya, apricots, pink grapefruit, blood oranges, and other foods. Estimates suggest 85 percent of American dietary intake of lycopene comes from tomatoes and tomato products.
Vitamin A A fat-soluble vitamin involved in the formation and maintenance of healthy skin, hair, and mucous membranes. Vitamin A helps us to see in dim light and is necessary for proper bone growth, tooth development, and fertility and has been well documented for decades. It is also an important antioxidant. Vitamin A is found in three main forms: retinol (Vitamin A1), 3,4-didehydroretinol (Vitamin A2), and 3-hydroxy-retinol (Vitamin A3). Foods rich in vitamin A include liver, sweet potatoes, carrots, milk, egg yolks, and mozzarella cheese.
Vitamin B It has been recently discovered that several of the B vitamins have antioxidant effects and that they stimulate the activity of the immune system.
Vitamin C Vitamin C is an important antioxidant, and is also part of the cellular chemistry that provides energy and for making the collagen protein involved in the building and health of cartilage, joints, skin, and blood vessels. Vitamin C is also called ascorbic acid, and can be found in high abundance in many fruits and vegetables and is also found in cereals, beef, poultry, and fish.
Vitamin E Alpha-tocopherol is the most active form of vitamin E in humans, and is a powerful biological antioxidant. Vitamin E, also known as alpha-tocopherol, is found in almonds, in many oils including wheat germ, safflower, corn, and soybean oils, and is also found in mangos, nuts, broccoli, and other foods.
Selenium Selenium is a mineral, not an antioxidant nutrient. However, it is a component of antioxidant enzymes. Plant foods like rice and wheat are the major dietary sources of selenium in most countries. The amount of selenium in soil, which varies by region, determines the amount of selenium in the foods grown in that soil. Animals that eat grains or plants grown in selenium-rich soil have higher levels of selenium in their muscle. In the United States, meats and bread are common sources of dietary selenium. Brazil nuts also contain large quantities of selenium.
Zinc Zinc is vital to about 200 different enzymes, to the formation of bone tissue, in the healing of wounds and sores, to the production of proteins, the regulation of ribosomal, ribonucleic acid synthesis and insulin and in the carbohydrate metabolism. Zinc is also an antioxidant.

Can antioxidants prevent cancer?

Considerable laboratory evidence from chemical, cell culture, and animal studies indicates that antioxidants may slow or possibly prevent the development of cancer. However, information from recent clinical trials is less clear. In recent years, large-scale, randomized clinical trials reached inconsistent conclusions.

How might antioxidants prevent cancer?

Antioxidants neutralize free radicals as the natural by-product of normal cell processes. Free radicals are molecules with incomplete electron shells which make them more chemically reactive than those with complete electron shells. Exposure to various environmental factors, including tobacco smoke and radiation, can also lead to free radical formation. In humans, the most common form of free radicals is oxygen. When an oxygen molecule (O2) becomes electrically charged or “radicalized” it tries to steal electrons from other molecules, causing damage to the DNA and other molecules. Over time, such damage may become irreversible and lead to disease including cancer. Antioxidants are often described as “mopping up” free radicals, meaning they neutralize the electrical charge and prevent the free radical from taking electrons from other molecules.

What does research show about how antioxidants help promote health?

  • Studies have linked dietary antioxidants and asthma incidence/severity
  • Subjects with a high exposure to oxidative air pollutants have shown short-term protective effects of antioxidants on lung function
  • Antioxidant supplementation (50 mg/d of vitamin E and 250 mg/d of vitamin C) might modulate the impact of ozone exposure on the small airways of children with moderate to severe asthma living in Mexico City
  • Observational studies suggest a role of a healthy antioxidant diet for the prevention of coronary heart disease and cancer
  • A number of observational studies in adults have found an association between low fruit intake and asthma or lower lung function
  • Eating apples twice or more in a week, compared with eating them less than once a month, was negatively associated with wheezing
  • Intake of bananas, but not other fruits, was negatively associated with wheeze. Bananas have a higher content of water soluble phenolic acids than other fruits, including apples, and could plausibly reduce asthma inflammation. Furthermore, bananas have been shown to increase the absorption of other nutrients and are rich in pro-vitamin A carotenoids.
  • Vitamin C has been shown in several case-control and cross-sectional studies to be associated with a reduced risk of asthma, but in the only available substantive longitudinal study, vitamin C intake had no effect on asthma incidence.
  • One report suggesting protection by flavones against markers of COPD
  • Fatty acid effects: Intake of omega-3 polyunsaturated fatty acids from fish oils, which is potentially beneficial, while omega-6 and trans-fatty acids, which may be detrimental to asthma
  • 18 737 children aged 6-7 years living in Italy. Intake of citrus fruit or kiwi fruit was a highly significant protective factor for wheeze in the last 12 months
  • 598 Dutch children aged 8–13 years. Our findings suggest that a high intake of whole grain products and fish may have a protective effect against asthma in children.

Which foods are rich in antioxidants?

Antioxidants are abundant in fruits and vegetables, as well as in other foods including nuts, grains, and some meats, poultry, and fish.

The highest ranked foods in four major categories are as follows:

Fruits: blueberries, cranberries, and blackberries.

Vegetables: beans, artichoke hearts, and surprisingly, russet potatoes.

Nuts: pecans, walnuts, and hazelnuts.

Spices: cinnamon, oregano, and ground cloves.

Here’s the list of the top 20 food sources of antioxidants, based on their total antioxidant capacity per serving size:



Food item


Serving size
Total antioxidant capacity per serving size
1 Small Red Bean (dried) Half cup 13727
2 Wild blueberry 1 cup 13427
3 Red kidney bean (dried) Half cup 13259
4 Pinto bean Half cup 11864
5 Blueberry (cultivated) 1 cup 9019
6 Cranberry 1 cup (whole) 8983
7 Artichoke (cooked) 1 cup (hearts) 7904
8 Blackberry 1 cup 7701
9 Dried Prune Half cup 7291
10 Raspberry 1 cup 6058
11 Strawberry 1 cup 5938
12 Red Delicious apple One 5900
13 Granny Smith apple One 5381
14 Pecan 1 ounce 5095
15 Sweet cherry 1 cup 4873
16 Black plum One 4844
17 Russet potato (cooked) One 4649
18 Black bean (dried) Half cup 4181
19 Plum One 4118
20 Gala apple One 3903

While some foods are high in antioxidants, they may not be well-absorbed. Researchers also found that cooking method also had a significant effect on the antioxidant content of the foods tested, but those effects were not consistent.

For example, cooked Russet and red potatoes had much lower antioxidant levels than those found in raw potatoes. Boiling also decreased antioxidant levels in carrots, but cooking tomatoes increased their antioxidant content.

Here’s another listing, by antioxidant ORAC test results (another method of measuring antioxidant strength):

Goji BerriesDark chocolate 25,30013,120
Milk chocolate 6,740
Prunes 5,770
Raisins 2,830
Blueberries 2,400
Blackberries 2,036
Kale 1,770
Strawberries 1,540
Spinach 1,260
Raspberries 1,220
Brussels sprouts 980
Plums 949
Alfalfa sprouts 930
Broccoli 890


REFERENCES:Tricia M. McKeever and John Britton, Pulmonary Perspective, Diet and Asthma American Journal of Respiratory and Critical Care Medicine Vol 170. pp. 725-729, (2004)

B. J. Okoko, P. G. Burney, R. B. Newson, J. F. Potts and S. O. Shaheen, Childhood asthma and fruit consumption

Eunyoung Cho, ScD; Johanna M. Seddon, MD; Bernard Rosner, PhD; Walter C. Willett, MD, DrPH; Susan E. Hankinson, ScD , Prospective Study of Intake of Fruits, Vegetables, Vitamins, and Carotenoids and Risk of Age-Related Maculopathy Arch Ophthalmol. 2004;122:883-892.

National Cancer Institute fact sheet on antioxidants