Universidad Nacional del Comahue

Facultad de Ciencias Médicas

Inglés

Actividad integradora

1 Experimental studies have demonstrated that free radicals can induce numerous pathological processes,
and it has been suggested that nutrients such as beta carotene, ascorbic acid, vitamin E, selenium, and zinc
may prevent such harmful effects because of their antioxidant capacity.1-3 2 Epidemiological data from
observational studies have indeed shown a strong relationship between the intake of antioxidant vitamins and
minerals, or of foods rich in these nutrients, and the risks of cancer and ischemic cardiovascular disease
(CVD).4-8 3 However, randomized, placebo-controlled, primary prevention trials in which antioxidant
micronutrients, single or in pairs, were taken at high doses over long periods have not confirmed this potential
beneficial effect,9-14 and 2 of these 10,11 even suggested harmful effects. 4 The seemingly contradictory results
between the observational studies and these randomized trials can be explained by the fact that the doses
used in clinical trials were much higher than the highest levels found in ordinary dietary intake—levels
associated with the lowest risk of cancer and CVD. 11111

5 The objective of the Supplementation en Vitamines et Minéraux Antioxydants (SU.VI.MAX) study was to test
whether an adequate and well-balanced intake of antioxidant nutrients reduces the incidence of cancers and
ischemic CVD in a middle-aged general population.

METHODS

6 Volunteers (women aged 35-60 years and men aged 45-60 years) living in France were invited to participate.
7 The lower age in women was determined by the incidence of breast and uterine cancers and the female-
male ratio of 1.5:1 by the lower incidence of ischemic CVD among women. 8 Eligible individuals were randomly
allocated to receive either a combination of antioxidants (120 mg of ascorbic acid, 30 mg of vitamin E, 6 mg of
beta carotene, 100 µg of selenium [as selenium-enriched yeast], and 20 mg of zinc [as gluconate]) or a
matching placebo in a single daily capsule.

9 Participants underwent regular health assessments and tests at different intervals, including measurements
of cholesterol, glucose, and antioxidants at specific years. 2 111110 The primary outcomes measured were
major fatal and nonfatal ischemic cardiovascular events and cancer of any kind, except for basal cell carcinoma
of the skin, while the secondary outcome was all-cause mortality.

COMMENT

11 Our study, performed in individuals not selected for risk factors, indicates that a 7.5-year low-dose
antioxidant supplementation lowered total cancer incidence in men but not in women. 12 A similar tendency
was observed for all-cause mortality. 13 This supplementation did not result in any major effect on ischemic
CVD incidence in men or women.

14 High doses of beta carotene supplementation may be deleterious in individuals with no clinical symptoms
but in whom the initial phase of cancer development has already started and could be ineffective in well-
nourished individuals with adequate antioxidant status. 15 The latter possibility may explain the difference
between men and women observed in our study. 16 Supplementation may have seemed effective only in men
because their nutritional intake and concentrations at baseline of some antioxidant nutrients, especially beta
carotene, was lower than in women. 17 Higher levels of vitamin C and beta carotene in women may be due to
a higher intake; however, in the case of beta carotene, we cannot exclude the effect of hormonal differences
or differences between the sexes in lipid and nutrient transport.

18 An inverse relationship between baseline serum beta carotene levels and cancer risk has been noted in
many observational studies.28,29 19 We observed this relationship in men but not women in the placebo group,
probably because of their lower baseline beta carotene concentrations. 20 After 7.5 years of supplementation,
 Universidad Nacional del Comahue
Facultad de Ciencias Médicas
Inglés

serum level of beta carotene increased in men to reach the serum level of the women in the placebo group.
31111

21 In conclusion, our results suggest that an adequate and well-balanced supplementation of antioxidant
nutrients, at doses that might be reached with a healthy diet that includes a high consumption of fruits and
vegetables, had protective effects against cancer in men. 22 Baseline beta carotene and vitamin C status was
lower in men than in women. 23 The ineffectiveness of supplementation in women may be due to their better
baseline antioxidant status.

1. Responder las siguientes preguntas en español, en base al texto proporcionado. Indicar las oraciones
empleadas para responder.
a. ¿Qué explica, según los autores, la aparente discrepancia entre los resultados de los estudios
observacionales y los ensayos aleatorios realizados anteriormente?
b. ¿Qué se proponían los autores al realizar esta investigación?
c. ¿Cuáles fueron los principales hallazgos de este estudio en relación a los principales
desenlaces de interés?
2. Decida si las siguientes afirmaciones son verdaderas o falsas. Subraye la información falsa. Indique la
oración (solo una) empleada como evidencia y proponga una corrección de los enunciados falsos.
a. Según estudios observacionales previos, las personas que consumen menos alimentos ricos
en vitaminas y minerales antioxidantes tienen menos probabilidades de desarrollar cáncer y
problemas cardíacos.
b. En experimentos previos en los que las personas tomaron grandes cantidades vitaminas
durante mucho tiempo, no se observaron mejorías en su salud.
c. Se incluyeron mujeres de edad mayor en comparación con los hombres, para determinar la
incidencia de cáncer de pecho y útero.
d. La mayor incidencia de enfermedades cardiovasculares en mujeres hizo que se incluyeran
más hombres que mujeres.
3. Reubicar las siguientes oraciones en los vacíos señalados en el texto. Hay una oración adicional.
a. In fact, the only trial that observed a beneficial effect on total mortality and cancer incidence
used nutritional doses of a combination of several vitamins and minerals and was performed
on a Chinese population with very low baseline micronutrient status because of poor life
conditions.
b. There was no significant difference of overall cancer incidence between the groups (267
cases in the intervention group vs 295 in the placebo group).
c. The efficiency of supplementation in reducing cancer incidence may be related to the ability
to correct antioxidant status with an adequate dose of antioxidant nutrients in individuals
with a suboptimal antioxidant status (as the men in our study).
d. These assessments also included physical exams, blood pressure checks, and various
screenings like fecal occult blood tests, Papanicolaou tests for women, and mammograms
for certain age groups.
 Universidad Nacional del Comahue
Facultad de Ciencias Médicas
Inglés

4. Elegir el título más apropiado

a. Estudio de los efectos de las deficiencias dietarias en la salud de hombres y mujeres de
mediana edad en Francia
b. Estudio sobre los efectos en la salud de las vitaminas y minerales antioxidantes
c. Factores de riesgo e incidencia de cáncer y enfermedades cardíacas en Francia
5. Análisis de aspectos lingüísticos.
a. Referentes: ¿a qué se refieren las siguientes palabras o frases en su contexto de uso?
i. Such (1)
ii. Their (1)
iii. This potential benefitial effect (3)
iv. These (3)
b. ¿Cuál de las siguientes describe mejor la función de la palabra "however" en la oración 3?
i. Destaca un contraste entre los resultados de los estudios observacionales y los
ensayos aleatorios.
ii. Introduce una nueva idea que apoya la afirmación anterior sobre la ingesta de
antioxidantes.
iii. Destaca la conclusión extraída de los datos epidemiológicos sobre vitaminas y
minerales antioxidantes.
iv. Indica la diferencia entre los estudios en los que se midió la ingesta de alimentos
ricos en antioxidantes y aquellos en los que se suministraron altas dosis de
suplementos.
c. Localizar las oraciones cuyas traducciones incompletas se ofrecen a continuación y luego
completarlas.
i. La suplementación ______________ efectiva sólo en los hombres porque
________________ y las concentraciones ____________ de
_____________________, especialmente el betacaroteno,
______________________________________ en las mujeres.
ii. ___________________ de vitamina C y betacaroteno en las mujeres
_______________________ a una mayor ingesta;
iii. El nivel ___________ de betacaroteno y vitamina C ______________ en los hombres
____________________.
d. Completar el siguiente cuadro con las palabras o frases resaltadas en negrita en el texto
Indica un hecho Indica un hecho Indica un hecho Indica una Indica una
en tiempo en tiempo en tiempo hipótesis en hipótesis en
presente pasado present perfect presente pasado