A tomato pill could "beat heart disease", "protect against strokes" and "save thousands of lives" according to various newspapers this week. We've looked at the evidence behind the claims.
What's all the fuss about?The excitement centres on lycopene, the bright red chemical that gives colour to tomatoes, watermelons, and pink grapefruit. Lycopene belongs to a group of chemicals called antioxidants. Other antioxidants include vitamin C, vitamin E, and beta-carotene.
There's been lots of attention paid to antioxidants because of their potential health benefits. The healthiest diets seem to contain large amounts of antioxidants. For example, a Mediterranean-style diet includes lots of grains, fruits, nuts, and vegetables, while also being low in red meat and saturated fats. There's growing evidence that a Mediterranean-style diet is one of the healthiest ways to eat.
Unfortunately, when researchers have tried to replicate the benefits of a healthy diet in pill form, it hasn't always been successful. The best research so far on antioxidant supplements found no evidence that they could help people live longer.
What's in the new pill?The problem with lycopene is that, in its natural form, it's difficult for the body to absorb. Tomatoes seem to provide more lycopene when they're cooked, and about 85 percent of our intake comes from processed foods, such as tomato juice, ketchup, pizza toppings, and tomato soup. In studies, researchers sometimes use tomato purée as a good source of lycopene.
To create a lycopene supplement in pill form, the food multinational Nestlé developed a combination of lycopene and milk protein. This creates a form of lycopene that's easily absorbed. Nestlé have licensed the product to a company called Cambridge Theranostics, which is marketing the pill under the brand name Ateronon.
Does it work?We asked the manufacturers of Ateronon what evidence they had for their product. They provided a study from 2002 which looked at 33 people. It found that a combination of lycopene and milk protein was absorbed by the body just as well as tomato purée.
The manufacturers also sent a description of two further studies, which looked at 10 and 12 people. Neither of these studies compared lycopene supplements with a placebo, which is an important way of making sure research doesn't give biased results. The two studies found that a lycopene and milk protein supplement reduced a chemical process in the body called oxidation. The theory is that oxidation makes cholesterol more harmful.
It's important to remember that, on its own, high cholesterol isn't an illness. The problem occurs when it builds up in your arteries and increases your risk of heart disease or a stroke. There isn't much point taking a drug or supplement to lower your cholesterol unless it also cuts your risk of these illnesses.
The best treatments for high cholesterol, such as drugs called statins, don't just reduce cholesterol levels. Long-term trials looking at tens of thousands of people have proved that these drugs prevent heart attacks and strokes, and help people to live longer. This kind of research simply doesn't exist for lycopene supplements.
What should I do now?It's always a good idea to talk to your doctor before taking supplements. People often assume that vitamins and similar products are safe, because they tend to come from "natural" sources. That's not always the case. In 1996, a large trial of beta-carotene and vitamin A was stopped early, because the supplements increased the risk of lung cancer for smokers and other vulnerable groups.
Most heart specialists would advise people to wait for any new drug or modified "natural" product to be clinically proven to offer benefits before taking it. People with heart disease or those at high risk are advised to take medications prescribed by their doctor, which have been proven to work. Following a Mediterranean-style diet with plenty of fruit and vegetables and little saturated fat has also been shown to lower cholesterol, and reduce heart attacks and strokes in those at risk.
Where does the story come from?Ateronon was launched at the British Cardiovascular Society Annual Conference and Exhibition (ACE) 2009, 1-3 June, EcXeL, London
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