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Vitamin E
=========

The term vitamin E describes a family of 8 antioxidants, 4 tocopherols
and 4 tocotrienols. alpha-tocopherol (a-tocopherol) is the only form
of vitamin E that is actively maintained in the human body and is
therefore, the form of vitamin E found in the largest quantities in
the blood and tissue.

Why do we need vitamin E?

Vitamin E, a fat-soluble vitamin, protects vitamin A and essential
fatty acids from oxidation in the body cells and prevents breakdown of
body tissues.

vitamin e

Do we get enough vitamin E?

According to recent surveys of the U.S. Department of Agriculture
(USDA), the intake of vitamin E by women 19 to 50 years of age
averaged less than 90% of the Recommended Daily Allowance (RDA). Men
of the same age had intakes close to 100% of the RDA. We need to
remind ourselves that the RDA is an absolute minimum requirement,
below which your body is actually in deficiency.

Vitamin E can be lost from foods during preparation, cooking, or
storage.

Beyond taking enough vitamin E to prevent an actual deficiency, is
there any scientific evidence which shows that taking vitamin E in
higher levels can promote good health and prevent and treat disease?
Let's examine this question.

Vitamin E and heart disease

Support for the role of vitamin E in heart disease prevention has come
from observational studies, particularly 2 cohort studies which were
published in 1993. In the 1st study, the Nurses' Health Study, the
researchers concluded that among 83,234 middle-aged women who
participated in the study, there was a 40% reduced risk of coronary
artery disease for those who took vitamin E supplements compared to
those who did not (New England Journal of Medicine 1993;328: 1444-9).
The 2nd study, the Health Professionals Follow-up Study, involved over
39,000 males and showed evidence of a significant association between
a high intake of vitamin E from supplements and a lower risk of heart
disease (New England Journal of Medicine 1993; 328:1450-1456).

Researchers are fairly certain that oxidative modification of
LDL-cholesterol ("bad" cholesterol) promotes blockages in coronary
arteries which may lead to atherosclerosis and heart attacks. Vitamin
E may help prevent or delay coronary heart disease by limiting the
oxidation of LDL-cholesterol. A 1994 review of 5,133 Finnish men and
women aged 30 - 69 suggested that increased dietary intake of vitamin
E was associated with decreased mortality from heart disease (1).

vitamin e and ldl cholesterol

The results of at least 5 large observational studies suggest that
increased vitamin E consumption is associated with a decreased risk of
myocardial infarction (heart attack) in both women and men. Each study
was a prospective study that measured vitamin E consumption in
presumably healthy people and followed them for several years to
determine how many of them were diagnosed with, or died as a result of
heart disease.

1. other large studies (1,2) found a significant reduction in the risk of heart disease only in those men and women who consumed alpha-tocopherol supplements of at least 100 IU daily, with the greatest benefit observed at an intake of 800 IU daily (3).

While 100 IU or more of supplemental vitamin E per day has been shown
to reduce the risk of heart attacks in healthy individuals, those with
pre-existing coronary artery disease often take 800 to 1200 IU/day
based on the pioneering work of the Shute brothers in the mid 1940s.

Vitamin E and cancer

The evidence is not as clear-cut when it comes to cancer and vitamin
E. Many types of cancer are believed to result from oxidative damage
to DNA caused by free radicals. Antioxidants - such as vitamin E -
help protect against the damaging effects of free radicals, which may
contribute to the development of chronic diseases such as cancer.
Vitamin E also may block the formation of nitrosamines, which are
carcinogens formed in the stomach from nitrites consumed in the diet.
Vitamin E may also protect against the development of cancers by
enhancing immune function (6). However, human trials and surveys which
tried to associate vitamin E with incidence of cancer have generally
been inconclusive.

The Nurses Health Study, which we referred to earlier, studied 83,234
women at baseline and sought to assess the incidence of breast cancer
during a 14-year follow-up. The study showed that pre-menopausal women
with a family history of breast cancer who consumed the highest
quantity of vitamin E enjoyed a 43% reduction in breast cancer
incidence compared to only a 16% risk reduction for women without a
family history of breast cancer.(8)

breast cancer

Based on this study, vitamin E appears to protect against
genetic-predisposed breast cancer better than environmentally-induced
breast cancer.

However other studies which have reviewed the effects of standard
vitamin E products (alpha-tocopherol acetate) taken by themselves have
failed to decisively show a protective benefit for cancer.(7,9) It is
possible that other forms of vitamin E found in food (such as gamma
tocopherol and tocotrienols) may be responsible for providing the
protective effect against breast cancer shown in some surveys which
evaluated total vitamin E intake. This is why I recommend that, when
selecting a vitamin E supplement, you choose one which contains other
tocopherols and tocotrienols, not just alpha-tocopherol.

In 2002, a researcher at Wake Forest University School of Medicine
compiled and analyzed the large volume of published data about vitamin
E and breast cancer and her comprehensive work was published in the
Journal of Nutritional Biochemistry.(4)

Taken together, the results of the studies presented indicate that
certain vitamin E compounds found in food confer a significant
protective effect, but that commercial alpha-tocopherol acetate
supplements fail to reduce the incidence of breast cancer for most
women. The data indicates that some other vitamin E compounds in food
may account for the dramatic reductions in breast cancer incidence
when dietary intake levels of vitamin E are measured.

Most studies have indicated that the form of vitamin E used in most
commercial preparations (alpha-tocopherol acetate) has not been shown
to protect against breast cancer.

It is the tocotrienolsicon, one of the 8 members of the vitamin E
family, however, which have demonstrated the most significant
potential to not only reduce breast cancer incidence, but also to
inhibit the propagation of existing breast cancer cells.

Tocotrienolsicon have been shown to inhibit the growth of estrogen
receptor positive breast cancer cells by as much as 50% in
culture.(10,12)

The objective of any cancer therapy is to induce the cancer cells to
differentiate in a way which promotes programmed cell death
(apoptosis). Several studies indicate that tocotrienols induce breast
cancer cell apoptosis.13,14

It therefore appears that the individual tocopherols and tocotrienols
have different biological activities as they relate to their effects
on health, and it is my recommendation that, when choosing a vitamin E
product, you select one which also contains other tocopherols and
tocotrienols, not just alpha-tocopherol. I recommend the book " The
Vitamin E Factor " for a better understanding of the importance of
tocotrienols and the other tocopherols.

It is especially important to take the tocotrienols along with some
form of oil or fat-containing food. When tocotrienols are taken on an
empty stomach, absorption is reduced by an average of 50%.

So when taking tocopherol and/or tocotrienol vitamin E supplements, I
would recommend that you take them with a meal or with fatty acid
capsules like fish oil (EPA-DHA).

Prostate cancer: some evidence associates higher intake of vitamin E
with a decreased incidence of prostate cancer (17), although the
evidence is not overwhelming.

Vitamin E and the risk of Alzheimer's disease.

Some evidence on the role of vitamin E in reducing the risk of
Alzheimer's was reported in 3 recent studies. The first study,
conducted at the Rush Institute for Healthy Aging of the
Rush-Presbyterian-St Luke's Medical Center found that an increased
vitamin E intake from foods was associated with a decreased risk of
developing Alzheimer's disease.

Alzheimers disease

The second study, conducted in the Netherlands, showed that vitamin E
from food, but not other antioxidants, may be associated with a
decreased risk. The third study, which was conducted in Italy,
evaluated a high dose of 2,000 IU and found a substantial protective
effect. It appears that the effect of vitamin E from supplements is
detectable only with high doses.

Vitamin E and cataracts

Cataracts are growths on the lens of the eye which cloud the vision.
They increase the risk of blindness and disability in aging adults.
Antioxidants are being studied to determine whether they can help
delay or prevent cataract growth. Observational studies have found
that lens clarity, which is used to diagnose cataracts, is better in
regular users of vitamin E supplements and in people with higher blood
levels of vitamin E (16).

Vitamin E from food or supplements?

Our bodies do not manufacture vitamin E. We have to get our vitamin E
either from our food or from supplements. Scientific studies also tell
us that we need to take much higher levels of vitamin E than the
Recommended Daily Allowance (RDA) to get its full benefits. Because
vitamin E is fat-soluble, it is generally found in fat-rich foods. Can
we get enough vitamin E from our food without ingesting thousands of
fat calories? Which foods should we choose?

You can get vitamin E from 4 main groups:

Vegetable oils. Corn, canola, sunflower, sesame, cottonseed,
 peanut, rice bran, and palm oils.

Nuts - almonds, walnuts, peanuts, pistachios and hazelnuts.

Oil seeds, legumes and grains. Corn, lentils, wheat, rice,
 northern beans, chickpeas, Barley Grass. and oats.

Wheat germ oil icon Extracted from the germ of wheat, Wheat germ
 oil has been used since the '20s as a vitamin E supplement. It
 offers a good combination of tocopherols plus tocotrienols.

But many scientists believe it is difficult for an individual to
consume more than 15 mg/day of alpha-tocopherol from food alone,
without also increasing fat intake above recommended levels.

If, like me, you believe that you need much more vitamin E than the
RDA to fend off diseases, delay the onset of aging and even possibly
slow down the progress of diseases like Alzheimer's, then it is
extremely difficult to get these amounts from food alone.

Food is a great way to get natural vitamin E, the whole family of
compounds. You can easily meet the RDA if you include nuts, legumes
and grains in your diet and use modest amounts of vegetable oils.

If you don't want to take vitamin E supplements then consider wheat
germ and wheat germ oil icon. These are great sources of natural
vitamin E. Because they are rich in vitamin E you can raise your
intake without taking in too much fat.

wheat germ

If on the other hand, you wish to take vitamin E supplements, then the
question becomes: how do I pick the right vitamin E product?

1. different compounds, 4 tocopherols and 4 tocotrienols make up the vitamin E family. Our food contains all eight compounds. Not so for most vitamin E supplements. Most contain only alpha-tocopherol. The best vitamin E products contain all 8 members of the vitamin E family - tocopherols plus tocotrienols - in their NATURAL form.

Why is the natural form of vitamin E better than the synthetic form?

In one word, the difference is: availability. Natural vitamin E has
roughly twice the availability of synthetic vitamin E.

Most vitamins are produced as synthetic. Most of the vitamins used to
make nutritional supplements (tablets, capsules, etc.) are synthetic.
Same thing for the vitamins used to fortify our cereals, milk, and
other foods. Is there a problem with that? For most vitamins NO. The
synthetic molecules behave and look exactly the same as the ones found
in our food.

Not so for alpha-tocopherol. There is a difference in the molecule, in
its potency and in the way it behaves in the body.

Here is the difference: The d-alpha-tocopherol in our food, the
natural form, is a single entity, in other words all the molecules are
identical. By contrast, the synthetic dl-alpha-tocopherol is a mixture
of 8 different molecular entities, known in the chemical jargon as
"stereoisomers". Of these 8, only 1 is identical to the natural form.
The other 7 do not exist in nature.

Synthetic dl-alpha-tocopherol is not harmful. But its value to your
body is only 1/2 of the natural.

Read the label - it's the only way to tell if you are getting natural
or synthetic. Natural will say "d-alpha-tocopherol", synthetic will
say "dl-alpha-tocopherol".

What is the health risk of too much vitamin E?

The health risk of too much vitamin E is low (18). A recent review of
the safety of vitamin E in the elderly concluded that taking vitamin E
supplements for up to 4 months at doses of 530 mg or 800 IU (35 times
the current RDA) had no negative side-effect on general health, body
weight, levels of body proteins, lipid levels, liver or kidney
function, thyroid hormones, amount or kinds of blood cells, and
bleeding time (19).

It should however be noted that ingestion of total vitamin E products
in excess of 1200 IU daily may interfere with absorption and
metabolism of vitamins A and K. But one can get benefits with much
lower levels of vitamin E.

The Institute of Medicine has set an upper tolerable intake level for
vitamin E at 1,000 mg (1,500 IU)/day for any form of supplementary
alpha-tocopherol because the nutrient can act as an anti-coagulant and
increase the risk of bleeding problems. Upper tolerable intake levels
"represent the maximum intake of a nutrient that is likely to pose no
risk of adverse health effects in almost all individuals in the
general population" (5).

One important caveat is for people who are on "blood thinners".
Individuals on anti-coagulant therapy or individuals who are vitamin K
deficient should not take alpha-tocopherol supplements without close
medical supervision because of the increased risk of hemorrhage.

I spend a lot of time researching the internet for the best prices on
supplements, and in my opinion the best prices for high-quality
vitamin E can be found hereicon. I also like Puritan Pride's special
"Buy 1 Get 2 FREE" promotions on vitamin E.

Vitamin E requires the presence of fats and bile in the gut to be
absorbed. The degree to which vitamin E is absorbed by the body is
dependent on the total absorption of dietary fat.

References

(1). Rimm EB, Stampfer MJ, Ascherio A, Giovannucci E, Colditz GA,
Willett WC. Vitamin E consumption and the risk of coronary heart
disease in men. N Engl J Med. 1993;328(20):1450-1456. (PubMed)

(2). Stampfer MJ, Hennekens CH, Manson JE, Colditz GA, Rosner B,
Willett WC. Vitamin E consumption and the risk of coronary disease in
women. N Engl J Med. 1993;328(20):1444-1449. (PubMed)

(3). Willett W. Personal Communication, 2000.

(4) Schwenke D.C. Does lack of tocopherols and tocotriemols put women
at increased risk of breast cancer? Journal of Nutritional
Biochemistry 13 (2002) 2-20.

(5). Institute of Medicine, Food and Nutrition board. Dietary
Reference Intakes: Vitamin C, Vitamin E, Selenium, and Carotenoids.
National Academy Press, Washington, DC, 2000.

(6). Weitberg AB and Corvese D. Effect of vitamin E and beta-carotene
on DNA strand breakage induced by tobacco-specific nitrosamines and
stimulated human phagocytes. J Exp Clin Cancer Res 1997;16:11-4.

(7). Freudenheim J.L., et al. Premenopausal breast cancer risk and
intake of vegetables, fruits and related nutrients. J. Natl. Cancer
Inst. 88 (1996) 340-348.

(8). Zhong S., et al. Dietary crotenoids and vitamins A, C, and E and
risk of breast cancer. J. Natl. Cancer Inst. 91 (1999) 547-556.

(9). Shibata A., et al. Intake of vegetables, fruits, beta-carotene,
vitamin C and vitamin supplements and cancer incidence among the
elderly-a prospective study. Br. J. Cancer. 66 (1992) 673-679.

(10). Nesaretnam, K. et al. Tocotrienols inhibit the growth of human
breast cancer cells irrespective of estrogen receptor status. Lipids
33 (1998) 461-469.

(11). Lonn EM and Yusuf S. Is there a role for antioxidant vitamins in
the prevention of cardiovascular diseases? An update on
epidemiological and clinical trials data. Can J Cardiol
1997;13:957-65.

(12). Nesaretnam K., et al. Effect of tocotrienols on the growth of a
human breast cancer cell line in culture. Lipids 30 (1995) 1139-1143.

(13). Sigournas G., et al. dl-alpha-tocopherol induces apoptosis in
erythroleukemia, prostate, and breast cancer cells. Nutr. Cancer 28
(1997) 30-35.

(14). Yu W, et al. Induction of apoptosis in human breast cancer cells
by tocopherols and tocotrienols. Nutr. Cancer 33 (1999) 26-32.

(15). McIntyre B.S., et al. Antiproliferative and apoptotic effects of
tocopherols and tocotrienols on preneoplastic and neoplastic mouse
mammary epithelial cells. Exp. Biol. Med. 224 (2000) 292-301.

(16). Leske MC, Chylack LT Jr., He Q, Wu SY, Schoenfeld E, Friend J,
Wolfe J. Antioxidant vitamins and nuclear opacities: The longitudinal
study of cataract. Ophthalmology 1998;105:831-6.

(17). Chan JM, Stampfer MJ, Giovannucci EL. What causes prostate
cancer? A brief summary of the epidemiology. Semin Cancer Biol
1998;8:263-73.

(18). Kappus H and Diplock AT. Tolerance and safety of vitamin E: A
toxicological position report. Free Radic Biol Med 1992;13:55-74.

(19). Meydani SN, Meydani M, Blumberg JB, Leka LS, Pedrosa M, Diamond
R, Schaefer EJ. Assessment of the safety of supplementation with
different amounts of vitamin E in healthy older adults. Am J Clin Nutr
1998;68:311-8.

Disclaimer: Throughout this website, statements are made pertaining to
the properties and/or functions of food and/or nutritional products.
These statements have not been evaluated by the Food and Drug
Administration and these materials and products are not intended to
diagnose, treat, cure or prevent any disease.

© 2002 Healing Daily

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