Christen Buchheim

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What can high-vitamin E foods do for you?Protect your skin from ultraviolet lightPrevent cell damage from free radicalsAllow your cells to communicate effectivelyHelp protect against prostate cancer and Alzheimer's diseaseWhat events can indicate a need for more high-vitamin E foods?

Digestive system problems, especially malabsorptionTingling or loss of sensation in the arms, hands, legs, or feetLiver or gallbladder problemsExcellent sources of vitamin E include: mustard greens, chard, sunflower seeds, and turnip greens. Very good sources include almonds and spinach.

For serving size for specific foods, see Nutrient Rating Chart below at the bottom of this page.

DescriptionFunctionDeficiency SymptomsToxicity SymptomsCooking, storage and processingFactors that affect functionDrug-nutrient interactionNutrient interactionHealth conditionsSupplementsFood SourcesPublic RecommendationsReferences

Description

What is vitamin E?

Even though its name makes it sound like a single substance, vitaminE is actually a family of fat-soluble vitamins that are activethroughout the body. Some members of the vitamin E family are calledtocopherols. These members include alpha tocopherol, beta tocopherol,gamma tocopherol, and delta tocopherol.

Other members of the vitamin E family are called tocotrienols.These members include alpha, beta, gamma, and delta tocotrienol. Asincreasing information has become available about these forms ofvitamin E, more and more of them are understood to have uniquefunctions.

How it Functions

What is the function of vitamin E?

Prevention of oxidative stress

Although humans must breathe oxygen to stay alive, oxygen is a riskysubstance inside the body because it can make molecules overlyreactive. When oxygen-containing molecules become too reactive, theycan start damaging the cell structures around them. In chemistry, thisimbalanced situation involving oxygen is called oxidative stress.

Vitamin E helps prevent oxidative stress by working togetherwith a group of nutrients that prevent oxygen molecules from becomingtoo reactive. This group of nutrients includes vitamin C, glutathione, selenium, and vitamin B3. Some researchers believe that vitamin E is the most important member of this oxidative stress-preventing group.

Supporting healthy skin

Vitamin E has sometimes been described as the "lightening rod" ofthe cell, allowing reactive molecules to strike the cell, likelightening, without causing damage. This "lightening rod" function ofvitamin E is particularly apparent in the case of the skin, sincevitamin E directly protects the skin from ultraviolet radiation (alsocalled UV light). In numerous research studies, vitamin E appliedtopically to the skin has been shown to prevent UV damage. When thediet contains vitamin E-rich foods, vitamin E can travel to the skincell membranes and exert this same protective effect.

Protection against Bladder Cancer

One of the benefits of making foods rich in vitamin E-nuts, seeds,spinach, mustard greens, peppers and olive oil-a part of your healthyway of eating is an up to 50% reduction in risk of developing bladdercancer, according to research presented at the annual meeting of theAmerican Association of Cancer Research, Orlando, FL, May 23, 2004.

Bladder cancer, which kills 12,500 Americans annually, is thefourth leading cancer killer among men, and is four times more commonin men than women. The study, which included 468 bladder cancerpatients and 534 cancer-free controls drawn from residents of Houston,TX, collected data using eating habits questionnaires. Those whosevitamin E intake was in the top 25% had half as much bladder cancer asthose in the lowest 25%.

Increasing vitamin E intake to the amount consumed by those inthe top group would not be difficult since the actually difference inthe amount of vitamin E-rich foods the two extremes consumed wassmall-the equivalent of a single daily serving of spinach or a handfulof almonds.

The research team looked at the two most common forms ofvitamin E, alpha- and gamma-tocopherol, and found that onlyalpha-tocopherol was associated with lower bladder cancer risk. Also,whether study participants got their vitamin E from food alone or fromvitamin pills, the reduction in risk was roughly the same. Those withthe highest intake of alpha-tocopherol from food had a 42% reduced riskof bladder cancer, and those with a vitamin E rich diet who also tookvitamin E supplements had a 44% reduced risk.

Vitamin E from Foods, but not Supplements Offers Protection against Prostate Cancer and Alzheimer's Disease

While the type of vitamin E usually used in supplements isalpha-tocopherol, research published in the December 2004 issue of the Proceedings of the National Academy of Sciencesindicates another form of vitamin E, gamma-tocopherol, but notalpha-tocopherol, inhibits prostate cancer cell proliferation, withoutaffecting healthy prostate cells.

Plus, the anti-cancer effect of gamma-tocopherol, when combinedwith other forms of vitamin E such as delta-tocopherol, appears to beadditive.

As noted above, Vitamin E is a generic term for a family of atleast eight structurally related molecules. When the first research wasconducted on vitamin E by the Shute brothers early in the 19th century,in rats, one fraction of vitamin E, alpha tocopherol, appeared morepotent since it was necessary for successful pregnancy and productionof offspring. For this reason, the Shutes named the vitamin"tocopherol," from the Greek word meaning "to give birth."

More recent research has revealed that, in humans, othervitamin E fractions may be even more beneficial. Gamma-tocopherol hasbeen found to exhibit anti-inflammatory effects, which has ledresearchers to think this fraction may be more cardioprotective thanthe alpha-tocopherol found in most supplements. Not only isgamma-tocopherol anti-inflammatory, but it is also highly attracted tothe nucleus in cells-the site where mutations in the genetic code canpromote the development of cancer.

When Dr. Jiang and his team investigated the anti-carcinogenicpotential of various forms of vitamin E, they found thatgamma-tocopherol, particularly in combination with other forms ofvitamin E such as delta-tocopherol, induced apoptosis (cell death) inandrogen-sensitive prostate cancer cells within 3 days of treatment.Alpha-tocopherol alone did not have this effect.

The gamma and delta E fractions appear to induce apoptosis byinterrupting the synthesis of sphingolipid, a fatty molecule in cellmembranes that acts as a signaling messenger to modulate events insidethe cell. In the cell membranes of human prostate cancer cells, theinterruption of sphingolipid's synthesis by gamma and delta tocopherolscauses the cancerous cells to self-destruct, while leaving healthycells unaffected. Both fractions, as well as alpha tocopherol, arenaturally present in foods rich in vitamin E, which include a number ofgreens (mustard greens, turnip greens, spinach, collard greens, andkale), sunflower seeds and almonds.

A high intake of vitamin E from food, but not from supplements(which usually contain just alpha-tocopherol) is also inverselyassociated with Alzheimer's disease. Rush University's Martha ClareMorris, Sc.D., lead nutrition researcher for CHAP, the Chicago Healthand Aging Project, found a 67% lower risk of Alzheimer's in subjectswith the highest intakes of vitamin E from food and concluded: "varioustocopherol forms rather than alpha-tocopherol alone may be important inthe vitamin E protective association with Alzheimer's disease."

Other roles for vitamin E

While most of the research on vitamin E has focused on its role inprevention of oxidative stress, a variety of new roles have recentlybeen suggested. Most of these new roles involve the transfer ofchemical information from one cell to another, or across differentstructures inside of a cell. This transfer of chemical information isreferred to as "cell signaling," and many researchers believe that cellsignaling cannot accurately take place without the help of vitamin E.

Deficiency Symptoms

What are deficiency symptoms for vitamin E?

Deficiency symptoms for vitamin E are difficult to pinpoint andcontroversial in the research literature. The area of broadestagreement involves malabsorption. In many research studies, low levelsof vitamin E are associated with digestive system problems wherenutrients are poorly absorbed from the digestive tract. These problemsinclude pancreatic disease, gallbladder disease, liver disease, andceliac disease.

A second area of focus for vitamin E deficiency symptoms iscalled peripheral neuropathy. This area focuses on nervous systemproblems in the arms, hands, legs, and feet. Pain, tingling, and lossof sensation in these extremities have been associated with vitamin Edeficiency. Although many healthcare practitioners report that skinproblems appear closely linked to vitamin E deficiency, there arelimited human research studies to support this view.

Toxicity Symptoms

What are toxicity symptoms for vitamin E?

When obtained from food sources alone, vitamin E has no documentedresearch of toxicity. Vitamin E supplements, when taken in very highdoses of 3000 IU or more, have been shown to have toxic effects. Theseeffects include intestinal cramps and diarrhea, fatigue, double vision,and muscle weakness. Below the 3000 IU level, the research on vitamin Etoxicity is inconsistent, but the majority of studies do notdemonstrate toxic effects.

An exception to the generally low risk of toxicity associated with vitamin E involves simultaneous vitamin Kdeficiency. For persons with vitamin K deficiency, high intake ofvitamin E can prolong bleeding time and interfere with clotting. In2000, the National Academy of Sciences set a Tolerable Upper IntakeLevel (UL) for vitamin E of 1,000mg (or 1,500 IU of vitamin E in theform of alpha-tocopherol). This daily limit applies to supplementalvitamin E only, and is intended to apply to all individuals age 19 andolder.

Impact of Cooking, Storage and Processing

How do cooking, storage, or processing affect vitamin E?

Exposure to air and factory processing can be particularly damagingto the vitamin E content of food. In wheat, for example, where most ofthe vitamin E is found in the germ layer, commercial processing removes50-90% of the food's vitamin E. In 60% extraction wheat flour - thekind that is used to make over 90% of all breads, baked goods, andpastas sold in the U.S., the alpha tocopherol content drops almost 90%,and the beta tocopherol content drops 43%. (Alpha and beta tocopherolare two forms of vitamin E.)

To help protect their vitamin E content, vegetables oils like olive oil, sunflower seed oil, and peanut oil should be kept in tightly capped containers to avoid unnecessary exposure to air.

Factors that Affect Function

What factors might contribute to a deficiency of vitamin E?

Since vitamin E is a fat-soluble vitamin, poor absorption of fat inthe digestive tract can contribute to vitamin E deficiency. Somespecific health conditions that can cause fat malabsorption includepancreatic disease, celiac disease, and gallbladder disease. Prematurebirth has also been shown to increase risk of vitamin E deficiency ininfants.

Drug-Nutrient Interactions

What medications affect vitamin E?

Use of the following medications can reduce the body's supply ofvitamin E: Anticonvulsant drugs (like Dilantin ™;) andcholesterol-lowering drugs (like probucol, cholestyramine, clofibrate,colestipol, and gemfibrozil) can significantly reduce the body's supplyof vitamin E.

Long-term, regular use of mineral oil (for example, asnon-prescription laxative) can also compromise the body's supply ofvitamin E.

Nutrient Interactions

How do other nutrients interact with vitamin E?

The recycling of vitamin E in the body is intricately connected to four other nutrients: vitamin C, glutathione, selenium, and vitamin B3.

Vitamin C is required to keep vitamin E in its metabolicallyactive form; glutathione (a very small protein molecule called atripeptide and consisting of three amino acid building blocks) isrequired to keep vitamin C in its active form; and selenium (amicromineral) and vitamin B3 (in a special form called NADPH) arerequired to keep glutathione in its active form.

The fact that vitamin E is so heavily dependent on vitamin C,vitamin B3, selenium, and glutathione means that a diet high in vitaminE cannot have its optimal effect unless it is also rich in foods thatprovide these other nutrients.

At moderately high levels of 1,000 milligrams or more, vitamin E can interfere with the bodily activities of vitamin K.The potential injury to vitamin K metabolism was largely the reason whythe National Academy of Sciences, in the year 2000, set a TolerableUpper Limit (UL) of 1,000 milligrams per day for vitamin E.

Health Conditions

What health conditions require special emphasis on vitamin E?

Vitamin E may play a role in the prevention and/or treatment of the following health conditions:

AcneAlzheimer's diseaseAngina pectorisAsthmaAtherosclerosisBreast cancerDiabetesEpilepsyFibrocystic breast diseaseGoutGraves' diseaseInfertility (male)Inflammatory bowel diseaseMacular degenerationMenopauseMigraineMultiple sclerosisOral cancersOsteoarthritisParkinson's diseasePeptic ulcersPeripheral vascular diseasePMSPregnancy-induced hypetensionPsoriasisRheumatoid arthritisSenile cataractsSquamous cancerStrokeTardive dyskinesiaVaginitisForm in Dietary Supplements

What forms of vitamin E are found in dietary supplements?

The vast majority of vitamin E supplements contain a single form ofthe vitamin, alpha-tocopherol. More specifically, most supplementscontain a natural form of alpha-tocopherol, called d-alpha tocopherol(or d-alpha tocopheryl acetate). Practitioners often prefer this formof the vitamin over a synthetic version called l-alpha tocopherol.

However, because vitamin E is actually a family of vitaminsinvolving many tocopherols and many tocotrienols, some practitionersrecommend vitamin E supplements containing not only d-alpha tocopherol,but other tocopherol and tocotrienol forms of vitamin E.

Supplements containing this wide variety of vitamin E forms aretypically referred to as "mixed tocopherol" or "mixed tocotrienol"supplements. Human research studies comparing the effects of differenttypes of vitamin E supplements are too limited to allow definiteconclusions, but recent research suggests dietary vitamin E ispreferable to supplements containing only one fraction of thisnutrient.

Food Sources

What foods provide vitamin E?

Excellent sources of vitamin E include mustard greens, turnip greens, chard, and sunflower seeds.

Very good sources of vitamin E include almonds and spinach.

Good sources of vitamin E include collard greens, parsley, kale, papaya, olives, bell pepper, brussels sprouts, kiwifruit, tomato, blueberries, and broccoli.