Vitamin E

Vitamin E
Drug class

The α-tocopherol form of vitamin E
Use Vitamin E deficiency, antioxidant
ATC code A11H
MeSH D014810
AHFS/Drugs.com MedFacts Natural Products
Biological target reactive oxygen species

Vitamin E refers to a group of eight fat-soluble compounds that include both tocopherols and tocotrienols.[1] There are many different forms of vitamin E, of which γ-tocopherol is the most common in the North American diet.[2] γ-Tocopherol can be found in corn oil, soybean oil, margarine and dressings.[3][4] α-Tocopherol, the most biologically active form of vitamin E, is the second most common form of vitamin E in the North American diet. This variant of vitamin E can be found most abundantly in wheat germ oil, sunflower, and safflower oils.[4][5] It is a fat-soluble antioxidant that stops the production of reactive oxygen species formed when fat undergoes oxidation.[6][7][8]

Contents

Health effects

While it was initially hoped that vitamin E supplementation would have a positive effect on health, research has not supported these conclusions.[9] Vitamin E does not decrease mortality in adults, even at large doses,[10] and may slightly increase it.[11] It does not improve blood sugar control in an unselected group of people with diabetes mellitus[10] or decrease the risk of stroke.[12] Daily supplementation of vitamin E does not decrease the risk of prostate cancer and may increase it.[13] Studies on its role in age related macular degeneration are ongoing as even though it is of a combination of dietary antioxidants used to treat the condition in may increase the risk.[14]

Deficiency

Vitamin E deficiency can cause:

Functions

Vitamin E has many biological functions. The antioxidant function is considered to be the most important function of vitamin E and is the one it is best known for.[19] As it is fat-soluble, it is incorporated into cell membranes, which protects them from oxidative damage. However, there are other functions that have also been recognized to be of importance. α-Tocopherol has a regulatory effect on enzymatic activities. For instance, protein kinase C (PKC), which plays a role in smooth muscle growth, can be inhibited by α-tocopherol. α-Tocopherol has a stimulatory effect on the dephosphorylation enzyme, protein phosphatase 2A, which in turn, cleaves phosphate groups from PKC leading to its deactivation, bringing the smooth muscle growth to a halt.[20] Vitamin E also has an effect on gene expression. Macrophages rich in cholesterol are found in the atherogenetic tissue. Scavenger receptor CD36 is a class B scavenger receptor found to be up-regulated by oxidized low density lipoprotein (LDL) and binds it.[21] Treatment with alpha tocopherol was found to down regulate the CD36 scavenger receptor gene expression as well as the scavenger receptor class A (SR-A).[21] In addition to the effect it has been shown to have on SRA and CD36, α-tocopherol also has an effect on expression of the connective tissue growth factor (CTGF).[22][23] CTGF gene, when expressed, is responsible for the repair of the wounds and regeneration of the extracellular tissue that is lost or damaged during atherosclerosis.[23] Moreover, vitamin E also plays a role in neurological functions,[24] and inhibition of platelet aggregation.[25][26][27] It has even been suggested that the most important function of vitamin E is as a signaling molecule, and that it has no significant role in antioxidant metabolism.[28][29]

So far, most human supplementation studies about vitamin E have used only alpha-tocopherol. This can affect levels of other forms of vitamin E, e.g. reducing serum gamma- and delta-tocopherol concentrations. Moreover, a 2007 clinical study involving alpha-tocopherol concluded that supplementation did not reduce the risk of major cardiovascular events in middle aged and older men.[30]

Dietary sources

mg/(100 g)
[note 1]
Some foods with vitamin E content[31]
low high
150 Wheat germ oil
41 Sunflower oil
34 Safflower oil
15 26 Nuts and nut oils, like almonds and hazelnuts[note 2]
15 Palm oil [32]
1.5 3.4 High-value green, leafy vegetables: spinach, turnip,
beet, collard, and dandelion greens[note 3]
2.1 Avocados
1.1 1.5 Asparagus[note 4]
1.5 Kiwifruit (green)
0.78 1.5 Broccoli[note 5]
0.8 1 Pumpkin[note 6]
0.26 0.94 Sweet potato[note 7][note 8]
0.9 Mangoes
0.54 0.56 Tomatoes[note 9]
0.36 0.44 Rockfish[note 10]
0.3 Papayas
0.13 0.22 Low-value green, leafy vegetables: lettuce[note 11]

Recommended daily intake

The Food and Nutrition Board at the Institute of Medicine report the following dietary reference intakes for vitamin E:[31][33]

mg/day Age
Infants
4 0 to 6 months
5 7 to 12 months
Children
6 1 to 3 years
7 4 to 8 years
11 9 to 13 years
Adolescents and Adults
15 14 and older

One IU of vitamin E is defined as equivalent to either: 0.67 mg of the natural form, RRR-alpha-tocopherol, also known as d-alpha-tocopherol; or 0.45 mg of the synthetic form, all-rac-alpha-tocopherol, also known as dl-alpha-tocopherol.[31]

History

The first use for vitamin E as a therapeutic agent was conducted in 1938 by Widenbauer. Widenbauer used wheat germ oil supplement on 17 premature new born infants suffering from growth failure. Eleven out of the original 17 patients recovered and were able to resume normal growth rates.[19] Later on, in 1948, while conducting experiments on alloxan effects on rats, Gyorge and Rose noted that the rats receiving tocopherol supplements suffered from less hemolysis than those that did not receive tocopherol.[34] In 1949, Gerloczy administered all-rac-α-tocopheryl acetate to prevent and cure edema.[35][36] Methods of administration used were both oral, that showed positive response, and intramuscular, which did not show a response.[19] This early investigative work on the benefits of vitamin E supplementation was the gateway to curing the vitamin E deficiency caused hemolytic anemia described during the 1960s. Since then, supplementation of infant formulas with vitamin E has eradicated this vitamin’s deficiency as a cause for hemolytic anemia.[19]

Forms

The eight forms of vitamin E are divided into two groups; four are tocopherols and four are tocotrienols. They are identified by prefixes alpha-, beta-, gamma-, and delta-. Natural tocopherols occur in the the RRR-configuration only. The synthetic form contains eight different stereoisomers and is called all-rac-α-tocopherol.[37]

α-Tocopherol

α-Tocopherol is an important lipid-soluble antioxidant. It performs its functions as antioxidant in what is known by the glutathione peroxidase pathway[38] and it protects cell membranes from oxidation by reacting with lipid radicals produced in the lipid peroxidation chain reaction.[15][7] This would remove the free radical intermediates and prevent the oxidation reaction from continuing. The oxidized α-tocopheroxyl radicals produced in this process may be recycled back to the active reduced form through reduction by other antioxidants, such as ascorbate, retinol or ubiquinol.[39] However, the importance of the antioxidant properties of this molecule at the concentrations present in the body are not clear and it is possible that the reason why vitamin E is required in the diet is unrelated to its ability to act as an antioxidant.[40] Other forms of vitamin E have their own unique properties; for example, gamma-tocopherol is a nucleophile that can react with electrophilic mutagens.[41]

Tocotrienols

Compared with tocopherols, tocotrienols are sparsely studied.[42][43][44] Less than 1% of PubMed papers on vitamin E relate to tocotrienols.[45] Current research direction is starting to give more prominence to the tocotrienols, the lesser known but more potent antioxidants in the vitamin E family. Some studies have suggested that tocotrienols have specialized roles in protecting neurons from damage[45] and cholesterol reduction[46] by inhibiting the activity of HMG-CoA reductase; delta-tocotrienol blocks processing of sterol regulatory element‐binding proteins (SREBPs).

Oral consumption of tocotrienols is also thought to protect against stroke-associated brain damage in vivo.[47] Until further research has been carried out on the other forms of vitamin E, conclusions relating to the other forms of vitamin E, based on trials studying only the efficacy of alpha-tocopherol, may be premature.[48]

Notes

  1. ^ "USDA Nutrient Data Laboratory". http://www.nal.usda.gov/fnic/foodcomp/search/.  In notes 2-11, USDA NDL Release 24 numbers are given as mg/(100 g). Low and high values vary some by raw versus cooked and by variety.
  2. ^ 26 almonds, 15 hazelnuts.
  3. ^ Spinach (2.0 raw, 2.1 cooked), turnip (2.9 raw, 1.9 cooked), beet (1.5 raw, 1.8 cooked), collard (2.3 raw, 0.88 cooked), and dandelion greens (3.4 raw, 2.4 cooked)
  4. ^ 1.1 raw, 1.5 cooked.
  5. ^ 0.78 raw, 1.5 cooked.
  6. ^ 1. raw, 0.8 cooked.
  7. ^ 0.26 raw, 0.94 boiled.
  8. ^ 0.94 mg/(100 g) corresponds to 1.6 kg of boiled sweet potatoes per day of the recommended intake for adults. The desired amount of vitamin E ÷ food's E value = amount of food. Thus, (15 (mg/day))÷((0.94 mg)/(100 g)) = (15 (mg/day))*((100 g)/(0.94 mg)) = (15*100 g)/(0.94 day) ≈ 1596 g/day ≈ 1.6 kg/day.
  9. ^ 0.54 raw, 0.56 cooked.
  10. ^ 0.36 raw, 0.44 cooked.
  11. ^ Lettuce (0.18 iceburg, 0.22 green leaf, 0.13 romaine, 0.15 red leaf, 0.18 butterhead).

References

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Further reading

External links