Is Your Life Being Shortened by a Lack of Vitamin E?
Dr Arya Sharma, Professor of Medicine and Chair in Obesity Research and Management at the University of Alberta states that body mass index (BMI) is a poor indicator of health. Nevertheless, he is concerned by the rapid increase in the prevalence of severe obesity (BMI of 40-59.9 vs normal weight BMI 18.5-24.9) because of its association with a loss of 6.5 to 13.7 years of life.
Being overweight and obesity increases the risk of non-alcoholic fatty liver disease (NAFLD). 75% of those who are obese or have diabetes have NAFLD. Possibly 90% of those who are severely obese. There is no widely accepted pharmaceutical treatment for NAFLD. The metabolic etiology of NAFLD is unknown but oxidative stress is widely accepted as a contributing factor.
Vitamin E is an antioxidant. In a meta-analysis of vitamin E supplementation trials in NAFLD patients, Ji and colleagues report vitamin E supplementation optimizes liver enzyme levels. Blood vitamin E concentrations are not reported. It isn’t known if low levels of serum and tissue vitamin E concentrations may contribute to the disease.
It is known that 60% of Americans are not consuming the estimated average requirement (EAR) for vitamin E. Translation: almost 100% are not consuming recommended dietary allowance (RDA) for vitamin E (15 mg/d for everyone over 14y of age). Children with NAFLD have a diet that is insufficient in vitamin E which may contribute to the pathophysiology (Vos et al, 2012).
So what is the takehome message? Vitamin E intakes are significantly less than recommended. The prevalence of severe obesity and NAFLD are increasing. Vitamin E supplementation to patients with NAFLD seems beneficial.
It would be helpful to know serum vitamin E concentrations in healthy individuals, those at risk of NAFLD, and those with NAFLD. Based on a nationally representative NHANES data, 62.5% of American adults (> 20y) have serum α-tocopherol concentrations below 30 µmol/L - the level at which risk of a cardiovascular event was lowest in the Alpha-Tocopherol Beta-Carotene study. Among Americans who did not self-report using dietary supplements, >80% were below the 30 µmol/L cutoff. Vitamin E status differed by age. Amongst non-supplement users, the prevalence of serum α-tocopherol below 30 µmol/L among 20-30y, 31-50y and 51+ y was 92.7%, 80.8% and 71.2%, respectively.
Americans are not consuming enough vitamin E. Vitamin E is a nutrient of concern.
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