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Providing perspectives on recent research into vitamins and nutritionals


Antioxidant Status Affects Bone Health and Muscle Strength

By Michael McBurney

Did you know that low serum vitamin E concentrations could lead to bone loss and muscle wasting?  Probably not but new data from the Swedish Mammography Cohort (SMC) and the Uppsala Longitudinal Study of Adult Men (ULSAM) finds that low serum concentrations of α-tocopherol are associated with an increased risk of fracture in elderly men and women.

Swedes, like many others, do not consume recommended amounts of vitamin E.  Because  an increase in oxidative stress with aging leads to age-related bone loss and muscle wasting (sarcopenia), inadequate vitamin E status is a health concern. During a 19y follow-up of 14,738 men and women, Michaelsson and colleagues report higher incidence of first fracture rate in women (Hazard ratio (HR) = 1.86) and men (HR = 3.33) with low vitamin E intake. Vitamin E supplementation was associated with a lower risk of fracture. The average serum α-tocopherol level was 11.6 mg/L (27 µmol/L).

Serum α-tocopherol levels have previously been correlated with physical performance in people ≥ 65y (Cesari et al, 2010). This relationship was observed in people with vitamin E concentrations averaging  30.0 µmol/L. To give perspective, among US adults ≥ 20y, 50% have serum α-tocopherol levels < 25.9 µmol/L. The lowest levels (on average) are found in African Americans (Ford et al, 2006). Between 1988-1994 and 2005-2006, the CDC reports that mean serum α-tocopherol levels increased significantly (pp 103). However longitudinal studies show that vitamin E supplement usage among health professionals dropped from a peak of 46% in 1998 to <20% in 2006 (Kim et al, 2013). The inference of course is that more people will have lower α-tocopherol levels now that fewer people are using vitamin E supplements.

All of these factors point to three conclusions: 1) Vitamin E status, measured as serum α-tocopherol concentrations, is important for maintaining strong bones and muscles.  2) Use of vitamin E supplements is decreasing. 3) Suboptimal α-tocopherol concentrations may be an unnecessary dietary contributor to fracture risk and muscle weakness.

Main citation

Michaelsson K, Wolk A, Byberg L, Arnlov A, Melhus H. Intake and serum concentrations of α-tocopherol in relation to fracture in elderly women and men: 2 cohort studies. 2013 Am J Clin Nutr doi:10.3945/ajcn.113.064691

Other citations

Mandolagas SC, Parfitt AM, What old means to bone. 2010 Trends Endocrinol Metab doi:10.1016/j.tem.2010.01.010

Cerullo F, Gambassi G, Cesari M, Rationale for antioxidant supplementation in sarcopenia. 2012 J Aging Res doi:10.1155/2012/316943

Cesari M, Pahor M, Bartali B, Cherubini A, Penninx BWJH, Williams GR, Atkinson H, Martin A, Guralnik JM, Ferrucci L. Antioxidants and physical performance in elderly persons: the Invecchiare in Chianti (InCHIANTI) study. 2004 Am J Clin Nutr 79:289-294