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13772Vitamin E Benefits Improve With Enhanced food Intake

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  • claudine intexas
    Jan 31, 2004
      NATAP - www.natap.org

      Vitamin E Benefits Improve With Enhanced food Intake

      Vitamin E is poorly absorbed when consumed with a low-fat meal and
      that bioavailability can be enhanced by food fortification with
      vitamin E

      Vitamin E bioavailability from fortified breakfast cereal is greater
      than that from encapsulated supplements

      Scott W Leonard, Carolyn K Good, Eric T Gugger and Maret G Traber

      1 From the Linus Pauling Institute (SWL and MGT) and the Department
      of Nutrition & Food Management (MGT), Oregon State University,
      Corvallis, and theBell Institute of Health and Nutrition, General
      Mills, Inc, Minneapolis (CKG and ETG).

      2 Supported by a grant from General Mills, Inc. The purchase of a
      liquid chromatograph-mass spectrometer was supported in part by the
      Natural Source Vitamin E Association. Unlabeled -tocopherol (used as
      a standard)and RRR--5,7-(CD3)2-tocopheryl acetate (d6--tocopheryl
      acetate, used as an internal standard) were gifts from James Clark
      (Cognis Nutrition and Health, LaGrange, IL).

      Background: Conflicting results from vitamin E intervention studies
      suggest supplemental vitamin E malabsorption.

      The authors said: [results of this study] suggest that unless
      subjects are carefully instructed to consume encapsulated vitamin E
      supplements with a meal containing fat, the subjects may not benefit
      from such supplements.

      Objective: We compared vitamin E bioavailability from a supplement
      with that from a fortified breakfast cereal.

      Design: Vitamin E bioavailability was evaluated by using
      deuterium-labeled all-rac--tocopherol in three 4-d trials (2 wk
      apart). Five fasting subjects sequentially consumed the following
      (with 236 mL fat-free milk): 400 IU d9--tocopheryl acetate (400-IU
      capsule), 41 g ready-to-eat wheat cereal containing 30 IU
      d9--tocopheryl acetate (30-IU cereal), and 45 g cereal containing 400
      IU d9--tocopheryl acetate (400-IU cereal). Five months later (trial
      4), they consumed a 400-IU capsule with 41 g vitamin E-free cereal.
      Blood was obtained up to 72 h after the start of each trial.

      Results: The mean (��SD) vitamin E bioavailabilities of the 30-IU
      cereal and the 400-IU cereal were 6 �� 2 and 26 �� 8 times,
      respectively, the vitamin E bioavailability of the 400-IU capsule.
      The areas under the o72-h d9--tocopherol curves for the 400-IU
      capsule, the 30-IU cereal, and the 400-IU cereal were 30 �� 7, 153 ��
      43, and 765 �� 164 ��mol �� h/L (all trial comparisons, P < 0.0001).
      In trial 4, 3 subjects barely responded and 2 subjects had areas
      under the curve that were similar to their 400-IU cereal responses.

      Conclusion: The low bioavailability of vitamin E from the 400-IU
      capsule and the variability observed when the capsule was consumed
      with cereal suggest that encapsulated vitamin E is poorly absorbed
      when consumed with a low-fat meal and that bioavailability can be
      enhanced by food fortification with vitamin E.


      Controversies have surrounded vitamin E since its discovery in 1922
      and the subsequent description of forms other than -tocopherol that
      had some vitamin E biological activity. Currently, only -tocopherol
      has been shown to reverse human vitamin E deficiency symptoms, and
      -tocopherol is the only form of vitamin E that meets the year 2000
      vitamin E recommended dietary allowance.

      In addition to the prevention of deficiency symptoms, the potential
      of antioxidants, especially vitamin E, to decrease the risk of
      chronic disease has been a popular topic in the nutrition field.
      Nonetheless, many Americans do not consume vitamin E-adequate diets.
      Vitamin E has been touted for decades as "heart protective," but
      credible scientific evidence has been lacking. In the 1990s,
      epidemiologic evidence and a relatively small (2002 subjects),
      randomized, placebo-controlled intervention study gave credence to
      the concept that vitamin E supplements could decrease heart attack
      risk. Subsequently, larger vitamin E intervention trials failed to
      show cardiovascular-protective effects. Moreover, dietary, but not
      supplemental, vitamin E has been reported to be associated with
      beneficial outcomes in heart disease, cancer, and Alzheimer disease.

      The lack of consistency in the outcomes of vitamin E supplement
      studies prompted us to consider the hypothesis that the
      bioavailability of supplemental vitamin E is highly dependent on the
      way in which the supplement is consumed. It is well known that fat
      malabsorption syndromes (eg, cholestatic liver disease) and genetic
      abnormalities in lipoprotein synthesis (eg, abetalipoproteinemia) or
      in the -tocopherol transfer protein (eg, ataxia with vitamin E
      deficiency) result in vitamin E malabsorption or abnormally low
      plasma transport. Indeed, supplemental vitamin E bioavailability is
      highly influenced by prandial status. Despite the requirement for
      normal fat digestion and absorption, it is generally assumed that
      vitamin E malabsorption does not occur in healthy humans. However,
      the amount of dietary fat needed for optimal vitamin E absorption is

      The possibility of vitamin E malabsorption from supplements led us to
      devise a trial to compare supplements with vitamin E-enriched foods.
      Vitamin E-fortified, ready-to-eat breakfast cereals are a major food
      source of -tocopherol in the American diet. Therefore, using
      stable-isotope-labeled -tocopherol, we tested whether encapsulated
      vitamin E consumed with fat-free milk was as effective in raising
      plasma -tocopherol concentrations as was vitamin E-fortified,
      wheat-based cereal eaten with fat-free milk. The doses used were
      equivalent to the US recommended dietary allowance for vitamin E (30
      IU) or those in a typical vitamin E supplement (400 IU). The form of
      vitamin E used was synthetic (all-rac--tocopheryl acetate) because
      this is the form that is routinely used to fortify breakfast cereals.
      To estimate vitamin E bioavailability, plasma labeled and unlabeled
      -tocopherol concentrations were measured, and areas under the curves
      (AUCs) for deuterated tocopherol were approximated.


      The bioavailability of vitamin E (400 IU d9--tocopheryl acetate) from
      a fortified breakfast cereal was 25-fold that from a supplement when
      both the cereal and the supplement were consumed with fat-free milk.
      Indeed, the 30-IU cereal had greater vitamin E bioavailability than
      did the 400-IU capsule: the 30-IU cereal, which was approximately
      one-tenth of the dose of the 400-IU capsule, resulted in a maximum
      plasma d9--tocopherol concentration that was 5-fold that observed
      with the 400-IU capsule. (Note that these comparisons do not take
      into account differences in administered dose.) When the 400-IU
      capsule was consumed with cereal and milk (trial 4), plasma
      d9--tocopherol concentrations increased in only 2 of the 5 subjects.

      The findings of the present study have important public health
      implications. When encapsulated vitamin E supplements are consumed
      with fat-free milk, -tocopherol absorption is minimal at best. The
      fat-free milk consumed with the breakfasts contained only 0.5% fat by
      wt (21), which may have contributed to the limited vitamin E
      absorption from the 400-IU capsule. This result was expected because
      vitamin E absorption requires biliary and pancreatic secretions, as
      well as chylomicron synthesis.

      However, the breakfast that contained <5% fat (consisting of vitamin
      E-fortified cereal plus fat-free milk) unexpectedly increased vitamin
      E bioavailability. Hydrolysis of -tocopheryl acetate and absorption
      of tocopherol were probably aided by the fine dispersal of vitamin E
      on the surface of the cereal flakes, in contrast to the capsule, in
      which the vitamin E was concentrated in a globule.

      These findings are significant because fortified breakfast cereals
      are a major source of vitamin E in the American diet. It should be
      emphasized that the 30 IU in the breakfast cereal did not increase
      total -tocopherol concentrations, and this result is consistent with
      the findings of Hayes et al, who used unlabeled vitamin E and found
      that plasma-tocopherolconcentrations did not differ whether 30 IU
      vitamin E was provided in capsules or as a fine emulsion in milk.
      Importantly, Hayes et al found that the vitamin E bioavailability, as
      estimated from plasma concentrations, of -tocopheryl acetate (100-200
      mg/d) provided as a microdispersion in milk was double that of the
      same dose provided in capsules or orange juice. Again, these results
      emphasize that the physical properties involved in how vitamin E is
      presented to the intestinal absorptive surfaces have great bearing on
      its bioavailability.

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