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To "E" or not to "E"? That seems to be the question. Should you take vitamin E supplements or not? Vitamin E is important to health. For example, it can:
*Protect the heart and blood vessels.
*Reduce of the risk of certain cancers including lung, oral, colon, rectal,
cervical, prostate, pancreatic, and liver.
*Support hormonal balance.
*Improve sperm function and fertility rates.
*Assist symptoms of premenstrual syndrome.
*Lower the risk and slow the progression of Alzheimer's disease
and other dementias.
*Normalize blood flow to and improve the function of the kidneys.
*Enhance immune system function and increase resistance to tissue
insult or injury.
*Lower incidence of upper respiratory inflammation or infection.
*Reduce the incidence of muscle injury.
*Reduce the risk of macular degeneration and cataracts.
*Help prevent pre-eclampsia in pregnant women.
*Work with vitamin A, essential fatty acids, vitamin C,
and other nutrients.
*Stop the breakdown of body tissues.
*And much more.
We're supposed to get at least 15 milligrams (that equals about 23 International Units or IU) a day. Most Americans do not achieve this daily quota. Only a fraction of people get that much vitamin E from food. One reason is the so-called "food" they are eating. The "top contributors" of vitamin E intake include ready-to-eat cereal, sweet bakery products, white bread, beef, oils and salad dressings. Except for the beef - which has its own problems due to the unnatural and toxic manner in which cattle are raised that creates imbalanced fats and deficiencies in meat - all the other items are nonfoods. They are stripped, over-processed, mummified, and loaded with everything from refined sugars and artificial flavors to deodorizers and manufactured ‘vitamins'. The good stuff including real vitamin-E complex - is virtually gone! Vitamin E is lost when foods like grains, flours, and oils are cooked, processed, and bleached. Yet such denatured nonfoods are the top sources for vitamin E (often due to artificial "fortification") in the American diet. Is it any wonder there is a deficiency?
There are many real foods that supply real vitamin E such as whole wheat and other whole grains, nuts, seeds, leafy greens, avocados, asparagus, Brussels sprouts, and unrefined vegetable oils. Sadly, the "fat is bad" hoax that was preached for years discouraged the use of many of these foods because they were "full of fat and calories." This reduced the intake of vitamin E and other valuable nutrients even more. Also, most Americans have come to LIKE white bread and gooey pastries. The closest thing to greens they eat is the ‘white' iceberg lettuce on their fast-food burger. "Vitamin E is found in many foods but, because it is destroyed by heat and oxidation during cooking and processing, intakes may be low among those who eat diets high in cooked and processed foods." Voila! Deficiency.
It is therefore no big surprise that many people take vitamin E supplements. Some take 200 or 400 IU a day; others take even more. That's higher than the RDA of 23 IU. And most people are not aware of what they are actually getting in those pills. The fear, confusion, and controversy arising from recent publicized studies involving vitamin E involve two important issues: (1) The definition of vitamin E. (2) The difference between NATURAL and SYNTHETIC vitamin E. i
CONFLICT AND CONFUSION
Research "keeps failing to demonstrate" any real benefits from taking alpha-tocopherol - the so-called "vitamin E". Results from studies are a conflicting, mixed bag. Although a few trials have shown "clinical benefit" from alpha-tocopherol supplementation for preventing heart disease, much of the evidence is against it! Alpha-tocopherol does not appear to reduce the incidence of heart attack, stroke, and the like or study results are "inconclusive" - anybody's guess. Alpha-tocopherol produces results "that are similar to, or not statistically better than, placebo" and in some studies, a potential for harm was suggested. Several studies show that people who have the highest intake of "vitamin E" from supplements and diet have a significantly reduced risk of heart attacks as well as cardiovascular death. Low blood levels of vitamin E are linked to increased risk of heart attack and stroke.
The big news is that vitamin E from food always seems to protect against heart disease, whereas fake "vitamin E" from supplements of alpha-tocopherol does not always do so. People who took alpha-tocopherol for three years had less oxidized LDL (so-called "bad" cholesterol) in their blood, something considered protective against heart disease. Yet they were just as likely to develop atherosclerosis as people taking a placebo. The same story occurs for the incidence of cancer - no outstanding benefits from alpha-tocopherol supplements. In one study, alpha-tocopherol appeared to reduce the incidence of prostate cancer. Another study found that participants with the highest BLOOD levels of alpha-tocopherol AND gamma-tocopherol were least likely to develop prostate cancer. People taking alpha-tocopherol longer than 10 years had a reduced risk of death from bladder cancer. Yet subjects of another study who consumed the most foods rich in vitamin-E complex had HALF the rate of bladder cancer than people who consumed the least amount. TOCOTRIENOLS, a now-acknowledged part of "vitamin E" not in supplements used in virtually all studies, has been found to have cancer-protective effects. In one trial, 400 IU alpha-tocopherol per day seemed to raise the risk of another tumor in cancer patients. To reduce cancer risk, the study authors suggested that people might be better off improving their diets rather than taking vitamin supplements. Alpha-tocopherol supplements did not reduce oxidative damage to fats and proteins in their bodies. People who took this and other separated "antioxidant" supplements fared no better than those who took placebos. Alpha-tocopherol did not protect human skin from oxidative stress by ultraviolet radiation. People getting plenty of vitamin E from food experience less cancer. The vitamin complex will enhance immune function, thus increasing the body's ability to fight cancers, among other things. The whole package is more effective than a single part!
Administration of alpha-tocopherol had a "neutral" effect in preventing kidney disease. Alpha tocopherol failed to slow the progression to Alzheimer's disease in people with mild cognitive impairment. Although vitamin E is important to immune function, one study found it had a protective effect on the common cold, but in another, people over age 60 taking alpha-tocopherol got more colds and other respiratory ‘infections' than those taking a placebo. Other studies found that alpha-tocopherol takers were no less likely than people who received placebos to get bronchitis and pneumonia. Daily supplementation with alpha-tocopherol does not prevent the development or progression of early or later stages of age-related macular degeneration.
A deficiency of vitamin E contributes to degenerative disorders of the brain and rest of the nervous system as well as muscular tissues. What is the best way to get vitamin E? A decline in mental function was the least in older people whose dietary vitamin E and alpha-tocopherol supplementation was highest compared to those with the lowest intake. Was it the supplements or the food? Another study found that vitamin E complex from foods, but NOT from supplements, was associated with a 32% reduction in the long-term development of Parkinson's disease. The participants got at least 10 IU of vitamin E a day through food - that's about an ounce of almonds or sunflower seeds every day. Powerful stuff! They did not have to get huge amounts of the vitamin because food complexes are always more potent and more effective than the fake (synthetic) "vitamin E". Similarly, foods rich in vitamin E, but NOT isolated alpha-tocopherol supplements, reduce the risk of Alzheimer's disease. Several studies have had the same results for Parkinson's and Alzheimer's. One reason is that "other" parts of vitamin E in foods such as gamma-tocopherol appear "to function differently in the body than alpha tocopherol." Tocotrienols not only magnify the effects of alpha-tocopherol, but they have "independent protective actions as well."
One very confusing factor is that the alpha-tocopherol used in these studies is called "vitamin E." Another factor is that researchers frequently don't (won't?, in order to continue receiving drug industry grants) distinguish between natural-source and synthetic alpha-tocopherol. The only message the public receives in the media is that "vitamin E" doesn't work. The poor or mixed results reported from "clinical intervention" with alpha-tocopherol are in contrast to that of many observational and epidemiological studies in which a lower rate of heart disease, stroke, and cancer; improved immune response, eye health, kidney health, hormonal balance, and other benefits occur when people have a high dietary intake or high blood levels of vitamin E. What's the real story? ii
DOES VITAMIN E KILL PEOPLE?
During 2005, there were a couple of studies that frightened many people into discontinuing their vitamin E supplements. One of these studies was a "meta-analysis" of vitamin E supplementation. This means the researchers looked at many previous studies - in this case, 19 published between 1993 and 2004 - and summarized the data from the entire lot. Their focus was "to evaluate a potential dose-dependent effect of vitamin E on total mortality." The conclusion they reached was that high-dose vitamin E supplements actually increased the death rate of people who took them.
This was a juicy, sensational story for the media since millions of Americans take vitamin-E supplements. However, there were plenty of problems with and weaknesses in this study. A spokesman for the Council for Responsible Nutrition said: "This is an unfortunate misdirection of science in an attempt to make something out of nothing for the sake of headlines." Here are some of the criticisms of the study:
1. The 19 trials that were analyzed consisted of a total of 135,967 volunteers. There was a "selection bias" and "erroneous interpretation of the studies". This means that the choice of those particular 19 studies was flawed, not very scientific. For example, trials in which less than 10 deaths were reported were excluded from the analysis. Five of the studies had participants at risk for, or diagnosed with cardiovascular disease; two of these studies (accounting for nearly half of all participants in the high-dose vitamin E group) analyzed the use of vitamin E in volunteers who were at a much greater risk of dying (from heart disease, other artery disease, diabetes, or hypertension) than the other three studies. Five other trials, which accounted for the other half of participants in the high-dose vitamin E trials, looked at the use of vitamin E in people with very dissimilar illnesses - cataracts, macular degeneration, Alzheimer's disease, Parkinson's disease, colon cancer, and the like. It would be extremely difficult to arrive at any meaningful conclusions with such disparity. Most of the participants were extremely ill and a high death rate was inevitable no matter what. The trials were different in other ways as well - in, for example, the age and number of the subjects, differences in nutritional status, the length of follow-up, and so on.
2. The focus of this study was supposed to be on vitamin E supplements. But five of the 11 high-dose studies - accounting for 61% of the total high-dose study population - administered vitamin E and other supplements. Harmful effects from other supplements could not be ruled out, nor the possibility of inter-reactions among the supplements. For example, in one study, synthetic beta-carotene (which has already been shown to have deleterious effects), zinc, and copper were given. Excessive zinc ingestion can cause copper deficiency and, although copper was also given, it was in a form that cannot be absorbed and in amounts which, even if absorbed, would not balance the high amount of zinc given. A deficiency of copper could have been created and this can contribute to cardiovascular problems, among other things. Other trials also used beta-carotene and a number of other vitamin, mineral, and antioxidant supplements. How could any honest scientist conclude that vitamin E was the agent that caused an increase in death rates?
3. The manner in which the statistics were compiled and analyzed would lend itself to a fallacious conclusion. For example, the method was based on the assumption that the underlying rate of death in all 19 studies was the same. But this was not the case. A more valid approach would have been to assume that the death rate varied from study to study. "If you make [that] alternate assumption, then vitamin E is unlikely to increase mortality at any dose." Additionally, two of the high-dose trials in the analysis were biased against finding a benefit for vitamin E. If these two trials were excluded from the meta-analysis, there would not have been any association made between high-dose vitamin E and increased risk of mortality. Why the need to fake the studies? Could it be because the studies were financed by the drug industry?
4. Of primary interest to us is the fact that, in reality, the trials that were reviewed did not really use vitamin E. Yes, it is a matter of definition, but one that is extremely important. A part or isolated portion of any nutrient in high doses can "disrupt the harmony of processes that make preventing and healing disease possible." The vitamin E used in the trials was not only an isolated part, but in 18 of the 19 trials, it was synthetic - a manufactured, poor-quality imitation, which is the only "nutrient" used in drug-industry financed trials.
The distinction here is natural versus synthetic, part versus the entire package. For many years, alpha-tocopherol was considered to be "vitamin E". In food, alpha-tocopherol never appears alone. This is well known, but alpha-tocopherol was chosen to be "vitamin E" because it appeared to be the most active and most important part (to whom?). Most all supplements contain just alpha-tocopherol (produced by the drug industry).
Recently, vitamin E has been receiving a new definition. (Who gave it its original definition?) Studies have been showing that other parts are also important and should be included in what is considered "vitamin E." Other tocopherols - beta, delta, and gamma - have now been welcomed into the family. In fact, research on gamma-tocopherol shows that, not only is it beneficial in its own right, but that taking alpha-tocopherol by itself decreases gamma-tocopherol concentrations by 30% to 50%. The concept of synergy and balance are creeping into scientific studies! Many researchers are now also including tocotrienols (alpha, beta, delta, and gamma) in the definition of vitamin E.
Research is showing they are indispensable, with health benefits galore. Of course, this leaves the question of what else is included in the vitamin E complex that has been ignored or not yet discovered. Will the real vitamin E please stand up? Food provides the whole package. It's always been there. Other components occur with the four tocopherols and four tocotrienols in real food such as the trace mineral selenium and various fatty acids.
The other factor is natural versus synthetic. All the parts of natural vitamin E (including d-alpha tocopherol) are in one form. Synthetic alpha-tocopherol (d, l alpha-tocopherol) is a mixture of 8 compounds, only one of which comes close to even resembling a natural form. It's a fake. And your body knows it. In most scientific studies, the counterfeit form is used because many scientists do not (will not?) recognize that there is a difference between the natural and synthetic. The synthetic is easy to make and cheap to use and produces high profits. Yet there is a lot of scientific evidence that the form does matter. And there is a huge amount of clinical evidence that the natural form and the whole package make a tremendous difference in the health of real people. Synthetic d,l alpha-tocopherol, especially when taken in high doses, can cause major imbalances, such as inhibiting glutathione S-transferases (important to detoxification of drugs and other toxins), increasing bleeding tendency, interfering with processing of vitamin A and other vitamins, and producing other adverse effects when taken long-term.
"When separated from their complexes, vitamins cannot be expected to perform their specific functions. Similarly, clinical trials that do not provide all the nutrients required for proper biochemical functioning cannot be expected to yield optimal results. When isolated into artificial commercial forms, like alpha-tocopherol, unintended consequences may result." A synthetic version of a small piece of real vitamin-E complex counteracts the good biochemistry of foods containing the E complex. It clashes with body chemistry.
The conclusion by the authors of the meta-analysis that vitamin E increases all-cause mortality is not honest and does not add up. Even though the imitation, separated part was used in almost all the trials, it is not so dangerous that it kills people! Although it has drug-like actions rather than nutritional actions, it is still not as harmful as most drugs. However, it does not provide the health benefits of the real vitamin-E complex, the benefits seen in all studies that analyze food intake. The authors concluded that people should not take vitamin E, but this may not be prudent (or is it simply an outright lie?). Yes, definitely avoid the separated or synthetic versions. Instead, obtain vitamin E in its natural complex form in real foods and in real food concentrates. There is a great amount of evidence that vitamin E from foods has many health benefits. This meta-analysis ignored the extensive number of studies that documented the health benefits of vitamin E - cardiovascular disease prevention and aid, cancer prevention, immune system support, kidney support, hormonal balance, mental clarity and memory, and so much more. [The medical/drug industry injures, maims, kills 2,500,000 people every year. It is the third leading cause of death in this country.]
Bottom line: Three other meta-analyses on E found no increased risk of death from taking supplements. This particular meta-analysis was a meta-mess. But it does, at least, induce us to look at the difference between an imitation vitamin part and the real, complex, multifaceted, interrelated whole vitamin. iii
HOPE or NO HOPE?
The second study - the HOPE and HOPE-TWO trial - was reported in March 2005. It involved about 4,000 people over the age of 55 with cardiovascular disease or diabetes mellitus. They were given 400 IU of "natural source" vitamin E or a placebo. The results, after 5.5 years, seemed to show that the vitamin E made no real difference in the occurrence of cancer, stroke, angina, or heart attacks. But it did appear that there were higher rates of heart failure. The authors concluded that, in people with vascular disease or diabetes, long-term vitamin E supplementation does not prevent cancer, heart attacks, or stroke and may increase the risk for heart failure. Does this mean if you take vitamin E you will develop heart failure? Not necessarily. If it were substantially increasing the risk of heart failure in a wide range of people, researchers would have noticed by now!!
Another study (July 2005) of 39,876 women who were at least 45 years of age used "natural source" vitamin E (600 IU) or placebo, and aspirin or placebo. There seemed to be no real benefit from vitamin E for major cardiovascular events or cancer, and did not affect total mortality. So is vitamin E useless?
No, it's not useless, but even the "natural source" vitamin E used in these studies is far less useful than the whole vitamin-E complex as found in real food. In real foods, the alpha-tocopherol part serves several functions, one of which is an anti-oxidant. An anti-oxidant prevents premature oxidation of the vitamin itself - it keeps the rest of the vitamin E parts in food from breaking down too quickly as in rancidity or rotting. Taken by itself, alpha-tocopherol can, to a very limited degree, do this in the body too. It can help prevent the breakdown of vitamin E factors that are already in the body. But at least two problems exist. One is that, once the other parts of vitamin E in the body become deficient, there is nothing much the alpha-tocopherol can do to help since its function was severely limited to begin with. Second, the alpha-tocopherol part was in essence "amputated" from the whole "body" of vitamin E; the synergy, balance, and essential interplay of functional parts of the complex was destroyed. As an "amputated" part, it can no longer function as it was supposed to and, taken in large doses or for a long periods of time, can cause imbalances - disrupting natural biochemistry. Imbalances are worse than deficiencies. In fact, research has already shown that taken by itself, alpha-tocopherol causes imbalances of other factors in the vitamin E-complex, such as the gamma-tocopherol.
Plenty of studies have shown a limited benefit from taking "natural source" alpha-tocopherol, but nothing to get really excited about. For example, the risk of heart attacks or the chances of dying from heart disease were reported to be a bit lower in some studies when "natural source" E was taken. It seems to lower the rate of prostate cancer and some other cancers a little. The really good news is that epidemiological studies keep showing that vitamin E intake from food definitely seems to lower the incidence of cardiovascular disease and cancer. It appeared to be only a simple leap of logic (to drug-industry paid "scientists") to think that alpha-tocopherol all by itself would do the same thing. But it doesn't. There is no true logic in assuming that a tiny fraction of an intricate, complicated complex will perform the same as the whole nutrient or whole food. Observational studies indicate that diets high in fresh fruits and vegetables and whole grains (sources of vitamin-E complex) reduce the incidence of cancer and heart disease, as well as everything from cataracts to Alzheimer's disease. Vitamin-E complex, like all vitamins and other nutrients in real foods, is delivered as part of a matrix that contains innumerable other substances in addition to the nutrients so-called "scientists" are willing to "recognize." It is certainly more than a bit presumptuous to think that scientists can do a better job in providing nutrients than does Nature herself. Many health professionals are beginning to come to the conclusion that we should stick to the "natural delivery system of vitamin E: in food." And it is virtually impossible to get too much vitamin E through real food. Foods richest in vitamin-E complex contain fats. Vitamin E is fat soluble, and parts of the complex are fatty acids. But the "low-fat" hoax of recent years resulted in many people avoiding foods containing fats. Not only was a vitamin E deficiency created, but it was made worse by recommending that alpha-tocopherol (so-called "vitamin E") supplements be taken. It brought about imbalances and deficiencies of other factors ordinarily found in the natural vitamin-E complex that were NOT in the supplement. Scientists have not yet determined all of vitamin E's roles. They have not even yet elucidated all its parts. There is no magic bullet. This is not a war. It is supposed to be a healing process. Be cautious about media hype and study results. Eat real food and, if needed, take real, whole food concentrates as supplements. Vitamin E in its whole food form is not a problem. Supplementing with only one part of the complex, or worse, a fake form of the part, is a real problem. iv
THERE IS A DIFFERENCE
Alpha-tocopherol used in scientific studies is applied as a drug and drug results are sought -including side effects (unwanted effects). Numerous studies have already indicated that foods rich in vitamin E - not supplements such as alpha-tocopherol - may lower risk of heart disease, cancer, Alzheimer's and Parkinson's disease, and many other ills. Natural but separated alpha-tocopherol can provide a limited amount of protection (preventing oxidation or breakdown of certain fats in the body), but not nearly as much as the whole complex. In fact, long-term ingestion of alpha-tocopherol by itself does imbalance other important, protective components of vitamin-E complex. Synthetic alpha-tocopherol is not recognized by the body as anything even close to a food part.
Targeting study participants for just one fraction of one vitamin complex does not reveal anything very useful about real life or about what is really needed for healthier living. A more wholesome diet and other general lifestyle modifications are preventive and healing therapies that have been proven to be effective. "Food is always the first defense," says Jeffrey Blumberg, Ph.D. Real foods such as fruits and vegetables are rich in hundreds and even thousands of important compounds that are not available in most supplements. And - this is very important - "the synergy between these compounds and the antioxidant vitamins may prove more important than the action of just one or two nutrients acting alone."
Recent study results have prompted researchers to "look beyond" alpha-tocopherol to the "other forms of vitamin E" such as gamma-tocopherol and tocotrienols. Perhaps these (so-called) scientists will eventually get the picture - vitamin E is a complex of many intricate, interrelated components, and each one is essential to the whole and to the nutrient's function or effectiveness (only if they stop taking drug-industry money). There is an ecology - a biotic interaction - among nutrient complexes in foods that cannot be disturbed without disrupting the whole.
Increased blood levels of gamma-tocopherol have been associated with a significantly reduced risk of prostate cancer. The benefits of selenium (another part of vitamin E complex) and alpha-tocopherol were seen as protecting from prostate cancer only when gamma-tocopherol levels were high. Gamma-tocopherol may be better for colon cancer than alpha-tocopherol. Tocotrienols have been found to have hormone-balancing powers, brain and nerve protecting powers, gene-regulating powers, oxygen-preserving powers, and much more. Tocotrienols may have benefit in preventing breast and other cancers, preeclampsia, and other diseases including heart disease. Tocotrienols may help lower cholesterol levels when needed. And they modulate several mechanisms linked with the aging process and aging-related diseases. No surprise that "some biological effects were found to be unique for tocotrienols." Selenium, co-enzyme Qs, essential fatty acids, and other synergistic parts of vitamin-E complex all have their own unique benefits in functioning cooperatively with all the other facets that make up the vitamin-E complex. It is suggested that, if you take a "vitamin E" supplement (alpha-tocopherol), you should take it with food containing at least a small amount of fat to promote absorption. "This is not a problem with the vitamin E found naturally in foods..." since real food sources already contain fatty acids.
Supplements of alpha-tocopherol (a small, isolated portion of E complex), especially when taken in high doses, "can disrupt the harmony of processes that make preventing and healing disease possible." The entire complex is "necessary" to support good blood circulation, for example, or to conserve oxygen and promote healthy cell oxidation, and to support the entire cardiovascular system and brain.
Separating and ingesting one part of one vitamin complex cannot be "an easy solution for a major problem with poor diets." Recent findings raise questions in the minds of many researchers. For example, can alpha-tocopherol, gamma-tocopherol, or any other parts of the vitamin-E complex really be thought of as separate since each one affects the others? "Combinations of different forms of vitamin E may be superior to each part alone." But, are there different forms of vitamin E or actually one form with many mutually-dependent, interrelated parts? Have "vitamin E" supplements (alpha-tocopherol) been shown to prevent diseases? Not really. Rather, hundreds, if not thousands, of studies in which large populations are observed have been very consistent in showing that "diets high in fruits and vegetables are protective against major chronic diseases. That's where the most proof is." Separated parts of foods or counterfeit imitations of food parts don't work well at all. It's the whole food packages of natural, complex nutrients that work best. v
SOURCES OF VITAMIN-E COMPLEX
Many foods provide vitamin-E complex such as unrefined vegetable, nut, and seed oils; seeds such as sunflower and sesame; nuts like almonds, brazils, chestnuts, filberts, pecans, walnuts, and peanuts; vegetables including corn (but not GMO corn), sweet potatoes, avocados, broccoli, asparagus, alfalfa, peas, lima beans, and many dark green, leafy vegetables; whole grains (with the germ) including whole wheat, barley, oats and rice; some fruits like olives, apples, peaches, and prunes. Rose hips and mints are a good source. Spirulina is reported by some to be a more reliable source of vitamin-E complex than wheat germ. Foods of animal origin often have low levels of vitamin-E complex, though much depends on the animal's diet. However, some organs and glands may be good sources including liver, pituitary, adrenals, testes, and ovaries.
A number of the above foods may appear in food concentrate supplements. Cataplex E, for example, contains dried pea vine, oat flour, bovine adrenal, spleen, and liver. Wheat Germ Oil is, of course, an excellent food source. Sesame Seed Oil is another source. Chlorophyll Complex and SP Green Food may also be considered, particularly when other related nutrient complexes are desired. Other supplements may contain some vitamin-E complex as part of their whole food components. Food sources are quite safe and are the most effective since they provide the whole package designed by Nature.
The above mentioned nutrients are from Standard Process and are available from this website. They are not available in any store.
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Originally published as an issue of Nutrition News and Views, reproduced with permission by the author, Judith A. DeCava, CNC, LNC.