Food supplement: Vitamin E

Vitamin E is actually a family of eight substances of which the most common is alpha-tocopherol. The functions of vitamin E in the body are poorly identified and cannot be explained solely by its antioxidant properties.

This justifies the use of vitamin E derivatives as food preservatives under the names E306, 307, 308 and 309, which have little activity as vitamins.

Decision of the European Health Authorities

In 2012, the European health authorities (EFSA, European Food Safety Authority and the European Commission) decided on certain health claims for foods and food supplements containing vitamin E (tocopherols and tocotrienols).

After examination of the scientific data, they considered that these products can claim to contribute to the protection of cells against free radicals (antioxidant effect) if and only if these products contain at least 1.8 mg of vitamin E (tocopherols and tocotrienols) per 100 g, 100 ml or per package if the product contains only one portion.

However, foods and food supplements containing vitamin E (tocopherols and tocotrienols) can NOT claim to be :

• be essential for healthy bones, teeth, hair, nails or skin;
• maintain heart health or regulate blood circulation;
• contribute to normal intellectual function or memory in the elderly;
• are necessary for the maintenance of vitality;
• protect the lens of the eye (against the effects of ageing);
• regenerate vitamin C;
• support the blood microcirculation of the scalp;
• maintain the functioning of the immune system.

These claims of effect are now prohibited for foods and food supplements containing vitamin E (tocopherols and tocotrienols).

Deficiency, uses and supposed properties of vitamin E

Vitamin E deficiency is rare and only occurs after several years of lack of intake. It is translated by pains and feelings of burning in the feet and the hands. It is seen in people with chronic bowel diseases or certain genetic diseases.

Insufficient intake could lead to cardiovascular problems, such as coronary heart disease. It can occur in patients who are taking medication to reduce the absorption of fat from the gut, for example as part of treatment for obesity or cholesterol.

Because of its antioxidant action, vitamin E is proposed for the prevention of cardiovascular diseases, cancers and age-related diseases such as osteoarthritis (rheumatism), cataracts, age-related retinal degeneration (AMD) or Alzheimer's disease.

How effective is vitamin E?

Vitamin E is probably the most widely studied vitamin, particularly in the prevention of cardiovascular disease. Unfortunately, the results of these studies are contradictory and sometimes worrying.

With regard to age-related diseases, vitamin E has shown slight efficacy in the early stages of Alzheimer's disease, and the American Psychiatry Association recommends its use in this indication.

While dietary surveys have shown that a diet rich in vitamin E is associated with a reduced risk of developing cardiovascular disease, administration of this vitamin over many years seems to have little effect on its occurrence. Several studies even suggest that continued administration of vitamin E may increase the risk of suffering a stroke, while other studies have found the opposite effect. In addition, a recent review of several dozen clinical trials suggested that vitamin E supplementation may increase mortality.

Finally, a large study published in 2014 clearly demonstrated that taking dietary supplements containing vitamin E and selenium significantly increases the risk of developing prostate cancer. Given the current state of knowledge, health authorities advise against taking vitamin E and selenium supplements and prohibit products containing selenium from claiming to have a beneficial effect on the prostate.

Precautions to take with vitamin E

Because of its anticoagulant properties, vitamin E should not be taken by patients who are taking blood-thinning drugs, who have had a stroke, or who have a digestive ulcer. For the same reason, vitamin E should be discontinued for one month before surgery.

It should not be combined with food supplements containing ginkgo, garlic or onions.

In 2014, an Australian study warned people with high blood pressure against taking vitamin E. Indeed, when taking 500 mg/day of vitamin E (tocopherols), the blood pressure of hypertensive people increased. Caution should therefore be exercised.

The rare side effects of high doses of vitamin E are fatigue, digestive problems and the occurrence of breast pain or emotional problems.

Forms and dosage of vitamin E

Vitamin E is available in various forms, such as tablets, soft capsules or oil solutions.

The recommended dietary allowance is 12 IU (12 mg) per day for an adult. Dietary supplements most often provide doses of 150-750 IU per day. The increased risk of developing a stroke has been observed with doses of 75 IU or more per day, taken continuously for several months or even years.

Pregnant or breastfeeding women should limit their intake of vitamin E to the Recommended Dietary Allowance.

Food sources of vitamin E

Vitamin E is found in vegetable oils such as rapeseed, wheat germ, sunflower, olive, argan and soybean oil, in dark green leafy vegetables such as cabbage, spinach and lamb's lettuce, in nuts such as walnuts, hazelnuts and almonds, in seeds, and in the fat of meat and fish.