thebear
03-27-2020, 02:10 PM
Vitamin E Prevents Damage to Cellular Membranes and Other Cellular Components
You and I are made of cells. Each of our cells is enclosed in an oily membrane. Inside our cells lie many specialized compartments. Each of those is also enclosed in a similar membrane. These oily membranes are what allow cells to protect themselves and to control what comes in and goes out, and what stays in and stays out. Controlling which things are found where is how our cells maintain their productivity, just like you keep different things in your bedroom, your kitchen, your living room, and your office if you have one. This allows you to sleep effectively in one place, cook effectively in another, relax effectively in another, and work effectively in another.
These oily membranes are made of many small pieces of fat known as "fatty acids." The fatty acids can be a lot like dominoes when they are exposed to harmful substances known as oxidants. The oxidants damage one fatty acid by oxidizing it. Then that fatty acid itself turns into an oxidant!
It oxidizes the next one
And the next one....
And the next one....
And the next one....
And the next one....
And the next one....
...if something doesn't stop this train...
...sooner or later they all fall down.
They all get damaged. Oxidized. Kaput. Washed up, wiped out, swimming with the fishes.
Vitamin E's only well established role is to stop this from happening.
When the fatty acids in the cell membrane oxidize, many of them shatter into smaller pieces. These little pieces of broken fatty acids are very much like shards of broken glass. They become a danger to everything else around them. (Not something you want to step on!) They can start damaging everything in your cell, including proteins and DNA. That makes vitamin E directly responsible for protecting the fatty acids in your cell membranes, and indirectly responsible for protecting everything else in the cell.
Vitamin E Deficiency
So what happens when we don't get enough?
The scientific word for vitamin E is "tocopherol," which comes from the Greek meaning "to carry a pregnancy to term." It was known as the "fertility vitamin" in the early days of its discovery. This is because lab animals with severe deficiencies became infertile.
In humans, severe deficiency results in neurological problems. This is because the brain is very oily and uses a lot of energy, which generates oxidants in the process. The neurological problems involve loss of coordination, difficulty walking, visual problems resulting from damage to the retina, and pain, weakness, numbness, or tingling in the hands and feet.
Deficiency also results in hemolytic anemia, a form of anemia where red blood cells get destroyed because their membranes fall apart.
Moderate deficits are not well studied, but they are likely to have the following effects:
Increased damage or poor healing in the gut, skin, and lungs.
Increased vulnerability to thyroid disorders and infections.
Increased wear and tear on the tissues more generally, worsening the risk of most chronic, degenerative diseases like heart disease and cancer.
Vitamin E Is Fat-Soluble
Notice that we keep taking about the role of vitamin E protecting the oily parts of our cells. Vitamin E is the third of the four fat-soluble vitamins we've discussed. That means it is found in the fatty portions of foods, is absorbed best with a large meal that contains fat, and will become deficient in diseases that impair our ability to digest and absorb fat.
Vitamin E is a "Chain-Breaking Antioxidant"
The domino effect of oxidation that occurs in cell membranes is called a chain reaction, and vitamin E is known as a "chain-breaking antioxidant." In fact, it is widely rumored within the classic rock underground that Fleetwood Mac's 1977 song, The Chain, in which they boldly stated, "you would never break the chain," was issued as a challenge to vitamin E.
Challenge... accepted!
Since vitamin E protects our cell membranes from oxidation, it is an "antioxidant" and is part of the "antioxidant system." Vitamin E relies on the larger system to get its job done. When an oxidized fatty acid is looking for the next domino to knock over within the membrane, vitamin E steps up and says, "pick meeeeeeeee!" After it takes one for the team, it needs to be rejuvenated. Vitamin E gets rejuvenated by vitamin C. In fact, this accounts for most if not all of vitamin C's contribution to the antioxidant system. Vitamin C gets its healing power from glucose, the main carbohydrate in our bodies, using the help of niacin, riboflavin, and thiamin in the process.
PUFAs are Uniquely Vulnerable to Oxidation
Now, get this. Inside our membranes, not all fatty acids are equal.
There are three types of fatty acids:
Saturated
Monounsaturated
Polyunsaturated
In fact, you'll see these three types listed on the label of packaged foods. These fatty acids are the main thing found in the fat we eat. When we eat fats and oils like butter or olive oil, these are mostly fat. When we eat other foods, smaller amounts of fat contribute to rich tastes and creamy textures. All foods contain all three types of fatty acids, but they contain them in different combinations.
Saturated fatty acids are most abundant in fats that are solid at room temperature, such as butter, coconut oil, or beef fat. Monounsaturated fatty acids are most abundant in oils that are liquid at room temperature but harden in the refrigerator, like olive oil. Polyunsaturated fatty acids are most abundant in oils that stay liquid even in the refrigerator.
To make it less of a mouthful, we will call polyunsaturated fatty acids "PUFAs" (POO-fuzz) from now on.
The oils richest in PUFAs are canola, soybean (often called "vegetable oil"), sunflower and safflower (if not labeled as "high-oleic"), corn, and cottonseed.
Within cell membranes, it is *only* PUFAs that oxidize. PUFAs are necessary in small amounts, and we will talk about that in the lesson on essential fatty acids. But they are vulnerable to oxidation in any amount. Vitamin E's only well established role, then, is to protect PUFAs from oxidation within our bodies.
Now, vitamin E plays the exact same role in plants and other animals. As a result, foods with higher PUFA content tend to have higher vitamin E content as well. This is important, because if the only need for vitamin E is to protect PUFAs, then the more PUFAs we get, the more E we need.
And yet, the ratios of vitamin E to PUFA in various foods are wildly different.
This is for a few different reasons:
Heat increases the rate of any chemical reaction, including the harmful reactions that lead to the oxidation of PUFAs. Unlike us warm-blooded animals, plants and cold-blooded or bloodless animals need more vitamin E for a given amount of PUFA in warmer environments and less E per PUFA in cooler environments.
Metabolic activity (breaking things down and building them up) generates oxidants. As a result, parts of an animal or plant that are very metabolically active (muscles, leaves) will have more vitamin E for a given amount of PUFA than less metabolically active parts (bones, seeds).
Among all forms of metabolism, photosynthesis is most dangerous. This is the process whereby plants take energy from sunlight and atoms from oxygen and water, and put them together to make glucose. Sunlight and oxygen both increase the rate of oxidation (in fact, oxidation is named after oxygen!), so the tremendous amount of these two factors involved in photosynthesis dramatically increase the need for E for a given amount of PUFA.
If we look at foods, then, we will notice a few things about the vitamin E-to-PUFA ratio:
It is low in fish, because fish are cold-blooded and need lots of PUFA to avoid becoming hardened in the cold water, yet don't need as much E because of that cold water.
It is very high in some tropical oils, such as palm oil, because of the warm environment. Coconut oil has very little vitamin E, though. This is because it has very little PUFA, and because the toughness of the meat and the hard shell slow the movement of oxygen and light through the coconut.
Green leaves have extremely high ratios, and seeds have very low ratios. Here I'm using the broad sense of "seed," anything you could plant in the ground and grow something with, including grains.
This is why grass-fed beef is anywhere from 1.3-fold to 5.4 fold higher in vitamin E than grain-fed beef. Although other animal products haven't been studied as much as beef has, generally meat, milk, and eggs from grass-fed animals are always higher in vitamin E than the same products from grain-fed animals.
If we look at the absolute amount of vitamin E in foods, wheat germ oil appears to have the most, with corn oil having half as much, palm oil a little bit less than corn oil, and butter and olive oil having practically none. But if we look at the vitamin E-to-PUFA ratio, things look very different. Palm oil is by far the winner, and wheat germ oil, olive oil, grass-fed butter, and corn oil are all similar.
Should We Use the Vitamin E Amount or the Ratio to PUFA?
The Institute of Medicine set the RDA for vitamin E in 2000, at the same time they set the RDA for vitamin C. Although they didn't express the RDA as a ratio between vitamin E and PUFA, they wrote that "high PUFA intakes should certainly be accompanied by increased vitamin E intakes."
Rarely do scientists use the word "certainly."
In fact, the principle that the more PUFA we get, the more E we need, is far more certain than the number given for the RDA.
The RDA is based on a single study where they tried inducing vulnerability of red blood cells to hemolysis on a low-vitamin E diet. They tried and tried, but they got nowhere until they started feeding "tocopherol-stripped corn oil."
Hemolysis is the process of red blood cells breaking apart, and it's what happens during hemolytic anemia. But in this study, they weren't inducing anemia. They were taking the red blood cells out of the people, then pouring hydrogen peroxide on them. Hydrogen peroxide is an oxidant, so vitamin E-depleted red blood cells will break apart in test tubes if you pour enough hydrogen peroxide on them. Tocopherol-stripped corn oil is corn oil that has been heated until all the vitamin E is destroyed. The heat doesn't just destroy the vitamin E, it also oxidizes the fatty acids, so the oil is full of extra oxidants just waiting to rip apart your cell membranes, wreck your proteins, and gum up your DNA.
So the RDA for vitamin E is the amount of vitamin E that will protect your red blood cells from falling apart when they've been taken out of your body and had hydrogen peroxide dumped on them, while you've been chronically eating the most toxic oil imaginable. However bad the average person's diet is, it isn't anywhere near as bad as the toxic diet used in this study, so vitamin E needs are probably lower than the RDA.
Even the people who made the RDA admit the data is pretty bad. In the following quote, the word "biomarker" means something we can measure to understand whether someone has enough vitamin E or needs more. α-Tocopherol is the main form of vitamin E.
"It is recognized that there are great uncertainties in the data utilized to set the α-tocopherol requirements. However, in the absence of other scientifically sound data, hydrogen peroxide-induced hemolysis is the best marker at the present time. It should be emphasized that research is urgently needed to explore the use of other biomarkers to assess vitamin E requirements."
That "urgent" need for research was identified 19 years ago. No changes yet.
Notice that when referring to the RDA itself, they wrote about "great uncertainties." But when they discussed the effect of PUFA, they wrote, "high PUFA intakes should certainly be accompanied by increased vitamin E intakes."
So, to summarize:
[emoji736] We are "greatly uncertain" about the absolute amount we need, but it's probably lower than the RDA.
[emoji736] We are certain that we need more E when we get more PUFA.
So, it follows that we should largely ignore the absolute amounts of E in our diet and instead seek a high E-to-PUFA ratio.
Vitamin E Cannot Completely Protect PUFA From Oxidation
There's just one catch: Vitamin E can't perfectly protect against high PUFA intakes. Remember how we called it a "chain-breaking antioxidant"? The "chain" starts when the first domino hits the second one, not when your finger hits the first one. In other words, vitamin E will never stop the first fatty acid from oxidizing. It will only stop the chain reaction from moving forward after this point. So if you eat a very large amount of PUFA and have a high exposure to oxidants from acute infection, chronic disease, metabolic problems, or toxin exposure, you will wind up with more fatty acids oxidized even if you have a very high intake of E.
Dietary Targets for PUFA and Vitamin E
So what we actually want to seek is:
A high vitamin-E-to-PUFA ratio.
A PUFA intake that isn't any higher than we need to get all of our nutrients in.
Whole foods like nuts and seeds are rich in PUFA, but also rich in many valuable nutrients. For example, we talked in past lessons about almonds being rich in B2, peanuts in B3, sunflower seeds in B5, and whole sesame seeds with the hull being rich in calcium. These foods have quite a lot of PUFA, but plenty of other nutrients. Their oils, by contrast, mainly just supply PUFA.
As a foundation for the diet, then, I would recommend the following:
[emoji736] Use high-PUFA foods like fatty fish, nuts, and seeds to meet your requirements of vitamins and minerals, but no more than needed for this.
[emoji736] Avoid high-PUFA oils like canola, soybean, corn, cottonseed, and sunflower or safflower oils that are not labeled as "high-oleic."
[emoji736] Use grass-fed animal products whenever possible (look for "grass-finished" labels, meaning they ate grass through the last few months of their life as well as earlier).
[emoji736] If your diet is more than 40% of Calories as fat, get the excess over 40% from oils that are very low in PUFA, such as butter, coconut oil, or the fat of red meat animals.
If you feel like you might need more E for skin, gut, lung, or brain health, or to lower the risk of chronic diseases like heart disease and cancer, work in red palm oil into your diet. As discussed in the first lesson palm oil is also a great source of vitamin A. The harvesting of palm oil often involves cruelty to orangutans, so look for sources that document cruelty-free practices.
Other Causes of Vitamin E Deficiency
Diet isn't the only thing that impacts vitamin E status:
[emoji777] Any intestinal disorders that hurt the digestion and absorption of fat can cause vitamin E deficiency.
[emoji777] There is a very rare genetic defect in a vitamin E transporter that requires extremely high doses of vitamin E to treat.
Vitamin E Supplements
Because vitamin E is fat-soluble, supplements should always be taken with a meal. If your meals are similar in fat content, take an E supplement with your largest meal. If they vary a lot in fat content, take it with your highest-fat meal.
Vitamin E supplements come in several forms.
SYNTHETIC ALPHA-TOCOPHEROL
Synthetic alpha-tocopherol is often called "all-rac" tocopherol. This consists of one form that is identical to natural vitamin E, and 7 forms that are not found naturally and have less, little, or no function. This is used only because it's cheap, and should be avoided.
D-ALPHA TOCOPHEROL
D-alpha-tocopherol is often labeled as "all-natural" or "RRR." This is the natural, fully functioning form. Alpha-tocopherol is, indeed, the most powerful and the most important form of vitamin E. However, it is one of only eight forms. High doses can flush out the other seven forms, so it isn't wise to take a supplement that only has this form unless it is a low dose, such as 15 mg or 20 IU.
MIXED TOCOPHEROLS
Natural vitamin E comes in eight forms, four tocopherols and four tocotrienols. Tocopherols are far more abundant in most foods than tocotrienols, so a supplement with "mixed tocopherols" is usually taken from a natural food that has a high tocopherol but low tocotrienol content.
It's important to recognize that, while the other tocopherols likely are important, alpha-tocopherol is still the best studied, most powerful, and most important form of vitamin E. If you use a mixed tocopherol supplement, make sure the label displays the alpha-tocopherol content and that it provides about 15 mg or 20 IU of this form.
MIXED TOCOTRIENOLS
There are four tocotrienols that make up the other half of the vitamin E spectrum. These are less studied than tocopherols, but they may have unique benefits by penetrating certain tissues better than tocopherols. High doses also lower cholesterol levels by acting similarly to the statin drugs that so many people are on. Tocotrienols are far less common in the food supply than tocopherols, found mainly in rice bran oil and palm oil.
Supplement Recommendations
As a means of ensuring some extra vitamin E, it is best to use a supplement that contains about 15 mg or 20 IU of alpha-tocopherol and also contains a mix of tocopherols or tocotrienols. One example is Jarrow Toco-Sorb.
However, if you feel like you have symptoms related to poor vitamin E status and a mixed tocopherol/tocotrienol supplement doesn't seem to help, it makes sense to experiment with a low-dose natural alpha-tocopherol, since it is the best studied and most important form. An example would be one drop of Now E-Oil per day, which provides 30 IU.
Switching from High-PUFA to Low-PUFA Oils
There's one clear case that warrants supplementation: if you consume PUFA-rich oils for a period of four years or more, your vitamin E requirement stays elevated for four years after you stop consuming them. If you switch, for example, from corn oil to coconut oil, the coconut oil will give you very little vitamin E, but your vitamin E requirement is actually calibrated to the amount in the corn oil.
In that case I would use one capsule of Jarrow Toco-Sorb or one drop of Now E-Oil per day.
High-Dose Vitamin E Supplements
There are some studies suggesting high doses of vitamin E may benefit immune function, heart disease, fatty liver, and age-related cognitive decline, cataracts, age-related macular degeneration, diabetes, and certain cancers. However, the studies are inconsistent, and some suggest high doses worsen the risk of diabetes and certain cancers.
High doses may also cause deficiencies of other fat-soluble vitamins, especially vitamin K. As a result, I do not recommend using high doses of vitamin E in most cases.
The only cases where high doses are clearly warranted are the rare genetic disorder of vitamin E transport, and intestinal problems that hurt fat absorption.
There may be reasons to use high doses of other fat-soluble vitamins, however, and in those cases using a proportional amount of vitamin E may be necessary to avoid causing imbalances. We will return to this topic after we cover the last fat-soluble vitamin, vitamin K, in the next lesson.
Wrapping Up
To wrap up:
[emoji736] Vitamin E is needed to protect our tissues from wear and tear as we age. It is especially important to our brain health and our fertility, and helps protect us from chronic, degenerative diseases like heart disease and cancer.
[emoji736] The ratio of vitamin E to PUFA is more important than the absolute amount of vitamin E.
[emoji736] We should seek a high ratio and avoid excess total PUFA regardless of E.
[emoji736] High-PUFA whole foods are good when they supply needed nutrients but the oils should be avoided.
[emoji736] Grass-fed animal products and fresh whole plant foods should be the foundation of the diet. Cruelty-free red palm oil is the best source of additional E.
[emoji736] Most people don't need a vitamin E supplement, but if you switch from high-PUFA oils to low-PUFA oils, it would be wise to supplement for about four years.
[emoji736] The best default supplement is one that provides close to 15 mg or 20 IU of alpha-tocopherol in a background of mixed tocopherols and tocotrienols.
[emoji736] Try a low-dose natural alpha-tocopherol without the other forms if the default does not give you the results you are looking for.
[emoji736] Higher doses are only warranted when treating rare disorders that cause severe vitamin E deficiency.
BEAR
You and I are made of cells. Each of our cells is enclosed in an oily membrane. Inside our cells lie many specialized compartments. Each of those is also enclosed in a similar membrane. These oily membranes are what allow cells to protect themselves and to control what comes in and goes out, and what stays in and stays out. Controlling which things are found where is how our cells maintain their productivity, just like you keep different things in your bedroom, your kitchen, your living room, and your office if you have one. This allows you to sleep effectively in one place, cook effectively in another, relax effectively in another, and work effectively in another.
These oily membranes are made of many small pieces of fat known as "fatty acids." The fatty acids can be a lot like dominoes when they are exposed to harmful substances known as oxidants. The oxidants damage one fatty acid by oxidizing it. Then that fatty acid itself turns into an oxidant!
It oxidizes the next one
And the next one....
And the next one....
And the next one....
And the next one....
And the next one....
...if something doesn't stop this train...
...sooner or later they all fall down.
They all get damaged. Oxidized. Kaput. Washed up, wiped out, swimming with the fishes.
Vitamin E's only well established role is to stop this from happening.
When the fatty acids in the cell membrane oxidize, many of them shatter into smaller pieces. These little pieces of broken fatty acids are very much like shards of broken glass. They become a danger to everything else around them. (Not something you want to step on!) They can start damaging everything in your cell, including proteins and DNA. That makes vitamin E directly responsible for protecting the fatty acids in your cell membranes, and indirectly responsible for protecting everything else in the cell.
Vitamin E Deficiency
So what happens when we don't get enough?
The scientific word for vitamin E is "tocopherol," which comes from the Greek meaning "to carry a pregnancy to term." It was known as the "fertility vitamin" in the early days of its discovery. This is because lab animals with severe deficiencies became infertile.
In humans, severe deficiency results in neurological problems. This is because the brain is very oily and uses a lot of energy, which generates oxidants in the process. The neurological problems involve loss of coordination, difficulty walking, visual problems resulting from damage to the retina, and pain, weakness, numbness, or tingling in the hands and feet.
Deficiency also results in hemolytic anemia, a form of anemia where red blood cells get destroyed because their membranes fall apart.
Moderate deficits are not well studied, but they are likely to have the following effects:
Increased damage or poor healing in the gut, skin, and lungs.
Increased vulnerability to thyroid disorders and infections.
Increased wear and tear on the tissues more generally, worsening the risk of most chronic, degenerative diseases like heart disease and cancer.
Vitamin E Is Fat-Soluble
Notice that we keep taking about the role of vitamin E protecting the oily parts of our cells. Vitamin E is the third of the four fat-soluble vitamins we've discussed. That means it is found in the fatty portions of foods, is absorbed best with a large meal that contains fat, and will become deficient in diseases that impair our ability to digest and absorb fat.
Vitamin E is a "Chain-Breaking Antioxidant"
The domino effect of oxidation that occurs in cell membranes is called a chain reaction, and vitamin E is known as a "chain-breaking antioxidant." In fact, it is widely rumored within the classic rock underground that Fleetwood Mac's 1977 song, The Chain, in which they boldly stated, "you would never break the chain," was issued as a challenge to vitamin E.
Challenge... accepted!
Since vitamin E protects our cell membranes from oxidation, it is an "antioxidant" and is part of the "antioxidant system." Vitamin E relies on the larger system to get its job done. When an oxidized fatty acid is looking for the next domino to knock over within the membrane, vitamin E steps up and says, "pick meeeeeeeee!" After it takes one for the team, it needs to be rejuvenated. Vitamin E gets rejuvenated by vitamin C. In fact, this accounts for most if not all of vitamin C's contribution to the antioxidant system. Vitamin C gets its healing power from glucose, the main carbohydrate in our bodies, using the help of niacin, riboflavin, and thiamin in the process.
PUFAs are Uniquely Vulnerable to Oxidation
Now, get this. Inside our membranes, not all fatty acids are equal.
There are three types of fatty acids:
Saturated
Monounsaturated
Polyunsaturated
In fact, you'll see these three types listed on the label of packaged foods. These fatty acids are the main thing found in the fat we eat. When we eat fats and oils like butter or olive oil, these are mostly fat. When we eat other foods, smaller amounts of fat contribute to rich tastes and creamy textures. All foods contain all three types of fatty acids, but they contain them in different combinations.
Saturated fatty acids are most abundant in fats that are solid at room temperature, such as butter, coconut oil, or beef fat. Monounsaturated fatty acids are most abundant in oils that are liquid at room temperature but harden in the refrigerator, like olive oil. Polyunsaturated fatty acids are most abundant in oils that stay liquid even in the refrigerator.
To make it less of a mouthful, we will call polyunsaturated fatty acids "PUFAs" (POO-fuzz) from now on.
The oils richest in PUFAs are canola, soybean (often called "vegetable oil"), sunflower and safflower (if not labeled as "high-oleic"), corn, and cottonseed.
Within cell membranes, it is *only* PUFAs that oxidize. PUFAs are necessary in small amounts, and we will talk about that in the lesson on essential fatty acids. But they are vulnerable to oxidation in any amount. Vitamin E's only well established role, then, is to protect PUFAs from oxidation within our bodies.
Now, vitamin E plays the exact same role in plants and other animals. As a result, foods with higher PUFA content tend to have higher vitamin E content as well. This is important, because if the only need for vitamin E is to protect PUFAs, then the more PUFAs we get, the more E we need.
And yet, the ratios of vitamin E to PUFA in various foods are wildly different.
This is for a few different reasons:
Heat increases the rate of any chemical reaction, including the harmful reactions that lead to the oxidation of PUFAs. Unlike us warm-blooded animals, plants and cold-blooded or bloodless animals need more vitamin E for a given amount of PUFA in warmer environments and less E per PUFA in cooler environments.
Metabolic activity (breaking things down and building them up) generates oxidants. As a result, parts of an animal or plant that are very metabolically active (muscles, leaves) will have more vitamin E for a given amount of PUFA than less metabolically active parts (bones, seeds).
Among all forms of metabolism, photosynthesis is most dangerous. This is the process whereby plants take energy from sunlight and atoms from oxygen and water, and put them together to make glucose. Sunlight and oxygen both increase the rate of oxidation (in fact, oxidation is named after oxygen!), so the tremendous amount of these two factors involved in photosynthesis dramatically increase the need for E for a given amount of PUFA.
If we look at foods, then, we will notice a few things about the vitamin E-to-PUFA ratio:
It is low in fish, because fish are cold-blooded and need lots of PUFA to avoid becoming hardened in the cold water, yet don't need as much E because of that cold water.
It is very high in some tropical oils, such as palm oil, because of the warm environment. Coconut oil has very little vitamin E, though. This is because it has very little PUFA, and because the toughness of the meat and the hard shell slow the movement of oxygen and light through the coconut.
Green leaves have extremely high ratios, and seeds have very low ratios. Here I'm using the broad sense of "seed," anything you could plant in the ground and grow something with, including grains.
This is why grass-fed beef is anywhere from 1.3-fold to 5.4 fold higher in vitamin E than grain-fed beef. Although other animal products haven't been studied as much as beef has, generally meat, milk, and eggs from grass-fed animals are always higher in vitamin E than the same products from grain-fed animals.
If we look at the absolute amount of vitamin E in foods, wheat germ oil appears to have the most, with corn oil having half as much, palm oil a little bit less than corn oil, and butter and olive oil having practically none. But if we look at the vitamin E-to-PUFA ratio, things look very different. Palm oil is by far the winner, and wheat germ oil, olive oil, grass-fed butter, and corn oil are all similar.
Should We Use the Vitamin E Amount or the Ratio to PUFA?
The Institute of Medicine set the RDA for vitamin E in 2000, at the same time they set the RDA for vitamin C. Although they didn't express the RDA as a ratio between vitamin E and PUFA, they wrote that "high PUFA intakes should certainly be accompanied by increased vitamin E intakes."
Rarely do scientists use the word "certainly."
In fact, the principle that the more PUFA we get, the more E we need, is far more certain than the number given for the RDA.
The RDA is based on a single study where they tried inducing vulnerability of red blood cells to hemolysis on a low-vitamin E diet. They tried and tried, but they got nowhere until they started feeding "tocopherol-stripped corn oil."
Hemolysis is the process of red blood cells breaking apart, and it's what happens during hemolytic anemia. But in this study, they weren't inducing anemia. They were taking the red blood cells out of the people, then pouring hydrogen peroxide on them. Hydrogen peroxide is an oxidant, so vitamin E-depleted red blood cells will break apart in test tubes if you pour enough hydrogen peroxide on them. Tocopherol-stripped corn oil is corn oil that has been heated until all the vitamin E is destroyed. The heat doesn't just destroy the vitamin E, it also oxidizes the fatty acids, so the oil is full of extra oxidants just waiting to rip apart your cell membranes, wreck your proteins, and gum up your DNA.
So the RDA for vitamin E is the amount of vitamin E that will protect your red blood cells from falling apart when they've been taken out of your body and had hydrogen peroxide dumped on them, while you've been chronically eating the most toxic oil imaginable. However bad the average person's diet is, it isn't anywhere near as bad as the toxic diet used in this study, so vitamin E needs are probably lower than the RDA.
Even the people who made the RDA admit the data is pretty bad. In the following quote, the word "biomarker" means something we can measure to understand whether someone has enough vitamin E or needs more. α-Tocopherol is the main form of vitamin E.
"It is recognized that there are great uncertainties in the data utilized to set the α-tocopherol requirements. However, in the absence of other scientifically sound data, hydrogen peroxide-induced hemolysis is the best marker at the present time. It should be emphasized that research is urgently needed to explore the use of other biomarkers to assess vitamin E requirements."
That "urgent" need for research was identified 19 years ago. No changes yet.
Notice that when referring to the RDA itself, they wrote about "great uncertainties." But when they discussed the effect of PUFA, they wrote, "high PUFA intakes should certainly be accompanied by increased vitamin E intakes."
So, to summarize:
[emoji736] We are "greatly uncertain" about the absolute amount we need, but it's probably lower than the RDA.
[emoji736] We are certain that we need more E when we get more PUFA.
So, it follows that we should largely ignore the absolute amounts of E in our diet and instead seek a high E-to-PUFA ratio.
Vitamin E Cannot Completely Protect PUFA From Oxidation
There's just one catch: Vitamin E can't perfectly protect against high PUFA intakes. Remember how we called it a "chain-breaking antioxidant"? The "chain" starts when the first domino hits the second one, not when your finger hits the first one. In other words, vitamin E will never stop the first fatty acid from oxidizing. It will only stop the chain reaction from moving forward after this point. So if you eat a very large amount of PUFA and have a high exposure to oxidants from acute infection, chronic disease, metabolic problems, or toxin exposure, you will wind up with more fatty acids oxidized even if you have a very high intake of E.
Dietary Targets for PUFA and Vitamin E
So what we actually want to seek is:
A high vitamin-E-to-PUFA ratio.
A PUFA intake that isn't any higher than we need to get all of our nutrients in.
Whole foods like nuts and seeds are rich in PUFA, but also rich in many valuable nutrients. For example, we talked in past lessons about almonds being rich in B2, peanuts in B3, sunflower seeds in B5, and whole sesame seeds with the hull being rich in calcium. These foods have quite a lot of PUFA, but plenty of other nutrients. Their oils, by contrast, mainly just supply PUFA.
As a foundation for the diet, then, I would recommend the following:
[emoji736] Use high-PUFA foods like fatty fish, nuts, and seeds to meet your requirements of vitamins and minerals, but no more than needed for this.
[emoji736] Avoid high-PUFA oils like canola, soybean, corn, cottonseed, and sunflower or safflower oils that are not labeled as "high-oleic."
[emoji736] Use grass-fed animal products whenever possible (look for "grass-finished" labels, meaning they ate grass through the last few months of their life as well as earlier).
[emoji736] If your diet is more than 40% of Calories as fat, get the excess over 40% from oils that are very low in PUFA, such as butter, coconut oil, or the fat of red meat animals.
If you feel like you might need more E for skin, gut, lung, or brain health, or to lower the risk of chronic diseases like heart disease and cancer, work in red palm oil into your diet. As discussed in the first lesson palm oil is also a great source of vitamin A. The harvesting of palm oil often involves cruelty to orangutans, so look for sources that document cruelty-free practices.
Other Causes of Vitamin E Deficiency
Diet isn't the only thing that impacts vitamin E status:
[emoji777] Any intestinal disorders that hurt the digestion and absorption of fat can cause vitamin E deficiency.
[emoji777] There is a very rare genetic defect in a vitamin E transporter that requires extremely high doses of vitamin E to treat.
Vitamin E Supplements
Because vitamin E is fat-soluble, supplements should always be taken with a meal. If your meals are similar in fat content, take an E supplement with your largest meal. If they vary a lot in fat content, take it with your highest-fat meal.
Vitamin E supplements come in several forms.
SYNTHETIC ALPHA-TOCOPHEROL
Synthetic alpha-tocopherol is often called "all-rac" tocopherol. This consists of one form that is identical to natural vitamin E, and 7 forms that are not found naturally and have less, little, or no function. This is used only because it's cheap, and should be avoided.
D-ALPHA TOCOPHEROL
D-alpha-tocopherol is often labeled as "all-natural" or "RRR." This is the natural, fully functioning form. Alpha-tocopherol is, indeed, the most powerful and the most important form of vitamin E. However, it is one of only eight forms. High doses can flush out the other seven forms, so it isn't wise to take a supplement that only has this form unless it is a low dose, such as 15 mg or 20 IU.
MIXED TOCOPHEROLS
Natural vitamin E comes in eight forms, four tocopherols and four tocotrienols. Tocopherols are far more abundant in most foods than tocotrienols, so a supplement with "mixed tocopherols" is usually taken from a natural food that has a high tocopherol but low tocotrienol content.
It's important to recognize that, while the other tocopherols likely are important, alpha-tocopherol is still the best studied, most powerful, and most important form of vitamin E. If you use a mixed tocopherol supplement, make sure the label displays the alpha-tocopherol content and that it provides about 15 mg or 20 IU of this form.
MIXED TOCOTRIENOLS
There are four tocotrienols that make up the other half of the vitamin E spectrum. These are less studied than tocopherols, but they may have unique benefits by penetrating certain tissues better than tocopherols. High doses also lower cholesterol levels by acting similarly to the statin drugs that so many people are on. Tocotrienols are far less common in the food supply than tocopherols, found mainly in rice bran oil and palm oil.
Supplement Recommendations
As a means of ensuring some extra vitamin E, it is best to use a supplement that contains about 15 mg or 20 IU of alpha-tocopherol and also contains a mix of tocopherols or tocotrienols. One example is Jarrow Toco-Sorb.
However, if you feel like you have symptoms related to poor vitamin E status and a mixed tocopherol/tocotrienol supplement doesn't seem to help, it makes sense to experiment with a low-dose natural alpha-tocopherol, since it is the best studied and most important form. An example would be one drop of Now E-Oil per day, which provides 30 IU.
Switching from High-PUFA to Low-PUFA Oils
There's one clear case that warrants supplementation: if you consume PUFA-rich oils for a period of four years or more, your vitamin E requirement stays elevated for four years after you stop consuming them. If you switch, for example, from corn oil to coconut oil, the coconut oil will give you very little vitamin E, but your vitamin E requirement is actually calibrated to the amount in the corn oil.
In that case I would use one capsule of Jarrow Toco-Sorb or one drop of Now E-Oil per day.
High-Dose Vitamin E Supplements
There are some studies suggesting high doses of vitamin E may benefit immune function, heart disease, fatty liver, and age-related cognitive decline, cataracts, age-related macular degeneration, diabetes, and certain cancers. However, the studies are inconsistent, and some suggest high doses worsen the risk of diabetes and certain cancers.
High doses may also cause deficiencies of other fat-soluble vitamins, especially vitamin K. As a result, I do not recommend using high doses of vitamin E in most cases.
The only cases where high doses are clearly warranted are the rare genetic disorder of vitamin E transport, and intestinal problems that hurt fat absorption.
There may be reasons to use high doses of other fat-soluble vitamins, however, and in those cases using a proportional amount of vitamin E may be necessary to avoid causing imbalances. We will return to this topic after we cover the last fat-soluble vitamin, vitamin K, in the next lesson.
Wrapping Up
To wrap up:
[emoji736] Vitamin E is needed to protect our tissues from wear and tear as we age. It is especially important to our brain health and our fertility, and helps protect us from chronic, degenerative diseases like heart disease and cancer.
[emoji736] The ratio of vitamin E to PUFA is more important than the absolute amount of vitamin E.
[emoji736] We should seek a high ratio and avoid excess total PUFA regardless of E.
[emoji736] High-PUFA whole foods are good when they supply needed nutrients but the oils should be avoided.
[emoji736] Grass-fed animal products and fresh whole plant foods should be the foundation of the diet. Cruelty-free red palm oil is the best source of additional E.
[emoji736] Most people don't need a vitamin E supplement, but if you switch from high-PUFA oils to low-PUFA oils, it would be wise to supplement for about four years.
[emoji736] The best default supplement is one that provides close to 15 mg or 20 IU of alpha-tocopherol in a background of mixed tocopherols and tocotrienols.
[emoji736] Try a low-dose natural alpha-tocopherol without the other forms if the default does not give you the results you are looking for.
[emoji736] Higher doses are only warranted when treating rare disorders that cause severe vitamin E deficiency.
BEAR