Is it worth taking a vitamin E supplement for cardiovascular health?
Olive oil, photo/Getty Images
Question: What’s your view on the use of vitamin E as a supplement to a reasonably balanced diet? As it’s a fat-soluble vitamin, what are the consequences of overdosing? I have a mitral valve incompetence and have had a deep vein thrombosis. I understand vitamin E is beneficial for cardiovascular disease. I’m not on medication, but use fish oil capsules daily.
Answer: Fashion trends change as the years go by. Trends in dietary supplements change, too, as research progresses. So-called ACE supplements (containing vitamins A, C and E) were fashionable a decade ago, but in recent times their popularity has faded as the popularity of multivitamins, minerals, fish oils and probiotics has grown. Nonetheless, vitamin E is as important today as it was a decade ago.
Vitamin E is the name given to a group of eight fat-soluble substances sourced from plants. Its major role is as an antioxidant protecting polyunsaturated fatty acids in cell walls from damaging free radicals. Epidemiological studies throughout the 1990s reported higher dietary intakes of vitamin E were associated with a reduced risk of cardiovascular disease, certain cancers, diabetic complications and cataracts. However, subsequent clinical trials proved less positive. Of these chronic diseases, the strongest evidence linked vitamin E to prevention of coronary heart disease, yet clinical trials of vitamin E supplementation haven’t found a consistent, clinically significant effect on cardiovascular disease outcomes.
Nutrition research and healthy-eating recommendations evolve through different phases and trends. In the past there was often a focus on individual nutrients and diseases, whereas nowadays a focus on dietary patterns is more common. A traditional Mediterranean-style diet, full of plant-derived foods and olive oil, is often highlighted as an example of a heart-healthy diet.
Indeed, a so-called “evolved Mediterranean diet”, rich in plant-derived foods and olive oil, was recently linked to a reduced risk of coronary heart disease among more than 40,000 Spanish participants in the European Prospective Investigation into Cancer and Nutrition (Epic) study. It was also associated with a lower risk of coronary heart disease among nearly 30,000 Italian women in the Epic study, according to a 2011 report in the American Journal of Clinical Nutrition.
Given your health problems, a heart-healthy diet is a good idea. And this should provide all your vitamin E needs, as dietary sources are widespread – vegetable oils, nuts, seeds, eggs, fish, margarines, wholegrains and leafy green vegetables. You’re unlikely to experience adverse effects from consuming vitamin E in food. High doses of vitamin E obtained from supplements have caused haemorrhage and interrupted blood clotting in animal trials, and also increased the risk of haemorrhagic stroke in clinical trials involving men.
The National Heart Foundation provides guidelines on a dietary pattern rather than focusing on individual nutrients:
- eat fruit and/or vegetables at every meal and most snacks;
- select whole grains, wholegrain breads and high-fibre breakfast cereals rather than white/low-fibre varieties;
- include fish, legumes, soy products or a small serving of lean meat/poultry at one or more meals a day;
- choose low-fat milk and milk products, soy or legume products every day;
- use small amounts of vegetable oils, margarine, nuts or seeds;
- drink plenty of fluids, particularly water.
Dietary supplements may seem an easy answer, but you probably don’t need them as, ironically, research has found users of dietary supplements tend to eat more healthily and live a healthier lifestyle than non-users. A recent study published in the American Journal of Clinical Nutrition again backed this up, finding that dietary-supplement use was associated with higher intakes of minerals from food sources.
Vitamin E targets* & dietary sources
Men should aim for 19mg of vitamin E a day, and women 14mg.
Food/Vitamin E
1 tbsp canola oil/3mg
1 tbsp olive oil/1mg
1 tsp margarine or spread/1mg
¼ cup mixed nuts/2.5mg
100g tinned salmon/2mg
1 cup cooked brown rice/0.6mg
½ cup silverbeet/2mg
½ cup kumara/5mg
½ cup pumpkin/2.5mg
1 medium carrot/0.5mg
*Ministry of Health target to reduce chronic disease risk
Email: nutrition@listener.co.nz, or write to “Nutrition”, c/o Listener, PO Box 90783, Victoria St West, Auckland 1142.