The
same study also had good news for the whole population: Cow’s milk with or
without fat promotes absorption of the natural form of vitamin E found in
foods.
People
in the study who drank milk along with the natural form of vitamin E absorbed
between 26.1 and 29.5 percent of the vitamin, depending on their health status.
Participants
with metabolic syndrome absorbed less vitamin E than healthy people in the
study, which concerns researchers because these individuals probably receive
less of the beneficial antioxidant properties of vitamin E.
Previous
research has shown that on average, humans absorb about 10 percent of a dose of
the most common vitamin E supplement if it is eaten without any fat. The
percentage of vitamin E absorbed after it is consumed refers to its
bioavailability, or how much of a given dose reaches the bloodstream. Its
bioavailability is influenced by processes that regulate fat absorption and the
delivery of fat to the bloodstream.
Metabolic
syndrome is defined as the presence of at least three of five factors that
increase the risk for heart disease and diabetes – excess belly fat, elevated
blood pressure, low “good” cholesterol, and high levels of blood glucose and
triglycerides. An estimated 35 percent of Americans have metabolic syndrome.
“The
fact that people with metabolic syndrome had lower bioavailability of vitamin E
was expected, but it had never been studied before and therefore we’ve had no
guidance to make recommendations for that population,” said Richard Bruno,
professor of human nutrition at The Ohio State University and lead author of
the study.
“This
work tells us that at least one-third of Americans have higher vitamin E
requirements than healthy people,” Bruno said. “Dietary requirements of
nutrients are generally defined only in the context of what a healthy person
needs, but considering that two-thirds of Americans are overweight or obese, a
healthy person might not be representative of our society.”
The
research, funded by the National Dairy Council, is published online in the American
Journal of Clinical Nutrition.
Because
obesity is the hallmark of metabolic syndrome, weight loss would be the most
logical way to create better conditions in the body for vitamin E absorption,
Bruno said. Most successful dieters cut calories by cutting fat, but
fat-containing foods tend to be among the best dietary sources of vitamin E.
“People
with metabolic syndrome could benefit from guidance to help them restrict
calorie intake without sabotaging their vitamin E intake,” he said.
Alpha-tocopherol,
a natural form of vitamin E in food and the only form essential to human
health, is an antioxidant that prevents fats from becoming rancid in the body.
The recommended daily intake is 15 milligrams, and most Americans consume about
half that amount.
Bruno’s
previous work had suggested that the fat in cream cheese could promote
absorption of vitamin E when provided as alpha-tocopheryl acetate, the form
commonly found in dietary supplements. In this new study of 10 healthy
participants and 10 people with metabolic syndrome, he sought to determine to
what extent milk fat might function as a vehicle to improve vitamin E
bioavailability regardless of health status when provided as alpha-tocopherol,
the form naturally found in food.
“It
was an effort to mimic what most Americans do in the morning: Grab something to
drink and take their vitamin pills,” he said. “Even though the amount of milk
fat made no difference in the effect, the bioavailability of vitamin E when
taken with a glass of milk was nearly three times higher than expected based on
prior studies.
“Milk
doesn’t have any appreciable vitamin E content, so to promote absorption, it
needs to be paired with food containing vitamin E to help facilitate its
bioavailability.”
The
most serious neurological effects caused by vitamin E deficiency are rare, but
Bruno said a significant proportion of Americans are living at “suboptimal
status” when it comes to fully benefiting from vitamin E’s antioxidant
properties.
The
researchers used a supplement containing the natural form of alpha-tocopherol,
which is abundant in certain vegetable oils, nuts and seeds. The common vitamin
E supplement found in grocery stores contains a chemically modified form of the
vitamin – alpha-tocopheryl acetate – meaning these findings might not apply to
the average vitamin E supplement unless a consumer specifically uses a supplement
containing alpha-tocopherol.
Though
the study didn’t specify how metabolic syndrome risk factors blunt vitamin E
absorption, levels of proteins in the blood that carry fat gave the researchers
some clues. Two lipoproteins in particular stood out: one generated by the
small intestine and another in the liver that secretes fat and vitamin E into
the blood. In study participants with metabolic syndrome, vitamin E enrichment
in both lipoproteins was lower than in healthy people.
“This
could imply that people with metabolic syndrome either have impairment of
absorption of vitamin E at the small intestine or because of an inability for
vitamin E to get out of the liver,” Bruno said. “We don’t know which – it could
be either one or both acting together.”
Bruno
is now working to determine a precise recommendation for the increased vitamin
E needs for people with metabolic syndrome.
This
work was also supported by the National Center for Advancing Translational
Sciences, which funds Ohio State’s Center for Clinical and Translational
Science
Co-authors
include Eunice Mah, Teryn Sapper, Chureeporn Chitchumroonchokchai, Mark Failla,
and Kevin Schill of the Department of Human Sciences Human Nutrition Program;
and Steven Clinton of the Division of Oncology, all at Ohio State; and Gerd
Bobe and Maret Traber of the Linus Pauling Institute at Oregon State
University.
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