Dr. Neal Barnard on Vitamin E. Get It from Food. Mostly Nuts & Seeds

 

 

"Researchers don't know how vitamin E might help, but it is an antioxidant, like those found in red wine, grapes and some teas. Antioxidants help protect cells from damage that can contribute to other diseases, says the federal Office on Dietary Supplements. Many foods contain vitamin E, such as nuts, seeds, grains, leafy greens and vegetable oils. There are many forms, and the study tested a synthetic version of one - alpha-tocopherol - at a pharmaceutical grade and strength, 2,000 international units a day. 

No one should rush out and buy vitamin E, several doctors warned. It failed to prevent healthy people from developing dementia or to help those with mild impairment ("pre-Alzheimer's") in other studies, and one suggested it might even be harmful."

 

AP news story by Marilynn Marchione

 

If you received this from email or on your smartphone click here to get to the web version with all the links or to write a comment.

Trials of Vitamin E for patients with Alzheimer's have been a mixed bag over the years.  Some were promising.  Some were not.  And after numerous vitamin E trials over the years, concerns arose that it might increase the risk for adverse effects (like mortality) when doses exceeded 400 IU.  As a result, vitamin E supplementation has fallen out of favor.  No one recommends it these days--at least not in supplement form.  And certainly not over 400 IU.

But, on New Year's Day, Jan. 1, 2014 there was some renewed glimmer of its usefulness in patients diagnosed with Alzheimers.  And at surprisingly high doses.  An no increased risk of mortality.

Here's the scoop:  

(from the New York Times)  A study, published in Wednesday’s issue of JAMA, The Journal of the American Medical Association, found that over a little more than two years of high-dose vitamin E slowed the decline of people with mild to moderate Alzheimer’s by about six months on average.

Vitamin E did not delay cognitive or memory deterioration, however. Instead, it seemed to temporarily protect something many patients consider especially valuable: their ability to perform daily activities like putting on clothes and feeding themselves.

Compared with other study participants, people who took vitamin E also required about two fewer hours of help from caregivers per day, the researchers said.

Want to learn more about the JAMA study?  Check out one of the following articles about the vitamin E study:

NPR

LA Times

Wall Street Journal

NYT

 

Dr. Neal Barnard's Advice on Getting Adequate Vitamin E from Food

 

All this "new" talk of a modest benefit of vitamin E in Alzheimer's patients, reminded me of Dr. Neal's Barnard's advice that for our "Brain's Sake" we should all make certain we get an adequate amount of vitamin E through our diets--from real food.  And according to Barnard, the best sources are from nuts & seeds.  We need about 15 mg/22.4 IU of vitamin E a day!

To that end, I wanted to share Dr. Barnard's advice on Vitamin E with all of you.  Consume about an ounce of nuts &/or seeds in order to get a mix of the different types of vitamin E (gamma-tocopherol & alpha-tocopherol) & choose those that have the highest amounts:  sunflower seeds, sesame seeds, almonds, pecans, walnuts (Black are higher than English), or pistachios.

The content below is excerpted from chapter 4 of Dr. Neal Barnard's Power Foods for the Brain.  New York: Hachette Book Group, 2013

 

Vitamin E Protects Against Free Radicals  (Chapt. 4)

Vitamin E protects your cells.  Specifically, it knocks out free radicals, those angry torpedoes that form, in part, due to copper and iron, as we saw in chapter 2.  Vitamin E is an antioxidant.  It neutralizes free radicals as they arise.

This is important for every part of your body.  But it is critical for your brain.  Skin cells & muscle cells can be replaced, and red blood cells and white blood cells turn over so quickly, they practically have a sell-by date.  But brain cells are forever.  Your ability to regenerate new ones is very limited, and there just aren't a lot of shiny new replacement parts ready to stand in for brain cells that have died!

Every brain cell, the axon that extends from it, and the synapses that link it with other cells are fragile.  Like an old stone statue in a town square assaulted day after day by air pollutants, and acid rain, each brain cell is nicked and pockmarked by the microscopic attacks of free radicals.  Vitamin E is a key part of your antioxidant shield.

So, does it work?  Does vitamin E actually protect your brain cells?  Dutch researchers analyzed the diets of 5,395 people, all of whom were fifty-five or older as the study began.  They tracked how much vitamin E they were getting in foods, and they then followed them over the next decade.  It turned out that those who got the MOST VITAMIN E cut their risk of developing Alzheimer's disease and other forms of dementia by about 25%.

Similarly, the Chicago researchers found that in older people followed over a four-year period, Alzheimer's disease developed in 14.3% of those who had relatively little vitamin E in their diets, but in only 5.9% of those who got the most vitamin E.  

Here is the math:  Every 5 milligram of vitamin E in a person's daily diet reduced the risk of developing Alzheimer's disease by 26%.

In the Dutch study, it did not matter if you had the APOE e4 allele--vitamin E was still helpful.  But in the Chicago study, it seemed to work only in people who did not have the APOE e4 allele, for reasons that are not clear.

Two caveats:  First, not all research teams have confirmed the protective effect of vitamin E for the brain. Second, don't rush to the store and buy a bottle of vitamin E.  Get it from foods instead.  

Here is why: Most vitamin E supplements have only one form of the vitamin, called alpha-tocopherol.  Foods provide it, too, but they also have a second form, called gamma-tocopherol, and others as well.  These various forms of vitamin E work as a team.  There is no need to bother with pills, and some evidence suggests that vitamin E pills are not effective against dementia.

What if you have Alzheimer's already?  Will vitamin E help?  In 1997, a large research project found that vitamin E did seem to slow down the decline of Alzheimer's disease.  Called the Alzheimer's Disease Cooperative Study, the project enrolled people with moderately severe symptoms.  Their average age was seventy-three, and they had had Alzheimer's disease for about five years.  By taking 1000 IU of vitamin E (alpha-tocopherol) twice a day, they were able to delay further decline by nearly two years.  "Decline" meant loss of the ability to perform activities of daily living, severe dementia, institutionalization, or death.

Unfortunately, this optimistic finding was not replicated by later studies and the role of vitamin E in Alzheimer's treatment remains a matter of debate. (H.L. note: EXCEPT until the recent 1/14 study in JAMA) So, for prevention, vitamin E-rich foods do seem to be effective, but once dementia has begun, its benefits are uncertain.

The recommended dietary allowance for vitamin E for adults is 15 milligrams (22.4 IU) per day.  The amount that helped in the Dutch study was around 18.5 milligrams (27.6 IU) per day.  The amount that helped in the Chicago study was just 7.6 milligrams (11.4 IU) per day.

 

Where Do You Find Vitamin E in Food?

You'll find traces of vitamin E in broccoli, spinach, sweet potatoes, mangoes, and avocados.  And there is much more in NUTS AND SEEDS, especially almonds, walnuts, hazelnuts, pine nuts, pecans, pistachios, sunflower seeds, sesame seeds, and flaxseed.

An ounce of typical nuts or seeds has about 5 milligrams of vitamin E.  How much is an ounce?  Pour some nuts or seeds into the palm of your hand and stop before they reach your fingers.  That is about an ounce.  If that's part of your routine, it trims your Alzheimer's risk by about one-quarter, if the Chicago findings hold.  

While nuts and seeds are rich in vitamin E, they are also high in fat, which means they pack a lot of calories, not to mention some saturated fat. So I would suggest using them sparingly, focusing on the vitamin E-rich varieties mentioned above, rather than peanuts or cashews, which have less vitamin E and more saturated fat.

(H.L. NOTE:  My "whole food" multivitamin has 16 IU of vitamin E from organic brown rice)

If you have a tendency to overdo it with nuts and seeds--you tear open a pack and pretty soon you've eaten the whole thing--try this:  Use them as an ingredient, rather than as a snack food that you might eat all by itself.  Sprinkle them on your salad, or into a sauce.  That way you'll be less tempted to go back for more.

 

Vitamin E-Rich Foods (amounts are listed in milligrams per ounce) 

High in Gamma-Tocopherol

Black Walnuts         8.1

Sesame Seeds          8.0

Pecans                    6.9

Pistachios               6.4

English Walnuts       5.9

Flaxseed                 5.7       

 

High in Alpha-Tocopherol

Sunflower seeds      7.4     

Almonds                 7.3

Almond butter        6.9

Hazelnuts               4.3

Pine nuts                2.8

Brazil nuts              1.6    

 

 

 Source:  World's Healthiest Foods  

NOTE:  In this table, the vitamin E amounts for the greens (spinach, Swiss chard, etc) are displayed as 1 cup of cooked greens, which contains the equivalent of many cups of raw greens. I don't know wht the equivalent is--just know from exerperience that cooked greens are greatly reduced from raw.  Even the cooked greens contain only a small amount of vitamin E.  Greens are in the "EXCELLENT" category because they are low calories & low in fat.  

Comments

[Chris O'Keefe]

I have a lifetime history of ulcerative colitis, doing very well with it, but the one food group I just cannot eat are seeds and nuts! Nuts! Anyway, just wondering what the multivitamin you mentioned is that provides E from rice. I'd like to try it! I'll also try to work more greens into my diet!

And any other suggestions of non-nut sources are welcome!

Thanks! Chris

[The Healthy Librarian]

Chris, I take (not regular at all) MegaFood Women Over 40 One Daily, made from whole food. Consumerlab said it did not dissolve as fast as it should based on it's testing--took 40 minutes, instead of 30. I now put it in my little coffee grinder & mix it into a smoothie. Could you eat nuts or seeds in the "Butter" format, as in sunflower seed butter, or almond butter, or tahini? Would that not be irritating? I wrote the company about this & here's what they replied:

Hello Debbie,

Thank you for taking the time to contact us!

The nutrients in MegaFood products are delivered through a variety of whole foods meant to be assimilated in the digestive tract just as food would be. Our products are not meant to dissolve in water as fast as say a Flintstone vitamin would, just as you wouldn't expect to see broccoli dissolve in water.

We truly appreciate Consumer Labs commitment to consumer safety, but because our products consist of complex food nutrients the USP test that they used simply does not apply to our products.

I hope you find this information helpful. Please feel free to reach out with additional questions.

Best,

ABIGAIL McSHINSKY
Customer Inquiries

[Chris O'Keefe]

That is useful information, and thanks for going the extra mile and getting details about the vitamins!!

I appreciate it, and am going to give tahini a shot!

Thanks again!!
Chris

[Kate]

I thought this recipe looked good(Nut and Seed energy balls). It is from Nava Atlas's Veg Kitchen FB page. After reading this post I made a batch for the first time. They are sitting in my refrigerator. Haven't tried one yet, but I think I will like them. I ground up the sesame seeds and also added ground flax. I feel like if I don't grind them up I will wind up swallowing them whole.

[Kate]

Here is the link that I forgot to include in my post about the Nut and Seed Energy Balls - www.vegkitchen.com/recipes/vegan-baking-and-sweets/no-bake-and-raw-sweets/nut-and-seed-energy-balls/