Suboptimal Serum α-Tocopherol Concentrations Observed among Younger Adults and Those Depending Exclusively upon Food Sources, NHANES 2003-20061-3

Michael I McBurney, Elaine A Yu, Eric D Ciappio, Julia K Bird, Manfred Eggersdorfer, Saurabh Mehta, Michael I McBurney, Elaine A Yu, Eric D Ciappio, Julia K Bird, Manfred Eggersdorfer, Saurabh Mehta

Abstract

Vitamin E is an essential nutrient for human health, with an established function as a lipid-soluble antioxidant that protects cell membranes from free radical damage. Low vitamin E status has been linked to multiple health outcomes, including total mortality. With vitamin E being identified as a 'shortfall nutrient' because >90% of American adults are not consuming recommended amounts of vitamin E, we aimed to determine the prevalence of both clinical vitamin E deficiency (serum α-tocopherol concentration < 12 μmol/L) and failure to meet a criterion of vitamin E adequacy, serum α-tocopherol concentration of 30 μmol/L, based on the Estimated Average Requirement (EAR) and lowest mortality rate in the Alpha-Tocopherol Beta-Carotene (ATBC) study. The most recent nationally-representative cross-sectional data (2003-2006) among non-institutionalized US citizens with available serum concentrations of α-tocopherol from the National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention were analyzed. Serum α-tocopherol distributions were compared between those reporting consumption of food without supplement use (FOOD) and food and supplement use (FOOD+DS) by sex, age, and race/ethnicity. Only 1% of the US population is clinically deficient. FOOD consumers have lower average α-tocopherol levels (24.9± 0.2 μmol/L) than FOOD+DS users (33.7 ± 0.3 μmol/L), even when adjusted for total cholesterol. Using a criterion of adequacy of 30 μmol/L, 87% of persons 20-30 y and 43% of those 51+y had inadequate vitamin E status (p<0.01). A significant greater prevalence of FOOD compared to FOOD+DS users did not meet the criterion of adequacy which was based on the EAR and low ATBC mortality rate consistently across age, sex, and race/ethnic groups. The prevalence of inadequate vitamin E levels is significantly higher among non-users of dietary supplements. With declining usage of vitamin E supplements, the population should be monitored for changes in vitamin E status and related health outcomes.

Conflict of interest statement

Competing Interests: The authors have the following interests: This study was supported by DSM Nutritional Products, a manufacturer of vitamins, including vitamin E, for food, dietary supplement, and pharmaceutical use. MM, EC, JB, and ME are employees of DSM Nutritional Products. There are no patents, products in development or marketed products to declare. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Fig 1. Distribution of serum α-tocopherol concentrations…
Fig 1. Distribution of serum α-tocopherol concentrations among individuals ≥20y, excluding pregnant or lactating women, stratified by supplement use.
Lines represent density (as a percentage) through non-parametric kernel density estimation.
Fig 2. Distribution of serum α-tocopherol:total cholesterol…
Fig 2. Distribution of serum α-tocopherol:total cholesterol concentrations among individuals ≥20y, excluding pregnant or lactating women, stratified by supplement use.
Lines represent density (as a percentage) through non-parametric kernel density estimation.
Fig 3. Distribution of serum α-tocopherol concentrations…
Fig 3. Distribution of serum α-tocopherol concentrations among individuals ≥20y, excluding pregnant or lactating women, stratified by sex and supplement use.
A. Males. B. Females. Lines represent density (as a percentage) through non-parametric kernel density estimation.
Fig 4. Distribution of serum α-tocopherol concentrations…
Fig 4. Distribution of serum α-tocopherol concentrations among individuals ≥20y, excluding pregnant or lactating women, stratified by race-ethicity and supplement.
A. Non-Hispanic White. B. Non-Hispanic Black. C. Mexican American. D. Other. Lines represent density (as a percentage) through non-parametric kernel density estimation.
Fig 5. Proportion (%) of adults ≥20y…
Fig 5. Proportion (%) of adults ≥20y at or below the serum α-tocopherol concentration shown on the Y-axis, excluding pregnant or lactating women, for the total population and by supplement use.
The dotted horizontal line represents a criterion of adequacy set at 30 μmol/L.

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