Written by Jessica Patella, ND. In a 12 year study of 2322 men aged 50, those with the lowest blood levels of vitamin E had a 167% greater risk of bone fracture.
Osteoporosis is a major concern for postmenopausal women, affecting over 4.5 million women over the age of 50 years (1). Osteoporosis often leads to fractures, which affects quality of life and mortality (2). Research is now showing that an increase in oxidative stress, which increases with aging, plays a role in age-related bone loss and osteoporosis (2,3). One of the most potent antioxidants to protect against oxidative stress is alpha-tocopherol, a form of vitamin E (2-4). Recent research has found that low intakes of alpha-tocopherol are associated with an increased risk of fracture in elderly men and women (2).
To evaluate vitamin E and fracture rate in women, the Swedish Mammography Cohort study, which included 90,303 women in Sweden, was reviewed. Diet and nutritional intake was recorded, based on food frequency questionnaires. During the average 19-year follow-up, 14,738 women experienced a fracture (3871 were hip fractures). When comparing alpha-tocopherol (vit E) intakes to fracture risk, there was a significant increase of fractures in women that did not consume at least 5 mg of alpha-tocopherol per day (average highest intake: 6.8 mg per day and the average lowest intake: 4.3 mg per day resulted in an adjusted hazard ratio of 1.86 (95% CI 1.67, 2.06)) (2).
To study men, the Uppsala Longitudinal Study of Adult Men cohort was reviewed. This included 2322 men who were 50 years old at enrollment and who were followed for an average of 12 years (2). Diet and nutritional intake was recorded in this cohort based on a 7-day diet diary. Again, lower intakes of alpha-tocopherol were associated with an increased risk of fractures ((average highest intakes: 8.1 mg per day and the lowest intake: below 4.1 mg per day resulted in an adjusted hazard ratio of 2.67 (95% CI 1.33, 5.38)) (2).
The Swedish Mammography study also found that there was a higher risk of both osteoporosis and sarcopenia (loss of muscle mass) in women with low intakes of alpha-tocopherol. For each 3 mg decrease in alpha-tocopherol intake, there was a significant difference in the bone mineral density (BMD) (each 3-mg resulted in 1.1% decrease BMD in the femur (P=0.005) and a 0.8% decrease in BMD in the lumbar spine with a p value of 0.09 (not considered significant) (2).
This was the first study to discover an association between low alpha-tocopherol intakes and increased fracture risk (2). Although it was a combination of two cohort studies, there were a large number of participants, which increases the strength of the association. Future research studies will be needed to confirm results.
In conclusion, consuming higher amounts of alpha-tocopherol per day of 6.8 mg – 8.1mg (10.2 to 12.2 IU) resulted in a lower risk for fractures in both men and women (2).
Source: Michaëlsson, Karl, et al. “Intake and serum concentrations of α-tocopherol in relation to fractures in elderly women and men: 2 cohort studies.” The American journal of clinical nutrition 99.1 (2014): 107-114.
© 2014 American Society for Nutrition
Posted March 3, 2014.
References:
- Centers for Disease Control and Prevention. Osteoporosis. Fast Stats.
- Michaelsson K, et al. Intake and serum concentrations of alpha-tocopherol in relation to fractures in elderly women and men: 2 cohort studies. 2013 Am J Clin Nutr doi:10.3945/ajcn.113.064691.
- Manolagas SC, Parfitt AM. What old means to bone. Trends Endocrinol Metab 2010; 21:369-74.
- Shuid AN, et al. Effects of alpha-tocopherol on the early phase of osteoporotic fracture healing. J Orthop Res 2011;29:1732–8.
