vitamin E

from The George Mateljan Foundation World’s Healthiest Foods

For serving size for specific foods see the Nutrient Rating Chart.

Basic Description Role in Health Support Summary of Food Sources Nutrient Rating Chart Impact of Cooking, Storage and Processing Risk of Dietary Deficiency Other Circumstances that Might Contribute to Deficiency

Relationship with Other Nutrients Risk of Dietary Toxicity Disease Checklist Public Health Recommendations References

Basic Description

Vitamin E is a blanket term for eight different naturally occurring nutrients—four different tocopherols and four different tocotrienols. Each of these vitamin E types is considered a fat-soluble antioxidant, and all eight are found in varying degrees in our daily diet. You may sometimes hear all eight molecules being referred to collectively as “tocochromanols.”

The most famous of the vitamin E group is alpha-tocopherol. Both with respect to diet and high-dose supplementation, it is among the most intensely studied of nutrients. This is because its ability to help prevent free radical damage is well documented Public health recommendations for vitamin E are typically measured in milligram equivalents of alpha-tocopherol equivalents, or mg ATE. You will find this abbreviation being used throughout our live website charts.

However, despite the current prominence of alpha-tocopherol in public health recommendations and nutrition research, scientists are also interested in potential health benefits associated with lesser studied members of the vitamin E family, especially the tocotrienols. Like tocopherols (including alpha-tocopherol), tocotrienols are naturally occurring forms of vitamin E. Since they cannot be converted by humans into alpha-tocopherol, the tocotrienols are not considered relevant in meeting vitamin E needs. However, preliminary studies suggest that tocotrienols can provide us with health benefits in a way that is distinct from alpha-tocopherol, as well as other tocopherols. We look forward to future research in this area.

In this introductory description of vitamin E, it is also worth mentioning the unusually confusing nature of its units of measurement. There is really no such thing as “milligrams of vitamin E” since this description fails to explain what forms of the vitamin were considered when making the determination. As mentioned earlier, our website chart present vitamin E data in terms of “mg ATE” which stands for “milligrams of alpha-tocopherol equivalents.” However, other types of equivalents can be used in presenting vitamin E data. For example, equivalents of d-alpha-tocopheryl acetate and equivalents of d-alpha-tocopheryl succinate can be used. (These two chelated, synthetic forms of vitamin E are frequently found in dietary supplements due to their longer shelf life).

While many of the World’s Healthiest Foods are rich in vitamin E, we see that average U.S. adults fail to come close to a minimal requirement for this important nutrient. Below, we’ll give you some guidance to help you chose foods rich in vitamin E that will better help you meet your daily needs.

You’ll have a number of foods to choose from to build a menu that is rich in vitamin E. We list seven of the World’s Healthiest Foods as excellent sources of vitamin E. Another six foods rate as very good sources, while twelve foods are listed as good.

Role in Health Support

Protection Against Free Radical Damage

Vitamin E is a potent antioxidant. Because it is fat soluble, we see it offer protection against damage to the fats that line the outside of every cell of our body.

When the fats in our membranes become damaged, important cell functions become compromised. Based on this important mechanism, researchers have studied whether diets low in vitamin E are associated with many diseases associated with aging.

We also see vitamin E protect fats from free radical damage before we eat them. We’ll talk about the role of vitamin E in protecting foods during storage below in the Impact of Cooking, Storage, and Processing section.

Protection Against Heart Disease

Vitamin E helps protect LDL cholesterol (sometimes referred to as “bad” cholesterol) from free radical damage. Free radical damage typically involves an unwanted interaction with a reactive oxygen-containing molecule. When vitamin E is deficient—and under some other circumstances as well—it is possible for LDL cholesterol to become insufficiently protected and damaged by oxygen. When damaged in this way, the LDL cholesterol is often referred to as “oxidized LDL.” If the process continues, it is possible for oxidized LDL to accumulate in blood vessel walls and create the early stages of hardening of the arteries (atherosclerosis).

Diets rich in vitamin E from vegetables, fish, and plant oils—like the Mediterranean diet for example—have been linked to cardiovascular prevention in large health surveys. Understand, though, that the potential benefits of this diet are not limited to or fully explained by vitamin E, and that dietary supplements of vitamin E (in comparison to vitamin E in food) have not demonstrated the same sort of preventive benefit that researchers hoped to see.

Summary of Food Sources

Of our seven excellent sources of vitamin E, five are green leafy vegetables. Followers of our WHFoods site will probably not be surprised by this—green leafy vegetables score well as sources of many different nutrients. With respect to vitamin E, their combination of nutrient richness and low calories is very compelling to our rating system. Expect each serving of greens to contain about 15 to 25% of your daily requirement.

Outside of greens, the foods with the most vitamin E tend to be high fat foods. These include nuts, seeds, extracted oils, and fatty fish. The amount of vitamin E per serving of nuts or seeds can vary widely, but you should expect to receive at least about 10% of your daily need, and sometimes as much as 80% (as we see with sunflower seeds).

Many oil rich-plants give us good amounts of vitamin E. These include olives and avocados, both of which provide between 10-15% of your daily need. Because these oily foods contain more calories, we rate them as good rather than very good or excellent sources. Still, we encourage using these plants or plant oils to help provide vitamin E.

We see a few of our World’s Healthiest seafoods are rich sources of vitamin E. Shrimp and sardines are two examples of this, with each topping 10% of daily requirements. Salmon and cod contain a little less vitamin E, yet can still be solid contributors.

Because most U.S. residents fail to get enough vitamin E in their daily diet, we recommend paying some attention to food sources of this important antioxidant. As long as you make a few of these vitamin E rich foods staple foods in your daily diet, you should be able to meet your intake requirements through foods alone..

Perhaps the easiest way to make sure you are getting enough vitamin E is by including sunflower seeds as snacks or as part of meals. This recipe for Healthy Turkey Salad contains nearly the whole Dietary Reference Intake (DRI) in one meal. Here are a few more recipes—Pureed Sweet Peas and 5-Minute Collard Greens with Sunflower Seeds—that include sunflower seeds.

We can also rely on meals that contain multiple foods providing more modest amounts of vitamin E, and allow them to stack up to become a more substantial amount. Our Poached Eggs Over Spinach and Mushrooms recipe contains spinach, eggs, and olive oil as sources of vitamin E. Together, they provide one-third of the RDA in only 10% of your daily calorie intake.

Recipes that contain nuts and nut butters will be a nice way to add vitamin E into your meals. You can be creative in the way you do this; for example, our 10-Minute Apricot Bars is a dessert recipe that provides more than 40% of the RDA for vitamin E.

There is a balance between getting plenty of fat-rich foods as sources of vitamin E and overdoing it and letting the calories pile up. As long as you choose wisely, you should be able to cover your vitamin E needs with just a few rich sources.

Nutrient Rating Chart

Introduction to Nutrient Rating System Chart

In order to better help you identify foods that feature a high concentration of nutrients for the calories they contain, we created a Food Rating System. This system allows us to highlight the foods that are especially rich in particular nutrients. The following chart shows the World’s Healthiest Foods that are either an excellent, very good, or good source of vitamin E. Next to each food name, you’ll find the serving size we used to calculate the food’s nutrient composition, the calories contained in the serving, the amount of vitamin E contained in one serving size of the food, the percent Daily Value (DV%) that this amount represents, the nutrient density that we calculated for this food and nutrient, and the rating we established in our rating system. For most of our nutrient ratings, we adopted the government standards for food labeling that are found in the U.S. Food and Drug Administration’s “Reference Values for Nutrition Labeling.” Read more background information and details of our rating system.

Impact of Cooking, Storage and Processing

The vitamin E in foods degrades slowly over time. For example, at room temperature, wheat flour loses about one-third of its vitamin E at close to one year of storage. That said, most people would be making use of their wheat flour long before this year-long time period.

Similarly, olive oil kept in a closed bottle will lose about 20-30% of its vitamin E over six months of storage. Don’t leave the bottle open, though, as all of the vitamin E will be gone after three or four months if you do. (While leaving olive oil in an opened bottle might sound unlikely, there are a good number of olive oil containers in the marketplace that feature an unsealed spout, and we do not recommend storage of olive oil in this way. You will find many more details about olive oil storage in our Extra Virgin Olive Oil food profile.)

Vitamin E also gets damaged by high heat cooking. For example, heating olive oil at 340°F (172°C) will lead to a destruction of the vitamin E, with almost half lost at three hours, and almost all of it gone by six hours. At WHFoods, we do not generally recommend any heating of extra virgin olive oil, and if we do include it in a heated sauce or other recipe, we heat it very gently and briefly. The delicate nature of vitamin E, and the fatty acids it protects, are good reasons to avoid heating of this oil. We adopt a similar approach for oil-rich foods like nuts and seeds, which we recommend be consumed in raw or minimally cooked form.

Usually in this section of our nutrient profiles, we discuss how specific nutrients are damaged in the storage of foods. But with respect to vitamin E, it is equally important to note that this nutrient can protect the foods from damage. For example, meat from chickens fed diets high in vitamin E show less evidence for free radical damage to their fats over 10 days of storage. Presumably, this vitamin E richness in the food consumed by the chickens helped protect their body fat from damage by oxygen. (We don’t have research comparing the human health consequences of consuming chicken fat with and without varying degrees of free radical damage. But we do know that animals fed diets that are rich in vitamin E typically provide us with animal foods that have good amounts of this vitamin as well.)

Risk of Dietary Deficiency

Given that the average U.S. adult eats exactly half the Dietary Reference Intake (DRI) for vitamin E—7.5 mg of the recommended 15 mg per day—the risk of dietary deficiency of vitamin E in the United States is substantial. In fact, vitamin E is one of the most common vitamin deficiencies in the United States, with as many as 92% of men and 98% of women failing to reach target intake goals.

In 2006, a research group from Tufts University did a statistical model of the best way to ensure vitamin E nutrition while staying within normal calorie levels and without impairing other nutrient intake. Among their conclusions, they asserted that a low intake of nuts and seeds—70% of their subjects didn’t eat any of either—was predictive of low vitamin E intake. Analyzing this conclusion in reverse, this is further evidence that nuts and seeds can be a good place to start when trying to achieve strong vitamin E nutrition. (Of course, low intake of dark green leafy vegetables by the average U.S. adult is another reason why so many people in the U.S. fail to meet their vitamin E needs.)

At first, it may seem like a paradox that we tend to eat diets high in fat, yet fail to have reliable vitamin E nutrition. That’s because not every type of dietary fat is as rich in vitamin E as nuts or seeds. The way plant cooking oils are manufactured and processed can lead to significant destruction of the nutrient before it ever gets to your plate. Generally speaking, you should expect highly processed foods (e.g., oils made from nuts and seeds) to contain less vitamin E than their whole, natural counterparts (e.g., whole nuts and seeds).

Other Circumstances that Might Contribute to Deficiency

Diets that overly restrict fat can limit vitamin E intake substantially. It will not be impossible to achieve vitamin E nutrition with a very low fat diet, but you’ll need to work much harder to do it. For example, if you decided that you wanted to get 100% of your DRI for vitamin E from sunflower seeds alone—our richest WHFoods source—you would need to allow for 18 grams of fat in your day’s food just to provide that amount. In an 1,800-calorie meal plan, that amount of fat would represent 9% of total calories all by itself. If you consumed an additional 18 grams of fat from all of the rest of your foods on that day, you diet for that day would already be close to 20% fat. On the other hand, if you were willing to obtain your vitamin E exclusively from dark green leafy vegetables, you could get 100% of the DRI from about 5 cups, representing 150-200 calories but only 2-5 grams of fat.

Any disease or medication that impairs the ability to digest fats will also endanger vitamin E nutrition. If this potentially describes you, make sure to talk to your doctor to make sure that you are protected against deficiency.

Relationship with Other Nutrients

Diets high in polyunsaturated fats—the type found in most fish and vegetable oils—may increase your requirement for vitamin E. Some sources recommend an older standard of an extra 0.6 mg of vitamin E for each gram of polyunsaturated fat. We are not convinced that this level of specificity is well supported, even though the principle of increasing vitamin E intake along with increased intake of polyunsaturated fat makes good sense to us. The World’s Healthiest Foods recipes tend to be moderate in polyunsaturated fats (and much higher in the more stable monounsaturated fats than most U.S. diets), and as such, we believe that our WHFoods recommendation of 15 milligrams of d-alpha-tocopherol equivalents per day should suffice for the average person.

Like other dietary antioxidants, vitamin E needs help from multiple nutrients to do its job at maximum efficiency. In particular, vitamin C helps to recycle vitamin E so it can continue to neutralize free radicals over and over again.

If vitamin K levels are low, too much vitamin E can lead to problems involving too easy bleeding from injuries and too slow closing of wounds. The amounts of vitamin E necessary to create this effect are large, however, and probably not achievable via diet alone. (In other words, dietary supplementation of vitamin E would most likely be required to create this degree of imbalance between vitamin E and vitamin K.)

Risk of Dietary Toxicity

We are not aware of a single published report of adverse effects from dietary vitamin E. Reflecting this lack of evidence for harm, the National Academy of Sciences set the Tolerable Upper Intake Limit (UL) for vitamin E at 1000 mg, more than 60 times the DRI, and more than 100 times what an average American eats in a day. You can feel confident that you are not eating toxic levels of vitamin E in your daily diet. Translated into IU, 1,000 milligrams of vitamin E represents 1,490 IU of d-alpha-tocopherol and 1,360 IU of d-alpha-tocopheryl acetate.

Disease Checklist

• Cancer
• Heart attack
• Stroke
• PMS
• Fibrocystic breast disease
• Diabetes
• Epilepsy
• Alzheimer’s disease
• Parkinson’s disease
• Macular degeneration
• Cataract
• Intermittent claudication
• Cold sores
• Immune health

Public Health Recommendations

In 2000, the National Academy of Sciences established a set of Dietary Reference Intakes (DRIs) for vitamin E. These recommendations included Adequate Intake (AI) levels for infants under one year of age, and Recommended Dietary Allowances (RDAs) for everyone else. These milligrams amounts represent alpha-tocopherol equivalents, or mg ATE. DRIs for vitamin E are as follows:

• 0-6 months: 4 mg
• 6-12 months: 5 mg
• 1-3 years: 6 mg
• 4-8 years: 7 mg
• 9-13 years: 11 mg
• 14+ years: 15 mg
• Pregnant women: 15 mg
• Lactating women: 19 mg

The most common DRI for vitamin E—15 milligrams ATE (alpha-tocopherol equivalents) —translates into approximately 22 IU of d-alpha-tocopherol and 20 IU of d-alpha-tocopheryl acetate. (The form of d-alpha-tocopherol is a naturally occurring form of vitamin E that is chemically classified as “non-esterified” and d-alpha-tocopheryl acetate is an esterified form commonly found in supplements due to its longer shelf life.)

The 2000 DRI recommendations also included a Tolerable Upper Intake Limit (UL) for adults of 1000 mg per day. As discussed above, this is more than an order of magnitude beyond even what the most vitamin E-rich diet could ever contain. For this reason, we should consider this UL more for supplement intake than guidance around dietary choices. Translated into IU, 1,000 milligrams of vitamin E represent 1,490 IU of d-alpha-tocopherol and 1,360 IU of d-alpha-tocopheryl acetate.

The Daily Value (DV) for vitamin E is 30 IU. The measurement of IU, short for International Units, is an older way to quantify vitamin E with 1 milligram of d-alpha-tocopherol from food equivalent to 1.49 IU.

References

• Azzini E, Polito A, Fumagalli A, et al. Mediterranean diet effect: an Italian picture. Nutr J 2011;10:125.
• Ben-Hassine K, Taamalli A, Ferchichi S, et al. Physicochemical and sensory characteristics of virgin olive oils in relation to cultivar, extraction system and storage conditions. Food Res Int 2013;54:1915-25.
• Casal S, Malheiro R, Sendas A, et al. Olive oil stability under deep-frying conditions. Food Chem Toxicol 2010;48:2972-9.
• Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press; 2000;284-324.
• Gao X, Wilde PE, Lichtenstein AH, et al. The maximal amount of dietary alpha-tocopherol intake in US adults (NHANES 2001-2). J Nutr 2006;136:1021-6.
• Krichene D, Allalout A, Mancebo-Campos V, et al. Stability of virgin olive oil and behavior of its natural antioxidants under medium temperature accelerated storage conditions. Food Chem 2010;121:171-7.
• Luciano G, Moloney AP, Priolo A, et al. Vitamin E and polyunsaturated fatty acids in bovine muscle and the oxidative stability of beef from cattle receiving grass or concentrate-based rations. J Anim Sci 2011;89:3759-68.
• Narciso-Gaytan C, Shin D, Sams AR, et al. Dietary lipid source and vitamin E effect on lipid oxidation stability of refrigerated fresh and cooked chicken meat. Poult Sci 2010;89:2726-34.
• Nielsen MM, Hansen A. Stability of vitamin E in wheat flour and whole wheat flour during storage. Cereal Chem 2008;85:716-20.
• Sen CK, Khanna S, and Roy S. (2006). Tocotrienols: vitamin E beyond tocopherols. Life Science 78(18): 2088-2098.
• U.S. Department of Agriculture, Agricultural Research Service. 2012. Total Nutrient Intakes: Percent Reporting and Mean Amounts of Selected Vitamins and Minerals from Food and Dietary Supplements, by Family Income and Age, What We Eat in America, NHANES 2009-2010.
• Valk EE, Hornstra G. Relationship between vitamin E requirement and polyunsaturated fatty acid intake in man: a review. Int J Vitam Nutr Res 2000;70:31-42.