Vitamin E
What is Vitamin E?
Vitamin E is an antioxidant known for its role in protecting cells, tissues, and organs from damage and immune-enhancing activity. Studies suggest that children with autism are at risk for vitamin E depletion, and that recommended intake has the potential to protect brain function.
Vitamin E is a fat-soluble nutrient that can be found in various nuts, seeds, and vegetable oils [1].
The fat-soluble aspect of the vitamin means that it is largely present in fat-containing foods and is much better absorbed in the bloodstream when eaten with a fat source.
In the body, vitamin E acts as an antioxidant, helping to protect the body’s cells from damage [2].
Additionally, vitamin E has been found to have immune-enhancing and anti-inflammatory properties, while also decreasing one’s risk of developing blood clots [1].
Vitamin E is made up of eight natural compounds that appear in foods - four kinds of tocopherols and four kinds of tocotrienols - each of which has a different activity in the body.
Alpha-tocopherol is considered the most active form of the vitamin and is frequently found listed on food packaging and supplement labels [3].
Some research has shown that children with autism are more likely to have lower levels of vitamin E [4]
Food Sources of Vitamin E
When it comes to dietary sources, vitamin E can be found naturally in foods especially those that contain fat [1]. Good sources of vitamin E include:
Some vegetable oils, such as:
Wheat germ oil
Sunflower oil
Nuts and seeds, such as:
Sunflower seeds
Red sweet bell pepper
Recommended Intake
The recommended amount of vitamin E that males and females need each day is dependent on age. These amounts are based on the Recommended Dietary Allowance (RDA), which is the average daily level of intake sufficient to meet the nutrient recommendations of nearly all (97-98%) of healthy individuals [3].
Males and Females
1-3 years: 6 mg/d
4-8 years: 7 mg/d
9-13 years: 11 mg/d
14-18 years: 15 mg/d
19+ years: 15 mg/d
Deficiency
The risk of deficiency is higher in selective eaters or people who have digestive disorders or are unable to properly digest and absorb fat (e.g., Crohn's disease, cystic fibrosis, celiac disease) [5].
Symptoms of deficiency may include [5]:
Difficulty walking or with coordination (ataxia)
Vision problems (retinopathy)
Loss of feeling in arms and legs (peripheral neuropathy)
Weakened immune function
Individuals at increased risk for vitamin B5 inadequacy include those who have [3]:
Restrictive diets and poor intake of vitamin E food sources and/or fat
Gastrointestinal difficulties affecting fat digestion and absorption
Toxicity
There have been no reported toxic effects from consuming increased amounts of vitamin E from natural food sources. However, research has shown the risk for increased bleeding when vitamin E supplement doses are greater than 1000 mg/d or if an individual is taking a blood-thinning medication such as warfarin. Thus, an upper limit for vitamin E has been established [5].
Upper Limits of Vitamin E
Males and Females
1-3 years: 200 mg/d
4-8 years: 300 mg/d
9-13 years: 600 mg/d
14-18 years: 800 mg/d
≥19 years: 1000 mg/d
Supplements
Dietary supplements for vitamin E come in multiple amounts and forms. They can be found in a multivitamin-mineral supplement or as a vitamin-E only supplement.
Vitamin-E only supplements often provide much higher doses than is recommended for adults. In addition, vitamin E supplements can be naturally or synthetically sourced. Vitamin E that comes from a natural source is listed as “d-alpha-tocopherol”, and if it is from a synthetic (laboratory-made) source it will read as “dl-alpha-tocopherol” [1]. The supplements will tell you the amount and the percentage of each on the supplement facts label.
Examples
Capsules/softgels (softgels can be punctured, if needed)
See multivitamins for a combination supplement
Note: All supplements are linked to Amazon for convenience, however, buying supplements on Amazon does not guarantee quality, as there are many “unverified resellers” selling nutrition supplements. To buy supplements that are verified to be sent directly to the consumer, you can create an account on the Autism Dietitian FullScript and search for the respective supplement under “Catalog”.
DISCLAIMER: Before starting any supplement or medication, always consult with your healthcare provider to ensure it is a good fit for your child. Dosage can vary based on age, weight, gender, and current diet.
Vitamin E & Autism in the Research
Inadequacy
Children with autism were found to have lower levels of vitamin E compared to children without autism [4].
When looking at the differences in nutrient intake among children with autism by ethnicity, Hispanic children were shown to have a greater intake of vitamin E than white children [6].
There is an increased risk for vitamin E inadequacy in children with autism with severe food selectivity [7].
Autism Severity
A significant correlation was found between vitamin E depletion and the severity of autism [8].
Brain Health
Tocotrienol-rich vitamin E has demonstrated potential in the prevention of neurodegenerative disorders [9].
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[1] Rizvi S, Raza ST, Ahmed F, Ahmad A, Abbas S, Mahdi F. The role of vitamin e in human health and some diseases. Sultan Qaboos Univ Med J. 2014;14(2):e157-e165.[2] Mount Sinai Health Library. Vitamin E. Mount Sinai; Available from:https://www.mountsinai.org/health-library/nutrition/vitamin-e
[3] National Institutes of Health Office of Dietary Supplements. Vitamin E. National Institutes of Health; 2020. Available from: https://ods.od.nih.gov/factsheets/VitaminE-Consumer/
[4] Adams JB, Audhya T, McDonough-Means S, et al. Nutritional and metabolic status of children with autism vs. neurotypical children, and the association with autism severity. Nutrition & Metabolism. 2011;8(1):34.
[5] The Nutrition Source. Vitamin E. Harvard School of Public Health; Available from: https://www.hsph.harvard.edu/nutritionsource/vitamin-e/#:~:text=Recommended%20Amounts,mg%20(28%20IU)%20daily.
[6] Buro A, Gray H. P142 Ethnicity Differences in Nutrient Intake, Diet Quality, and Mealtime Behaviors Among Children with Autism Spectrum Disorder (ASD). Journal of Nutrition Education and Behavior. 2019;51(7):S96.
[7] Sharp WG, Postorino V, McCracken CE, et al. Dietary intake, nutrient status, and growth parameters in children with autism spectrum disorder and severe food selectivity: an electronic medical record review. Journal of the Academy of Nutrition and Dietetics. 2018;118(10):1943-1950.
[8] Adams JB, Audhya T, McDonough-Means S, et al. Nutritional and metabolic status of children with autism vs. neurotypical children, and the association with autism severity. Nutr Metab (Lond). 2011;8:34.
[9] Gumpricht E, Rockway S. Can ω-3 fatty acids and tocotrienol-rich vitamin E reduce symptoms of neurodevelopmental disorders? Nutrition. 2014;30(7):733-738.
Authors
April Allen, Dietetic Intern
Laura Flournoy, Dietetic Intern
Brittyn Coleman, MS, RDN/LD, CLT
