In a recent webinar from the American Society of Nutrition, Dr. Maret Traber and Dr. Joan M. Cook-Mills discussed the importance of meeting the ERA for vitamin E in expecting mothers and infants; specifically the a-tocopherol instead of g-tocopherol. In today’s society, we have some of the most advanced medical for people throughout the world, and new practices with pre-natal care that have shown to greatly help influence embryo development. However, even with all of these new practices and advancements, the current miscarriage rate amount women in the United States is over 20%. Currently, only about 4% of women meet the RDA for vitamin E, and 96% fall below the RDA of 15 mg a day.
So what role does vitamin E play in the development of the embryo and through the early stages of development, specifically to the brain? Vitamin e is a fat soluble antioxidant, meaning that it breaks down free radicals in the body, but not just any free radicals. This antioxidant breaks down a specific free radicals that can damage the brain and comes from a process known as lipid peroxidation. Lipid peroxidation is the oxidative degradation of lipids, most commonly polyunsaturated fatty acids. In the process, free radicals “steal” electrons from the lipids in cell membranes, resulting in cell damage. Vitamin e, specifically a-tocopherol, block these free radicals from removing the electron from the cell membranes of these lipids and prevent cell damage.
You might be wondering how this matters, or if they can even tell that it has anything to do with embryonic development. However, Dr. Traber and Oregon State University conducted a study with zebra fish to examine the difference in embryo development in fish with a vitamin e sufficient diet compared to those with an insufficient vitamin e diet. Those fish who had a sufficient diet, had fully developed and normal functioning embryos. Those who were insufficient were not able to develop, specifically in the brain, and all fish had died after 5 days of birth. But how does this related to humans? Well upon examination of variations of vitamin e that was needed in a variety of species, all had the same core components, most specifically a-tocopherol.
Based on the current evidence paired with the lack of vitamin e intake in women, the speakers made some recommendations that could assist in improving vitamin e supplementation. First, making sure that an adequate amount of vitamin e is in pre natal vitamins. As for the diet during pregnancy, consuming more a-tocopherol and less g-tocopherol could be beneficial as g-tocopherol increases inflammation from allergic responses. Additionally, decrease the amount of N-6 fatty acids consumed as longer chain polyunsaturated fats increase the amount of free radicals produced, and increase the amount of N-3 fatty acids (omega-3) consumed as they are the shortest chains, and produce less free radicals. All of these recommendations could help improve the embryonic development and improve development in the early stages of childhood development.
David, just wanted to give a quick reply to your comment and give some clarification, the study that you provided did actually show one benefit, and that was a decrease in the risk of placental abruption. Additionally, looking out the results of abdominal pain, which was self reported, they may have been a statistically significant difference, it was a loss change and may not be clinically significant. Lastly, the topic of term prelabor rupture of membranes. I did a little, more research into the topic of lrelabor membrane rupture, and it is actually more common than you think. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2492588/#!po=1.61290) according to this study, nearly 10% of all pregnancies at term (meaning at least 37 weeks) will have term prelabor membrane rupture. Additionally, over 99% if these pregnancies will be completed without complication, and most women will begin having contractions within 12 hours if the membrane rupture. The true problem with prelabor membrane rupture is when the fetus is preterm, but the study you brought up found no difference in that condition. Lastly, the authors of your study themselves stated there was no data or support the belief that women taking vitamin e would would be at a greater risk for adverse pregnancy outcomes. One thing i did not like about the study is that it did not examine the neurocognitive outcomes of the children produced in the studies examined in the review, and that was the purpose of vitamin e supplementation in the webinar i viewed.
Anthony – Knowledge about the best practices regarding prenatal healthcare is important both for the health of the mother and her child. Regarding your comment about the current state of medicine, it is still surprising that many soon-to-be mothers could still be uninformed about all the intricacies of their pregnancy, which makes it that much more vital to continue researching this complex process and adequately disseminating the findings. I was intrigued that the research team chose to use an animal model in their study at the expense of a lack of application to a human model. Thus, I did a quick Google search and found a helpful website (https://www.yourgenome.org/facts/why-use-the-zebrafish-in-research) that seems to corroborate the use of this specific fish due to the similarities of its genetic structure with that of a human. Finally, I also decided to Google Vitamin E and prenatal health and found a review (http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004069.pub3/full) that not only finds no benefits from taking Vitamin E, but also states that “it may increase abdominal pain for women and also increase the number of women having early rupture of membranes at term.” While this seems counter intuitive and disagrees with the webinar you watched, at the very least it confirms the fact that more research still needs to be conducted concerning the best practices for prenatal healthcare.