What is Vitamin E
Vitamin E is an antioxidant. This means it protects body tissue from damage caused by substances called free radicals, which can harm cells, tissues, and organs. They are believed to play a role in certain conditions related to aging.
Vitamin E is also important in the formation of red blood cells and it helps the body use vitamin K. It also helps widen blood vessels and keep blood from clotting inside them. On top of that the body also needs vitamin E to help keep the immune system strong against viruses and bacteria.
In epidemiological studies, higher intakes of vitamin E have been related to reduction in cardiovascular disease, diabetic, certain cancers and cataracts. (1)
It is estimated that >90% of Americans do not consume sufficient dietary vitamin E, as α-tocopherol, to meet estimated average requirements. (2)
Deficiency of Vitamin E
Symptoms not very clear cut, but may include fatigue, inflamed varicose veins, wounds healing slowly, premature aging and sub-fertility, acne, anemia, muscle disease, dementia, cancers, gallstones, shortened red blood cell life span, spontaneous abortion (miscarriage), and uterine degeneration
Without sufficient E in the body, the essential fatty acids are altered so that blood cells break down and hemoglobin formation is impaired. Several amino acids cannot be utilized, and pituitary and adrenal glands reduce their level of functioning, iron absorption and hemoglobin formation are impaired.
The average diet today contains much less natural vitamin E than it did 50 years ago. This is partially due to lack of nutrients in the soil as well as use of farming pesticides.
Where is Vitamin E found?
Vitamin E is found in nuts, oils, vegetables, sunflower seeds, whole grains, spinach, oils, seeds, wheat oils, asparagus, avocado, beef, seafood, apples, carrots, celery, etc .
Vitamin E is lost in food processing which includes milling, cooking, freezing, long storage periods and when exposed to air. Vitamin E should not be taken together with inorganic iron supplements as it may destroy the vitamin, while organic iron, such as ferrous gluconate and ferrous fumarate does not affect the vitamin.
Vitamin E in Pregnancy:
Vitamin E is important for the development of your baby
1. Vitamin E for Baby's Brain Health
Vitamin E is critical to the early development of an embryo's nervous system. Part of the reason is because one of its function is to protect the Omega-3 fatty acids functioning, in particularly DHA and DHA is crucial for brain health
2. Development of Eyes and Head
When it comes to embryo nervous system development, one of the most important parts are the eyes and head. Correct amount (not too much of Vitamin E) will assist in healthy development
3. Stunting of Growth
Deficiency of Vitamin E during pregnancy can cause stunted growth
4. Improved cognitive function
Higher concentration of Vitamin E at birth has been associated with superior cognitive function at the age of 2 years old. (2)
How about supplements?
Look out for "d-alpha-tocopherol" on the list of ingredients - that means that the Vitamin E is from natural sources, whereas "dl-alpha-tocopherol" will indicate that it is synthetic.
Recommended daily intake
So what are the recommended daily intake of Vitamin E? For adults older than 18 years, pregnant women, and breastfeeding women, the maximum dose is 1,000 milligrams daily (or 1,500 IU).
2. Traber MG. Vitamin E inadequacy in humans: causes and consequences. Adv Nutr.
2014 Sep;5(5):503-14. Review.
Types of Vitamin A
There are 2 types of Vitamin A in the human diet:
- Preformed vitamin A (also called retinol) is used directly by the body and is found in animal products like eggs, milk, and liver.
- Provitamin A carotenoids are found in green leafy vegetables, orange/yellow-coloured fruit and vegetables like cabbage, carrot, lettuce, spinach, mango. By far the most important provitamin A carotenoid is beta-carotene (1)
What does Vitamin A do for you?
Vitamin A help preserve vision, fight infections, maintain healthy skin and bones, and regulate cell growth and division. Without enough vitamin A, you may be at a higher risk for night blindness or experience skin disorders or infections. It is also a key structural component in the development and maintenance of the heart, lungs, kidneys and other organs.
Vitamin A plays a critical role in:
- Maintaining body homeostasis
- Prevention of anemia
- Support pregnancy metabolism
- Pregnancy fetal development, especially bones, teeth, skin, and vision
So do you need to have good source of Vitamin A during pregnancy? The truth is developing babies need some Vitamin A. Vitamin A deficiency can lead to fetal and infant growth retardation. In fact, The World Health Organization (WHO) estimates that between 250,000 and 500,000 children are born blind every year. WHO also estimates that 13.8 million children have some degree of visual loss related to vitamin A deficiency.(2) If the pregnant mother don’t have enough Vitamin A in her body to start with, how would the fetal development be normal?
It is important to remember however that taking too much Vitamin A during pregnancy brings a small risk of birth defects, however too little Vitamin A brings risk of visual loss and growth retardation hence it will be extremely important to take a balance.
The Linus Pauling Institute states that “No increase in the risk of vitamin A-associated birth defects has been observed at doses of preformed vitamin A from supplements below 3,000 mcg/day (10,000 IU/day). Since a number of foods in the U.S. are fortified with preformed vitamin A, pregnant women should avoid multivitamin or prenatal supplements that contain more than 1,500 mcg (5,000 IU) of vitamin A. Vitamin A from beta-carotene is not known to increase the risk of birth defects.”
How much Vitamin A you need:
(RDAs for vitamin A are given as mcg of retinol activity equivalents (RAE) to account for the different bioactivities of retinol and provitamin A carotenoids)
Pregnant women age 18 and younger: 750 mcg RAE per day
Pregnant women age 19 and older: 770 micrograms RAE per day
Breastfeeding women age 18 and younger: 1,200 mcg RAE per day
Breastfeeding women age 19 and older: 1,300 mcg RAE per day
Nonpregnant women: 700 mcg RAE per day
You don't have to get the recommended amount of vitamin A every day. Instead, aim for that amount as an average over the course of a few days or a week.
2. Vision Disorders—Advances in Research and Treatment: 2012 Edition
Vitamin D is a very important vitamin for the baby's mother and baby. Mothers need to ensure their vitamin D levels are normal during pregnancy and while breastfeeding.
But first, what actually is vitamin D? It is a vitamin that is formed mainly in the skin and then altered in the body to a more active component. Most importantly, it is needed in every cell for the body to function properly!
Also known as the sunshine vitamin, 90% of vitamin D is made from sunlight exposure directly onto the skin. Women who do not get enough sun are observed to have low levels of vitamin D. The darker your skin, the more sun exposure one needs! So mothers need to expose themselves to sun to prevent getting low levels of Vitamin D or take a vitamin D supplementation.
Apart from that, a normal level of vitamin D is needed to absorb calcium from food. Calcium, which is vital for building strong bones, strong teeth and is important for the nervous system. Adequate levels are important for the immune system to work properly.
A recent study found that 1,500 to 2000IU of vitamin D daily had the greatest benefits in preventing preterm labour/births and infections. (1)
What happens if you don't?
Vitamin D deficiency is common during pregnancy. A newborn baby's vitamin D level is the same as its mother. If the mother has a low vitamin D level during pregnancy, then her baby too will be born with a low vitamin D level. There will be very little vitamin D contain in breast milk, so if the baby is vitamin D deficient, they will remain deficient while being breastfed. Because Vitamin D deficiency symptoms are generally less obvious, one might think they have sufficient amounts until getting a blood test!
Low levels of Vitamin D in children and adults have also been linked to the development of many illnesses.
Inadequate vitamin D can lead to abnormal bone growth, fractures or rickets in newborns! Because the bones don't form normally, the child can be short and the legs bowed. At times, when the calcium level in the blood is very low, it will lead to the child having seizures(fits). If you think this is 'kind of' rare, check out Dr Rangan Chatterjee's story on how his son had seizure because of being deficient in this simple vitamin. (2)
Vitamin D from food consumption alone is not enough!
Only 10% of food contain vitamin D naturally, so a lot are fortified with this vitamin. All milk are vitamin D fortified. The best way to really ensure adequate vitamin D is through supplementation.
1. Dawodu A, Akinbi H. Vitamin D nutrition in pregnancy: current opinion. International Journal of Women’s Health. 2013;5:333-343. doi:10.2147/IJWH.S34032.
Dr Nicole Ng (MBBS) is a medical doctor with a passion in women's health and medical research