PRESCRIPTIONS
Form of vitamin E may help heart

By Amy Tousman

Q. Should I take vitamin E supplements to prevent a heart attack?

A. This has been the subject of much recent debate. Past research showed that vitamin E could improve heart health by preventing cholesterol from combining with oxygen and damaging arteries. It also seemed to help prevent blood clots that could cause blockages in arteries. Many recent studies have failed to show such a benefit from vitamin E.

These conflicting results may be due to the form of vitamin E studied. There are several types of vitamin E. A form called alpha-tocopherol is found in most supplements. Another form called gamma-tocopherol is the main type in food.

In most of the studies where no benefit was found, alpha-tocopherol supplements were used. Few studies have tested gamma-tocopherol. This is surprising because people with heart disease have less of the gamma form in their blood than healthy people. Also, too much alpha-tocopherol can suppress gamma-tocopherol.

A study published in the March 2003 American Journal of Clinical Nutrition sheds some light on this. In this study, healthy volunteers took either alpha-tocopherol alone or mixed tocopherols which included alpha, delta and high amounts of gamma-tocopherol. A control group took no supplement.

A test called "Platelet aggregation" was done on participants. This test measures the ability of blood platelets to clump together and form dangerous blood clots. After supplementation, platelet aggregation decreased in the mixed-tocopherol group but not in the alpha-tocopherol group or the control group. These results indicate a decreased risk of a heart attack or stroke. It seems that a combination of tocopherols has a more powerful effect than any one type alone.

Although this is only one study, it seems reasonable to recommend a supplement of 200 to 400 international units daily, especially if you are at increased risk for heart disease.

Choose a "mixed tocopherol" formula containing several forms of vitamin E including d-alpha-tocopherol and gamma-tocopherol. Examples include Nature's Bounty High Gamma Complete, GNC Isomer E and Natrol Tocotrien-All.

Include vitamin E-rich foods such as avocados, peanuts, pistachios, walnuts, almonds, sunflower seeds and safflower oils in your diet. Although foods have less vitamin E than supplements, they contain the right mix of all forms of vitamin E.

These foods are high in calories, so if you are watching your weight, limit portions of these foods to 1 to 2 tablespoons per day.