A recent meta-analysis published in the British Medical Journal (BMJ) has it that vitamin E supplements may increase the risk of severe strokes, broadly concluding that “indiscriminate widespread use of vitamin E should be cautioned against.”
The study’s authors stated that, although research has shown alpha-tocopherol vitamin E to be instrumental in preventing ischemic stroke, it may raise the risk of the more detrimental, though less prevalent, hemorrhagic stroke. “In terms of absolute risk,” the study said, “this translates into one additional hemorrhagic stroke for every 1,250 individuals taking vitamin E, in contrast to one ischemic stroke prevented per 476 individuals taking vitamin E.”
This meta-analysis follows a similarly negative study printed in BMJ last August that linked calcium supplementation to increased risk of heart attack. That story found fast fame in the popular press, though adverse effects on the supplemental calcium market have yet to appear. The vitamin E stroke risk story has begun to pick up steam in mainstream news, appearing in The Washington Post and the BBC, as well as finding a spot on America’s go-to health website WebMD.
NBJ Bottom Line
Since 2005—when a widely-publicized meta-analysis linked alpha-tocopherol to all-cause mortality and vitamin E supplement sales tumbled 32% in a year—vitamin E sellers have plodded along on a “no news is good news” basis. But, boy, vitamin E could sure use some good news. According to NBJ’s 2010 Supplement Report, the vitamin E market has not recorded positive annual sales growth since 1999, having shrunk 61% since that time.
Scientific merits of meta-analyses aside—the studies are often criticized for indefinite variables and hypotheses that anticipate industry-threatening results—the vitamin E fallout of 2005 showed just how devastating these studies can be. And the issue seems to be beyond accentuating the positive over the negative; choosing one stroke over another is a grim prospect. Industry advocates, like Dr. Andrew Shao, senior vice president of scientific and regulatory affairs at the Council for Responsible Nutrition (CRN), are doing their best to discredit and defuse the threat to vitamin E producers.“These analyses of very specific and narrow segments of the population do not address the vitamin E inadequacy of the American diet,” Shao said in a recent interview with NutraIngredients-USA.com. “Supplementation still plays an important role in filling this gap for Americans.”
Vitamin E is a mature market, with few frontiers for growth. New prospects are opening for tocotrienol—the new vitamin E wonder-isomer and little brother of alpha-tocopherol—and research is currently underway to explore its potential benefits to reducing chance of stroke. The market is still small, however, and expensive to enter, as extraction is a costly and resource-intensive process. Plus supplement manufacturers are looking to differentiate tocotrienol products from their vitamin E forebears.
As it is, the industry will hold its breath and wait to see if the bad press dissipates or escalates.