E Is for Eluding Heart Disease

By Christine Gorman

Vitamin E's ribald reputation as a sexual enhancer has made it one of the most ballyhooed -- and best-selling -- of all dietary supplements. Truth is, E does little to lift the libido but it does appear to influence matters of the heart vitally. Two studies, reported in last week's New England Journal of Medicine, found that people who swallowed large doses of the vitamin in pill form -- at least 10 times the daily allotment recommended by the U.S. government -- had a nearly 40% lower risk of heart disease than those who consumed more modest doses. That two studies, involving a total of more than 120,000 people, came to the same conclusion was especially striking, says Dr. Meir Stampfer, who directed one of the studies at Boston's Brigham and Women's Hospital. "Sometimes, things pop up by chance, but to see it twice, that's when you start to believe it."

The studies followed 87,000 female nurses ages 34 to 59 and 40,000 male health professionals ages 40 to 75 for a period of four to eight years. Participants were not actually given the vitamins; instead, they made their own choices and were questioned repeatedly about all aspects of their health habits and diets. Those who took more vitamins tended to exercise more and have a somewhat healthier life-style, but even when researchers corrected for such differences, there was a major advantage for those who took at least 100 units of the nutrient daily for at least two years. Significantly, those who took just the recommended daily allowance (10 units), which can be obtained from such foods as nuts, whole-grain bread and vegetable oil, or even three times that amount showed no such advantage. On the other hand, there was no greater benefit in taking more than 100 units, the amount of E in some brands of multiple-vitamin pills popular in the U.S.

The studies provide some of the best evidence so far that the popular practice of ingesting large amounts of vitamins may turn out to be more than just an expensive fad. Still, experts caution that the research does not provide a conclusive link between vitamin E and healthy hearts. "We cannot yet make public-policy recommendations," says Claude Lenfant, director of the U.S. National Heart, Lung and Blood Institute. "We need randomized trials" in which the subjects do not know if they are taking the vitamin.

Chances are that if the protective effect is real, then the explanation lies in vitamin E's ability to prevent oxidation of fatty compounds in the blood -- the same biochemical reaction that turns butter rancid. Researchers believe that when low-density lipoprotein, the "bad cholesterol," is oxidized, it builds up more easily on artery walls. By blocking oxidation, vitamin E may counteract some of the risk of heart attack associated with LDL.

Should people start stocking up on vitamin E? Not necessarily. Although most scientists believe that large doses are not toxic in the short term, no one knows about safety over the long run. Some researchers caution that taken in such large amounts, the supplement is no longer a vitamin but a drug and should be thoroughly tested. In any case, vitamin supplements cannot substitute for good health habits. Unfortunately for those who want a quick fix, getting plenty of exercise, cutting down on dietary fat and quitting smoking remain far better prescriptions for preventing heart disease than anything one can obtain from a vitamin bottle.

With reporting by Janice M. Horowitz/New York