Insufficient vitamin E intakes may increase hip fracture risk

According to a new study from Norway, older people with low blood vitamin E concentrations seem to have an increased risk of developing hip fracture.

The observational study measured serum vitamin E (alpha-tocopherol) concentrations in 1,168 men and women aged 65–79 years who suffered hip fractures during up to 11 years (1). The study results showed a linear increasing risk of hip fracture with lower serum alpha-tocopherol concentrations, with a 51% higher risk for participants with the lowest blood levels compared to participants with the highest levels.

The researchers commented that oxidative stress has been suggested as contributing to the development of osteoporosis and fractures (2). Vitamin E has strong antioxidant properties which can potentially counteract damage to bones. Experimental results indicate that in addition to its antioxidant effect, alpha-tocopherol could have a possible direct role in bone remodeling and promoting osteoclast fusion, thus stimulating bone resorption (3). The evidence from human studies is very limited, but reviews conclude that higher vitamin E intakes seem to be associated with increased bone mineral density (BMD) and decreased fracture risk (4, 5). The new results confirm those of an earlier study with 654 older men (6). The dietary intake of vitamin E is relatively low in many countries, e.g., in the Nordic countries (7).

1. Holvik K. et al. Low serum concentrations of alpha-tocopherol are associated with increased risk of hip fracture. A NOREPOS study. Osteoporos Int. Published online August 2014.
   
2. Manolagas S. C. From estrogen-centric to aging and oxidative stress: a revised perspective of the pathogenesis of osteoporosis. Endocr Rev. 2010; 31:266–300.
   
3. Fujita K. et al. Vitamin E decreases bone mass by stimulating osteoclast fusion. Nat Med. 2012; 18:589–594.
   
4. Nieves J. W. Skeletal effects of nutrients and nutraceuticals, beyond calcium and vitamin D. Osteoporos Int. 2013; 24:771–786.
   
5. Ahmadieh H. and Arabi A. Vitamins and bone health: beyond calcium and vitamin D. Nutr Rev. 2011; 69:584–598.
   
6. Michaëlsson K. et al. Intake and serum concentrations of alpha-tocopherol in relation to fractures in elderly women and men: 2 cohort studies. AmJ Clin Nutr. 2014; 99:107–114.
   
7. Jenab M. et al. Dietary intakes of retinol, beta-carotene, vitamin D and vitamin E in the European Prospective Investigation into Cancer and Nutrition cohort. Eur J Clin Nutr. 2009; 63(Suppl 4):S150–S178.