In the Journals

Early childhood vitamin E intake linked to lower risk for elevated ALT

Higher early childhood intake of vitamin E correlated with a lower risk for elevated mid-childhood alanine aminotransferase levels, according to recently published data.

“We are still learning more about the long-term risks of high ALT in childhood. Cross-sectional studies of children show a link between ALT and metabolic risk, and adults longitudinal studies show higher that higher ALT levels are associated with later risk of diabetes and mortality,” Jennifer A. Woo Baidal, MD, MPH, from the Columbia University Medical Center, New York, told Healio Gastroenterology and Liver Disease. “Diet quality – not just calories – matter, and most Americans don’t get enough alpha-tocopherol in their diet. Promoting a diet rich in antioxidants such as alpha-tocopherol should start early in life and may help promote later liver health.”

Jennifer A. Woo Baidal, MD, MPH
Jennifer A. Woo Baidal

According to Woo Baidal and colleagues, higher intake of the alpha-tocopherol isoform of vitamin E previously demonstrated a cross-sectional correlation with lower degrees of steatosis, and alpha-tocopherol supplementation improved histologic outcomes.

The researchers selected 528 children from the ongoing prospective prebirth cohort study Project Viva, 22% of whom had elevated mid-childhood ALT levels. Children with elevated ALT levels had similar maternal-reported early childhood mean total energy intake as those with normal ALT levels.

Vitamin E with food

In early childhood, the researchers found that fruit and vegetable intake and energy-adjusted saturated fat, polyunsaturated fat, fructose, vitamin D and vitamin C intake correlated significantly with vitamin E intake (P < .001).

Children in the second, third and fourth higher quartiles of early childhood vitamin E intake had significantly lower risk for elevated ALT in mid-childhood according to both unadjusted (OR = 0.65; 95% CI, 0.41-1.02) and adjusted analysis (OR = 0.62; 95% CI, 0.39-0.99) compared with those in the lowest quartile.

Findings persisted after the researchers accounted for early childhood diet, adjusted with the significant dietary factors above (OR = 0.62; 95% CI, 0.36-1.08), and after adjusting for early childhood diet with mid-childhood BMI z score (OR = 0.56; 95% CI, 0.32-0.99).

“For most young children, the best place to get the alpha-tocopherol isoform of vitamin E is from a healthy diet. Green leafy vegetables, bell peppers, and asparagus are some sources, as well as nuts such as almonds,” Woo Baidal said. “Children may require multiple chances to learn to like these foods, so physicians can counsel parents that it could take dozens of exposures to a food before a child will decide they like it. Strategies that parents can use to increase their young child’s consumption of vegetables and other foods rich in alpha-tocopherol include providing vegetables at every meal, role modelling of healthy eating, and avoiding pressured or forceful feeding of their child.” – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.

Higher early childhood intake of vitamin E correlated with a lower risk for elevated mid-childhood alanine aminotransferase levels, according to recently published data.

“We are still learning more about the long-term risks of high ALT in childhood. Cross-sectional studies of children show a link between ALT and metabolic risk, and adults longitudinal studies show higher that higher ALT levels are associated with later risk of diabetes and mortality,” Jennifer A. Woo Baidal, MD, MPH, from the Columbia University Medical Center, New York, told Healio Gastroenterology and Liver Disease. “Diet quality – not just calories – matter, and most Americans don’t get enough alpha-tocopherol in their diet. Promoting a diet rich in antioxidants such as alpha-tocopherol should start early in life and may help promote later liver health.”

Jennifer A. Woo Baidal, MD, MPH
Jennifer A. Woo Baidal

According to Woo Baidal and colleagues, higher intake of the alpha-tocopherol isoform of vitamin E previously demonstrated a cross-sectional correlation with lower degrees of steatosis, and alpha-tocopherol supplementation improved histologic outcomes.

The researchers selected 528 children from the ongoing prospective prebirth cohort study Project Viva, 22% of whom had elevated mid-childhood ALT levels. Children with elevated ALT levels had similar maternal-reported early childhood mean total energy intake as those with normal ALT levels.

Vitamin E with food

In early childhood, the researchers found that fruit and vegetable intake and energy-adjusted saturated fat, polyunsaturated fat, fructose, vitamin D and vitamin C intake correlated significantly with vitamin E intake (P < .001).

Children in the second, third and fourth higher quartiles of early childhood vitamin E intake had significantly lower risk for elevated ALT in mid-childhood according to both unadjusted (OR = 0.65; 95% CI, 0.41-1.02) and adjusted analysis (OR = 0.62; 95% CI, 0.39-0.99) compared with those in the lowest quartile.

Findings persisted after the researchers accounted for early childhood diet, adjusted with the significant dietary factors above (OR = 0.62; 95% CI, 0.36-1.08), and after adjusting for early childhood diet with mid-childhood BMI z score (OR = 0.56; 95% CI, 0.32-0.99).

“For most young children, the best place to get the alpha-tocopherol isoform of vitamin E is from a healthy diet. Green leafy vegetables, bell peppers, and asparagus are some sources, as well as nuts such as almonds,” Woo Baidal said. “Children may require multiple chances to learn to like these foods, so physicians can counsel parents that it could take dozens of exposures to a food before a child will decide they like it. Strategies that parents can use to increase their young child’s consumption of vegetables and other foods rich in alpha-tocopherol include providing vegetables at every meal, role modelling of healthy eating, and avoiding pressured or forceful feeding of their child.” – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.

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