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Early increased vitamin E intake linked to liver health later in childhood

Alanine aminostransferase maintained better levels at mid-childhood when children took in a higher amount of the alpha-tocopherol isoform of vitamin E at early childhood, according to data published in Hepatology.

“Early and mid-childhood could be key windows of opportunity to prevent rising ALT levels. Moreover, identifying protective factors against elevated ALT levels could inform future interventions to prevent pediatric [non-alcoholic fatty liver disease (NAFLD)],” Jennifer A. Woo Baidal, MD, MPH, from the division of pediatric gastroenterology, hepatology and nutrition at Columbia University Medical Center and colleagues wrote. “Vitamin E is a prime candidate for protection against development of NAFLD. ... Identifying the prospective association of alpha-tocopherol intake during early childhood with later ALT levels could inform future efforts to prevent liver damage in children.”

Researchers examined the relationship between higher vitamin E (alpha-tocopherol) intake during early childhood and ALT levels during mid-childhood, and how BMI impacted this relationship. They studied dietary intake at early childhood visits (median 3.1 years) of 528 children enrolled in Project Viva, an ongoing prospective pre-birth cohort study, using a food frequency questionnaire, then collected child blood and anthropometric data at mid-childhood (median 7.6 years). Adjustments were made for child age, sex, race/ethnicity, diet and age-adjusted, sex-specific BMI z-score at mid-childhood.

At early childhood, mean alpha-tocopherol intake was 3.7±1.0 mg/day (range 1.4-9.2). In total, 22% of children had an elevated ALT level at mid-childhood and mean BMI z-score was 0.41±1.0 units. Analysis of multivariable-adjusted logistic regression models showed that children with higher early childhood vitamin E intake had lower likelihood of high ALT at mid-childhood (adjusted OR 0.62 [95% CI, 0.39-0.99]) for quartiles 2 to 4 compared with the lowest quartile of intake. These findings persisted after accounting for early childhood diet (AOR 0.62 [0.36, 1.08]) and were reinforced after accounting for mid-childhood BMI z-score (AOR 0.56 [0.32, 0.99]).

“Our results extend the existing literature showing alpha-tocopherol treatment effect in established NAFLD to suggest that alpha-tocopherol intake early in childhood could have a protective role against liver injury later in childhood,” they wrote. “Modifiable risk factors, specifically intake of vitamin E, should be considered in future interventions to identify approaches to prevent pediatric NAFLD.” – by Savannah Demko

Disclosures: The authors report no relevant financial disclosures.