STUDIES OF TOCOPHEROL REQUIREMENTS IN HEALTH AND DISEASE

Abstract

Premature infants were fed an artificial formula essentially free of tocopherol over the first 6 months of life. These infants were compared to two other groups of prematures one fed a formula of "average" tocopherol content, and the third group a tocopherol-fortified product. Although the use of the "tocopherol-free" product resulted in extremely low tocopherol concentration in serum, no significant differences were observed in the three groups of infants with respect to weight increment, hemoglobin concentration, erythrocyte counts, hematocrit value, or in erythrocyte glutathione and glucose-6-phosphate dehydrogenase activity. The requirements of the normal premature infant are met by a formula containing 3.0 mg of alpha tocopherol per liter of formula, in terms of achieving normal concentrations in serum during a 1-to-2-month period. Absorption studies in healthy full-term infants in the first week of life failed to reveal any significant differences in the degree of absorption of tocopherol as d-alpha tocopherol acetate, d-1 alpha tocopherol acetate and d alpha tocopheryl polyethylene glycol succinate, when administered in test doses providing 2.0 and 10.0 mg of free tocopherol. Observations on the effects of tocopherol supplementation on concentrations in serum of healthy full-term infants fed partly skim milk formula suggest that a daily supplement providing 0.5 mg of free tocopherol is adequate to produce a rapid rise to normal serum levels. However, except in terms of tocopherol concentrations, this study does not answer the question of true biological need for a tocopherol supplement in artificially fed infants. Because of the variable but marked decrease in tocopherol absorption in children with fibrocystic disease, very large supplements are necessary to maintain normal levels in serum. The observations reported here suggest that a minimum supplement of 100 mg tocopherol per day (free to-copherol as d-alpha tocopheryl polyethylene glycol succinate) is likely to be necessary in such patients, in order to restore serum concentrations to normal.