Vitamin E intake, α-tocopherol levels and pulmonary function in children and adolescents with cystic fibrosis

Br J Nutr. 2015 Apr 14;113(7):1096-101. doi: 10.1017/S0007114515000215. Epub 2015 Mar 12.


Pancreatic insufficiency cystic fibrosis (CF) patients receive vitamin E supplementation according to CF-specific recommendations in order to prevent deficiencies. It has been suggested that higher serum α-tocopherol levels could have protective effects on pulmonary function (PF) in patients with CF. Whether current recommendations are indeed optimal for preventing deficiency and whether vitamin E has therapeutic benefits are subjects of debate. Therefore, we studied vitamin E intake as well as the long-term effects of vitamin E intake, the coefficient of fat absorption (CFA) and IgG on α-tocopherol levels. We also examined the long-term effects of serum α-tocopherol and serum IgG on forced expiratory volume in 1 s expressed as percentage of predicted (FEV₁% pred.) in paediatric CF patients during a 7-year follow-up period. We found that CF patients failed to meet the CF-specific vitamin E recommendations, but serum α-tocopherol below the 2·5th percentile was found in only twenty-three of the 1022 measurements (2 %). Furthermore, no clear effect of vitamin E intake or the CFA on serum α-tocopherol was found (both P≥ 0·103). FEV₁% pred. was longitudinally inversely associated with age (P< 0·001) and serum IgG (P= 0·003), but it was not related to serum α-tocopherol levels. We concluded that in the present large sample of children and adolescents with CF, vitamin E intake was lower than recommended, but serum α-tocopherol deficiency was rare. We found no evidence that higher serum α-tocopherol levels had protective effects on PF. Adjustment of the recommendations to the real-life intake of these patients may be considered.

Keywords: IgG.

MeSH terms

  • Adolescent
  • Adolescent Development
  • Child
  • Child Development
  • Child Nutritional Physiological Phenomena
  • Child, Preschool
  • Cohort Studies
  • Cystic Fibrosis / blood
  • Cystic Fibrosis / diet therapy*
  • Cystic Fibrosis / physiopathology
  • Diet / adverse effects
  • Dietary Supplements*
  • Disease Progression
  • Female
  • Humans
  • Infant
  • Intestinal Absorption
  • Longitudinal Studies
  • Male
  • Netherlands / epidemiology
  • Patient Compliance*
  • Practice Guidelines as Topic
  • Respiratory System / physiopathology*
  • Retrospective Studies
  • Vitamin E / administration & dosage
  • Vitamin E / metabolism
  • Vitamin E / therapeutic use*
  • Vitamin E Deficiency / epidemiology
  • Vitamin E Deficiency / etiology
  • Vitamin E Deficiency / prevention & control*
  • alpha-Tocopherol / blood*
  • alpha-Tocopherol / metabolism


  • Vitamin E
  • alpha-Tocopherol