Associations between Lifestyle Factors and Vitamin E Metabolites in the General Population

The antioxidant vitamin E (alpha-tocopherol, alpha-TOH) protects lipids from oxidation by reactive oxygen species. We hypothesized that lifestyle factors associate with vitamin E metabolism marked by urinary alpha-tocopheronolactone hydroquinone (alpha-TLHQ) and alpha-carboxymethyl-hydroxychroman (alpha-CEHC levels), as potential reflection of lipid oxidation. We conducted a cross-sectional study in the Netherlands Epidemiology of Obesity Study. Serum alpha-TOH, and urinary alpha-TLHQ and alpha-CEHC were quantified by liquid chromatography coupled with tandem mass spectrometry. Information on the lifestyle factors (sleep, physical activity (PA), smoking and alcohol) were collected through questionnaires. Multivariable linear regression analyses were performed to assess the associations between the lifestyle factors and alpha-TOH measures. A total of 530 participants (46% men) were included with mean (SD) age of 56 (6) years. Of the examined lifestyle factors, only poor sleep was associated with a higher serum alpha-TOH (mean difference: 4% (95% CI: 1, 7%)). Current smoking was associated with higher urinary alpha-CEHC (32%: (14%, 53%)), with evidence of a dose-response relationship with smoking intensity (low pack years, 24% (2, 52%); high pack years, 55% (25, 93%)). Moderate physical activity was associated with a lower alpha-TLHQ relative to alpha-CEHC (-17%: (-26, -6%), compared with low PA). Only specific lifestyle factors associate with vitamin E metabolism. Examining serum alpha-TOH does not provide complete insight in vitamin E antioxidant capacity.