Fatores relacionados ao estado nutricional de vitamina E: repercussões dos alimentos ultraprocessados e da pandemia da Covid-19

Abstract

Vitamin E plays an antioxidant role, contributing to the prevention of chronic non-communicable diseases (NCDs). Therefore, identifying the factors that determine its nutritional status is essential, ranging from food consumption to sanitary, environmental, socioeconomic, metabolic, and genetic aspects, which may increase the risk of vitamin E deficiency. In this context, this study evaluated the relationship of two factors with vitamin E nutritional status: 1) the dietary pattern, assessed through a systematic review (SR) that investigated the relationship between the consumption of ultraprocessed foods (UPF) and micronutrient status, including serum alpha-tocopherol; and 2) the COVID-19 pandemic, through the BRAZUCA-PÓS-COVID-19 cohort, which aimed to assess the impact of COVID-19 on vitamin E status in adults and older adults in Natal-RN. The SR followed the Preferred Reporting Items for Systematic Reviews and MetaAnalyses, with a protocol registered in PROSPERO (CRD42023488818). The search was conducted in the PubMed/MEDLINE, LILACS/SciELO, EMBASE, Scopus, and Web of Science databases, including human studies that analyzed nutritional biomarkers and the relationship between UPF and micronutrients. The cohort study involved 30 adult and elderly participants, of both genders, who had their serum vitamin E concentrations measured before and after the pandemic, in addition to socioeconomic, anthropometric, and biochemical data. The serum concentration of alpha-tocopherol was analyzed by Ultra High-Performance Liquid Chromatography. Vitamin E deficiency (VED) was considered with values ⦤ 12 μmol/L, and inadequacy < 30 μmol/L, corrected by the Total Cholesterol value. Of the three eligible studies in the SR, two were conducted to examine the relationship between UPF consumption and vitamin E status in pregnant women and lactating women. It was found that a higher amount of UPF in the diet was associated with a higher concentration of gamma-tocopherol in pregnant women (β=9.0, 95% CI 6.2, 11.8) and a lower concentration of serum alpha-tocopherol in lactating women (β= –0.17, 95% CI= −0.047, −0.010). In the cohort population, a reduction in serum alpha-tocopherol levels was observed post-pandemic (from 17.7 to 10.5 μmol/L), with an increase in VED cases from 45.8% to 54.2% (p<0.05). When alpha-tocopherol was adjusted for Total Cholesterol (μmol/L/mg), the median was 0.08 and 0.51 before and after the pandemic, respectively, showing a statistically significant negative change (Δ = -0.43; p<0.001). The results indicate negative outcomes from UPF consumption and the COVID-19 pandemic on vitamin E nutritional status, suggesting that dietary patterns and the public health emergency condition are factors influencing VED in this population. These findings also highlight the gap in the literature on vitamin E in adults and older adults, a group susceptible to oxidative stress and micronutrient deficiency, indicating the need for future investigations to monitor this condition.