More funds needed for Vit E trials

CUT RED TAPE: Malaysia is the first in the world to carry out human trials on the effectiveness of palm oil vitamin E in treating stroke and heart attack. Experts tell Ooi Tee Ching that faster flow of public money for clinical trials could mean hope for dying patients.

MANY who attended the recent "Palm Oil Nutrition Week" lecture presented by Universiti Sains Malaysia (USM) Professor Dr Yuen Kah Hay were surprised when he revealed he was a stroke victim.

He showed no signs of mental regression or physical disability. Indeed, seeing is believing.

The spritely 59-year-old is a living proof that with proper supplementation of palm oil vitamin E and blood thinning medication, one can reduce the risk of contracting stroke that plagues 15 per cent of Malaysia's population.

On top of proper supplementation, one must also refrain from choosing a lifestyle that contributes to early death. This includes eating too much junk food, not exercising, smoking and over-indulging in alcohol.

Heart attack and stroke are deadly diseases caused by a blockage of bloodflow to the heart or brain. The most common reason for this is a build-up of fatty deposits on the inner walls of the vessels that supply blood to the heart and brain.

The World Health Organisation (WHO) statistics show that globally, more people die of stroke and heart disease than all cancers combined. By 2030, WHO estimates the death toll to jump as high as 23 million.

Although the numbers look depressing, there is increasing medical evidence that palm oil vitamin E can reduce the risks of cardiovascular diseases.

Vitamin E is an oil soluble nutrient that is made up of eight siblings, namely four tocopherols and four tocotrienols. Soft oils like olive, soya, canola and sunflower only contain tocopherols. Tropical oils such as palm and rice bran, however, have both tocopherols and tocotrienols.

Over the last 30 years, scientific studies have shown that palm oil vitamin E, particularly the tocotrienol variants, is a far more potent antioxidant than tocopherols.

Tocotrienols are usually extracted from palm oil because the oil palm tree is able to produce the highest concentrate compared with other oil crops. Every year, Malaysia exports some RM50 million worth of palm oil health supplements, mainly to Europe, the United States, Canada and Japan. A kilogramme of palm oil vitamin E sells for US$500 (RM1,515).

In an interview with Business Time recently, Yuen explained that the difference between tocotrienols and tocopherols is the 'tail' on the vitamin E molecule. 

"Tocopherols have long saturated tails while tocotrienols have unsaturated tails."

The unique structure of tocotrienols enables them to do many things that tocopherols cannot do. This includes more powerful anti-oxidative function in cells, the ability to penetrate internal organs and activation of gene signals.

Since 2009, Yuen and his team have run brain scans on 200 volunteers before and after the administration of the tocotrienol supplements and placebo in a randomised, double-blind study.

After one year, those on tocotrienol supplements showed only a little increase in the amount of white matter lesions, compared with the group on placebo which saw a seven-fold increment.

By the second year, the placebo group continued to show a bigger area of cell degeneration while those on tocotrienols showed slower brain cell death.

What the preliminary findings showed, Yuen said, is that palm oil vitamin E is able to stop human brain cells from dying in the event of a stroke. "They work by suppressing two key signals in the cells to prevent them from dying. So, if people were to take tocotrienols as a supplement, it can prevent brain cells from dying in the event of a stroke and also stimulate the reconstruction of blood vessels thereafter." 

In view of such promising findings, Yuen said it is imperative that the administrative momentum of clinical trials is accelerated. 

As Malaysia's population starts to age, the government needs to steadfastly support clinical trials for deadly diseases. With better public awareness and timely administration of government money, many lives can be saved from degenerative diseases.

"We cannot afford to have start-and-stops in government funding to clinical trials. There has got to be a steady momentum to this quest in order to reach any significantly meaningful outcome that can benefit so many lives," Yuen said.

In a separate interview held in Petaling Jaya, Selangor, Dr Chandan K. Sen, professor of surgery at the Ohio State University Medical Center concurred with Yuen. In the US, the government readily commits deserving funds for the long term to ensure research talent are expeditiously optimised. 

Having dealt with Vitamin E since the start of his career almost 20 years ago, he reiterated that tocotrienols are the better half in the Vitamin E family.

Last year, for the first time in the US, Sen and his team reported a human trial proving palm tocotrienols are potent neuroprotective agents. This is after having studied stroke prevention effects of tocotrienols, using animal and cellular models for the last 13 years. 

Sen said his team's initial findings matched that of Yuen in that tocotrienols help recovery from stroke by inducing growth of new brain arteries that bypass stroke-affected areas.

Following this assessment, Sen said tocotrienols can be orally consumed with blood-thinning drugs like aspirin to prevent a brain attack. "If I had a mini stroke, I would want to take something that would minimise my damage should I suffer from a full-blown stroke. We are testing this in clinical trials now." 

Next year, Sen and his colleagues plan to have a much larger clinical trial to assess the safety and effectiveness of tocotrienols against stroke and end stage liver diseases.

"If palm tocotrienols are established in fighting serious liver diseases, it would benefit the bulk of dying patients in developing nations who cannot afford costly liver transplants," he added.