Researchers studied nearly 4,800 children in China to understand how two important vitamins—E and A—work together in the body. Both vitamins help with immunity, bones, and overall health. The scientists discovered something interesting: when vitamin E levels are low, they have a strong connection to vitamin A levels. But once vitamin E reaches a certain healthy amount (3.579 µg/mL), this connection becomes weaker. This finding suggests that getting enough vitamin E might be especially important for helping the body use vitamin A properly, particularly for older children and those who don’t eat many vitamin E-rich foods.

The Quick Take

  • What they studied: How vitamin E and vitamin A levels relate to each other in children’s bodies, and whether there’s a specific vitamin E level where this relationship changes.
  • Who participated: Nearly 4,800 children between birth and 10.8 years old who came to health clinics in Ningbo, China for regular check-ups between 2018 and 2021.
  • Key finding: There’s a magic number for vitamin E: 3.579 µg/mL. Below this level, vitamin E and A work closely together. Above it, the connection becomes much weaker. This was confirmed with strong statistical evidence (p < 0.001).
  • What it means for you: Making sure children get enough vitamin E may help their bodies maintain healthy vitamin A levels. This is especially important for older children and families with limited access to foods rich in vitamin E. However, more research is needed before making major dietary changes based on this finding alone.

The Research Details

Scientists collected information from children who visited health clinics for routine check-ups over a three-year period. They measured the amount of vitamin E and vitamin A in the children’s blood and looked for patterns in how these two vitamins relate to each other. They used statistical tools to find the exact point where the relationship between the vitamins changes—like finding the temperature where water turns to ice.

The researchers organized children into groups based on whether they had too little, normal, or too much of each vitamin. Then they used mathematical models to see if the relationship between the two vitamins stayed the same across all levels, or if it changed at certain points. This approach helped them identify the specific threshold where vitamin E’s influence on vitamin A becomes noticeably different.

Understanding how these two vitamins interact helps doctors and nutritionists know what vitamin levels to aim for in children. If vitamin E is especially important for vitamin A absorption and use, then making sure children get enough vitamin E becomes a priority for public health. This is particularly important in areas where children might not have access to foods containing these vitamins.

This study included a large number of children (4,752), which makes the findings more reliable. The research was published in Scientific Reports, a well-respected scientific journal. The statistical methods used were appropriate for finding threshold effects. However, because this is a cross-sectional study (a snapshot in time rather than following children over months or years), it shows relationships but cannot prove that vitamin E directly causes changes in vitamin A levels.

What the Results Show

The study found that vitamin E and vitamin A levels are connected, but this connection works differently depending on how much vitamin E a child has. When vitamin E is below 3.579 µg/mL, every increase in vitamin E is strongly linked to increases in vitamin A (the connection coefficient was 35.829). This means in this lower range, the two vitamins move together closely.

Once vitamin E reaches 3.579 µg/mL and above, the connection becomes much weaker (the connection coefficient dropped to 9.828). In other words, adding more vitamin E doesn’t boost vitamin A as much once you’ve reached this threshold. The researchers confirmed this threshold was real and not due to chance (p < 0.001).

Children with vitamin E deficiency had the lowest vitamin A levels on average (236.9 ng/mL), while children with excess vitamin E had the highest vitamin A levels (292.4 ng/mL). This 55 ng/mL difference shows that vitamin E status matters for vitamin A status.

The study also showed that vitamin E levels varied widely among children, ranging from very low (2.4 µg/mL in deficient children) to quite high (7.0 µg/mL in children with excess). Similarly, vitamin A levels ranged from 236.9 to 292.4 ng/mL depending on deficiency status. These variations suggest that many children may not be getting optimal amounts of these vitamins.

Previous research has shown that vitamins E and A are both important for immune function and health, but their specific interaction in children hasn’t been well studied. This research adds new information by identifying a specific threshold where their relationship changes. This finding aligns with what scientists know about how fat-soluble vitamins work together in the body, but provides more precise numbers for children specifically.

This study only looked at one moment in time for each child, so we can’t know if the vitamin levels caused the relationship or if something else caused both. The study was done in one region of China, so results might be different in other parts of the world with different diets and environments. The researchers couldn’t measure all the factors that might affect vitamin levels, such as diet quality, sun exposure, or individual differences in how bodies absorb vitamins. Finally, this study shows a relationship but doesn’t prove that increasing vitamin E will definitely improve vitamin A status in individual children.

The Bottom Line

Based on this research (moderate confidence level): Ensure children have adequate vitamin E intake through foods like nuts, seeds, vegetable oils, and leafy greens. Pay special attention to children over age 5 and those with limited access to vitamin E-rich foods. However, don’t start giving children vitamin supplements without talking to a doctor first, as too much of these vitamins can also be harmful. More research is needed before making major dietary recommendations based solely on this finding.

Parents and caregivers of children aged 0-10 should be aware of this research, especially if their children have limited access to nutritious foods. Healthcare providers working with children in developing regions or low-income areas should pay attention to these findings. Children with known vitamin deficiencies should definitely discuss this with their doctor. People without access to diverse foods should consider consulting a nutritionist.

If vitamin E levels are improved through diet, it may take several weeks to months to see changes in vitamin A levels, since the body stores these fat-soluble vitamins. Don’t expect immediate changes. If a child has a deficiency, improvement might take longer and may require medical supervision.

Want to Apply This Research?

  • Track weekly servings of vitamin E-rich foods (almonds, sunflower seeds, spinach, olive oil) and note any changes in energy levels or immune health (fewer colds/infections) over 8-12 weeks.
  • Add one vitamin E-rich food to your child’s daily meals: sprinkle seeds on yogurt, add nuts to snacks, or use olive oil in cooking. Log this daily in the app to build the habit.
  • Set monthly reminders to review vitamin E food intake and note any changes in your child’s health markers (illness frequency, skin health, energy levels). Share this data with your pediatrician at annual check-ups to see if dietary improvements correlate with better health outcomes.

This research describes a relationship between vitamin E and vitamin A levels in children but does not establish that changing vitamin E intake will directly improve vitamin A status in individual children. This study was conducted in China and results may not apply to all populations. Do not start giving your child vitamin supplements or make significant dietary changes based on this research alone. Always consult with your pediatrician or a registered dietitian before making decisions about your child’s nutrition, especially if your child has known vitamin deficiencies or health conditions. This information is for educational purposes and should not replace professional medical advice.