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| The advertisement |
The blogger wrote to his most-learned Great Sifu Dr. J.B. Lim in search of an answer to a friend’s enquiry. He is most grateful for the prompt response as follows:
Sunday, 5 October, 2014 8:39 PM
From: Tai Onn Lau
Dear Great Sifu Dr. JB Lim,
A good friend of mine, Mr. C.K. Chew, on reading an advertisement carried by the local Chinese daily Sin Chew Jit Poh yesterday October 4, 2014 that mentioned about the ability of “PALM TOCOTRIENOL” in protecting the brain cells and thus reducing the brain damage caused by stroke, requested me to seek your expert opinions on such a claim.
I would therefore appreciate it very much if you care to comment, provided that you are free at the moment, and offer us a simple and short explanation in layman terms on this substance called “PALM TOCTRIENOL” and further advice us if the oral supplementation of such a complex for hypertensive patients does help to minimize stroke-induced injury to the brain to the best of your knowledge?
Thank you very much.
Regards,
TO Lau
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Sunday, 5 October, 2014 11:56 PM
From: Lim Juboo
Dear Sifu,
I really cannot answer your friend’s question with certainty. I have not seen or read the paper on this claim.
There are a lot of other studies on the health-protective actions of tocopherols. This vitamin is just one of the many classes or families of vitamin Es, just like another vitamin E-like substance called tocotrienols, especially alpha-tocotrienol which we know can protect the heart, and possibly cancers as well. Some studies showed that alpha-tocotrienol is even better than tocopherols, and I think so myself. Unfortunately alpha-tocotrienol is more expensive than tocopherols, and both are richly found in our Malaysian palm oil. Thus it may be better to use red palm oil as a cooking oil than taking vitamin E supplements from the pharmacy. 
Both tocopherols and tocotrienols are fat-soluble antioxidants with multiple physiological-biochemical functions in the body. Both may have cardio-protective and cancer-preventive actions and not just anti-stroke damage properties alone.
There was a two-year human clinical study on tocopherol and its stroke protective action. It was carried out by Prof Dr Yuen Kah Hay at the Universiti Sains Malaysia. I understand the paper was published in the “Stroke Journal” of the AHA (American Heart Association).
Prof Yuen claimed it may protect the white matter of the brain and the lesion caused by oxygen deprivation following a stroke. This is a theoretical possibility because tocopherols and its families as I know, do act as an antioxidant that may also act to preserve tissue damage from anoxia (total lack of oxygen) or hypoxia (low oxygen supply) following a stroke where blood supply to the brain is cut off.
In short technical language, tocopherol may be a neuro-degeneration protective vitamin when there is a lack of blood supply to the brain due to a stricture / hemorrhage in the vessel (cerebral ischemia)?
However I must exert I have not read the published paper. As such, I cannot answer your question with certainty. In medicine, scientific research or in nutrition we are very strict about casual or ill-designed studies.
I do not know how the study was designed, the methodology used, the collection of the data, and how they were statistically analyzed for correlation and statistical significance. This is very, very important aspect before we made conclusion for the scientific community to accept.
For that, I reserve my opinion, albeit there are other health-protective actions by these classes of vitamin E.
Jb lim
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The blogger’s reply to Dr. JB Lim:
Monday, 6 October, 2014 11:38 AM
From: Tai Onn Lau
Dear Great Sifu,
Thank you very much for your prompt response and the educating piece of advice.
That advertisement by the public-listed pharmaceutical company HOVID (formerly known as HO YAN HOR) just made a one-line statement about the benefit of PALM TOCOTRIENAL without giving any further details of the research (they claimed themselves to be the pioneer of the research of this substance) deserves queries by a highly-qualified medical researcher like your goodself. In fact, I am also sceptical in all kinds of advertisements boasting how good their products are with the sole intention of making money from the public.
Please permit me to post your reply into my blog for sharing with all interested readers: http://taionn.blogspot.com/2014/10/palm-tocotrienol-to-help-stroke-induced.html.
Thank you.
Best regards,
TO Lau
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Additional comments from the Great Sifu:
Monday, 6 October, 2014 9:30 PM
You are welcomed.
Just to let you know a lot of clinical trials are funded by drug and very rich health food companies with vested interest. Research is extremely, extremely expensive and very time consuming. Thus there is very little opportunity for a researcher to get the funding from their own university to run clinical trials involving hundreds or thousands of people over a long period. Universities hardly have such massive budget of tens or hundreds of millions of US dollars for any single research project.
Universities can hardly afford such expensive budget. But large international drug companies can support multimillion dollar R & D project over 20 years and longer.
But there are also terms and strings attached given to the researchers. A lot of undesirable data can be hidden or manipulated, and the data belongs to the drug company, not to the researcher or to the university where it was conducted. We are fully aware of this problem. So we can never know the truth by the time the paper is published. There is no way any independent researcher or any university to repeat the experiment or trial to confirm the results.
Why Vitamin E?
Just to add another point. Vitamin E or tocopherols is not the only food substance with antioxidant properties. Ever since vitamin E was first found to have anti-sterility properties in female rats shown by Olcott and Mattill in 1934, and the first vitamin to be shown to have antioxidant activities in the prolongation of induction time towards oxidation in oils in 1936, many other plant foods, fruits and vegetables were also found to have antioxidant properties, most of them exhibiting far greater antioxidants activities than vitamin E.
Until today, thousands of plant foods have already been discovered to have antioxidants scores far, far stronger - hundreds of times stronger than tocopherols (vitamin E)
But since vitamin E was the first substance to be discovered to have this property, scientists till today still use vitamin E as the reference score around which all other antioxidants are compared. Many of other the food substances discovered today have shown tens to hundreds of times stronger antioxidant scores than all the tocopherols combined. So this is no great deal or anything to shout about tocopherol having neurodegenerative protection in post CVA patients.
But I think because palm oil (a major economy of Malaysia) from which both tocopherols and tocotrienols can be extracted, are both fat-soluble (which probability are the only ones that dissolves in fats). This is one of the plus points. All other antioxidants, albeit far stronger than vitamin E are water soluble (as far as my food chemistry tells me).
This may also be the second plus point for vitamin E. Because the tocopherols are all fat soluble, there are all non-polar molecules (chemistry: meaning no electric charge in the poles of their molecules or molecular arrangements- hence are fat soluble).
This advantage fits well with the brain and neuro-tissues which are also non-polar in nature in chemical composition since the brain and nervous tissue are mainly lipid (fats) in chemical composition, even though the brain produces a lot of electrical discharges from neurochemicals, transmitters, electrolytes, CNF, etc.
Thus you can easily understand that only an oil or a fat can dissolve into another oil or fat media. Water cannot dissolve or mix with oil, or oil with water. Polar and non-polar molecules are poles apart so to speak even for a lay person to understand without a degree in chemistry.
Thus my explanation may be clear to you that vitamin E may be the only fat soluble antioxidant than can penetrate into the lipid (fat) tissues of the brain, albeit its antioxidant properties are far lower than most other water soluble antioxidants.
This, to my reasoning, is probably the only reason why tocopherols (vitamin E) can act effectively in post-stroke damage. No other food related water-soluble antioxidant substances may be able do this effectively as they are not fat miscible agents. I think so! It is a matter of understanding physical chemistry. This has little to do with the understanding of medicine or nutrition.
But I still want Dr Yuen’s paper to see how he conducted the study. I need to scrutinize scientific data, and see how they are analyzed and interpreted. I am not easily deceived by just one study no matter who the researcher was.
A lot of researchers – specialist doctors and biomedical scientists conduct research without consulting or seeking the advice of a bio-statistician who can help tremendously with the design, analysis, and the interpretation of the data. This is to prevent flaws, bias and criticism later.
It may be a very brilliant study, but if a study is ill-designed and has a lot of flaws and bias from the very beginning itself, the entire “years of findings” is only fit for the waste paper basket. At doctoral level we were taught to be wary of this. Statistics is a very strong part and parcel of scientific research.
Scientists and specialist doctors who wants to do research MUST always get the help of a (bio)statistician to plan first. Else members of the scientific community will start criticizing the paper.
Regards,
Jb lim
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The blogger is also grateful to an e-buddy Captain flyer168 for his feedback as follows:
Tuesday, 7 October, 2014 12:20 AM
Dear Sifu Dr Lim Ju Boo,
A very enlightening piece of advice, thank you.
What is your comment on this?
“Clinical Investigation of the Protective Effects of Palm Vitamin E Tocotrienols on Brain White Matter”
Also to share this...
You be the judge.
Thank you.
flyer168