VITAL improves lifestyle of young schoolchildren, is inexpensive, easy to implement, and should be expanded to improve health and reduce healthcare's financial burden.

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Several reports on the favorable effect of vitamin E (alpha-tocopherol) in peripheral vascular disease have appeared recently (1, 2, 3, 4). The peripheral vascular disorders treated have included thrombophlebitis, phlebothrombosis, indolent (varicose) ulcers, arteriosclerosis obliterans and thromboangiitis obliterans. Symptoms were reported as improved and leg lesions healed in most of the cases.The exact mode of action of vitamin E is not known. A vast literature has been built up on experimental results in animals and in veterinary medicine. One theory is based on its &dquo;fat antioxidant&dquo; properties. In dogs, oral administration of vitamin E prevented experimental necrotizing arteritis, which could be produced by a combination of a special fat diet and reduced renal function (5).Other theories are concerned with the relation of vitamin E to the basic framework of the cell structure, the synthesis of cell proteins and the breakdown of cell enzymes (6). It is suggested that vitamin E in large doses is not substitution therapy, but a form of chemotherapy.The matter of standardization of vitamin E is in a similar uncertain state.The synthetic and natural substances are both expressed in terms of alpha-tocopherol, presumably the most active of the four known tocopherols. The synthetic alpha-tocopherol is presumably pure and standardized in terms of weight. The natural substance is actually a mixture but potency is expressed in terms of alpha-tocopherol. This potency must be determined by biologic assay, chemical methods or spectrophotometric determinations. All three methods have large margins of error.

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