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Tang L, Liu M, Mu J, Tian J. Association between circulating antioxidants and sleep disorders: comprehensive results from NHANES 2017-2018. Food Funct 2024; 15:6657-6672. [PMID: 38814101 DOI: 10.1039/d4fo00413b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
Background: Oxidative stress plays an important role in the occurrence and pathological process of numerous human diseases. A bidirectional relationship was found between sleep disorders and oxidative stress. However, the association between circulating antioxidant levels and the risk of sleep disorders at the population-scale has yet to be determined. Methods: We used the dataset from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 data release cycle and included 3062 adult participants aged 25-75 years. The circulating antioxidants levels in serum were measured, and the sleep status was assessed by self-reported sleep disorder questionnaire tests. We investigated the association and exposure-response relationship between the 12 main circulating antioxidants and sleep disorders using a generalized additive model (GAM), multiple linear, binary logistic, and restricted cubic spline (RCS) regression models. Multiple sensitivity analyses were conducted to validate the results of our study. Results: Significantly lower serum concentrations of ten antioxidants were observed in the group which had trouble sleeping symptoms compared to the control group. After adjusting for all the covariates, the binary logistic regression models indicated that six of the circulating antioxidants including alpha-carotene, alpha-cryptoxanthin, trans-beta-carotene, beta-cryptoxanthin, lutein and zeaxanthin, and vitamin C, showed a significant association with the risk of overall trouble sleeping symptoms, with odds ratios corresponding to 0.88 (95% CI: 0.80-0.96), 0.74 (95% CI: 0.62-0.87), 0.87 (95% CI: 0.79-0.97), 0.85 (95% CI: 0.75-0.95), 0.72 (95% CI: 0.61-0.84), and 0.83 (95% CI: 0.74-0.93), respectively. The GAM and multiple linear regression revealed similar associations whereas the RCS regression models further confirmed their significant negative exposure-response relationship. Conclusions: The circulating carotenoids and vitamin C levels were negatively correlated with the risk of sleep disorders. Higher circulating antioxidant levels were significantly associated with a lower risk of sleep disorders. The potential health risk of low circulating antioxidants levels was higher in the female population than in the male population.
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Affiliation(s)
- Liwei Tang
- Shenzhen Key Laboratory of Marine Biotechnology and Ecology, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, Guangdong, 518055 China.
| | - Min Liu
- Shenzhen Key Laboratory of Marine Biotechnology and Ecology, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, Guangdong, 518055 China.
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, 518055 China
| | - Jingjing Mu
- Affiliated Psychological Hospital of Anhui Medical University, Anhui Mental Health Center, Hefei Fourth People's Hospital, Hefei 230022, China
| | - Jing Tian
- Shenzhen Key Laboratory of Marine Biotechnology and Ecology, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, Guangdong, 518055 China.
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2
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Stringham NT, Green M, Roche W, Prado-Cabrero A, Mulcahy R, Nolan J. Lutein, zeaxanthin, and meso-zeaxanthin supplementation attenuates inflammatory cytokines and markers of oxidative cardiovascular processes in humans. Nutr Metab Cardiovasc Dis 2024:S0939-4753(24)00177-7. [PMID: 38890092 DOI: 10.1016/j.numecd.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 05/03/2024] [Accepted: 05/06/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND AND AIMS Systemic inflammation and oxidation are primary contributors to the development of atherosclerosis. Oxidation of low-density lipoprotein (LDL) particles within the vascular endothelium has been hypothesized to be an initial step in the formation of atherosclerotic plaques, with inflammatory cytokines serving as the signaling mechanism for concomitant macrophage activation. Supplementation with the antioxidative macular xanthophylls (lutein [L], zeaxanthin [Z], and meso-zeaxanthin [MZ]) has been shown to aid in the reduction of inflammatory physiologic responses; therefore, we hypothesized that in our study population, supplementation with these xanthophylls would facilitate a systemic reduction in markers of inflammation and cardiovascular lipid oxidation. METHODS AND RESULTS In this double-blind placebo-controlled supplementation study, participants were randomly allocated to receive the active intervention containing L (10 mg) + MZ (10 mg) + Z (2 mg) or placebo (containing sunflower oil). Serum concentrations of carotenoids (assessed by HPLC), inflammatory cytokines (IL-6, IL-1β, TNF-α) and oxidized LDL (OxLDL; by solid-phase sandwich ELISA) were measured at baseline and at 6-months. Results showed that over the supplementation period, compared to placebo, the active group demonstrated statistically significant increases in serum concentrations of L, Z, & MZ (p < 0.05), reductions in inflammatory cytokines IL-1β (p < 0.001) and TNF-α (p = 0.003), as well as a corresponding reduction in serum OxLDL (p = 0.009). CONCLUSIONS Our data show that L, Z, & MZ supplementation results in decreased serum IL-1β, TNF-α, and OxLDL. This suggests that these carotenoids are acting systemically to attenuate oxidative lipid products and inflammation, thus reducing their contribution to atherosclerotic plaque formation.
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Affiliation(s)
- Nicole T Stringham
- Nutrition Research Centre Ireland (NRCI), Southeast Technical University, Waterford, Ireland; Northern Arizona University, Flagstaff, AZ, USA.
| | - Marina Green
- Nutrition Research Centre Ireland (NRCI), Southeast Technical University, Waterford, Ireland
| | - Warren Roche
- Nutrition Research Centre Ireland (NRCI), Southeast Technical University, Waterford, Ireland
| | - Alfonso Prado-Cabrero
- Nutrition Research Centre Ireland (NRCI), Southeast Technical University, Waterford, Ireland
| | - Riona Mulcahy
- Nutrition Research Centre Ireland (NRCI), Southeast Technical University, Waterford, Ireland
| | - John Nolan
- Nutrition Research Centre Ireland (NRCI), Southeast Technical University, Waterford, Ireland
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3
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Hu W, Seah V, Huang V, Kim JE. Effect of Antioxidant Supplementation on Macular Pigment Optical Density and Visual Functions: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Adv Nutr 2024; 15:100216. [PMID: 38582248 PMCID: PMC11052915 DOI: 10.1016/j.advnut.2024.100216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 03/14/2024] [Accepted: 03/29/2024] [Indexed: 04/08/2024] Open
Abstract
Antioxidants are bioactive molecules that function to scavenge free radicals and balance oxidative stress. Although all antioxidants can act as reactive oxygen species scavengers, their efficacy on eye health may vary. Moreover, the comparative effectiveness and potential additive effect between groups of antioxidants, hitherto, have not been systematically studied. A systematic review and network meta-analysis were conducted to investigate the comparative or additive effect of dietary antioxidant supplements on eye health. Four databases (PubMed, Embase, CINAHL, and Cochrane) were searched, and relevant randomized controlled trials were identified. Out of 60 articles selected for systematic review, 38 were included in the network meta-analysis, categorized into 8 distinct antioxidant-supplemented groups and placebo. All groups significantly increased macular pigment optical density and contrast sensitivity at low spatial frequency, whereas only the antioxidant mixture + lutein (L) + fatty acid combination exhibited significant improvements in visual acuity (hazard ratio = -0.15; 95% confidence interval: -0.28, -0.02) and L + zeaxanthin combination for photostress recovery time (hazard ratio = -5.75; 95% confidence interval: -8.80, -1.70). Especially, the L + zeaxanthin + fatty acid combination was ranked best for macular pigment optical density (surface under the cumulative ranking: 99.3%) and second best for contrast sensitivity at low spatial frequency (67.7%). However, these findings should be interpreted with caution due to low quality of evidence, primarily influenced by indirectness and potential publication bias. Overall, antioxidant supplementation was estimated to improve eye health parameters, whereas different combinations of antioxidants may also have varying effects on improving visual health from multiple perspectives. This study was registered at PROSPERO as CRD42022369250.
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Affiliation(s)
- Weili Hu
- Department of Food Science and Technology, National University of Singapore, Singapore
| | - Vernice Seah
- Department of Food Science and Technology, National University of Singapore, Singapore
| | - Vanessa Huang
- Department of Food Science and Technology, National University of Singapore, Singapore
| | - Jung Eun Kim
- Department of Food Science and Technology, National University of Singapore, Singapore.
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4
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Hu W, Shankar P, Yao Y, Su X, Kim JE. Effect of xanthophyll-rich food and supplement intake on visual outcomes in healthy adults and those with eye disease: a systematic review, meta-analysis, and meta-regression of randomized controlled trials. Nutr Rev 2023; 82:34-46. [PMID: 37094947 DOI: 10.1093/nutrit/nuad037] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
CONTEXT Xanthophyll intake is known to improve eye health; however, its benefits on visual outcomes have not been systematically studied, particularly in a population with eye diseases. OBJECTIVE A systematic review, meta-analysis, and meta-regression were conducted to investigate the effect of xanthophyll intake on visual outcomes, and further subgroup analysis was performed on the basis of eye disease status. DATA SOURCES The PubMed, Scopus, Embase, CINAHL, Cochrane, and Web of Science databases were searched, and relevant randomized controlled trials were identified. DATA EXTRACTION For systematic review, meta-analysis, and meta-regression, 43, 25, and 21 articles were selected, respectively. DATA ANALYSIS Xanthophyll intake enhanced macular pigment optical density (MPOD) for both heterochromatic flicker photometry (weighted mean difference [WMD], 0.05; 95% confidence interval [CI], 0.03-0.07) and autofluorescence imaging (WMD, 0.08; 95%CI, 0.05-0.11) measurements and decreased photostress recovery time (WMD, -2.35; 95%CI, -4.49 to -0.20). While enhancement in visual acuity logarithm of the minimum angle of resolution was observed in response to the xanthophyll-rich food and supplement intake only for patients with eye disease (WMD, -0.04; 95%CI, -0.07 to -0.01). Meta-regression showed a positive correlation between change in MPOD (heterochromatic flicker photometry) and the corresponding change in serum lutein levels (regression coefficient = 0.068; P = 0.00). CONCLUSION Intake of xanthophyll-rich food or supplements can improve eye health. Additional improvement in visual acuity was observed in patients with eye disease. A positive association between MPOD and serum lutein level, while absent with dietary xanthophyll intake, suggests the importance of bioavailability when examining the effect of xanthophyll on eye health. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021295337.
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Affiliation(s)
- Weili Hu
- are with the Department of Food Science and Technology, National University of Singapore, Singapore, Singapore
| | - Pavitra Shankar
- are with the Department of Food Science and Technology, National University of Singapore, Singapore, Singapore
| | - Yuanhang Yao
- are with the Department of Food Science and Technology, National University of Singapore, Singapore, Singapore
| | - Xinyi Su
- is with the Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jung Eun Kim
- are with the Department of Food Science and Technology, National University of Singapore, Singapore, Singapore
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5
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Li X, Holt RR, Keen CL, Morse LS, Zivkovic AM, Yiu G, Hackman RM. Potential roles of dietary zeaxanthin and lutein in macular health and function. Nutr Rev 2023; 81:670-683. [PMID: 36094616 DOI: 10.1093/nutrit/nuac076] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Lutein, zeaxanthin, and meso-zeaxanthin are three xanthophyll carotenoid pigments that selectively concentrate in the center of the retina. Humans cannot synthesize lutein and zeaxanthin, so these compounds must be obtained from the diet or supplements, with meso-zeaxanthin being converted from lutein in the macula. Xanthophylls are major components of macular pigments that protect the retina through the provision of oxidant defense and filtering of blue light. The accumulation of these three xanthophylls in the central macula can be quantified with non-invasive methods, such as macular pigment optical density (MPOD). MPOD serves as a useful tool for assessing risk for, and progression of, age-related macular degeneration, the third leading cause of blindness worldwide. Dietary surveys suggest that the dietary intakes of lutein and zeaxanthin are decreasing. In addition to low dietary intake, pregnancy and lactation may compromise the lutein and zeaxanthin status of both the mother and infant. Lutein is found in modest amounts in some orange- and yellow-colored vegetables, yellow corn products, and in egg yolks, but rich sources of zeaxanthin are not commonly consumed. Goji berries contain the highest known levels of zeaxanthin of any food, and regular intake of these bright red berries may help protect against the development of age-related macular degeneration through an increase in MPOD. The purpose of this review is to summarize the protective function of macular xanthophylls in the eye, speculate on the compounds' role in maternal and infant health, suggest the establishment of recommended dietary values for lutein and zeaxanthin, and introduce goji berries as a rich food source of zeaxanthin.
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Affiliation(s)
- Xiang Li
- are with the Department of Nutrition, UC Davis, Davis, California, USA
| | - Roberta R Holt
- are with the Department of Nutrition, UC Davis, Davis, California, USA
| | - Carl L Keen
- are with the Department of Nutrition, UC Davis, Davis, California, USA
- is with the Department of Internal Medicine, UC Davis, Sacramento, California, USA
| | - Lawrence S Morse
- are with the Department of Ophthalmology and Vision Science, UC Davis Medical Center, Sacramento, California, USA
| | - Angela M Zivkovic
- re with the Department of Nutrition, UC Davis, Davis, California, USA
| | - Glenn Yiu
- are with the Department of Ophthalmology and Vision Science, UC Davis Medical Center, Sacramento, California, USA
| | - Robert M Hackman
- are with the Department of Nutrition, UC Davis, Davis, California, USA
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Potential Properties of Natural Nutraceuticals and Antioxidants in Age-Related Eye Disorders. LIFE (BASEL, SWITZERLAND) 2022; 13:life13010077. [PMID: 36676026 PMCID: PMC9863869 DOI: 10.3390/life13010077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 12/23/2022] [Accepted: 12/25/2022] [Indexed: 12/29/2022]
Abstract
Eye health is crucial, and the onset of diseases can reduce vision and affect the quality of life of patients. The main causes of progressive and irreversible vision loss include various pathologies, such as cataracts, ocular atrophy, corneal opacity, age-related macular degeneration, uncorrected refractive error, posterior capsular opacification, uveitis, glaucoma, diabetic retinopathy, retinal detachment, undetermined disease and other disorders involving oxidative stress and inflammation. The eyes are constantly exposed to the external environment and, for this reason, must be protected from damage from the outside. Many drugs, including cortisonics and antinflammatory drugs have widely been used to counteract eye disorders. However, recent advances have been obtained via supplementation with natural antioxidants and nutraceuticals for patients. In particular, evidence has accumulated that polyphenols (mostly deriving from Citrus Bergamia) represent a reliable source of antioxidants able to counteract oxidative stress accompanying early stages of eye diseases. Luteolin in particular has been found to protect photoreceptors, thereby improving vision in many disease states. Moreover, a consistent anti-inflammatory response was found to occur when curcumin is used alone or in combination with other nutraceuticals. Additionally, Coenzyme Q10 has been demonstrated to produce a consistent effect in reducing ocular pressure, thereby leading to protection in patients undergoing glaucoma. Finally, both grape seed extract, rich in anthocyanosides, and polynsatured fatty acids seem to contribute to the prevention of retinal disorders. Thus, a combination of nutraceuticals and antioxidants may represent the right solution for a multi-action activity in eye protection, in association with current drug therapies, and this will be of potential interest in early stages of eye disorders.
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7
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Zhang Y, Hao J, Cao K, Qi Y, Wang N, Han S. Macular pigment optical density responses to different levels of zeaxanthin in patients with high myopia. Graefes Arch Clin Exp Ophthalmol 2022; 260:2329-2337. [PMID: 35044504 DOI: 10.1007/s00417-021-05532-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/27/2021] [Accepted: 12/16/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Measurement of macular pigment optical density (MPOD) can be conducted to assist in the diagnosis of multiple fundus diseases. METHODS Fifty-four subjects with high myopia were prospectively recruited for a 3-month clinical trial. Detailed ophthalmologic examinations and MPOD measurements were performed. The subjects in each high myopia category group were randomly subdivided into 5 intervention groups, including a low-dose Lycium barbarum group (10 g Lycium barbarum, containing 10 mg of zeaxanthin and 1 mg of lutein), low-dose control group (1 mg of lutein), high-dose Lycium barbarum group (20 g of Lycium barbarum, containing 20 mg of zeaxanthin and 2 mg lutein), high-dose control group (2 mg of lutein), and a blank control group. Differences in the MPODs among the high myopia groups were calculated with Welch two-sample t tests. A linear mixed-effects model was constructed and Pearson's correlation analysis was performed to determine correlations between MPOD and other factors. The MPOD values at baseline and the 3-month follow-up were compared with the Mann-Whitney test. RESULTS The category 1 group had a significantly higher MPOD than the category 2 (P = 0.02) and category 3 groups (P < 0.001). The category 2 group had a significantly higher MPOD than the category 3 group (P < 0.001). The MPOD significantly decreased with increasing axial length (AL) and decreasing best-corrected visual acuity (BCVA) in the category 1-3 groups and with increasing age and increasing intraocular pressure (IOP) in the category 2-3 groups. The MPOD was significantly higher in the group who received high-dose zeaxanthin from Lycium barbarum than in the group who received high-dose lutein at 3 months (P = 0.0403), while no significant difference was identified between the low-dose zeaxanthin group and low-dose lutein group (P = 0.1117). CONCLUSIONS The MPOD was negatively correlated with the category of high myopia. Supplementation of zeaxanthin from Lycium barbarum is beneficial in preventing the loss of macular pigment of high myopia patients. TRIAL REGISTRATION Trial registration number and date of registration: ChiCTR2100046748.
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Affiliation(s)
- Yue Zhang
- Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China.,Beijing Institute of Ophthalmology, No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Jie Hao
- Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China.,Beijing Institute of Ophthalmology, No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Yue Qi
- Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Ningli Wang
- Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China.,Beijing Institute of Ophthalmology, No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Song Han
- Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China.
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8
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Carotenoid extraction and analysis from blood plasma/serum. Methods Enzymol 2022; 670:423-457. [DOI: 10.1016/bs.mie.2022.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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9
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Wilson LM, Tharmarajah S, Jia Y, Semba RD, Schaumberg DA, Robinson KA. The Effect of Lutein/Zeaxanthin Intake on Human Macular Pigment Optical Density: A Systematic Review and Meta-Analysis. Adv Nutr 2021; 12:2244-2254. [PMID: 34157098 PMCID: PMC8634499 DOI: 10.1093/advances/nmab071] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/15/2021] [Accepted: 05/11/2021] [Indexed: 01/05/2023] Open
Abstract
Lutein, zeaxanthin, and meso-zeaxanthin are the only carotenoids found in the human macula and may have a role in visual function. These carotenoids are reported to protect the retina, and thus vision, as antioxidants and by acting as a blue light filter. Our objective was to determine a minimum concentration of lutein/zeaxanthin intake that is associated with a statistically significant and/or clinically important change in macular pigment optical density (MPOD) among adults with healthy eyes. We searched Ovid MEDLINE, CENTRAL, and the Commonwealth of Agriculture Bureau for English-language studies through to July 2020. Two reviewers screened results to identify studies that evaluated supplements or dietary sources of lutein/zeaxanthin on MPOD among adults with healthy eyes. One reviewer extracted data and assessed strength of evidence, which was confirmed by a second reviewer. Two independent reviewers assessed the risk of bias. Meta-analyses were stratified by total lutein/zeaxanthin dose. We included 46 studies (N = 3189 participants; mean age = 43 y; 42% male). There was no statistically significant change in MPOD among studies evaluating <5 mg/d of total lutein/zeaxanthin intake which primarily assessed dietary interventions for 3-6 mo (pooled mean difference, 0.02; 95% CI: -0.01 to 0.05). The pooled mean increase in MPOD was 0.04 units (95% CI: 0.02 to 0.07) among studies evaluating 5 to <20 mg/d of lutein/zeaxanthin and was 0.11 units (95% CI: 0.06 to 0.16) among studies evaluating ≥20 mg/d of lutein/zeaxanthin for 3-12 mo. MPOD increased with lutein/zeaxanthin intake, particularly at higher doses, among adults with healthy eyes. The effects of lutein/zeaxanthin intake at doses <5 mg/d or from dietary sources is less clear. Increased lutein/zeaxanthin intake can help with maintaining ocular health. Future research is needed to determine the minimum dose and duration of lutein/zeaxanthin intake that is associated with a clinically important change in MPOD or visual function.
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Affiliation(s)
| | - Saraniya Tharmarajah
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yuanxi Jia
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Richard D Semba
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Debra A Schaumberg
- Department of Ophthalmology & Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA,Evidera, Inc., Bethesda, MD, USA
| | - Karen A Robinson
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
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10
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Böhm V, Lietz G, Olmedilla-Alonso B, Phelan D, Reboul E, Bánati D, Borel P, Corte-Real J, de Lera AR, Desmarchelier C, Dulinska-Litewka J, Landrier JF, Milisav I, Nolan J, Porrini M, Riso P, Roob JM, Valanou E, Wawrzyniak A, Winklhofer-Roob BM, Rühl R, Bohn T. From carotenoid intake to carotenoid blood and tissue concentrations - implications for dietary intake recommendations. Nutr Rev 2021; 79:544-573. [PMID: 32766681 PMCID: PMC8025354 DOI: 10.1093/nutrit/nuaa008] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
There is uncertainty regarding carotenoid intake recommendations, because positive and negative health effects have been found or are correlated with carotenoid intake and tissue levels (including blood, adipose tissue, and the macula), depending on the type of study (epidemiological vs intervention), the dose (physiological vs supraphysiological) and the matrix (foods vs supplements, isolated or used in combination). All these factors, combined with interindividual response variations (eg, depending on age, sex, disease state, genetic makeup), make the relationship between carotenoid intake and their blood/tissue concentrations often unclear and highly variable. Although blood total carotenoid concentrations <1000 nmol/L have been related to increased chronic disease risk, no dietary reference intakes (DRIs) exist. Although high total plasma/serum carotenoid concentrations of up to 7500 nmol/L are achievable after supplementation, a plateauing effect for higher doses and prolonged intake is apparent. In this review and position paper, the current knowledge on carotenoids in serum/plasma and tissues and their relationship to dietary intake and health status is summarized with the aim of proposing suggestions for a "normal," safe, and desirable range of concentrations that presumably are beneficial for health. Existing recommendations are likewise evaluated and practical dietary suggestions are included.
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Affiliation(s)
- Volker Böhm
- Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena, Germany
| | - Georg Lietz
- Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Begoña Olmedilla-Alonso
- Institute of Food Science, Technology and Nutrition, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - David Phelan
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, Waterford, Ireland
| | | | | | - Patrick Borel
- C2VN, INRAE, INSERM, Aix Marseille Univ, Marseille, France
| | - Joana Corte-Real
- Population Health Department, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Angel R de Lera
- Departmento de Química Orgánica, Centro De Investigaciones Biomédicas and Instituto de Investigación Biomédica de Vigo, Universidade de Vigo, Vigo, Spain
| | | | | | | | - Irina Milisav
- University of Ljubljana, Ljubljana, Slovenia
- University of Ljubljana, Faculty of Health Sciences, Ljubljana, Slovenia and with University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
| | - John Nolan
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, Waterford, Ireland
| | - Marisa Porrini
- Universitàdegli Studi di Milano, Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, Milan, Italy
| | - Patrizia Riso
- Universitàdegli Studi di Milano, Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, Milan, Italy
| | - Johannes M Roob
- Research Unit Chronic Inflammation in Nephrology, Clinical Division of Nephrology, Department of Internal Medicine, Medical University, Graz, Austria
| | | | - Agata Wawrzyniak
- Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Brigitte M Winklhofer-Roob
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University, Graz, Austria
| | - Ralph Rühl
- Paprika Bioanalytics BT, Debrecen, Hungary and with CISCAREX UG, Berlin, Germany
| | - Torsten Bohn
- Population Health Department, Luxembourg Institute of Health, Strassen, Luxembourg
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11
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Johra FT, Bepari AK, Bristy AT, Reza HM. A Mechanistic Review of β-Carotene, Lutein, and Zeaxanthin in Eye Health and Disease. Antioxidants (Basel) 2020; 9:E1046. [PMID: 33114699 PMCID: PMC7692753 DOI: 10.3390/antiox9111046] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 12/23/2022] Open
Abstract
Carotenoids are natural lipid-soluble antioxidants abundantly found as colorful pigments in fruits and vegetables. At least 600 carotenoids occur naturally, although about 20 of them, including β-carotene, α-carotene, lycopene, lutein, zeaxanthin, meso-zeaxanthin, and cryptoxanthin, are detectable in the human blood. They have distinct physiological and pathophysiological functions ranging from fetal development to adult homeostasis. β-carotene is a precursor of vitamin A that essentially functions in many biological processes including vision. The human macula lutea and eye lens are rich in lutein, zeaxanthin, and meso-zeaxanthin, collectively known as macular xanthophylls, which help maintain eye health and prevent ophthalmic diseases. Ocular carotenoids absorb light from the visible region (400-500 nm wavelength), enabling them to protect the retina and lens from potential photochemical damage induced by light exposure. These natural antioxidants also aid in quenching free radicals produced by complex physiological reactions and, consequently, protect the eye from oxidative stress, apoptosis, mitochondrial dysfunction, and inflammation. This review discusses the protective mechanisms of macular xanthophylls in preventing eye diseases such as cataract, age-related macular degeneration, and diabetic retinopathy. Moreover, some preclinical animal studies and some clinical trials are discussed briefly to understand carotenoid safety and efficacy.
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Affiliation(s)
| | | | | | - Hasan Mahmud Reza
- Department of Pharmaceutical Sciences, School of Health and Life Sciences, North South University, Bashundhara R/A, Dhaka 1229, Bangladesh; (F.T.J.); (A.K.B.); (A.T.B.)
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Widomska J, SanGiovanni JP, Subczynski WK. Why is Zeaxanthin the Most Concentrated Xanthophyll in the Central Fovea? Nutrients 2020; 12:nu12051333. [PMID: 32392888 PMCID: PMC7284714 DOI: 10.3390/nu12051333] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 12/17/2022] Open
Abstract
Diet-based xanthophylls (zeaxanthin and lutein) are conditionally essential polar carotenoids preferentially accreted in high concentrations (1 mM) to the central retina, where they have the capacity to impart unique physiologically significant biophysical biochemical properties implicated in cell function, rescue, and survival. Macular xanthophylls interact with membrane-bound proteins and lipids to absorb/attenuate light energy, modulate oxidative stress and redox balance, and influence signal transduction cascades implicated in the pathophysiology of age-related macular degeneration. There is exclusive transport, sequestration, and appreciable bioamplification of macular xanthophylls from the circulating carotenoid pool to the retina and within the retina to regions required for high-resolution sensory processing. The distribution of diet-based macular xanthophylls and the lutein metabolite meso-zeaxanthin varies considerably by retinal eccentricity. Zeaxanthin concentrations are 2.5-fold higher than lutein in the cone-dense central fovea. This is an ~20-fold increase in the molar ratio relative to eccentric retinal regions with biochemically detectable macular xanthophylls. In this review, we discuss how the differences in the specific properties of lutein and zeaxanthin could help explain the preferential accumulation of zeaxanthin in the most vulnerable region of the macula.
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Affiliation(s)
- Justyna Widomska
- Department of Biophysics, Medical University of Lublin, Jaczewskiego 4, 20-090 Lublin, Poland
- Correspondence: (J.W.); (J.P.S.); Tel.: 48-81448-6333 (J.W.)
| | - John Paul SanGiovanni
- Department of Nutritional Sciences, The University of Arizona, 1657 East Helen Street, Tucson, AZ 85721, USA
- Correspondence: (J.W.); (J.P.S.); Tel.: 48-81448-6333 (J.W.)
| | - Witold K. Subczynski
- Department of Biophysics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA;
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The Effect of Lutein on Eye and Extra-Eye Health. Nutrients 2018; 10:nu10091321. [PMID: 30231532 PMCID: PMC6164534 DOI: 10.3390/nu10091321] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 09/14/2018] [Accepted: 09/16/2018] [Indexed: 02/07/2023] Open
Abstract
Lutein is a carotenoid with reported anti-inflammatory properties. A large body of evidence shows that lutein has several beneficial effects, especially on eye health. In particular, lutein is known to improve or even prevent age-related macular disease which is the leading cause of blindness and vision impairment. Furthermore, many studies have reported that lutein may also have positive effects in different clinical conditions, thus ameliorating cognitive function, decreasing the risk of cancer, and improving measures of cardiovascular health. At present, the available data have been obtained from both observational studies investigating lutein intake with food, and a few intervention trials assessing the efficacy of lutein supplementation. In general, sustained lutein consumption, either through diet or supplementation, may contribute to reducing the burden of several chronic diseases. However, there are also conflicting data concerning lutein efficacy in inducing favorable effects on human health and there are no univocal data concerning the most appropriate dosage for daily lutein supplementation. Therefore, based on the most recent findings, this review will focus on lutein properties, dietary sources, usual intake, efficacy in human health, and toxicity.
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Perez-Moral N, Saha S, Philo M, Hart DJ, Winterbone MS, Hollands WJ, Spurr M, Bows J, van der Velpen V, Kroon PA, Curtis PJ. Comparative bio-accessibility, bioavailability and bioequivalence of quercetin, apigenin, glucoraphanin and carotenoids from freeze-dried vegetables incorporated into a baked snack versus minimally processed vegetables: Evidence from in vitro models and a human bioavailability study. J Funct Foods 2018; 48:410-419. [PMID: 30344649 PMCID: PMC6189524 DOI: 10.1016/j.jff.2018.07.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
A process for incorporating phytochemical-rich vegetables into potato snacks was developed. Highest phytochemical concentrations were achieved using freeze-dried vegetables. There was excellent retention of flavonoids and glucosinolates in the final snack product. Bioavailability of phytochemicals from the snack was similar to that of cooked vegetables.
The aim was to incorporate vegetables containing the phytochemicals quercetin, apigenin, glucoraphanin and carotenoids into a processed potato-based snack and assess their bioaccessibility and bioavailability. Three different processing routes were tested for incorporation and retention of phytochemicals in snacks using individually quick frozen or freeze-dried vegetables. No significant differences in the uptake or transport of quercetin or apigenin between a vegetable mix or snacks were observed using the CaCo-2 transwell model. Simulated in vitro digestions predicted a substantial release of quercetin and apigenin, some release of glucoraphanin but none for carotenes from either the snack or equivalent steamed vegetables. In humans, there were no significant differences in the bioavailability of quercetin, apigenin or glucoraphanin from the snack or equivalent steamed vegetables. We have shown that significant quantities of freeze-dried vegetables can be incorporated into snacks with good retention of phytochemicals and with similar bioavailability to equivalent steamed vegetables.
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Affiliation(s)
- Natalia Perez-Moral
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk NR4 7UA, UK
| | - Shikha Saha
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk NR4 7UA, UK
| | - Mark Philo
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk NR4 7UA, UK
| | - Dave J Hart
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk NR4 7UA, UK
| | - Mark S Winterbone
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk NR4 7UA, UK
| | - Wendy J Hollands
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk NR4 7UA, UK
| | - Mike Spurr
- PepsiCo R&D, 4 Leycroft Road, Leicester, UK
| | - John Bows
- PepsiCo R&D, 4 Leycroft Road, Leicester, UK
| | - Vera van der Velpen
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Paul A Kroon
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk NR4 7UA, UK
| | - Peter J Curtis
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, UK
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Olmedilla-Alonso B, Estévez-Santiago R, Silván JM, Sánchez-Prieto M, de Pascual-Teresa S. Effect of Long-Term Xanthophyll and Anthocyanin Supplementation on Lutein and Zeaxanthin Serum Concentrations and Macular Pigment Optical Density in Postmenopausal Women. Nutrients 2018; 10:nu10080959. [PMID: 30044439 PMCID: PMC6116081 DOI: 10.3390/nu10080959] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/16/2022] Open
Abstract
Xanthophylls (lutein, L; zeaxanthin, Z) and anthocyanins are often included in food supplements to improve ocular health. There are no dietary reference intakes for them. The aim was to assess the effects of L, Z and anthocyanin supplementation on short and long-term lutein status markers (serum concentration and macular pigment optical density (MPOD)). Seventy-two postmenopausal women were randomized into a parallel study of 8 months: Group A-anthocyanines (60 mg/day); Group X-xanthophylls (6 mg L + 2 mg Z/day); Group X+A-anthocyanines (60 mg/day) + xanthophylls (6 mg L + 2 mg Z/day). At the beginning of the study, 4 and 8 month serum L and Z concentrations were determined (HPLC), as well as L, Z and anthocyanine dietary intake and MPOD (heterochromic flicker photometry). Baseline concentrations of L (0.35 ± 0.19 μmol/L), Z (0.11 ± 0.05 μmol/L), L+Z/cholesterol/triglycerides (0.07 ± 0.04 μmol/mmol) increased in Group X (2.8- and 1.6-fold in L and Z concentrations) and in group XA (2- and 1.4-fold in L and Z concentrations). MPOD (baseline: 0.32 ± 0.13 du) was not modified in any of the groups at the end of the study. There were no differences in the dietary intake of L+Z and anthocyanin at any point in time in any group. Supplementation of L and Z at a dietary level provoked an increase in their serum concentration that was not modified by simultaneous supplementation with anthocyanins.
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Affiliation(s)
- Begoña Olmedilla-Alonso
- Instituto de Ciencia y Tecnología de Alimentos y Nutrición (ICTAN-CSIC), C/José Antonio Novais, 10, 28040 Madrid, Spain.
| | - Rocío Estévez-Santiago
- Instituto de Ciencia y Tecnología de Alimentos y Nutrición (ICTAN-CSIC), C/José Antonio Novais, 10, 28040 Madrid, Spain.
| | - José-Manuel Silván
- Instituto de Ciencia y Tecnología de Alimentos y Nutrición (ICTAN-CSIC), C/José Antonio Novais, 10, 28040 Madrid, Spain.
| | - Milagros Sánchez-Prieto
- Instituto de Ciencia y Tecnología de Alimentos y Nutrición (ICTAN-CSIC), C/José Antonio Novais, 10, 28040 Madrid, Spain.
| | - Sonia de Pascual-Teresa
- Instituto de Ciencia y Tecnología de Alimentos y Nutrición (ICTAN-CSIC), C/José Antonio Novais, 10, 28040 Madrid, Spain.
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Hwang JS, Han SG, Lee CH, Seo HG. Lutein suppresses hyperglycemia-induced premature senescence of retinal pigment epithelial cells by upregulating SIRT1. J Food Biochem 2018. [DOI: 10.1111/jfbc.12495] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jung Seok Hwang
- Department of Food Science and Biotechnology of Animal Products, Sanghuh College of Life Sciences; Konkuk University, 120 Neungdong-ro; Gwangjin-gu Seoul 05029 Korea
| | - Sung Gu Han
- Department of Food Science and Biotechnology of Animal Products, Sanghuh College of Life Sciences; Konkuk University, 120 Neungdong-ro; Gwangjin-gu Seoul 05029 Korea
| | - Chi-Ho Lee
- Department of Food Science and Biotechnology of Animal Products, Sanghuh College of Life Sciences; Konkuk University, 120 Neungdong-ro; Gwangjin-gu Seoul 05029 Korea
| | - Han Geuk Seo
- Department of Food Science and Biotechnology of Animal Products, Sanghuh College of Life Sciences; Konkuk University, 120 Neungdong-ro; Gwangjin-gu Seoul 05029 Korea
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Stringham JM, Stringham NT, O'Brien KJ. Macular Carotenoid Supplementation Improves Visual Performance, Sleep Quality, and Adverse Physical Symptoms in Those with High Screen Time Exposure. Foods 2017; 6:foods6070047. [PMID: 28661438 PMCID: PMC5532554 DOI: 10.3390/foods6070047] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 06/27/2017] [Accepted: 06/28/2017] [Indexed: 11/16/2022] Open
Abstract
The dramatic rise in the use of smartphones, tablets, and laptop computers over the past decade has raised concerns about potentially deleterious health effects of increased "screen time" (ST) and associated short-wavelength (blue) light exposure. We determined baseline associations and effects of 6 months' supplementation with the macular carotenoids (MC) lutein, zeaxanthin, and mesozeaxanthin on the blue-absorbing macular pigment (MP) and measures of sleep quality, visual performance, and physical indicators of excessive ST. Forty-eight healthy young adults with at least 6 h of daily near-field ST exposure participated in this placebo-controlled trial. Visual performance measures included contrast sensitivity, critical flicker fusion, disability glare, and photostress recovery. Physical indicators of excessive screen time and sleep quality were assessed via questionnaire. MP optical density (MPOD) was assessed via heterochromatic flicker photometry. At baseline, MPOD was correlated significantly with all visual performance measures (p < 0.05 for all). MC supplementation (24 mg daily) yielded significant improvement in MPOD, overall sleep quality, headache frequency, eye strain, eye fatigue, and all visual performance measures, versus placebo (p < 0.05 for all). Increased MPOD significantly improves visual performance and, in turn, improves several undesirable physical outcomes associated with excessive ST. The improvement in sleep quality was not directly related to increases in MPOD, and may be due to systemic reduction in oxidative stress and inflammation.
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Affiliation(s)
- James M Stringham
- Nutritional Neuroscience Laboratory, Department of Psychology, University of Georgia, Athens, GA 30602, USA.
| | - Nicole T Stringham
- Interdisciplinary Neuroscience Program, Biomedical and Health Sciences Institute, University of Georgia, Athens, GA 30602, USA.
| | - Kevin J O'Brien
- Vision Sciences Laboratory, Department of Psychology, University of Georgia, Athens, GA 30602, USA.
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Stringham NT, Holmes PV, Stringham JM. Supplementation with macular carotenoids reduces psychological stress, serum cortisol, and sub-optimal symptoms of physical and emotional health in young adults. Nutr Neurosci 2017; 21:286-296. [PMID: 28198205 DOI: 10.1080/1028415x.2017.1286445] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Oxidative stress and systemic inflammation are the root cause of several deleterious effects of chronic psychological stress. We hypothesize that the antioxidant and anti-inflammatory capabilities of the macular carotenoids (MCs) lutein, zeaxanthin, and meso-zeaxanthin could, via daily supplementation, provide a dietary means of benefit. METHODS A total of 59 young healthy subjects participated in a 12-month, double-blind, placebo-controlled trial to evaluate the effects of MC supplementation on blood cortisol, psychological stress ratings, behavioural measures of mood, and symptoms of sub-optimal health. Subjects were randomly assigned to one of three groups: placebo, 13 mg, or 27 mg / day total MCs. All parameters were assessed at baseline, 6 months, and 12 months. Serum MCs were determined via HPLC, serum cortisol via ELISA, and macular pigment optical density (MPOD) via customized heterochromatic flicker photometry. Behavioural data were obtained via questionnaire. RESULTS Significant baseline correlations were found between MPOD and Beck anxiety scores (r = -0.28; P = 0.032), MPOD and Brief Symptom Inventory scores (r = 0.27; P = 0.037), and serum cortisol and psychological stress scores (r = 0.46; P < 0.001). Supplementation for 6 months improved psychological stress, serum cortisol, and measures of emotional and physical health (P < 0.05 for all), versus placebo. These outcomes were either maintained or improved further at 12 months. CONCLUSIONS Supplementation with the MCs significantly reduces stress, cortisol, and symptoms of sub-optimal emotional and physical health. Determining the basis for these effects, whether systemic or a more central (i.e. brain) is a question that warrants further study.
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Affiliation(s)
- Nicole Tressa Stringham
- a Interdisciplinary Neuroscience Program, Biomedical and Health Sciences Institute , University of Georgia , Athens, GA 30602, USA.,b Department of Psychology , University of Georgia , Athens, GA 30602, USA
| | - Philip V Holmes
- a Interdisciplinary Neuroscience Program, Biomedical and Health Sciences Institute , University of Georgia , Athens, GA 30602, USA.,b Department of Psychology , University of Georgia , Athens, GA 30602, USA
| | - James M Stringham
- b Department of Psychology , University of Georgia , Athens, GA 30602, USA
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