A novel extrinsic reference method for assessing the vitamin A value of plant foods

Association between dietary vitamin A intake from different sources and non-alcoholic fatty liver disease among adults

Non-alcoholic fatty liver disease (NAFLD) has become an urgent public health issue with high global prevalence, but data on NAFLD are inconsistent. The association of total dietary vitamin A intake with the NAFLD risk was not well documented in previous studies. To explore the relationship between dietary vitamin A intake from different sources and NAFLD risk among American adults. Data were collected from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2014. Logistic regression and restricted cubic spline models were used to estimate the relationship between total dietary vitamin A intake and NAFLD risk. 6,613 adult participants were included. After adjusting potential confounders, the odds ratios (ORs) with 95% confidence intervals (CIs) of NAFLD for the highest quartile intake of total vitamin A, preformed vitamin A, provitamin A carotenoids were respectively 0.86 (0.69-1.06), 0.97 (0.74-1.28), and 0.78 (0.61-0.99), compared to the lowest quartile. Stratifying gender and age, provitamin A carotenoids intake was inversely associated with NAFLD risk in females and participants aged < 45 years. Dose-response analysis indicated a linear negative relationship between provitamin A carotenoids intake and NAFLD risk. Provitamin A carotenoids intake was inversely associated with NAFLD, especially in women and those aged < 45 years among adult American.

Use of Theoretical Subjects to Develop a Method for Assessing Equivalence of Dietary Vitamin A in a Mixed Diet

BACKGROUND

Although the vitamin A (VA) equivalency of provitamin A carotenoids from single foods or capsules has been studied using several approaches, there is currently no reliable method to determine VA equivalency for mixed diets.

OBJECTIVES

To reach the objective of identifying a method to determine the VA equivalency of provitamin A carotenoids in mixed diets, we tested a new approach using preformed VA as proxy for provitamin A.

METHODS

We studied 6 theoretical subjects who were assigned physiologically plausible values for dietary VA intake, retinol kinetic parameters, plasma retinol pool size, and VA total body stores. Using features in the Simulation, Analysis and Modeling software, we specified that subjects ingested a tracer dose of stable isotope-labeled VA on day 0 followed by 0-μg supplemental VA or 200, 400, 800, 1200, 1600, and 2000 μg VA daily from day 14 to day 28; we assigned VA absorption to be 75%. For each supplement level, we simulated plasma retinol specific activity (SAp) over time and calculated the mean decrease in SAp relative to 0 μg. Group mean data were fitted to a regression equation to calculate predicted VA equivalency at each supplement level on day 28.

RESULTS

For each subject, higher VA supplement loads resulted in lower SAp, with the magnitude of the decrease differing among subjects. The mean predicted amount of absorbed VA was within 25% of individual subjects' assigned amount for 4 of the 6 subjects, and the mean ratio of predicted to assigned amount of absorbed VA over all supplement loads ranged from 0.60 to 1.50, with an overall mean ratio of 1.0.

CONCLUSIONS

Results for preformed VA suggest that this protocol may be useful for determining VA equivalency of provitamin A carotenoids in free-living subjects if mixed diets with known provitamin A content were substituted for the VA supplements.

Comparative bioavailability of vitamins in human foods sourced from animals and plants

Vitamins are essential components of enzyme systems involved in normal growth and function. The quantitative estimation of the proportion of dietary vitamins, that is in a form available for utilization by the human body, is limited and fragmentary. This review provides the current state of knowledge on the bioavailability of thirteen vitamins and choline, to evaluate whether there are differences in vitamin bioavailability when human foods are sourced from animals or plants. The bioavailability of naturally occurring choline, vitamin D, vitamin E, and vitamin K in food awaits further studies. Animal-sourced foods are the almost exclusive natural sources of dietary vitamin B-12 (65% bioavailable) and preformed vitamin A retinol (74% bioavailable), and contain highly bioavailable biotin (89%), folate (67%), niacin (67%), pantothenic acid (80%), riboflavin (61%), thiamin (82%), and vitamin B-6 (83%). Plant-based foods are the main natural sources of vitamin C (76% bioavailable), provitamin A carotenoid β-carotene (15.6% bioavailable), riboflavin (65% bioavailable), thiamin (81% bioavailable), and vitamin K (16.5% bioavailable). The overview of studies showed that in general, vitamins in foods originating from animals are more bioavailable than vitamins in foods sourced from plants.

An ex vivo intestinal absorption model is more effective than an in vitro cell model to characterise absorption of dietary carotenoids following simulated gastrointestinal digestion

To get the most accurate food digestion-related data, and how this affects nutrient absorption, it is critical to carefully simulate human digestion systems using model settings. In this study, the uptake and transepithelial transportation of dietary carotenoids was compared using two different models that have previously been used to assess nutrient availability. The permeability of differentiated Caco-2 cells and murine intestinal tissue were tested using all-trans-β-carotene and lutein prepared in artificial mixed micelles and micellar fraction from orange-fleshed sweet potato (OFSP) gastrointestinal digestion. Transepithelial transport and absorption efficiency were then determined using liquid chromatography tandem-mass spectrometry (LCMS-MS). Results showed that the mean uptake for all-trans-β-carotene in the mouse mucosal tissue was 60.2 ± 3.2% compared to 36.7 ± 2.6% in the Caco-2 cells with the mixed micelles as the test sample. Similarly, the mean uptake was higher in OFSP with 49.4 ± 4.1% following mouse tissue uptake compared to 28.9 ± 4.3% using Caco-2 cells for the same concentration. In relation to the uptake efficiency, the mean percentage uptake for all-trans-β-carotene from artificial mixed micelles was 1.8-fold greater in mouse tissue compared to Caco-2 cells (35.4 ± 1.8% against 19.9 ± 2.6%). Carotenoid uptake reached saturation at 5 µM when assessed with the mouse intestinal cells. These results demonstrate the practicality of employing physiologically relevant models simulating human intestinal absorption processes that compares well with published human in vivo data. When used in combination with the Infogest digestion model, the Ussing chamber model, using murine intestinal tissue, may thus be an efficient predictor of carotenoid bioavailability in simulating human postprandial absorption ex vivo.

Association between retinol intake and hyperuricaemia in adults

OBJECTIVE

Current evidences on the association between hyperuricaemia and retinol intake remain inconsistent. Furthermore, no known studies have investigated the relationship between hyperuricaemia and retinol intake from animal food and plant food separately. This study aimed to assess the relationship between different sources of retinol intake and risk of hyperuricaemia among US adults.

DESIGN

Univariate and multivariate weighted logistic regression models and restricted cubic spline models were used to assess the associations of total, animal-derived and plant-derived retinol intakes with the risk of hyperuricaemia. Dietary retinol was measured through two 24-h dietary recall interviews. Hyperuricaemia was defined as serum uric acid level ≥7·0 and ≥6·0 mg/dl in men and women, respectively.

SETTING

Data from the National Health and Nutrition Examination Survey 2009-2014 were used in this cross-sectional study.

PARTICIPANTS

Overall, 12 869 participants aged ≥20 years were included.

RESULTS

Compared with the lowest quintile, the multivariable OR of hyperuricaemia for the highest quintile intake of total, animal-derived and plant-derived retinol were 0·71 (95 % CI 0·52, 0·96), 0·76 (95 % CI 0·59, 0·96) and 0·92 (95 % CI 0·72, 1·17), respectively. The inverse association between dietary intake of total retinol and the risk of hyperuricaemia was observed in men. Dose-response analyses revealed a novel linear trend between the risk of hyperuricaemia and total, animal-derived retinol intake separately.

CONCLUSIONS

Our findings indicated that intakes of total and animal-derived retinol were negatively associated with hyperuricaemia in US adults.

Food intake biomarkers for green leafy vegetables, bulb vegetables, and stem vegetables: a review

BACKGROUND

Numerous studies acknowledged the importance of an adequate vegetable consumption for human health. However, current methods to estimate vegetable intake are often prone to measurement errors due to self-reporting and/or insufficient detail. More objective intake biomarkers for vegetables, using biological specimens, are preferred. The only concentration biomarkers currently available are blood carotenoids and vitamin C, covering total fruit and vegetable intake. Identification of biomarkers for specific vegetables is needed for a better understanding of their relative importance for human health. Within the FoodBAll Project under the Joint Programming Initiative "A Healthy Diet for a Healthy Life", an ambitious action was undertaken to identify candidate intake biomarkers for all major food groups consumed in Europe by systematically reviewing the existent literature. This study describes the review on candidate biomarkers of food intake (BFIs) for leafy, bulb, and stem vegetables, which was conducted within PubMed, Scopus and Web of Science for studies published through March 2019.

RESULTS

In total, 65 full-text articles were assessed for eligibility for leafy vegetables, and 6 full-text articles were screened for bulb and stem vegetables. Putative BFIs were identified for spinach, lettuce, endive, asparagus, artichoke, and celery, but not for rocket salad. However, after critical evaluation through a validation scheme developed by the FoodBAll consortium, none of the putative biomarkers appeared to be a promising BFI. The food chemistry data indicate that some candidate BFIs may be revealed by further studies.

CONCLUSION

Future randomized controlled feeding studies combined with observational studies, applying a non-targeted metabolomics approach, are needed in order to identify valuable BFIs for the intake of leafy, bulb, and stem vegetables.

Exopolysaccharides from milk fermented by lactic acid bacteria enhance dietary carotenoid bioavailability in humans in a randomized crossover trial and in rats

BACKGROUND

Dietary supplementation with carotenoids can have beneficial health effects, but carotenoids are poorly absorbed.

OBJECTIVES

We aimed to evaluate how milk fermented by lactic acid bacteria affects dietary carotenoid bioavailability in humans and rats and to investigate mechanisms by which active components in milk fermented by Lactobacilli enhance dietary carotenoid absorption.

METHODS

Male rats (n = 8/group) were administered β-carotene or β-carotene + fermented milk. Rats (n = 6/group) were also pretreated with ezetimibe, a cholesterol absorption inhibitor, to investigate β-carotene transport mechanisms. In humans, 3 studies were conducted using a randomized crossover method. Subjects (n = 16/study) consumed a vegetable (carrot, tomato, or spinach) drink alone or with a fermented milk drink. Blood samples were collected at various time points after consumption.

RESULTS

In rats, the serum β-carotene area under the concentration-time curve (AUC) was significantly higher for the β-carotene + fermented milk than for β-carotene only. A significant correlation (r = 0.83, P < 0.001) between the exopolysaccharide (EPS) content of fermented milk and serum β-carotene AUC was observed. Ezetimibe treatment did not suppress elevations in serum β-carotene concentrations induced by fermented milk ingestion. In humans, the incremental area under the concentration-time curve (iAUC) for β-carotene in the plasma triacylglycerol-rich lipoprotein (TRL) fraction was significantly (1.8-fold, range: 0.6-3.9) higher when carrot + fermented milk was consumed compared with carrot drink alone. A significantly (6.5-fold, range: 0.04-7.7) higher iAUC for lycopene in the plasma TRL fraction was observed for subjects who consumed tomato + fermented milk compared with tomato drink alone. A significant increase in plasma lutein in all fractions was observed after consumption of spinach + fermented milk, but not with spinach drink alone.

CONCLUSIONS

Co-ingestion of β-carotene and fermented milk significantly increased dietary β-carotene bioavailability in humans and rats. EPSs could affect the physical properties of fermented milk to enhance dietary β-carotene absorption mediated by simple diffusion mechanisms. These findings may be relevant for methods to increase dietary carotenoid bioavailability.This trial was registered at umin.ac.jp/ctr as UMIN000034838, UMIN000034839, and UMIN000034840.

Meeting the Vitamin A Requirement: The Efficacy and Importance of β-Carotene in Animal Species

Vitamin A is essential for life in all vertebrate animals. Vitamin A requirement can be met from dietary preformed vitamin A or provitamin A carotenoids, the most important of which is β-carotene. The metabolism of β-carotene, including its intestinal absorption, accumulation in tissues, and conversion to vitamin A, varies widely across animal species and determines the role that β-carotene plays in meeting vitamin A requirement. This review begins with a brief discussion of vitamin A, with an emphasis on species differences in metabolism. A more detailed discussion of β-carotene follows, with a focus on factors impacting bioavailability and its conversion to vitamin A. Finally, the literature on how animals utilize β-carotene is reviewed individually for several species and classes of animals. We conclude that β-carotene conversion to vitamin A is variable and dependent on a number of factors, which are important to consider in the formulation and assessment of diets. Omnivores and herbivores are more efficient at converting β-carotene to vitamin A than carnivores. Absorption and accumulation of β-carotene in tissues vary with species and are poorly understood. More comparative and mechanistic studies are required in this area to improve the understanding of β-carotene metabolism.

A review of vitamin A equivalency of β-carotene in various food matrices for human consumption

Vitamin A equivalency of β-carotene (VEB) is defined as the amount of ingested β-carotene in μg that is absorbed and converted into 1 μg retinol (vitamin A) in the human body. The objective of the present review was to discuss the different estimates for VEB in various types of dietary food matrices. Different methods are discussed such as mass balance, dose-response and isotopic labelling. The VEB is currently estimated by the US Institute of Medicine (IOM) as 12:1 in a mixed diet and 2:1 in oil. For humans consuming β-carotene dissolved in oil, a VEB between 2:1 and 4:1 is feasible. A VEB of approximately 4:1 is applicable for biofortified cassava, yellow maize and Golden Rice, which are specially bred for human consumption in developing countries. We propose a range of 9:1-16:1 for VEB in a mixed diet that encompasses the IOM VEB of 12:1 and is realistic for a Western diet under Western conditions. For a 'prudent' (i.e. non-Western) diet including a variety of commonly consumed vegetables, a VEB could range from 9:1 to 28:1 in a mixed diet.

The effects of daily consumption of β-cryptoxanthin-rich tangerines and β-carotene-rich sweet potatoes on vitamin A and carotenoid concentrations in plasma and breast milk of Bangladeshi women with low vitamin A status in a randomized controlled trial

BACKGROUND

The potential of β-cryptoxanthin (CX)-rich foods to form vitamin A (VA) in humans in not well understood.

OBJECTIVE

We measured the effects of consuming CX- and β-carotene (BC)-rich foods on plasma and breast milk VA and carotenoids in lactating women with low VA status.

DESIGN

Participants were randomly assigned to 4 groups (n = 34, 34, 34, and 33, respectively) receiving orange-fleshed sweet potatoes (OFSPs) (12 mg BC/d), tangerines (5.3 mg CX/d), white-fleshed sweet potatoes (WFSPs) with a VA supplement (0.5 mg/d), or WFSPs 2 times/d, 6 d/wk for 3 wk. All except the VA group received placebo capsules identical in appearance to VA supplements. Changes in plasma and breast milk VA, BC, and CX were measured.

RESULTS

Plasma retinol increased in the VA group. Plasma BC in the OFSP group and CX in the tangerine group increased 250% and 830%, respectively; apparent relative absorption in the CX group, considering the amounts consumed, was 4 times that in the BC group. Mean (±SEM) changes in milk VA in the OFSP (0.028 ± 0.074 μmol/L) and tangerine (0.067 ± 0.091 μmol/L) groups did not differ from those in the control (-0.077 ± 0.068 μmol/L) or VA (0.277 ± 0.094 μmol/L) group. Milk CX increased in the tangerine group.

CONCLUSIONS

VA capsules increased plasma and milk VA concentrations. The greater change in CX concentrations in the tangerine group than in BC concentrations in the OFSP group suggests that CX in tangerines was better absorbed, but both foods failed to increase milk VA concentrations. This trial was registered at clinicaltrials.gov as NCT01420406.

An LC/MS/MS method for stable isotope dilution studies of β-carotene bioavailability, bioconversion, and vitamin A status in humans

Isotope dilution is currently the most accurate technique in humans to determine vitamin A status and bioavailability/bioconversion of provitamin A carotenoids such as β-carotene. However, limits of MS detection, coupled with extensive isolation procedures, have hindered investigations of physiologically-relevant doses of stable isotopes in large intervention trials. Here, a sensitive liquid chromatography-tandem mass spectrometry (LC/MS/MS) analytical method was developed to study the plasma response from coadministered oral doses of 2 mg [(13)C10]β-carotene and 1 mg [(13)C10]retinyl acetate in human subjects over a 2 week period. A reverse phase C18 column and binary mobile phase solvent system separated β-carotene, retinol, retinyl acetate, retinyl linoleate, retinyl palmitate/retinyl oleate, and retinyl stearate within a 7 min run time. Selected reaction monitoring of analytes was performed under atmospheric pressure chemical ionization in positive mode at m/z 537→321 and m/z 269→93 for respective [(12)C]β-carotene and [(12)C] retinoids; m/z 547→330 and m/z 274→98 for [(13)C10]β-carotene and [(13)C5] cleavage products; and m/z 279→100 for metabolites of [(13)C10]retinyl acetate. A single one-phase solvent extraction, with no saponification or purification steps, left retinyl esters intact for determination of intestinally-derived retinol in chylomicrons versus retinol from the liver bound to retinol binding protein. Coadministration of [(13)C10]retinyl acetate with [(13)C10]β-carotene not only acts as a reference dose for inter-individual variations in absorption and chylomicron clearance rates, but also allows for simultaneous determination of an individual's vitamin A status.

The challenge to reach nutritional adequacy for vitamin A: β-carotene bioavailability and conversion--evidence in humans

β-Carotene is an important dietary source of vitamin A for humans. However, the bioavailability and vitamin A equivalency of β-carotene are highly variable and can be affected by food- and diet-related factors, including the food matrix, food-processing techniques, size of the dose of β-carotene, and the amounts of dietary fat, fiber, vitamin A, and other carotenoids in the diet as well as by characteristics of the target population, such as vitamin A status, nutrient deficiencies, gut integrity, and genetic polymorphisms associated with β-carotene metabolism. The absorption of β-carotene from plant sources ranges from 5% to 65% in humans. Vitamin A equivalency ratios for β-carotene to vitamin A from plant sources range from 3.8:1 to 28:1, by weight. Vitamin A equivalency ratios for β-carotene from biofortified Golden Rice or biofortified maize are 3.8:1 and 6.5:1, respectively, and are lower than ratios for vegetables that have more complex food matrices (10:1 to 28:1). The vitamin A equivalency of β-carotene is likely to be context-specific and dependent on specific food- and diet-related factors and the health, nutritional, and genetic characteristics of human populations. Although the vitamin A equivalency of β-carotene is highly variable, the provision of vegetable and fruit sources of β-carotene has significantly increased vitamin A status in women and children in community settings in developing countries; these results support the inclusion of dietary interventions with plant sources of β-carotene as a strategy for increasing vitamin A status in populations at risk of deficiency.

An LC/MS method for d8-β-carotene and d4-retinyl esters: β-carotene absorption and its conversion to vitamin A in humans

The intestinal absorption and metabolism of β-carotene is of vital importance in humans, especially in populations that obtain the majority of their vitamin A from provitamin A carotenoids. MS has provided a better understanding of the absorption of β-carotene, the most potent provitamin A carotenoid, through the use of stable isotopes of β-carotene. We report here an HPLC-MS method that eliminates the need for complicated sample preparation and allows us to detect and quantify newly absorbed d8-β-carotene as well as its d4-retinyl ester metabolites in human plasma and chylomicron fractions. Both retinoids and β-carotene were recovered in a single simple extraction that did not involve saponification, thus allowing subsequent quantitation of individual fatty acyl esters of retinol. Separation of d8-β-carotene and its d4-retinyl ester metabolites was achieved using the same C30 reversed-phase liquid chromatography followed by mass spectrometry in selected ion monitoring and negative atmospheric pressure chemical ionization modes, respectively. Total time for the two successive runs was 30 min. This HPLC-MS method allowed us to quantify the absorption of intact d8-β-carotene as well as its extent of conversion to d4-retinyl esters in humans after consumption of a single 5 mg dose of d8-β-carotene.

Single nucleotide polymorphisms upstream from the β-carotene 15,15'-monoxygenase gene influence provitamin A conversion efficiency in female volunteers

β-Carotene, the most abundant provitamin A carotenoid in the diet, is converted to retinal by β-carotene 15,15'-monoxygenase (BCMO1). However, β-carotene absorption and conversion into retinal is extremely variable among individuals, with proportions of low responders to dietary β-carotene as high as 45%. Recently, 2 common nonsynonymous single nucleotide polymorphisms (SNPs) within the BCMO1 coding region (R267S; rs12934922 and A379V; rs7501331) revealed reduced catalytic activity, confirming that genetic variations contribute to the low responder phenotype. Because 4 SNPs 5' upstream from the BCMO1 gene were recently shown to affect circulating carotenoid concentrations, the current study aimed to investigate the effects of these SNPs on β-carotene conversion efficiency. Three of the 4 polymorphisms (rs6420424, rs11645428, and rs6564851) reduced the catalytic activity of BCMO1 in female volunteers by 59, 51, and 48%, respectively. The TG-rich lipoprotein fraction retinyl palmitate:β-carotene ratio was negatively correlated with the G allele of rs11645428 (r = -0.44; P = 0.018), whereas it was positively correlated with the G allele of rs6420424 (r = 0.53; P = 0.004) and the T allele of rs6564851 (r = 0.41; P = 0.028). Furthermore, large inter-ethnic variations in frequency of affected alleles were detected, with frequencies varying from 43 to 84% (rs6420424), 52 to 100% (rs11645428), and 19 to 67% (rs6564851). In summary, a range of SNPs can influence the effectiveness of using plant-based provitamin A carotenoids to increase vitamin A status in at-risk population groups and this effect may vary depending on ethnic origin.

Mammalian carotenoid-oxygenases: key players for carotenoid function and homeostasis

Humans depend on a dietary intake of lipids to maintain optimal health. Among various classes of dietary lipids, the physiological importance of carotenoids is still controversially discussed. On one hand, it is well established that carotenoids, such as β,β-carotene, are a major source for vitamin A that plays critical roles for vision and many aspects of cell physiology. On the other hand, large clinical trials have failed to show clear health benefits of carotenoids supplementation and even suggest adverse health effects in individuals at risk of disease. In recent years, key molecular players for carotenoid metabolism have been identified, including an evolutionarily well conserved family of carotenoid-oxygenases. Studies in knockout mouse models for these enzymes revealed that carotenoid metabolism is a highly regulated process and that this regulation already takes place at the level of intestinal absorption. These studies also provided evidence that β,β-carotene conversion can influence retinoid-dependent processes in the mouse embryo and in adult tissues. Moreover, these analyses provide an explanation for adverse health effects of carotenoids by showing that a pathological accumulation of these compounds can induce oxidative stress in mitochondria and cell signaling pathways related to disease. Advancing knowledge about carotenoid metabolism will contribute to a better understanding of the biochemical and physiological roles of these important micronutrients in health and disease. This article is part of a Special Issue entitled Retinoid and Lipid Metabolism.

Nutritional biomarkers and foodomic methodologies for qualitative and quantitative analysis of bioactive ingredients in dietary intervention studies

Traditional dietary assessment methods, such as 24-h recalls, weighted food diaries and food frequency questionnaires (FFQs) are highly subjective and impair the assessment of successfully accomplished dietary interventions. Foodomic technologies offer promising methodologies for gathering scientific evidence from clinical trials with sensitive methods (e.g., GC-MS, LC-MS, CE, NMR) to detect and quantify markers of nutrient exposure or subtle changes in dietary patterns. This review provides a summary of recently developed foodomic methodologies for the detection of suggested biomarkers, including the food specificity for each suggested biomarker and a brief description of the key aspects of 24-h recalls that may affect marker detection and stability, such as mixed nutrients and cooking processes. The primary aim of this review is to contribute to the assessment of the metabolic effects of active ingredients and foods using cutting-edge methods to improve approaches to future nutritional programs tailored for health maintenance and disease prevention.

New frontiers in science and technology: nuclear techniques in nutrition

The use of nuclear techniques in nutrition adds value by the increased specificity and sensitivity of measures compared with conventional techniques in a wide range of applications. This article provides a brief overview of well-established stable-isotope techniques to evaluate micronutrient bioavailability and assess human-milk intake in breastfed infants to monitor the transfer of micronutrients from the mother to the infant. Recent developments are highlighted in the use of nuclear techniques to evaluate biological interactions between food, nutrition, and health to move the agenda forward.

Dietary spinach saponin-enriched lipophilic fraction inhibits platelet aggregation and blood coagulation

In this study, we investigated the effect of spinach saponin-enriched lipophilic fraction (SSEF) on collagen (10 μg/mL)-stimulated platelet aggregation in vivo. Dietary SSEF dose-dependently inhibited collagen-induced platelet aggregation by decreasing thromboxane A₂ production and intracellular Ca²⁺ agonist activity as an aggregation-inducing autacoidal molecule. In addition, SSEF significantly increased the formation of cyclic AMP and cyclic GMP, intracellular Ca²⁺ antagonists that are aggregation-inhibiting molecules in collagen-stimulated platelets. These results suggest that SSEF is a potent inhibitor of collagen-stimulated platelet aggregation in vivo. Prothrombin time and activated partial thromboplastin time, indicators of blood coagulation, were potently prolonged by dietary SSEF in vivo. These findings suggest that SSEF prolongs the interval time between the conversion of fibrinogen to fibrin. Dietary SSEF also inhibited 0.4 M sucrose-induced hemolysis. Accordingly, our data demonstrate that SSEF might be a useful tool for inhibiting platelet activation and blood coagulation in thrombotic diseases.

Beta-carotene is an important vitamin A source for humans

Experts in the field of carotenoids met at the Hohenheim consensus conference in July 2009 to elucidate the current status of β-carotene research and to summarize the current knowledge with respect to the chemical properties, physiological function, and intake of β-carotene. The experts discussed 17 questions and reached an agreement formulated in a consensus answer in each case. These consensus answers are based on published valid data, which were carefully reviewed by the individual experts and are justified here by background statements. Ascertaining the impact of β-carotene on the total dietary intake of vitamin A is complicated, because the efficiency of conversion of β-carotene to retinol is not a single ratio and different conversion factors have been used in various surveys and following governmental recommendations within different countries. However, a role of β-carotene in fulfilling the recommended intake for vitamin A is apparent from a variety of studies. Thus, besides elucidating the various functions, distribution, and uptake of β-carotene, the consensus conference placed special emphasis on the provitamin A function of β-carotene and the role of β-carotene in the realization of the required/recommended total vitamin A intake in both developed and developing countries. There was consensus that β-carotene is a safe source of vitamin A and that the provitamin A function of β-carotene contributes to vitamin A intake.

Colors with functions: elucidating the biochemical and molecular basis of carotenoid metabolism

Carotenoids affect a rich variety of physiological functions in nature and are beneficial for human health, serving as antioxidants in lipophilic environments and blue light filters in the macula of human retina. These dietary compounds also serve as precursors of a unique set of apo-carotenoid cleavage products, including retinoids. Although knowledge about retinoid biology has tremendously increased, the metabolism of retinoids' parent precursors remains poorly understood. Recently, molecular players in carotenoid metabolism have been identified and biochemically characterized. Moreover, mutations in their corresponding genes impair carotenoid metabolism and induce various pathologies in animal models. Polymorphisms in these genes alter carotenoid and retinoid homeostasis in humans as well. This review summarizes our current knowledge about the molecular/biochemical basis of carotenoid metabolism and particularly the physiological role of carotenoids in retinoid-dependent physiological processes.

beta-Carotene conversion products and their effects on adipose tissue

Recent epidemiological data suggest that beta-carotene may be protective against metabolic diseases in which adipose tissue plays a key role. Adipose tissue constitutes the major beta-carotene storage tissue and its functions have been shown to be modulated in response to beta-carotene breakdown products, especially retinal produced after cleavage by beta-carotene 15,15'-monooxygenase (BCMO1), and retinoic acid arising from oxidation of retinal. However, the possibility exists that beta-carotene in its intact form can also affect adipocyte function. Development of a knock out model and identification of a loss-of-function mutation have pointed out BCMO1 as being probably the sole enzyme responsible for provitamin A conversion into retinal in mammals. The utilisation of BCMO1(-/-)mice should provide insights on beta-carotene effect on its own in the future. In humans, intervention studies have highlighted the huge interindividual variation of beta-carotene conversion efficiency, possibly due to genetic polymorphisms, which might impact on response to beta-carotene. This brief review discusses the processes involved in beta-carotene conversion and the effect of cleavage products on body fat and adipose tissue function.

Vitamin A equivalence of spirulina beta-carotene in Chinese adults as assessed by using a stable-isotope reference method

BACKGROUND

Spirulina is a high-protein food supplement that contains carotenoids.

OBJECTIVE

The objective of the study was to determine the vitamin A equivalence of spirulina beta-carotene in humans.

DESIGN

Spirulina was grown in a 23 atom% (2)H(2)O cultural solution. Spirulina beta-carotene showed the greatest enrichment as [(2)H(10)]trans beta-carotene. Ten healthy Chinese men with a mean (+/-SD) serum retinol concentration of 1.7 +/- 0.3 micromol/L and a body mass index (in kg/m(2)) of 23 +/- 3 consumed 5.8 micromol [(13)C(10)]retinyl acetate in oil as a reference dose with a breakfast containing 13 g fat. One week later, each subject consumed 7.9 mumol trans beta-carotene in spirulina with a breakfast containing 22 g fat. All subjects followed diets low in carotenoid and vitamin A. Forty blood samples were collected from each subject over a span of 56 d. Concentrations and enrichments of retinol and beta-carotene in serum samples were determined by using HPLC and a mass spectrometer.

RESULTS

Compared with the serum response to [(13)C(10)]retinyl acetate dose, the mean conversion factor of spirulina beta-carotene to retinol was 4.5 +/- 1.6 (range: 2.3-6.9) by weight. It was estimated that 80% of the conversion occurred within the first 24 h after spirulina administration.

CONCLUSION

In a group of well-nourished, normal-weight Chinese men following low-vitamin A diets, 4.5 mg spirulina beta-carotene consumed with 22 g fat has the same vitamin A activity as does 1 mg retinyl acetate.

Comparison of the uptake and secretion of carotene and xanthophyll carotenoids by Caco-2 intestinal cells

Carotenoids have been shown to have potential beneficial effects on human health which has led to an increasing interest in the study of their bioavailability. A Caco-2 cell model, as previously described, was employed to examine the percentage transfer of the carotenoids α-carotene, β-carotene, lycopene, astaxanthin, β-cryptoxanthin, lutein and zeaxanthin through an intact, highly differentiated Caco-2 cell monolayer at a range of different amounts. Our results show that astaxanthin, a carotenoid with powerful antioxidant capacity, had the highest percentage transfer overall. We examined the cellular uptake and secretion of lutein and zeaxanthin to compare two structurally similar carotenoids. Both were efficiently transported through the monolayer with a range between 5·1 (sem 1·2) % to 20·2 (sem 3·3) % and 5·5 (sem 2·5) % to 13·4 (sem 4) % for lutein and zeaxanthin, respectively. These carotenoids were compared to each other at each added amount and no significant difference was observed between the two xanthophylls. The carotene carotenoids α-carotene, β-carotene and lycopene and the xanthophyll β-cryptoxanthin were also examined and had lower uptake and secretion values when compared to lutein, zeaxanthin and astaxanthin. The xanthophyll β-cryptoxanthin was also not significantly different when compared to the carotene carotenoids. Data generated from this study compares well with in vivo bioavailability studies. Furthermore, the model provides comparative data on the relative absorption and transfer of seven different carotenoids. Our data indicate that lower amounts of carotenoids were absorbed and transferred more efficiently than higher amounts suggesting a saturation effect at higher exposure.

Studies on the bioavailability of the provitamin A carotenoid, β-carotene, using human exfoliated colonic epithelial cells

The possibility of using exfoliated colonic epithelial cells for assessing the bioavailability of β-carotene was examined. Analysis of exfoliated colonic epithelial cells showed the presence of β-carotene and vitamin A. The β-carotene content was significantly lower in cells from stool samples of subjects on a β-carotene-poor diet than those receiving a single dose of a β-carotene supplement. Colonic epithelial cells isolated from stool samples collected daily during a wash-out period while the subjects were on a β-carotene-poor diet showed a steady decrease in β-carotene content, reaching the lowest value on day 7. Kinetic analysis showed that a single dose of a β-carotene supplement in the form of spirulina (Spirulina platensis) or agathi (Sesbania grandiflora) after the wash-out period caused an increase in the β-carotene content after a lag period of 5–7 d, but the vitamin A levels during these periods were not significantly affected. Analysis of plasma β-carotene concentration also showed similar changes, which correlated with those of exfoliated colonic cells. A relationship between the β-carotene content of the diet and that of the colonic epithelial cells suggests that analysis of the β-carotene content in exfoliated human colonic epithelial cells is a useful non-invasive method to assess the bioavailability of provitamin A β-carotene.

Stable isotope dilution techniques for assessing vitamin A status and bioefficacy of provitamin A carotenoids in humans

Vitamin A deficiency is a major global public health problem. Among the variety of techniques that are available for assessing human vitamin A status, evaluating the provitamin A nutritional values of foodstuffs and estimating human vitamin A requirements, isotope dilution provides the most accurate estimates. Although the relative expense of isotope dilution restricts its applications, it has an important function as the standard of reference for other techniques. Mathematical modelling plays an indispensable role in the interpretation of isotope dilution data. This review summarises recent applications of stable isotope methodology to determine human vitamin A status, estimate human vitamin A requirements, and calculate the bioconversion and bioefficacy of food carotenoids.

Plasma carotenoids as biomarkers of intake of fruits and vegetables: ecological-level correlations in the European Prospective Investigation into Cancer and Nutrition (EPIC)

OBJECTIVE

The aim of this study was to assess the ability of a single 24-h dietary recall (24HDR) and food questionnaires (FQ) to predict plasma carotenoid levels at the ecological level by assessing the relationship between mean plasma carotenoid levels and mean intake of fruit and vegetables measured by 24HDR and FQ across 16 European regions.

DESIGN

A random subsample of 3089 subjects was included, stratified by age and gender. They provided blood samples and dietary information between 1992 and 2000 as part of the European Prospective Investigation into Cancer and Nutrition.

RESULTS

Using Spearman's correlation coefficients, the correlations between mean regional 24HDR fruit and vegetable variables and corresponding mean plasma carotenoid levels were generally higher than the correlations using FQ means. The highest correlation was between the 24HDR citrus fruit variable and beta-cryptoxanthin (r = 0.90). For 24HDR, total fruits and vegetables were highly correlated with lutein, zeaxanthin, and beta-cryptoxanthin (r = 0.83-0.87), while vegetables were more closely related with lutein (r = 0.69) and zeaxanthin (r = 0.68), and fruits correlated with zeaxanthin (r = 0.87) and beta-cryptoxanthin (r = 0.84). Root vegetables (r = 0.81) and total carrots (r = 0.71) were well correlated with alpha-carotene. In the multivariate models adjusting for age, body mass index, and season, and using observations of means stratified by sex and region, the association was generally higher for 24HDR compared to FQ.

CONCLUSION

Mean regional intakes of fruits and vegetables in several European countries were closely correlated with corresponding mean plasma levels of individual carotenoids. Fruits and vegetables measured by 24HDR were generally better able to predict plasma carotenoids at the ecological level.

Plasma appearance of labeled beta-carotene, lutein, and retinol in humans after consumption of isotopically labeled kale

The bioavailability of carotenoids from kale was investigated by labeling nutrients in kale with 13C, feeding the kale to seven adult volunteers, and analyzing serial plasma samples for labeled lutein, beta-carotene, and retinol. Ingested doses of labeled carotenoids were 34 micromol for beta-carotene and 33 micromol for lutein. Peak plasma concentrations, areas under the plasma concentration-time curves (AUCs), and percentages of dose recovered at peak plasma concentrations were calculated. Average peak plasma concentrations were 0.38, 0.068, and 0.079 microM for [13C]lutein, [13C]beta-carotene, and [13C]retinol, respectively. Average AUC values (over 28 days) were 42.8, 13.6, 13.2 microM h for [13C]lutein, [13C]beta-carotene, and [13C]retinol, respectively. Percentages of dose recovered at peak plasma concentrations were 3.6, 0.7, and 0.7% for [13C]lutein, [13C]beta-carotene, and [13C]retinol, respectively. A positive relationship was observed between baseline plasma retinol levels and [13C]retinol plasma response. It is possible that this relationship was mediated either through some aspect of beta-carotene absorption or via the common pathways of metabolism for postdose and endogenous retinoid.

Intestinal absorption and metabolism of carotenoids: insights from cell culture

Cell culture models are useful for studying intestinal absorption and metabolism of carotenoids. The human intestinal cell line, Caco-2, has been the most widely used model for these studies. The PF11 and TC7 clones of Caco-2 exhibit beta-carotene-15,15'-oxygenase activity, a key enzyme in the conversion of carotenoids to vitamin A. Studies on the recent cloning of this enzyme are discussed. An in vitro cell culture system used to study intestinal absorption of carotenoids is presented. Under conditions mimicking the postprandial state, Caco-2 cells on membranes take up carotenoids and secrete them incorporated into chylomicrons. Both the cellular uptake and secretion of beta-carotene are saturable, concentration-dependent processes. The selective absorption of all-trans beta-carotene versus its cis isomers, the differential absorption of individual carotenoids, and the specific interactions between carotenoids during their absorption are discussed. The participation of a specific epithelial transporter in the intestinal absorption of carotenoids is proposed.

Carotenoid and retinoid metabolism: insights from isotope studies

Use of isotopes as tracers has had an important role in elucidating key features of vitamin A and retinoid metabolism in animal models and humans. Their use has shown that beta-carotene absorption is variable, and that the appearance of beta-carotene and its metabolites in the blood by time since dosing follows characteristic patterns. Retinol formed from beta-carotene shows a different pattern, as does lutein. In this article, we summarize and discuss insights and some surprises into the absorption and metabolism of vitamin A, beta-carotene, and lutein that were gained with the use of isotope tracers in humans, rats, and cells as models.

Carotenoid bioavailability is higher from salads ingested with full-fat than with fat-reduced salad dressings as measured with electrochemical detection

BACKGROUND

The amount of dietary fat required for optimal bioavailability of carotenoids in plant matrices is not clearly defined.

OBJECTIVE

The objective was to quantify the appearance of carotenoids in plasma chylomicrons after subjects ingested fresh vegetable salads with fat-free, reduced-fat, or full-fat salad dressings.

DESIGN

The subjects (n = 7) each consumed 3 salads consisting of equivalent amounts of spinach, romaine lettuce, cherry tomatoes, and carrots with salad dressings containing 0, 6, or 28 g canola oil. The salads were consumed in random order separated by washout periods of > or =2 wk. Blood samples were collected hourly from 0 to 12 h. Chylomicrons were isolated by ultracentrifugation, and carotenoid absorption was analyzed by HPLC with coulometric array detection.

RESULTS

After ingestion of the salads with fat-free salad dressing, the appearance of alpha-carotene, beta-carotene, and lycopene in chylomicrons was negligible. After ingestion of the salads with reduced-fat salad dressing, the appearance of the carotenoids in plasma chylomicrons increased relative to that after ingestion of the salads with fat-free salad dressing (P < 0.04). Similarly, the appearance of the carotenoids in plasma chylomicrons was higher after the ingestion of salads with full-fat than with reduced-fat salad dressing (P < 0.02).

CONCLUSIONS

High-sensitivity HPLC with coulometric array detection enabled us to quantify the intestinal absorption of carotenoids ingested from a single vegetable salad. Essentially no absorption of carotenoids was observed when salads with fat-free salad dressing were consumed. A substantially greater absorption of carotenoids was observed when salads were consumed with full-fat than with reduced-fat salad dressing.

Isotopic labeling and LC-APCI-MS quantification for investigating absorption of carotenoids and phylloquinone from kale (Brassica oleracea)

The ability to study bioavailability of nutrients from foods is an important step in determining the health impact of those nutrients. This work describes a method for studying the bioavailability of nutrients from kale (Brassica oleracea var. Acephala) by labeling the nutrients with carbon-13, feeding the kale to an adult volunteer, and analyzing plasma samples for labeled nutrients. Results showed that conditions for producing atmospheric intrinsically labeled kale had no detrimental effect on plant growth. Lutein, beta-carotene, retinol, and phylloquinone were analyzed using liquid chromatography-atmospheric pressure chemical ionization mass spectrometry. Analysis of plasma samples showed that labeled lutein peaked in plasma at 11 h (0.23 microM), beta-carotene peaked at 8 (0.058 microM) and 24 h (0.062 microM), retinol peaked at 24 h (0.10 microM), and phylloquinone peaked at 7 h (3.0 nM). This method of labeling kale with (13)C was successful for producing clearly defined kinetic curves for (13)C-lutein,(13)C-beta-carotene, (13)C-retinol, and (13)C-phylloquinone.

Bioavailability and vitamin A value of carotenes from red palm oil assessed by an extrinsic isotope reference method

Red palm oil (RPO) contains high concentrations of beta- and alpha-carotene, and is presumed to possess a higher vitamin A value than other foods. The objective was to determine the metabolic vitamin A and carotene values of refined red palm oil in healthy adult subjects, using a stable isotope reference method. Twelve healthy subjects were administered a small standardised meal containing 10 g RPO (2.4 mg beta-carotene and 1.8 mg alpha-carotene) in a blended juice-based drink also containing 2 mg tetradeuterated retinyl acetate (d4-RA) as a metabolic reference. At baseline and at several times after the test meal, the concentrations of carotenes and of d4- and d0-(unlabelled) retinyl esters, in the plasma chylomicron-rich (d < 1.006) fraction were determined by high high-performance liquid chromatography and gas chromatography mass spectrometry, respectively. The masses of palm oil-derived vitamin A and carotenes absorbed ('yield') were calculated assuming 80% absorption of the d4-RA reference dose. The mean yield of retinol from the RPO was 0.41 mg, ranging from 0.17 mg to 0.86 mg. The mean yields of beta- and alpha-carotene were 0.29 mg and 0.25 mg, respectively, suggesting that beta-carotene was more extensively metabolised than alpha-carotene. Subjects assimilated an average of 23% of the dose of carotenes, as the sum of retinol and unmetabolised carotenes. The vitamin A values of red palm oil obtained under these conditions, a mean of 0.17 mg retinol absorbed per mg beta-carotene consumed (beta-carotene : retinol equivalency of 5.7:1) is higher than that of all other vegetable sources we have evaluated to date.

Vitamin A uptake from foods

PURPOSE OF REVIEW

To review our current understanding of vitamin A uptake from foods.

RECENT FINDINGS

There are advancements in understanding the molecular processes involved in vitamin A uptake and the regulation of these processes. A number of genes involved in vitamin A transport and metabolism have been recently identified. The identification of mutations in human genes and targeted disruption of mouse genes have provided further insight as to how these genes contribute to meeting nutritional needs.

SUMMARY

The rate limiting steps in the lymphatic absorption of vitamin A involve intracellular processing of vitamin A within the enterocyte. The key steps appear to be related to chylomicron formation and secretion and are closely coupled with fat absorption. The genes encoding serum retinol binding protein, cellular retinol binding protein I and cellular retinol binding protein II have been disrupted by homologous recombination in mice. Studies of these knockout mice indicate that extrahepatic uptake of postprandial vitamin A may play a particularly important role in the maternal-offspring transfer of vitamin A. Further studies of the transfer of maternal dietary vitamin A have important implications for assessing the upper limits of maternal vitamin A supplementation.

Isotopic tracer techniques for studying the bioavailability and bioefficacy of dietary carotenoids, particularly beta-carotene, in humans: a review

Vitamin A deficiency is a serious health problem in many developing countries. Provitamin A carotenoids in fruit and vegetables are the major source of vitamin A for a large proportion of the world's population. However, the contribution of plant foods is substantial only when both the consumption and provitamin A content of such food is high and, at the same time, the bioefficacy of the provitamin A is high. With respect to provitamin A carotenoids, the term bioefficacy is defined as the product of the fraction of the ingested amount that is absorbed (bioavailability) and the fraction of that which is converted to retinol in the body (bioconversion). Isotopic tracer techniques can meet the need for accurate and precise estimates of the bioavailability, bioconversion, and bioefficacy of dietary carotenoids in humans. Use of such techniques will enable proper evaluation of food-based approaches to eliminating vitamin A deficiency. In addition, the putative antioxidant capacities of carotenoids can be better understood if their bioavailability is known. Here, we discuss how tracer techniques can be applied to obtain reliable and representative data. A step-by-step discussion of aspects related to these techniques is provided, including study design, choice of isotopic tracers, dosing regimen, collection of samples, chemical analysis of samples, and data analysis.

Carotenoid bioavailability and bioconversion

The possible role of carotenoids and their metabolites in disease prevention is far from fully understood, because the bioavailabilities of carotenoids are complicated by multiple factors that affect their absorption, breakdown, transport, and storage. Rapid progress in developing sophisticated methodologies, including use of stable-isotope dilution methods, now allows for an accurate determination of the true vitamin A activity of provitamin A carotenoids. The recent identification of specific enzymes, which catalyze the breakdown of beta-carotene as well as nonprovitamin A carotenoids, is providing a better understanding of the functions of carotenoids at the molecular level. The pathways and possible mechanisms of carotenoid breakdown and factors affecting the bioavailability of carotenoids, such as carotenoid type, food matrix, interaction with other carotenoids and other food components, nutritional status, aging, and infection, are discussed in this review.

Alpha- and beta-carotene from a commercial puree are more bioavailable to humans than from boiled-mashed carrots, as determined using an extrinsic stable isotope reference method

The extent to which processing affects the carotene or vitamin A value of foods is poorly understood. An extrinsic reference method was used to estimate the mass of carotenes and vitamin A derived from various preparations made from the same lot of carrots. Using a repeated-measures design, nine healthy adult subjects consumed test meals of either carrot puree (commercial baby food) or boiled-mashed carrots on separate days; six of the subjects also consumed a test meal of raw-grated carrot. Test meals supplied 34.7 micromol (18.6 mg) carrot beta-carotene (beta C), plus 6 micromol deuterium-labeled retinyl acetate (d(4)-RA) in oil solution. Baseline-adjusted carotene and retinyl ester (R-ester) area-under-curve (AUC) responses in the triacylglycerol-rich lipoprotein (TRL) fraction (0-8.5 h) were determined using HPLC and gas chromatography-mass spectrometry. The masses of absorbed beta C, alpha-carotene (alpha C) and R-ester were estimated by comparing their AUC values with that of deuterium-labeled retinyl ester (d(4)-R-ester), assuming the latter represented 80% of the d(4)-RA reference dose. Absorption of beta C and alpha C was approximately twofold greater from carrot puree than from boiled-mashed carrots, whereas the retinol yield was only marginally (P = 0.11) influenced by treatment. Carotene and R-ester absorption from raw-grated carrot was intermediate to, and did not differ significantly from the cooked preparations. The vitamin A yield (puree, 0.53 mg; boiled-mashed, 0.44 mg) of cooked carrot containing 18.6 mg beta C was substantially less than that predicted by current convention and limited primarily by intestinal carotene uptake. Processing can therefore significantly improve bioavailability of carrot carotenes, and in some cases influence the carotene value more than the intrinsic vitamin A value.