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Zhu X, Cheang I, Tang Y, Shi M, Zhu Q, Gao R, Liao S, Yao W, Zhou Y, Zhang H, Li X. Associations of Serum Carotenoids With Risk of All-Cause and Cardiovascular Mortality in Hypertensive Adults. J Am Heart Assoc 2023; 12:e027568. [PMID: 36752230 PMCID: PMC10111495 DOI: 10.1161/jaha.122.027568] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Background Systemic oxidative stress is involved in the development of hypertension, whereas carotenoids are a group of natural antioxidants. Our study aims to evaluate the relationships between the serum concentrations of major carotenoids and mortality in hypertensive adults. Methods and Results Data on 5 serum carotenoids from the National Health and Nutrition Examination Survey (NHANES) III and NHANES 2001-2006 were included. Outcome measures (all-cause and cardiovascular mortality) were identified from the National Death Index through December 31, 2019. Multiple Cox proportional hazards regression and restricted cubic spline analyses were performed to determine the association between carotenoid levels and outcomes. A total of 8390 hypertensive adults were included in the analysis. At a median follow-up duration of 16.6 years, all-cause and cardiovascular mortality occurred in 4005 (47.74%) and 1205 (14.36%) participants, respectively. Compared with the lowest quartiles, the highest quartiles of 5 major serum carotenoids were associated with lower risk of all-cause mortality, with multivariable-adjusted hazard ratios (HRs) of 0.63 (95% CI, 0.56-0.71) for α-carotene, 0.70 (95% CI, 0.61-0.80); for β-carotene, 0.67 (95% CI, 0.58-0.76); for β-cryptoxanthin, 0.74 (95% CI, 0.64-0.86) for lycopene; and 0.72 (95% CI, 0.63-0.83) for lutein/zeaxanthin. For cause-specific mortality, this association with the fourth quartile of serum carotenoids was evident for a reduced rate of cardiovascular mortality, with a 32% reduction for α-carotene (HR, 0.68 [95% CI, 0.55-0.86]), a 29% reduction for β-cryptoxanthin (HR, 0.71 [95% CI, 0.56-0.89]), and a 26% reduction for lycopene (HR, 0.74 [95% CI, 0.59-0.94]), but not for β-carotene and lutein/zeaxanthin. In addition, we found that serum α-carotene, β-carotene, β-cryptoxanthin, and lutein/zeaxanthin levels were nonlinearly related to all-cause mortality with inflection points of 2.43, 8.49, 5.12, and 14.17 μg/dL, respectively. Serum α-carotene, β-cryptoxanthin, and lutein/zeaxanthin concentrations showed nonlinear associations with cardiovascular mortality with inflection points of 2.31, 5.26, and 15.40 μg/dL, respectively. Conclusions Findings suggest that higher serum carotenoid concentrations were associated with lower risks of all-cause and cardiovascular mortality in hypertensive adults.
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Affiliation(s)
- Xu Zhu
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical University, Jiangsu Province HospitalNanjingChina
| | - Iokfai Cheang
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical University, Jiangsu Province HospitalNanjingChina
| | - Yuan Tang
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical University, Jiangsu Province HospitalNanjingChina
| | - Mengsha Shi
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical University, Jiangsu Province HospitalNanjingChina
| | - Qingqing Zhu
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical University, Jiangsu Province HospitalNanjingChina
| | - Rongrong Gao
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical University, Jiangsu Province HospitalNanjingChina
| | - Shengen Liao
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical University, Jiangsu Province HospitalNanjingChina
| | - Wenming Yao
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical University, Jiangsu Province HospitalNanjingChina
| | - Yanli Zhou
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical University, Jiangsu Province HospitalNanjingChina
| | - Haifeng Zhang
- Department of CardiologyThe Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu SchoolSuzhouChina
| | - Xinli Li
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical University, Jiangsu Province HospitalNanjingChina
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Fujii R, Suzuki K, Yamada H, Kawado M, Hashimoto S, Tsuboi Y, Wakai K, Iso H, Watanabe Y, Fujino Y, Tamakoshi A. Association between serum carotenoids and premature mortality in a population-based case-control study. NAGOYA JOURNAL OF MEDICAL SCIENCE 2022; 84:607-620. [PMID: 36237882 PMCID: PMC9529633 DOI: 10.18999/nagjms.84.3.607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 11/10/2021] [Indexed: 11/24/2022]
Abstract
Carotenoids are abundant pigments mainly contained in vegetables and fruits, and show antioxidant properties by quenching free radicals in human body. Few studies have investigated associations between serum carotenoid levels and premature mortality. The objective of this study was to investigate the association between serum carotenoid level and premature mortality in a Japanese population. This study included 446 Japanese adults (174 men, aged of 40-64) recruited as participants in the Japan Collaborative Cohort (JACC) Study. Serum carotenoid level was measured by high-performance liquid chromatography. Premature mortality was defined as death before 65 years old during the follow-up period. Premature mortality was ascertained in 60 men (34.5%) and 65 women (23.9%). In men, compared to the 1st tertile of serum β-cryptoxanthin and provitamin A, those who were in the 3rd tertile had lower risks of premature all-cause mortality (OR, 95% CI: 0.19, 0.07-0.47 for β-cryptoxanthin, and 0.24, 0.09-0.61 for provitamin A). In women, compared to the 1st tertile of serum β-cryptoxanthin, those who were in the 3rd tertile had higher risks of premature all-cause mortality (OR, 95% CI: 1.94, 1.00-4.03). These significant associations were observed in analyses for premature cancer mortality. We found significant associations between higher levels of serum β-cryptoxanthin and provitamin A and lower risks of premature mortality among Japanese men, while a different directional association was found in women. Although these findings suggest roles of serum carotenoids on premature mortality, further studies are needed to validate this association in other populations.
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Affiliation(s)
- Ryosuke Fujii
- Department of Preventive Medical Sciences, Fujita Health University School of Medical Sciences, Toyoake, Japan
| | - Koji Suzuki
- Department of Preventive Medical Sciences, Fujita Health University School of Medical Sciences, Toyoake, Japan
| | - Hiroya Yamada
- Department of Hygiene, Fujita Health University School of Medicine, Toyoake, Japan
| | - Miyuki Kawado
- Department of Hygiene, Fujita Health University School of Medicine, Toyoake, Japan
| | - Shuji Hashimoto
- Department of Hygiene, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yoshiki Tsuboi
- Department of Preventive Medical Sciences, Fujita Health University School of Medical Sciences, Toyoake, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yoshiyuki Watanabe
- Department of Nursing, Faculty of Health and Medical Sciences, Kyoto University of Advanced Science, Kyoto, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
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Rojo-Trejo MH, Robles-Osorio ML, Sabath E. Liposoluble vitamins A and E in kidney disease. World J Nephrol 2022; 11:96-104. [PMID: 35733655 PMCID: PMC9160709 DOI: 10.5527/wjn.v11.i3.96] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/15/2021] [Accepted: 04/21/2022] [Indexed: 02/06/2023] Open
Abstract
Kidney disease (KD) is characterized by the presence of elevated oxidative stress, and this is postulated as contributing to the high cardiovascular morbidity and mortality in these individuals. Chronic KD (CKD) is related to high grade inflammatory condition and pro-oxidative state that aggravates the progression of the disease by damaging primary podocytes. Liposoluble vitamins (vitamin A and E) are potent dietary antioxidants that have also anti-inflammatory and antiapoptotic functions. Vitamin deficits in CKD patients are a common issue, and multiple causes are related to them: Anorexia, dietary restrictions, food cooking methods, dialysis losses, gastrointestinal malabsorption, etc. The potential benefit of retinoic acid (RA) and α-tocopherol have been described in animal models and in some human clinical trials. This review provides an overview of RA and α tocopherol in KD.
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Affiliation(s)
| | | | - Ernesto Sabath
- Department of Renal Medicine, Nutrition School, Universidad Autónoma de Querétaro, Querétaro 76090, Mexico
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Simkin AJ. Carotenoids and Apocarotenoids in Planta: Their Role in Plant Development, Contribution to the Flavour and Aroma of Fruits and Flowers, and Their Nutraceutical Benefits. PLANTS (BASEL, SWITZERLAND) 2021; 10:plants10112321. [PMID: 34834683 PMCID: PMC8624010 DOI: 10.3390/plants10112321] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 05/05/2023]
Abstract
Carotenoids and apocarotenoids are diverse classes of compounds found in nature and are important natural pigments, nutraceuticals and flavour/aroma molecules. Improving the quality of crops is important for providing micronutrients to remote communities where dietary variation is often limited. Carotenoids have also been shown to have a significant impact on a number of human diseases, improving the survival rates of some cancers and slowing the progression of neurological illnesses. Furthermore, carotenoid-derived compounds can impact the flavour and aroma of crops and vegetables and are the origin of important developmental, as well as plant resistance compounds required for defence. In this review, we discuss the current research being undertaken to increase carotenoid content in plants and research the benefits to human health and the role of carotenoid derived volatiles on flavour and aroma of fruits and vegetables.
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Affiliation(s)
- Andrew J. Simkin
- School of Biosciences, University of Kent, Canterbury CT2 7NJ, UK; or
- Crop Science and Production Systems, NIAB-EMR, New Road, East Malling, Kent ME19 6BJ, UK
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Cerna J, Anaraki NSA, Robbs CM, Adamson BC, Flemming IR, Erdman JW, Labriola LT, Motl RW, Khan NA. Macular Xanthophylls and Markers of the Anterior Visual Pathway among Persons with Multiple Sclerosis. J Nutr 2021; 151:2680-2688. [PMID: 34087931 DOI: 10.1093/jn/nxab164] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/01/2021] [Accepted: 04/28/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Multiple sclerosis (MS) can cause retinal thinning among persons with MS with optic neuritis (MS-ON). Macular xanthophylls are carotenoids that comprise the macular pigment, filtering blue light and countering photo-oxidation. However, macular xanthophyll status and its implications for markers of neuroaxonal degeneration have not been examined in MS. OBJECTIVES This study characterized differences in macular and serum xanthophylls, and retinal morphometry [retinal nerve fiber layer thickness at the macular (mRNFL) and optic disc (odRNFL) and total macular volume (TMV)] in individuals with MS and healthy controls (HC). Associations between macular pigment optical density (MPOD) and retinal morphometry were also examined. METHODS Adults aged 45-64 y (HC, n = 42; MS, n = 40) participated in a cross-sectional study. MPOD was measured via heterochromatic flicker photometry. Retinal morphometry was measured via optical coherence tomography (OCT). Serum carotenoids were quantified using HPLC. Dietary carotenoids were collected using 7-d records. One-factor ANOVA was conducted to determine group effects on macular, serum, and dietary carotenoids. Partial correlations examined the relations between MPOD, retinal morphometry, diet, and serum carotenoids. RESULTS Relative to HC, persons with MS-ON had lower MPOD (Cohen's d = 0.84, P = 0.014), lower odRNFL (Cohen's d = 2.16, P <0.001), lower mRNFL (Cohen's d = 0.57, P = 0.028), and lower TMV (Cohen's d = 0.95, P = 0.011). MS without ON (MS) had lower odRNFL (Cohen's d = 0.93, P = 0.001) than HC and lower serum lutein than MS-ON subjects (Cohen's d = 0.65, P = 0.014). Among MS, MPOD was positively correlated with odRNFL thickness (ρ = 0.43, P = 0.049) and TMV (ρ = 0.45, P = 0.039), whereas odRNFL was negatively correlated with serum lutein (ρ = -0.68, P = 0.016) and zeaxanthin (ρ = -0.62, P = 0.028). CONCLUSIONS Persons with MS-ON exhibited poorer xanthophyll status in the macula and serum. MPOD was associated with beneficial anatomical features in the MS group. These findings warrant confirmation with larger cohorts and prospective trials to evaluate xanthophyll effects on the anterior visual pathway in MS.
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Affiliation(s)
- Jonathan Cerna
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, USA
| | | | - Connor M Robbs
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, USA
| | - Brynn C Adamson
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, USA.,Multiple Sclerosis Research Collaborative, University of Illinois, Urbana, IL, USA
| | - Isabel R Flemming
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, USA
| | - John W Erdman
- Department of Food Science and Human Nutrition, University of Illinois, Urbana, IL, USA
| | - Leanne T Labriola
- Ophthalmology, Carle Foundation Hospital, Urbana, IL, USA.,Surgery, University of Illinois College of Medicine, Urbana, IL, USA
| | - Robert W Motl
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Naiman A Khan
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, USA.,Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, USA.,Multiple Sclerosis Research Collaborative, University of Illinois, Urbana, IL, USA
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Fujii R, Tsuboi Y, Maeda K, Ishihara Y, Suzuki K. Analysis of Repeated Measurements of Serum Carotenoid Levels and All-Cause and Cause-Specific Mortality in Japan. JAMA Netw Open 2021; 4:e2113369. [PMID: 34115126 PMCID: PMC8196342 DOI: 10.1001/jamanetworkopen.2021.13369] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
IMPORTANCE The associations of levels of diverse serum carotenoids ascertained via repeated measurements with all-cause, cancer, and cardiovascular disease (CVD) mortality risk have not been considered in previous prospective studies. OBJECTIVE To investigate the association between repeated measurement of serum carotenoid levels and all-cause and cause-specific mortality risk. DESIGN, SETTING, AND PARTICIPANTS This cohort study's baseline data were collected using information from physical examinations from 1990 to 1999. Eligible participants were followed up until December 2017, with a median (interquartile range) follow-up period of 22.3 (15.5-25.3) years. Included individuals were age 40 years or older at the baseline data collection, were residents of the study site in the town of Yakumo, Hokkaido, Japan, and participated in a physical examination at least once from 1990 to 1999. Among eligible participants, after excluding 332 individuals, 3116 individuals were included in the analysis. Data analysis was conducted in April 2020. EXPOSURES Repeated measurements of 6 serum carotenoid levels and 4 associated indices. MAIN OUTCOMES AND MEASURES All-cause, cancer, and CVD mortality, categorized by International Classification of Diseases, Ninth Revision and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes, were recorded. A time-dependent Cox regression model was performed to examine associations between time-varying serum carotenoid levels and mortality. RESULTS Among 3116 individuals who received physical examinations, the mean (SD) age was 54.7 (10.6) years and 1883 (60.4%) were women. During the follow-up period, 762 deaths from all causes, 253 deaths from cancer, and 210 deaths from CVD were ascertained. In a time-dependent Cox regression analysis, for every 25% higher serum levels of total carotenoids, risks were statistically significantly lower for all-cause mortality (hazard ratio [HR], 0.85; 95% CI, 0.82-0.87; P < .001), cancer mortality (HR, 0.82; 95% CI, 0.78-0.87; P < .001), and CVD mortality (HR, 0.86; 95% CI, 0.81-0.91; P < .001). Using only baseline measures, for every 25% higher serum levels of total carotenoids, risks were also statistically significantly lower for all-cause mortality (HR, 0.92; 95% CI, 0.89-0.95; P < .001), cancer mortality (HR, 0.87; 95% CI, 0.83-0.93; P < .001), and CVD mortality (HR, 0.93; 95% CI, 0.88-0.99; P = .03) but with larger HRs than those associated with repeated measurements. CONCLUSIONS AND RELEVANCE This study found that higher levels of serum carotenoids in analysis using repeated measurements were associated with significantly lower all-cause and cause-specific mortality over a follow-up period of 25 years.
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Affiliation(s)
- Ryosuke Fujii
- Department of Preventive Medical Sciences, Fujita Health University School of Medical Sciences, Toyoake, Japan
| | - Yoshiki Tsuboi
- Department of Preventive Medical Sciences, Fujita Health University School of Medical Sciences, Toyoake, Japan
| | - Keisuke Maeda
- Department of Preventive Medical Sciences, Fujita Health University School of Medical Sciences, Toyoake, Japan
| | - Yuya Ishihara
- Department of Preventive Medical Sciences, Fujita Health University School of Medical Sciences, Toyoake, Japan
| | - Koji Suzuki
- Department of Preventive Medical Sciences, Fujita Health University School of Medical Sciences, Toyoake, Japan
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Tan BL, Norhaizan ME. Carotenoids: How Effective Are They to Prevent Age-Related Diseases? Molecules 2019; 24:E1801. [PMID: 31075966 PMCID: PMC6539799 DOI: 10.3390/molecules24091801] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/03/2019] [Accepted: 05/06/2019] [Indexed: 01/30/2023] Open
Abstract
Despite an increase in life expectancy that indicates positive human development, a new challenge is arising. Aging is positively associated with biological and cognitive degeneration, for instance cognitive decline, psychological impairment, and physical frailty. The elderly population is prone to oxidative stress due to the inefficiency of their endogenous antioxidant systems. As many studies showed an inverse relationship between carotenoids and age-related diseases (ARD) by reducing oxidative stress through interrupting the propagation of free radicals, carotenoid has been foreseen as a potential intervention for age-associated pathologies. Therefore, the role of carotenoids that counteract oxidative stress and promote healthy aging is worthy of further discussion. In this review, we discussed the underlying mechanisms of carotenoids involved in the prevention of ARD. Collectively, understanding the role of carotenoids in ARD would provide insights into a potential intervention that may affect the aging process, and subsequently promote healthy longevity.
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Affiliation(s)
- Bee Ling Tan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia.
| | - Mohd Esa Norhaizan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia.
- Laboratory of Molecular Biomedicine, Institute of Bioscience, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia.
- Research Centre of Excellent, Nutrition and Non-Communicable Diseases (NNCD), Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia.
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Huang J, Weinstein SJ, Yu K, Männistö S, Albanes D. Relationship Between Serum Alpha-Tocopherol and Overall and Cause-Specific Mortality. Circ Res 2019; 125:29-40. [PMID: 31219752 DOI: 10.1161/circresaha.119.314944] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
RATIONALE Although there has been a long-standing interest in the human health effects of vitamin E, a comprehensive analysis of the association between circulating vitamin E and long-term mortality has not been conducted. OBJECTIVE Determine whether serum α-tocopherol (the predominant form of vitamin E) is related to long-term overall and cause-specific mortality and elucidate the dose-response relationships with better quantification of the associations. METHODS AND RESULTS We conducted a biochemical analysis of 29 092 participants in the ATBC Study (Alpha-Tocopherol, Beta-Carotene Cancer Prevention) that originally tested vitamin E and β-carotene supplementation. Serum α-tocopherol was measured at baseline using high-performance liquid chromatography, and during a 30-year follow-up we identified 23 787 deaths, including deaths from cardiovascular disease (9867), cancer (7687), respiratory disease (2161), diabetes mellitus (119), injuries and accidents (1255), and other causes (2698). After adjusting for major risk factors, we found that men with higher serum α-tocopherol had significantly lower all-cause mortality (hazard ratios=0.83, 0.79, 0.75, and 0.78 for quintile 2 (Q2)-Q5 versus Q1, respectively; Ptrend<0.0001), and significantly decreased mortality from cardiovascular disease, heart disease, stroke, cancer, respiratory disease, and other causes, with risk reductions from 17% to 47% for the highest versus lowest quintile. The α-tocopherol association with overall mortality was similar across subgroups of smoking intensity, years of smoking, alcohol consumption, trial supplementation, and duration of follow-up. The association was, however, significantly modified by baseline age and body mass index, with stronger inverse associations for younger men and men with a lower body mass index ( Pinteraction≤0.006). CONCLUSIONS In this long-term prospective cohort study, higher baseline serum α-tocopherol biochemical status was associated with lower risk of overall mortality and mortality from all major causes. Our data support the long-term health benefits of higher serum α-tocopherol for overall and chronic disease mortality and should be replicated in other more diverse populations.
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Affiliation(s)
- Jiaqi Huang
- From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD (J.H., S.J.W., K.Y., D.A.)
| | - Stephanie J Weinstein
- From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD (J.H., S.J.W., K.Y., D.A.)
| | - Kai Yu
- From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD (J.H., S.J.W., K.Y., D.A.)
| | - Satu Männistö
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland (S.M.)
| | - Demetrius Albanes
- From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD (J.H., S.J.W., K.Y., D.A.)
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Mullan K, Cardwell CR, McGuinness B, Woodside JV, McKay GJ. Plasma Antioxidant Status in Patients with Alzheimer's Disease and Cognitively Intact Elderly: A Meta-Analysis of Case-Control Studies. J Alzheimers Dis 2019; 62:305-317. [PMID: 29439339 DOI: 10.3233/jad-170758] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Serum antioxidants may afford neuroprotection against Alzheimer's disease (AD) via correction of the pro-oxidative imbalance but findings reported have been inconsistent. We compared the pooled mean difference in serum levels of ten dietary antioxidants between patients with AD and cognitively intact controls from 52 studies in meta-analyses using random-effects models. Patients with AD had significantly lower plasma levels of α-carotene, β-carotene, lycopene, lutein, vitamin A, C, and E, and uric acid. No significant difference was observed for plasma levels of β-cryptoxanthin and zeaxanthin. Considerable heterogeneity was detected across studies. The lower serum levels of dietary antioxidants from the carotene and vitamin subclasses observed in individuals with AD suggest reduced systemic availability of these subclasses in this prevalent form of dementia. To our knowledge, these are the first meta-analyses to demonstrate lower serum lycopene and to evaluate β-cryptoxanthin, lutein, and zeaxanthin levels in AD. In light of the significant heterogeneity detected across studies, caution should be exercised in the interpretation of the data and therapeutic intervention approaches considered through supplementation measures. Our data may better inform interventions to improve antioxidant status in a condition of major public health importance.
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Affiliation(s)
- Kathryn Mullan
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Chris R Cardwell
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Jayne V Woodside
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Gareth J McKay
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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10
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Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, Tonstad S, Vatten LJ, Riboli E, Norat T. Dietary intake and blood concentrations of antioxidants and the risk of cardiovascular disease, total cancer, and all-cause mortality: a systematic review and dose-response meta-analysis of prospective studies. Am J Clin Nutr 2018; 108:1069-1091. [PMID: 30475962 PMCID: PMC6250988 DOI: 10.1093/ajcn/nqy097] [Citation(s) in RCA: 205] [Impact Index Per Article: 34.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 04/27/2018] [Indexed: 12/14/2022] Open
Abstract
Background High dietary intake or blood concentrations (as biomarkers of dietary intake) of vitamin C, carotenoids, and vitamin E have been associated with reduced risk of cardiovascular disease, cancer, and mortality, but these associations have not been systematically assessed. Objective We conducted a systematic review and meta-analysis of prospective studies of dietary intake and blood concentrations of vitamin C, carotenoids, and vitamin E in relation to these outcomes. Design We searched PubMed and Embase up to 14 February 2018. Summary RRs and 95% CIs were calculated with the use of random-effects models. Results Sixty-nine prospective studies (99 publications) were included. The summary RR per 100-mg/d increment of dietary vitamin C intake was 0.88 (95% CI: 0.79, 0.98, I2 = 65%, n = 11) for coronary heart disease, 0.92 (95% CI: 0.87, 0.98, I2 = 68%, n = 12) for stroke, 0.89 (95% CI: 0.85, 0.94, I2 = 27%, n = 10) for cardiovascular disease, 0.93 (95% CI: 0.87, 0.99, I2 = 46%, n = 8) for total cancer, and 0.89 (95% CI: 0.85, 0.94, I2 = 80%, n = 14) for all-cause mortality. Corresponding RRs per 50-μmol/L increase in blood concentrations of vitamin C were 0.74 (95% CI: 0.65, 0.83, I2 = 0%, n = 4), 0.70 (95% CI: 0.61, 0.81, I2 = 0%, n = 4), 0.76 (95% CI: 0.65, 0.87, I2 = 56%, n = 6), 0.74 (95% CI: 0.66, 0.82, I2 = 0%, n = 5), and 0.72 (95% CI: 0.66, 0.79, I2 = 0%, n = 8). Dietary intake and/or blood concentrations of carotenoids (total, β-carotene, α-carotene, β-cryptoxanthin, lycopene) and α-tocopherol, but not dietary vitamin E, were similarly inversely associated with coronary heart disease, stroke, cardiovascular disease, cancer, and/or all-cause mortality. Conclusions Higher dietary intake and/or blood concentrations of vitamin C, carotenoids, and α-tocopherol (as markers of fruit and vegetable intake) were associated with reduced risk of cardiovascular disease, total cancer, and all-cause mortality. These results support recommendations to increase fruit and vegetable intake, but not antioxidant supplement use, for chronic disease prevention.
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Affiliation(s)
- Dagfinn Aune
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
- Department of Nutrition, Bjørknes University College, Oslo, Norway
- Department of Preventive Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - NaNa Keum
- Departments of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Edward Giovannucci
- Departments of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Lars T Fadnes
- Bergen Addiction Research Group, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Darren C Greenwood
- Biostatistics Unit, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, United Kingdom
| | - Serena Tonstad
- Department of Preventive Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Lars J Vatten
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
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11
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Ma E, Iso H, Yamagishi K, Ando M, Wakai K, Tamakoshi A. Dietary Antioxidant Micronutrients and All-Cause Mortality: The Japan Collaborative Cohort Study for Evaluation of Cancer Risk. J Epidemiol 2018; 28:388-396. [PMID: 29806637 PMCID: PMC6111108 DOI: 10.2188/jea.je20170023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Oxidative stress, the imbalance between pro- and antioxidants, has been implicated in the etiology and pathophysiology of the incidence and mortality of many diseases. We aim to investigate the relations of dietary intakes of vitamin C and E and main carotenoids with all-cause mortality in Japanese men and women. Methods The Japan Collaborative Cohort Study for Evaluation of Cancer Risk had 22,795 men and 35,539 women, aged 40–79 years at baseline (1988–1990), who completed a valid food frequency questionnaire and were followed up to the end of 2009. Results There were 6,179 deaths in men and 5,355 deaths in women during the median follow-up of 18.9 years for men and 19.4 years for women. Multivariate hazard ratios for the highest versus lowest quintile intakes in women were 0.83 (95% confidence interval [CI], 0.76–0.90; P for trend < 0.0001) for vitamin C, 0.85 (95% CI, 0.78–0.93; P for trend < 0.0001) for vitamin E, 0.88 (95% CI, 0.81–0.96; P for trend = 0.0006) for β-carotene, and 0.90 (95% CI, 0.82–0.98; P for trend = 0.0002) for β-cryptoxanthin. The joint effect of any two of these highly correlated micronutrients showed significant 12–17% reductions in risk in the high-intake group compared with the low-intake group in women. These significant associations were also observed in the highest quintile intakes of vitamin C, vitamin E, and β-carotene in female non-smokers but were not observed in female smokers, male smokers, and non-smokers. Conclusions Higher dietary intakes of antioxidant vitamins may reduce the risk of all-cause mortality in middle-aged Japanese women, especially female non-smokers.
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Affiliation(s)
- Enbo Ma
- Department of Clinical Trial and Clinical Epidemiology, University of Tsukuba Faculty of Medicine
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, University of Tsukuba Faculty of Medicine
| | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Graduate School of Medicine
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Graduate School of Medicine
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12
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Abstract
Diet is likely to be an important determinant of cardiovascular disease (CVD) risk. In this article, we will review the evidence linking the consumption of fruit and vegetables and CVD risk. The initial evidence that fruit and vegetable consumption has a protective effect against CVD came from observational studies. However, uncertainty remains about the magnitude of the benefit of fruit and vegetable intake on the occurrence of CVD and whether the optimal intake is five portions or greater. Results from randomized controlled trials do not show conclusively that fruit and vegetable intake protects against CVD, in part because the dietary interventions have been of limited intensity to enable optimal analysis of their putative effects. The protective mechanisms of fruit and vegetables may not only include some of the known bioactive nutrient effects dependent on their antioxidant, anti-inflammatory, and electrolyte properties, but also include their functional properties, such as low glycemic load and energy density. Taken together, the totality of the evidence accumulated so far does appear to support the notion that increased intake of fruits and vegetables may reduce cardiovascular risk. It is clear that fruit and vegetables should be eaten as part of a balanced diet, as a source of vitamins, fiber, minerals, and phytochemicals. The evidence now suggests that a complicated set of several nutrients may interact with genetic factors to influence CVD risk. Therefore, it may be more important to focus on whole foods and dietary patterns rather than individual nutrients to successfully impact on CVD risk reduction. A clearer understanding of the relationship between fruit and vegetable intake and cardiovascular risk would provide health professionals with significant information in terms of public health and clinical practice.
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Affiliation(s)
- Eman M Alissa
- a Faculty of Medicine, King Abdul Aziz University , Jeddah , Saudi Arabia
| | - Gordon A Ferns
- b Medical Education and Metabolic Medicine, Brighton and Sussex Medical School, University of Brighton , Brighton , United Kingdom
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13
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Sugiura M. [β-Cryptoxanthin and the risk for lifestyle-related disease: findings from recent nutritional epidemiologic studies]. YAKUGAKU ZASSHI 2017; 135:67-76. [PMID: 25743900 DOI: 10.1248/yakushi.14-00208-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Antioxidant micronutrients, such as vitamins and carotenoids, exist in abundance in fruits and vegetables and have been known to contribute to the body's defense against reactive oxygen species. Numerous recent epidemiologic studies have demonstrated that a high dietary consumption of fruit and vegetables rich in carotenoids or with high serum carotenoid concentrations results in lower risks of certain cancers, diabetes, and cardiovascular disease. These epidemiologic studies have suggested that antioxidant carotenoids may have a protective effect against several lifestyle-related diseases. β-Cryptoxanthin is a carotenoid pigment found in Japanese mandarin (Citrus unshiu MARC.) fruit, which is mainly produced in Japan. Our nutritional epidemiologic survey, the Mikkabi Study, utilized data derived from health examinations of inhabitants performed in the town of Mikkabi in Shizuoka, Japan. In this survey, we measured serum β-cryptoxanthin as a specific biomarker to estimate the consumption of Japanese mandarin fruit. From the cross-sectional analyses from the Mikkabi Study, we found inverse associations of serum β-cryptoxanthin with the risks for atherosclerosis, insulin resistance, liver dysfunction, metabolic syndrome, low bone mineral density, and oxidative stress. In this review, recent epidemiologic studies about the associations between serum β-cryptoxanthin with the risk for several lifestyle-related diseases were reviewed.
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Affiliation(s)
- Minoru Sugiura
- Okitsu Citrus Research Station, NARO Institute of Fruit Tree Science (NIFTS), National Agriculture and Food Research Organization (NARO)
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14
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Nakamura M, Sugiura M, Ogawa K, Ikoma Y, Yano M. Serum β-cryptoxanthin and β-carotene derived from Satsuma mandarin and brachial-ankle pulse wave velocity: The Mikkabi cohort study. Nutr Metab Cardiovasc Dis 2016; 26:808-814. [PMID: 27212620 DOI: 10.1016/j.numecd.2016.04.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 04/04/2016] [Accepted: 04/04/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS Findings of observational studies suggest cardioprotective effects of antioxidant vitamins and carotenoids. However, recent meta-analyses failed to show the beneficial effects of supplemental intake of antioxidants on cardiovascular disease (CVD). We aimed to assess the association between CVD risk and β-cryptoxanthin in Japan, where Satsuma mandarin, a major source of β-cryptoxanthin, is widely consumed. METHODS AND RESULTS This was part of the Mikkabi cohort study. Surveys were conducted at baseline, in 2003 and 2005, and on follow-up in 2006, 2009, and 2013. We examined brachial-ankle pulse wave velocity (baPWV) with a high cut-off value set at 18.3 m s(-1). Hazard ratios (HR) and 95% confidence intervals for high baPWV were estimated using a Cox proportional hazards model with adjustment for potential confounders. A total of 635 participants with baPWV of less than 18.3 m s(-1) at baseline were included in the analysis. During the follow-up period of 57,921 person-months, 99 subjects developed high baPWV. After multivariate adjustment, the HR for high baPWV in the highest tertile compared with the lowest tertile was significantly low for β-cryptoxanthin, β-carotene, and total carotenoids. Serum concentrations of β-cryptoxanthin and β-carotene were higher in people who ate Satsuma mandarin frequently. Compared with <1/d intake of Satsuma mandarin, 3-4/d was associated with a low risk of high PWV. CONCLUSION This study indicated that β-cryptoxanthin and β-carotene derived from Satsuma mandarin are candidate micronutrients for preventing arteriosclerosis development. Further longitudinal and interventional studies will be required to validate the effect on CVD.
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Affiliation(s)
- M Nakamura
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu City, Shizuoka 431-3192, Japan.
| | - M Sugiura
- Citrus Research Division, NARO Institute of Fruit Tree Science, National Agriculture and Food Research Organization (NARO), 485-6 Okitsu-nakachou, Shimizu, Shizuoka City, Shizuoka 424-0292, Japan
| | - K Ogawa
- Citrus Research Division, NARO Institute of Fruit Tree Science, National Agriculture and Food Research Organization (NARO), 485-6 Okitsu-nakachou, Shimizu, Shizuoka City, Shizuoka 424-0292, Japan
| | - Y Ikoma
- Citrus Research Division, NARO Institute of Fruit Tree Science, National Agriculture and Food Research Organization (NARO), 485-6 Okitsu-nakachou, Shimizu, Shizuoka City, Shizuoka 424-0292, Japan
| | - M Yano
- Citrus Research Division, NARO Institute of Fruit Tree Science, National Agriculture and Food Research Organization (NARO), 485-6 Okitsu-nakachou, Shimizu, Shizuoka City, Shizuoka 424-0292, Japan
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15
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Dietary, circulating beta-carotene and risk of all-cause mortality: a meta-analysis from prospective studies. Sci Rep 2016; 6:26983. [PMID: 27243945 PMCID: PMC4886629 DOI: 10.1038/srep26983] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 05/11/2016] [Indexed: 12/31/2022] Open
Abstract
Observational studies evaluating the relation between dietary or circulating level of beta-carotene and risk of total mortality yielded inconsistent results. We conducted a comprehensive search on publications of PubMed and EMBASE up to 31 March 2016. Random effect models were used to combine the results. Potential publication bias was assessed using Egger’s and Begg’s test. Seven studies that evaluated dietary beta-carotene intake in relation to overall mortality, indicated that a higher intake of beta-carotene was related to a significant lower risk of all-cause mortality (RR for highest vs. lowest group = 0.83, 95%CI: 0.78–0.88) with no evidence of heterogeneity between studies (I2 = 1.0%, P = 0.416). A random-effect analysis comprising seven studies showed high beta-carotene level in serum or plasma was associated with a significant lower risk of all-cause mortality (RR for highest vs. lowest group = 0.69, 95%CI: 0.59–0.80) with low heterogeneity (I2 = 37.1%, P = 0.145). No evidence of publication bias was detected by Begg’s and Egger’s regression tests. In conclusion, dietary or circulating beta-carotene was inversely associated with risk of all-cause mortality. More studies should be conducted to clarify the dose-response relationship between beta-carotene and all-cause mortality.
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Mathys L, Balzarini J. The role of cellular oxidoreductases in viral entry and virus infection-associated oxidative stress: potential therapeutic applications. Expert Opin Ther Targets 2015; 20:123-43. [PMID: 26178644 DOI: 10.1517/14728222.2015.1068760] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Cellular oxidoreductases catalyze thiol/disulfide exchange reactions in susceptible proteins and contribute to the cellular defense against oxidative stress. Oxidoreductases and oxidative stress are also involved in viral infections. In this overview, different aspects of the role of cellular oxidoreductases and oxidative stress during viral infections are discussed from a chemotherapeutic viewpoint. AREAS COVERED Entry of enveloped viruses into their target cells is triggered by the interaction of viral envelope glycoproteins with cellular (co)receptor(s) and depends on obligatory conformational changes in these viral envelope glycoproteins and/or cellular receptors. For some viruses, these conformational changes are mediated by cell surface-associated cellular oxidoreductases, which mediate disulfide bridge reductions in viral envelope glycoprotein(s). Therefore, targeting these oxidoreductases using oxidoreductase inhibitors might yield an interesting strategy to block viral entry of these viruses. Furthermore, since viral infections are often associated with systemic oxidative stress, contributing to disease progression, the enhancement of the cellular antioxidant defense systems might have potential as an adjuvant antiviral strategy, slowing down disease progression. EXPERT OPINION Promising antiviral data were obtained for both strategies. However, potential pitfalls have also been identified for these strategies, indicating that it is important to carefully assess the benefits versus risks of these antiviral strategies.
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Affiliation(s)
- Leen Mathys
- a 1 Rega Institute for Medical Research, KU Leuven , Minderbroedersstraat 10 blok x - bus 1030, Leuven, Belgium
| | - Jan Balzarini
- b 2 Rega Institute for Medical Research, KU Leuven , Minderbroedersstraat 10 blok x - bus 1030, Leuven, Belgium +32 16 3 37352 ; +32 16 3 37340 ;
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17
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The shifting perception on antioxidants: the case of vitamin E and β-carotene. Redox Biol 2015; 4:272-8. [PMID: 25625581 PMCID: PMC4803796 DOI: 10.1016/j.redox.2014.12.017] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 12/22/2014] [Accepted: 12/28/2014] [Indexed: 12/11/2022] Open
Abstract
Antioxidants are vital for aerobic life, and for decades the expectations of antioxidants as health promoting agents were very high. However, relatively recent meta-analyses of clinical studies show that supplementation of antioxidants does not result in the presumed health benefit, but is associated with increased mortality. The dilemma that still needs to be solved is: what are antioxidants in the end, healthy or toxic? We have evaluated this dilemma by examining the presumed health effects of two individual antioxidants with opposite images i.e. the “poisonous” β-carotene and the “wholesome” vitamin E and focused on one aspect, namely their role in inducing BPDE-DNA adducts. It appears that both antioxidants promote DNA adduct formation indirectly by inhibition of the protective enzyme glutathione-S-transferase π (GST π). Despite their opposite image, both antioxidants display a similar type of toxicity. It is concluded that, in the appreciation of antioxidants, first their benefits should be identified and substantiated by elucidating their molecular mechanism. Subsequently, the risks should be identified including the molecular mechanism. The optimal benefit–risk ratio has to be determined for each antioxidant and each individual separately, also considering the dose. To date, the debate on the health benefit of antioxidants continues. The effect of vitamin E and β-carotene on BPDE-DNA adduct formation was evaluated. Both antioxidants promote DNA adduct formation by inhibition of GST π. Accurate benefit–risk analyses give a balanced view on the effects of antioxidants.
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18
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Min JY, Min KB. Serum lycopene, lutein and zeaxanthin, and the risk of Alzheimer's disease mortality in older adults. Dement Geriatr Cogn Disord 2014; 37:246-56. [PMID: 24247062 DOI: 10.1159/000356486] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/08/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Oxidative stress is implicated in the pathogenesis of Alzheimer's disease (AD). Accumulating evidence shows that antioxidant-rich food reduces the risk of AD by inhibiting oxidative stress. This study investigates whether serum levels of carotenoids were associated with the risk of AD mortality in a nationally representative sample of US adults. METHODS We used data from the Third Nutrition and Health Examination Survey (NHANES III) database and the NHANES III Linked Mortality File. A total of 6,958 participants aged older than 50 years were included in this study. RESULTS We found that high serum levels of lycopene and lutein+zeaxanthin at baseline were associated with a lower risk of AD mortality after adjustment for potential covariates. The reduction in the mortality risk was progressively raised by increasing serum lycopene (HR = 0.26, 95% CI 0.10-0.69) and lutein+zeaxanthin (HR = 0.43, 95% CI 0.22-0.85) levels. In contrast, no associations with AD mortality were observed for other serum carotenoids, including alpha-carotene, beta-carotene, and beta-cryptoxanthin. CONCLUSION High serum levels of lycopene and lutein+zeaxanthin are associated with a lower risk of AD mortality in adults. Our findings suggest that a high intake of lycopene- or lutein+zeaxanthin-rich food may be important for reducing the AD mortality risk.
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Affiliation(s)
- Jin-young Min
- Department of Epidemiology, Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
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19
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Ford ES, Li C, Cunningham TJ, Croft JB. Associations between antioxidants and all-cause mortality among US adults with obstructive lung function. Br J Nutr 2014; 112:1662-73. [PMID: 25315508 PMCID: PMC4560207 DOI: 10.1017/s0007114514002669] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Chronic obstructive pulmonary disease is characterised by oxidative stress, but little is known about the associations between antioxidant status and all-cause mortality in adults with this disease. The objective of the present study was to examine the prospective associations between concentrations of α- and β-carotene, β-cryptoxanthin, lutein/zeaxanthin, lycopene, Se, vitamin C and α-tocopherol and all-cause mortality among US adults with obstructive lung function. Data collected from 1492 adults aged 20-79 years with obstructive lung function in the National Health and Nutrition Examination Survey III (1988-94) were used. Through 2006, 629 deaths were identified during a median follow-up period of 14 years. After adjustment for demographic variables, the concentrations of the following antioxidants modelled as continuous variables were found to be inversely associated with all-cause mortality among adults with obstructive lung function: α-carotene (P= 0·037); β-carotene (P= 0·022); cryptoxanthin (P= 0·022); lutein/zeaxanthin (P= 0·004); total carotenoids (P= 0·001); vitamin C (P< 0·001). In maximally adjusted models, only the concentrations of lycopene (P= 0·013) and vitamin C (P= 0·046) were found to be significantly and inversely associated with all-cause mortality. No effect modification by sex was detected, but the association between lutein/zeaxanthin concentrations and all-cause mortality varied by smoking status (P interaction= 0·048). The concentrations of lycopene and vitamin C were inversely associated with all-cause mortality in this cohort of adults with obstructive lung function.
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Affiliation(s)
- Earl S. Ford
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F78, Atlanta, GA 30341, USA
| | - Chaoyang Li
- Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Timothy J. Cunningham
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F78, Atlanta, GA 30341, USA
| | - Janet B. Croft
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F78, Atlanta, GA 30341, USA
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20
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Sugiura M. Nutritional Epidemiologic Survey of the Relationship between Satsuma Mandarin Intake and the Risk for Lifestyle-related Diseases : Mikkabi Prospective Cohort Study. J JPN SOC FOOD SCI 2014. [DOI: 10.3136/nskkk.61.373] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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21
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Dietary intake of carotenoids and their antioxidant and anti-inflammatory effects in cardiovascular care. Mediators Inflamm 2013; 2013:782137. [PMID: 24489447 PMCID: PMC3893834 DOI: 10.1155/2013/782137] [Citation(s) in RCA: 167] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 09/19/2013] [Accepted: 10/10/2013] [Indexed: 12/13/2022] Open
Abstract
Cardiovascular disease related to atherosclerosis represents nowadays the largest cause of morbidity and mortality in developed countries. Due to inflammatory nature of atherosclerosis, several studies had been conducted in order to search for substances with anti-inflammatory activity on arterial walls, able to exert beneficial roles on health. Researches investigated the role of dietary carotenoids supplementation on cardiovascular disease, due to their free radicals scavenger properties and their skills in improving low-density lipoprotein cholesterol resistance to oxidation. Nevertheless, literature data are conflicting: although some studies found a positive relationship between carotenoids supplementation and cardiovascular risk reduction, others did not find any positive effects or even prooxidant actions. This paper aimed at defining the role of carotenoids supplementation on cardiovascular risk profile by reviewing literature data, paying attention to those carotenoids more present in our diet (β-carotene, α-carotene, β-cryptoxanthin, lycopene, lutein, zeaxanthin, and astaxanthin).
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22
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Renzi LM, Dengler MJ, Puente A, Miller LS, Hammond BR. Relationships between macular pigment optical density and cognitive function in unimpaired and mildly cognitively impaired older adults. Neurobiol Aging 2013; 35:1695-9. [PMID: 24508218 DOI: 10.1016/j.neurobiolaging.2013.12.024] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 12/18/2013] [Accepted: 12/21/2013] [Indexed: 02/03/2023]
Abstract
Low carotenoid status (especially of the xanthophylls, lutein [L], and zeaxanthin [Z]) is common in older adults and has been associated with a number of degenerative diseases of the central nervous system ranging from retina (e.g., macular degeneration) to brain (e.g., Alzheimer's disease). In this study, we tested whether retinal measures of L + Z (macular pigment optical density [MPOD]), used as a surrogate for brain L + Z levels, were related to cognitive function when comparing healthy older adults with mildly cognitively impaired older adults. Twenty-four subjects with mild cognitive impairment were compared with 24 matched controls. Subjects were matched with respect to age, body mass index, ethnicity, sex, and smoking status. Degree of cognitive impairment and cognitive ability was determined via structured clinical interview. MPOD was measured psychophysically. In healthy older adults, MPOD was only related to visual-spatial and constructional abilities (p = 0.04). For subjects with mild cognitive impairment (MCI), however, MPOD was broadly related to cognition including the composite score on the mini-mental state examination (p = 0.02), visual-spatial and constructional abilities (p = 0.04), language ability (p = 0.05), attention (p = 0.03), and the total scale on the Repeatable Battery for the Assessment of Neuropsychological Status (p = 0.03). It is possible that L/Z status may be more strongly related to cognition when individuals are considered with established onset of cognitive decline.
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Affiliation(s)
- Lisa M Renzi
- Department of Psychology, Vision Sciences and Human Biofactors Laboratories, The University of Georgia, Athens, GA, USA; Abbott Nutrition, Columbus, OH, USA
| | - Melissa J Dengler
- Department of Psychology, Vision Sciences and Human Biofactors Laboratories, The University of Georgia, Athens, GA, USA; Nevada State College, Henderson, NV, USA
| | - Antonio Puente
- Department of Psychology, Neuropsychology and Memory Assessment Laboratory, The University of Georgia, Athens, GA, USA
| | - L Stephen Miller
- Department of Psychology, Neuropsychology and Memory Assessment Laboratory, The University of Georgia, Athens, GA, USA
| | - Billy R Hammond
- Department of Psychology, Vision Sciences and Human Biofactors Laboratories, The University of Georgia, Athens, GA, USA.
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23
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Bellavia A, Larsson SC, Bottai M, Wolk A, Orsini N. Fruit and vegetable consumption and all-cause mortality: a dose-response analysis. Am J Clin Nutr 2013; 98:454-9. [PMID: 23803880 DOI: 10.3945/ajcn.112.056119] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The association between fruit and vegetable (FV) consumption and overall mortality has seldom been investigated in large cohort studies. Findings from the few available studies are inconsistent. OBJECTIVE The objective was to examine the dose-response relation between FV consumption and mortality, in terms of both time and rate, in a large prospective cohort of Swedish men and women. DESIGN FV consumption was assessed through a self-administrated questionnaire in a population-based cohort of 71,706 participants (38,221 men and 33,485 women) aged 45-83 y. We performed a dose-response analysis to evaluate 10th survival percentile differences (PDs) by using Laplace regression and estimated HRs by using Cox regression. RESULTS During 13 y of follow-up, 11,439 deaths (6803 men and 4636 women) occurred in the cohort. In comparison with 5 servings FV/d, a lower consumption was progressively associated with shorter survival and higher mortality rates. Those who never consumed FV lived 3 y shorter (PD: -37 mo; 95% CI: -58, -16 mo) and had a 53% higher mortality rate (HR: 1.53; 95% CI: 1.19, 1.99) than did those who consumed 5 servings FV/d. Consideration of fruit and vegetables separately showed that those who never consumed fruit lived 19 mo shorter (PD: -19 mo; 95% CI: -29, -10 mo) than did those who ate 1 fruit/d. Participants who consumed 3 vegetables/d lived 32 mo longer than did those who never consumed vegetables (PD: 32 mo; 96% CI: 13, 51 mo). CONCLUSION FV consumption <5 servings/d is associated with progressively shorter survival and higher mortality rates. The Swedish Mammography Cohort and the Cohort of Swedish Men were registered at clinicaltrials.gov as NCT01127698 and NCT01127711, respectively.
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Affiliation(s)
- Andrea Bellavia
- Units of Nutritional Epidemiology and Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Karppi J, Laukkanen JA, Mäkikallio TH, Ronkainen K, Kurl S. Low β-carotene concentrations increase the risk of cardiovascular disease mortality among Finnish men with risk factors. Nutr Metab Cardiovasc Dis 2012; 22:921-928. [PMID: 22494809 DOI: 10.1016/j.numecd.2012.01.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 01/18/2012] [Accepted: 01/18/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND & AIMS Healthy diet rich in fruits and vegetables is an important factor in prevention of cardiovascular diseases (CVD). Some previous epidemiological studies have suggested that dietary and serum carotenoids are associated with decreased CVD mortality, but the results have been inconsistent. We assessed relations between the concentrations of serum carotenoids and CVD mortality among Eastern Finnish men. METHODS & RESULTS The study population consisted of 1031 Eastern Finnish men aged 46-65 years in the Kuopio Ischaemic Heart Disease Risk Factor (KIHD) cohort. Subjects were classified quartiles according to concentrations of carotenoids and subgroups according to risk factors. Hazard ratios of serum lycopene, α-carotene and β-carotene were estimated by the Cox proportional hazard model after adjusting for potential confounding factors. During the median 15.9-year follow-up, 122 deaths from CVDs, were identified among the cohort subjects. Low serum concentrations of β-carotene were strongly related to an increased CVD mortality risk after adjustment for confounders. For β-carotene, the hazard ratio (95% confidence interval) for the lowest versus highest quartile was 2.23 (1.26-3.93; P=0.006). However, the strongest risk of CVD mortality was observed among smokers with lowest levels of β-carotene (HR=3.15, 95%, CI: 1.19-8.33; P=0.020). Other carotenoids and the sum of carotenoids were not significantly related to increased risk of CVD mortality. CONCLUSIONS Low concentrations of serum β-carotene concentrations may increase the risk for CVD mortality among Eastern Finnish men; thus elevated serum concentrations of β-carotene may have clinical and public health relevance.
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Affiliation(s)
- J Karppi
- University of Eastern Finland, Department of Medicine, Institute of Public Health and Clinical Nutrition, FI-70211 Kuopio, Finland.
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Nicklett EJ, Semba RD, Xue QL, Tian J, Sun K, Cappola AR, Simonsick EM, Ferrucci L, Fried LP. Fruit and vegetable intake, physical activity, and mortality in older community-dwelling women. J Am Geriatr Soc 2012; 60:862-8. [PMID: 22587851 PMCID: PMC3639003 DOI: 10.1111/j.1532-5415.2012.03924.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To examine the relationship between fruit and vegetable intake, physical activity, and all-cause mortality in older women. DESIGN Six Cox proportional hazards models examined independent and additive relationships between physical activity, carotenoids, and all-cause mortality. Additional models tested whether physical activity and carotenoids were conjointly related to mortality. Models were adjusted for age, education, and race and ethnicity. SETTING Baltimore, Maryland. PARTICIPANTS Seven hundred thirteen women aged 70 to 79 participating in the Women's Health and Aging Studies. MEASUREMENTS Total serum carotenoids, a marker of fruit and vegetable intake, and physical activity were measured at baseline. Physical activity was measured according to kilocalorie expenditure. RESULTS During 5 years of follow-up, 82 (11.5%) participants died. Measured continuously, physical activity improved survival (HR = 0.52, 95% CI = 0.41-0.66, P < .001). The most active women were more likely to survive than the least physically active women (HR = 0.28, 95% CI = 0.13-0.59, P < .001). Continuous measures of carotenoids improved survival (HR = 0.67, 95% CI = 0.51-0.89, P = .01). Women in the highest tertile of total carotenoids were more likely to survive those in the lowest (HR = 0.50, 95% CI = 0.27-0.91, P = .03). When examined in the same model, continuous measures of physical activity (HR = 0.54, 95% CI = 0.42-0.68, P < .001) and carotenoids (HR = 0.76, 95% CI = 0.59-0.98, P = .04) predicted survival during follow-up. CONCLUSION The combination of low total serum carotenoids and low physical activity, both modifiable risk factors, strongly predicted earlier mortality. These findings provide preliminary support that higher fruit and vegetable intake and exercise improve survival.
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Affiliation(s)
- Emily J Nicklett
- School of Social Work, University of Michigan, Ann Arbor, Michigan 48109, USA.
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Nicklett EJ, Semba RD, Simonsick EM, Szanton S, Bandeen-Roche K, Ferrucci L, Guralnik JM, Fried LP. Diet quality and social support: factors associated with serum carotenoid concentrations among older disabled women (the Women's Health and Aging Study). J Nutr Health Aging 2012; 16:511-8. [PMID: 22659988 PMCID: PMC3475721 DOI: 10.1007/s12603-012-0031-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE This study investigated the relationship between social support (including instrumental support, emotional support, social interaction, social space, and family networks) and diet quality, as indicated by serum carotenoid levels. DESIGN AND METHODS The sample consisted of participants in the Women's Health and Aging Study with longitudinal carotenoid data (n=325). We performed regression analyses using baseline indicators of social support and changes in social support to determine whether baseline levels and/or change in levels of social support predict changes in serum carotenoid levels. Social support changes were measured over 1 year from baseline to follow-up round 1. Carotenoid level changes were established from follow-up round 1 to round 2. To determine whether or not regression to the mean was driving these results, we performed an analysis that included baseline and change levels of social support indicators. RESULTS At baseline, the frequency of leaving one's home was associated with a decrease in carotenoid levels. Leaving one's home more frequently predicted an increase in carotenoid levels and attending fewer activities predicted a decrease in carotenoid levels. IMPLICATIONS In older, community-resident disabled women, baseline levels of social support did not consistently predict diet quality. However, change in social support predicted both positive and negative change in diet quality and thus provides supportive evidence that social activity and family interaction may play meaningful roles in the maintenance of diet quality among functionally compromised older women. Further research is necessary to more fully understand the impact of multiple forms of social supports on the diet quality of older adults.
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Affiliation(s)
- E J Nicklett
- Johns Hopkins University, Center on Aging and Health, Baltimore, MD 21231, USA.
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Di Tomo P, Canali R, Ciavardelli D, Di Silvestre S, De Marco A, Giardinelli A, Pipino C, Di Pietro N, Virgili F, Pandolfi A. β-Carotene and lycopene affect endothelial response to TNF-α reducing nitro-oxidative stress and interaction with monocytes. Mol Nutr Food Res 2011; 56:217-27. [PMID: 22162208 DOI: 10.1002/mnfr.201100500] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Revised: 09/06/2011] [Accepted: 09/26/2011] [Indexed: 11/12/2022]
Abstract
SCOPE Cardiovascular disease (CVD) is associated with vascular oxidative imbalance and inflammation. Increased reactive oxygen species (ROS) generation is associated with a functional inactivation of nitric oxide (NO) due to the reaction with O₂⁻, leading to peroxynitrite (ONOO⁻) formation and subsequent reduction in the beneficial effect of vascular NO bioavailability. Carotenoids'-rich diets have been associated with decreased risk of CVD, but the underlying mechanism is still unknown. METHODS AND RESULTS In human umbilical vein endothelial cells (HUVECs), both β-carotene (BC) or lycopene (Lyc) significantly affected tumor necrosis factor-α (TNF-α)-induced inflammation, being associated with a significant decrease in the generation of ROS (spectrofluorometry) and nitrotyrosine (an index of ONOO⁻ formation, cytofluorimetry), an increased NO/cGMP (cyclic guanosine monophosphate) levels (EIA), and a down-regulation of NF-κB-dependent adhesion molecule expression (Western blot and EMSA) and monocyte-HUVEC interaction (adhesion assay). Our results indicate that BC or Lyc treatment reduce the inflammatory response in TNF-α-treated HUVECs. This is due to the redox balance protection and to the maintenance of NO bioavailability. CONCLUSION Our observations provide background for a novel mechanism for carotenoids' anti-inflammatory activity in the vasculature and may contribute to a better understanding of the protective effects of carotenoid-rich diets against CVD risk.
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Affiliation(s)
- Pamela Di Tomo
- Department of Biomedical Sciences, "G. d'Annunzio" University, Chieti-Pescara, Italy
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A carotenoid health index based on plasma carotenoids and health outcomes. Nutrients 2011; 3:1003-22. [PMID: 22292108 PMCID: PMC3260489 DOI: 10.3390/nu3121003] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 11/16/2011] [Accepted: 11/25/2011] [Indexed: 12/21/2022] Open
Abstract
While there have been many studies on health outcomes that have included measurements of plasma carotenoids, this data has not been reviewed and assembled into a useful form. In this review sixty-two studies of plasma carotenoids and health outcomes, mostly prospective cohort studies or population-based case-control studies, are analyzed together to establish a carotenoid health index. Five cutoff points are established across the percentiles of carotenoid concentrations in populations, from the tenth to ninetieth percentile. The cutoff points (mean ± standard error of the mean) are 1.11 ± 0.08, 1.47 ± 0.08, 1.89 ± 0.08, 2.52 ± 0.13, and 3.07 ± 0.20 µM. For all cause mortality there seems to be a low threshold effect with protection above every cutoff point but the lowest. But for metabolic syndrome and cancer outcomes there tends to be significant positive health outcomes only above the higher cutoff points, perhaps as a triage effect. Based on this data a carotenoid health index is proposed with risk categories as follows: very high risk: <1 µM, high risk: 1-1.5 µM, moderate risk: 1.5-2.5 µM, low risk: 2.5-4 µM, and very low risk: >4 µM. Over 95 percent of the USA population falls into the moderate or high risk category of the carotenoid health index.
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Unno K, Sugiura M, Ogawa K, Takabayashi F, Toda M, Sakuma M, Maeda KI, Fujitani K, Miyazaki H, Yamamoto H, Hoshino M. Beta-cryptoxanthin, plentiful in Japanese mandarin orange, prevents age-related cognitive dysfunction and oxidative damage in senescence-accelerated mouse brain. Biol Pharm Bull 2011; 34:311-7. [PMID: 21372377 DOI: 10.1248/bpb.34.311] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Increased oxidative stress is known to accelerate age-related pathologies. Beta-cryptoxanthin (β-CRX, (3R)-β,β-caroten-3-ol) is a potent antioxidant that is highly rich in Satsuma mandarin orange (mandarin), which is the most popular fruit in Japan. We investigated the antioxidative and anti-aging effects of β-CRX and mandarin using senescence-accelerated mice (SAMP10), which were characterized by a short lifespan, high generation of superoxide anions in the brain and poor learning ability with aging. β-CRX (0.5-5.0 µg/ml) or mandarin juice (3.8-38.0%) was added to drinking water of SAMP10 one to 12 months of age. β-CRX was dose-dependently incorporated into the cerebral cortex and the contents were similar to the concentration of β-CRX in the human frontal lobe. These mice also had higher learning ability. The level of DNA oxidative damage was significantly lower in the cerebral cortex of mice that ingested β-CRX and mandarin than control mice. In addition, the mice that ingested β-CRX (>1.5 µg/ml) and mandarin (>11.3%) exhibited a higher survival when 12 month-old, the presenile age of SAMP10, than control mice. These results suggest that β-CRX is incorporated into the brain and has an important antioxidative role and anti-aging effect.
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Affiliation(s)
- Keiko Unno
- Laboratory of Bioorganic Chemistry, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka 422–8526, Japan.
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Koh WP, Yuan JM, Wang R, Lee YP, Lee BL, Yu MC, Ong CN. Plasma carotenoids and risk of acute myocardial infarction in the Singapore Chinese Health Study. Nutr Metab Cardiovasc Dis 2011; 21:685-90. [PMID: 20227258 PMCID: PMC2891412 DOI: 10.1016/j.numecd.2009.12.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Revised: 12/09/2009] [Accepted: 12/10/2009] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIM Modification of low-density lipoprotein due to oxidative stress is essential in the development of coronary atherosclerosis. Data of specific carotenoids except β-carotene on cardioprotective effects in humans are limited. METHODS AND RESULTS This study examined the associations between plasma concentrations of specific carotenoids and incidence of acute myocardial infarction. The study included 280 incident cases of acute myocardial infarction and 560 matched controls nested within the Singapore Chinese Health Study, a prospective cohort of 63,257 Chinese men and women aged 45-74 years old enrolled in 1993-1998 in Singapore. Retinol and carotenoids in prediagnostic plasma were quantified using high-performance liquid chromatography. High levels of plasma β-cryptoxanthin and lutein were associated with decreased risk of acute myocardial infarction after adjustment for multiple risk factors for coronary heart disease. For β-cryptoxanthin, the odds ratio (95% confidence interval) for the highest (Q5) versus the lowest (Q1) quintile was 0.67 (0.37-1.21) (P for trend=0.03). For lutein, the odds ratios (95% confidence intervals) for the combined Q2-Q3 and the combined Q4-Q5 versus Q1 were 0.71 (0.45-1.12) and 0.58 (0.35-0.94) respectively (P for trend=0.03). There was no statistically significant association between other carotenoids or retinol and risk of acute myocardial infarction. CONCLUSIONS High plasma levels of β-cryptoxanthin and lutein were associated with decreased risk of acute myocardial infarction. The findings of this study support a cardioprotective role of these two carotenoids in humans.
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Affiliation(s)
- Woon-Puay Koh
- Department of Epidemiology and Public Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jian-Min Yuan
- The Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Renwei Wang
- The Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Yian-Ping Lee
- Department of Cardiology, National University Hospital, Singapore
| | - Bee-Lan Lee
- Department of Epidemiology and Public Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mimi C. Yu
- The Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Choon-Nam Ong
- Department of Epidemiology and Public Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Marino M, Masella R, Bulzomi P, Campesi I, Malorni W, Franconi F. Nutrition and human health from a sex-gender perspective. Mol Aspects Med 2011; 32:1-70. [PMID: 21356234 DOI: 10.1016/j.mam.2011.02.001] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 01/25/2011] [Accepted: 02/18/2011] [Indexed: 02/07/2023]
Abstract
Nutrition exerts a life-long impact on human health, and the interaction between nutrition and health has been known for centuries. The recent literature has suggested that nutrition could differently influence the health of male and female individuals. Until the last decade of the 20th century, research on women has been neglected, and the results obtained in men have been directly translated to women in both the medicine and nutrition fields. Consequently, most modern guidelines are based on studies predominantly conducted on men. However, there are many sex-gender differences that are the result of multifactorial inputs, including gene repertoires, sex steroid hormones, and environmental factors (e.g., food components). The effects of these different inputs in male and female physiology will be different in different periods of ontogenetic development as well as during pregnancy and the ovarian cycle in females, which are also age dependent. As a result, different strategies have evolved to maintain male and female body homeostasis, which, in turn, implies that there are important differences in the bioavailability, metabolism, distribution, and elimination of foods and beverages in males and females. This article will review some of these differences underlying the impact of food components on the risk of developing diseases from a sex-gender perspective.
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Affiliation(s)
- Maria Marino
- Department of Biology, University Roma Tre, Viale Guglielmo Marconi 446, I-00146 Roma, Italy
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Semba RD, Patel KV, Ferrucci L, Sun K, Roy CN, Guralnik JM, Fried LP. Serum antioxidants and inflammation predict red cell distribution width in older women: the Women's Health and Aging Study I. Clin Nutr 2010; 29:600-4. [PMID: 20334961 DOI: 10.1016/j.clnu.2010.03.001] [Citation(s) in RCA: 234] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2009] [Revised: 02/11/2010] [Accepted: 03/01/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND & AIMS Red cell distribution width (RDW), a measure of heterogeneity in the size of circulating erythrocytes, is associated with some chronic diseases and predicts mortality. Although oxidative damage and inflammation have been theorized to affect RDW, the relationships of antioxidants and inflammation with RDW have not been well characterized. The aims were to determine whether total serum carotenoids, α-tocopherol, selenium, protein carbonyls, and interleukin-6 (IL-6) are associated with RDW and predict RDW over time. METHODS RDW was measured at baseline, 12 months, and 24 months follow-up in 786 moderately to severely disabled community-dwelling women, aged ≥65 years, in the Women's Health and Aging Study I in Baltimore, Maryland. RESULTS Selenium was significantly associated with RDW at baseline and predicted RDW over two years' follow-up in separate multivariate mixed-effects models that adjusted for other covariates. As expected, the addition of IL-6 to the models attenuated the association of serum selenium with RDW, as low antioxidant levels are known to upregulate IL-6. Total carotenoids were associated with RDW at baseline and one year follow-up. Protein carbonyls and α-tocopherol were not significantly associated with RDW. CONCLUSION Serum selenium is an independent predictor of RDW and may potentially mediate effects on RDW through IL-6.
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Affiliation(s)
- Richard D Semba
- Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States.
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Hunt KJ, Walsh BM, Voegeli D, Roberts HC. Inflammation in aging part 1: physiology and immunological mechanisms. Biol Res Nurs 2009; 11:245-52. [PMID: 19934111 DOI: 10.1177/1099800409352237] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
During the aging process, remodeling of several body systems occurs, and these changes can have a startling effect upon the immune system. The reduction in sex steroids and growth hormones and declines in vitamin D concentration that accompany the aging process are associated with increases in the baseline levels of inflammatory proteins. At the same time, inflammation arising from atherosclerosis and other chronic diseases further contributes to the inflammatory milieu and effects a state of chronic inflammation. This chronic inflammation, or ''inflammaging'' as it has been termed, seems to be associated with a host of adverse effects contributing to many of the health problems that increase morbidity and decrease both quality of life and the ability to maintain independence in old age. For nurses to be truly informed when caring for older people and to ensure that they have a detailed understanding of the complexities of older people's health needs, they must have a knowledge of the physiological and immunological changes with age. This is the first of a two-part article on inflammatory processes in aging. These age-related changes are presented here, including an examination of the impact of genetic and lifestyle factors. The effect of these changes on the health of the individual and implications for practice are described in Part 2.
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Affiliation(s)
- Katherine J Hunt
- School of Health Sciences, University of Southampton, Highfield, Southampton SO17 1BJ, United Kingdom.
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Kishimoto Y, Tani M, Uto-Kondo H, Iizuka M, Saita E, Sone H, Kurata H, Kondo K. Astaxanthin suppresses scavenger receptor expression and matrix metalloproteinase activity in macrophages. Eur J Nutr 2009; 49:119-26. [DOI: 10.1007/s00394-009-0056-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Accepted: 09/14/2009] [Indexed: 12/21/2022]
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Huerta JM, González S, Fernández S, Patterson AM, Lasheras C. Lipid peroxidation, antioxidant status and survival in institutionalised elderly: A five-year longitudinal study. Free Radic Res 2009; 40:571-8. [PMID: 16753834 DOI: 10.1080/10715760600580470] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Oxidative stress has been related to ageing and risk of death. To determine whether oxidative status was associated with all-cause risk of death we carried out a prospective study in 154 non-smoking Spanish elderly without major illness. Baseline glutathione peroxidase (GPx) and superoxide dismutase (SOD) were analysed in plasma and erythrocytes. alpha-tocopherol, beta-carotene, lycopene and retinol were determined in serum samples and malondialdehyde (MDA), as a lipid peroxidation marker, in plasma. Mean survival time was 4.3 years. A total of 31 death cases (20.1%) occurred during the follow-up. Plasma-MDA predicted mortality independently of all other variables, while erythrocyte-SOD (e-SOD), beta-carotene and alpha-tocopherol were positively associated with survival. alpha-tocopherol and MDA were revealed as independent predictors in a joint survival model, being the group with low MDA and high alpha-tocopherol that with the lowest mortality. In conclusion, a higher risk of death was associated with increased lipid peroxidation and lower antioxidant defenses.
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Affiliation(s)
- José M Huerta
- Departamento de Biología Funcional, Area de Fisiología. Facultad de Medicina, Universidad de Oviedo, Julián Clavería s/n, Oviedo 33006, Spain
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Riccioni G, D'Orazio N, Palumbo N, Bucciarelli V, di Ilio E, Bazzano LA, Bucciarelli T. Relationship between plasma antioxidant concentrations and carotid intima-media thickness: the Asymptomatic Carotid Atherosclerotic Disease In Manfredonia Study. ACTA ACUST UNITED AC 2009; 16:351-7. [PMID: 19384236 DOI: 10.1097/hjr.0b013e328325d807] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | | | - Nicola Palumbo
- Analyses Laboratory, ‘San Camillo de Lellis' Hospital, Manfredonia, Foggia
| | - Valentina Bucciarelli
- Department of Biomedical Science, Clinical Biochemistry, University ‘G. D'Annunzio’, Chieti, Italy
| | - Emanuela di Ilio
- Department of Biomedical Science, Clinical Biochemistry, University ‘G. D'Annunzio’, Chieti, Italy
| | - Lydia A. Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Tonino Bucciarelli
- Department of Biomedical Science, Clinical Biochemistry, University ‘G. D'Annunzio’, Chieti, Italy
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Lauretani F, Semba RD, Dayhoff-Brannigan M, Corsi AM, Di Iorio A, Buiatti E, Bandinelli S, Guralnik JM, Ferrucci L. Low total plasma carotenoids are independent predictors of mortality among older persons: the InCHIANTI study. Eur J Nutr 2008; 47:335-40. [PMID: 18709473 DOI: 10.1007/s00394-008-0732-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2007] [Accepted: 07/23/2008] [Indexed: 01/28/2023]
Abstract
BACKGROUND Plasma carotenoids are considered a valid biological marker for fruit and vegetable dietary intake. Recent studies show that low carotenoid levels are associated with a high risk of inflammation, cancer, and cardiovascular disease. AIM OF THE STUDY To determine whether low plasma carotenoids are associated with increased mortality among older adults. METHODS Longitudinal study among 1,043 adults, 65 years and older, in the InCHIANTI study, a population-based cohort of adults living in the community in the Tuscany region, Italy. RESULTS Mean total carotenoid concentration was 1.80 micromol/l. During eight years of follow-up, 310 (29.7%) of participants died. Eight-year survival was lower in the lowest compared with the highest tertile of total serum carotenoids (P < 0.0001 by Mantel-Haenszel chi-square). In a multivariate Cox proportional hazards model adjusted for age, education, smoking, body mass index, energy intake, and chronic diseases, adults in the highest tertile of plasma carotenoids at enrollment had lower mortality compared to those in the lowest tertile (Hazards Ratio obtained by considering carotenoids level as an ordinal variable 0.81, 95%; CI 0.65-0.99; P for trend = 0.046). CONCLUSIONS Low plasma carotenoids are an independent risk factor for mortality among older adults living in the community.
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Nikolić M, Nikić D, Petrović B. Fruit and vegetable intake and the risk for developing coronary heart disease. Cent Eur J Public Health 2008; 16:17-20. [PMID: 18459474 DOI: 10.21101/cejph.a3442] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of the paper was to study the relationship between dietary intake of fruit and vegetable intake and the risk of coronary heart disease. We used data from a case-control study, conducted from 2001 to 2003, among 290 randomly selected cases (mean age 59.98 +/- 10.03 years) with first event of an acute coronary syndrome and 290 selected paired controls by sex, age and region (mean age 59.43 +/- 10.10 years), admitted to the same hospitals as cases without any suspicion of coronary disease. Using questionnaires, we assessed fruit and vegetable intake and estimated odds ratio of developing coronary heart disease by the intake. The benefit of fruit or vegetable consumption increased proportionally by the number of servings consumed (p for trend < 0.0001). Those in the upper tertile of fruit consumption (> 5 items/day) had 60% lower risk for coronary heart disease (odds ratio= 0.56, 95% CI = 0.35-0.89, p < 0.05), when compared to those in the lowest tertile (<1 item/day). Consumption of vegetable >3 items/day was associated with 70% lower risk of coronary heart disease (OR = 0.25, 95% CI = 0.09 - 0.66, p < 0.05), compared to subjects who did not consume vegetables. In agreement with previous studies, we found an inverse relation between vegetable and fruit intake and coronary heart risk. Consumption of fruits and vegetables seemed to provide significant protection against coronary heart disease.
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Total plasma carotenoids and mortality in the elderly: results of the Epidemiology of Vascular Ageing (EVA) study. Br J Nutr 2008; 101:86-92. [PMID: 18507882 DOI: 10.1017/s0007114508998445] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Carotenoids are pigments found in fruits and vegetables. While high intakes of fruits and vegetables have been found to be associated with lower mortality, our objective is to investigate if total plasma carotenoids, via their antioxidant properties, are associated with mortality risk in a free-living elderly population. The 'Epidemiology of Vascular Ageing' (EVA) study (n 1389; 59-71 years) is a 9-year longitudinal study with six waves of follow-up. The association between baseline total plasma carotenoids and mortality was determined by Cox proportional hazards regression analyses. Low total plasma carotenoid level was significantly associated with all-cause mortality in men but not in women. After controlling for potential confounding factors, mortality risk increased significantly in men (P = 0.03) with plasma carotenoids in the lowest quintile compared with men with plasma carotenoids in the highest (relative risk 2.94 (95% CI 1.21, 7.17)). A significant association between mortality by cancer and low plasma carotenoid level variable was also found in men (unit = 1 micromol/l; relative risk 1.72 (95% CI 1.02, 2.86); P = 0.01). Associations between total plasma carotenoids and mortality risk remained statistically significant after taking into account: (1) plasma Se level, which previously was found associated with mortality in this population and (2) thiobarbituric acid-reactive substances level considered as an indicator of oxidative stress. By showing, prospectively, in a general healthy elderly population, that total plasma carotenoid levels were independently associated with mortality risk in men, the present study suggests that total plasma carotenoid levels could be a health indicator in elderly populations.
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Buijsse B, Feskens EJM, Kwape L, Kok FJ, Kromhout D. Both alpha- and beta-carotene, but not tocopherols and vitamin C, are inversely related to 15-year cardiovascular mortality in Dutch elderly men. J Nutr 2008; 138:344-50. [PMID: 18203902 DOI: 10.1093/jn/138.2.344] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The role of beta-carotene, alpha-tocopherol, and vitamin C in the prevention of cardiovascular diseases (CVD) is controversial. Prospective studies on gamma-tocopherol and carotenoids other than beta-carotene are sparse. We assessed relations between the intake of different carotenoids, alpha- and gamma-tocopherol, and vitamin C with 15-y CVD mortality in elderly men who participated in the Zutphen Elderly Study. Information on diet and potential confounding factors was collected in 1985, 1990, and 1995. In 1985, 559 men (mean age approximately 72 y) free of chronic diseases were included in the current analysis. After 15 y of follow-up, comprising 5744 person-years, 197 men had died from CVD. After adjustment for age, smoking, and other potential lifestyle and dietary confounders, relative risks (RR) (95% CI) of CVD death for a 1-SD increase in intake were 0.81 (0.66-0.99) for alpha-carotene and 0.80 (0.66-0.97) for beta-carotene. Carrots were the primary source of alpha- and beta-carotene and their consumption was related to a lower risk of death from CVD (adjusted RR, 0.83; 95% CI = 0.68-1.00). Intakes of carotenoids other than alpha- and beta-carotene were not associated with CVD mortality, nor were vitamin C and alpha- and gamma tocopherol. In conclusion, dietary intakes of alpha-carotene and beta-carotene are inversely associated with CVD mortality in elderly men. This study does not indicate an important role for other carotenoids, tocopherols, or vitamin C in lowering the risk of CVD death.
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Affiliation(s)
- Brian Buijsse
- Division of Human Nutrition, Wageningen University, Wageningen, 6700 EV The Netherlands
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Functional foods and physical activities in health promotion of aging people. Maturitas 2007; 58:327-39. [PMID: 17980978 DOI: 10.1016/j.maturitas.2007.09.011] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2006] [Revised: 09/05/2007] [Accepted: 09/21/2007] [Indexed: 12/21/2022]
Abstract
Foods contain many bioactive compounds that can improve humans' health, helping to decrease the risk of cataract, macular degeneration, cardiovascular and neurological diseases, osteoporosis, and cancer. Regular practice of exercise and physical activity could also help to drive away aging-associated diseases (obesity, osteoporosis, type 2 diabetes, hypertension, Alzheimer's disease, Parkinson's disease, dementia, and stroke). Exercise recommendations to promote both women's and men's health and disease conditions that hinder exercise practice are described. Health promotion practices should focus on both dietary intake of functional foods and regular practice of exercise within the framework of a healthy lifestyle.
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Agudo A, Cabrera L, Amiano P, Ardanaz E, Barricarte A, Berenguer T, Chirlaque MD, Dorronsoro M, Jakszyn P, Larrañaga N, Martínez C, Navarro C, Quirós JR, Sánchez MJ, Tormo MJ, González CA. Fruit and vegetable intakes, dietary antioxidant nutrients, and total mortality in Spanish adults: findings from the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain). Am J Clin Nutr 2007; 85:1634-42. [PMID: 17556703 DOI: 10.1093/ajcn/85.6.1634] [Citation(s) in RCA: 141] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Epidemiologic data suggest that persons with diets rich in fruit and vegetables are at a lower risk of several chronic diseases and mortality than are persons with diets poor in fruit and vegetables. Often, this effect is attributed to antioxidant micronutrients found in plant foods. OBJECTIVE We aimed to assess the relation of mortality to the consumption of fruit, vegetables, and other plant foods and to the dietary intake of vitamin C, vitamin E, and carotenoids. DESIGN The study was a prospective study in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition. During 6.5 y of follow-up, 562 deaths occurred in 41 358 subjects aged 30-69 y. Proportional hazards regression analysis was used to assess the relation between dietary factors and total mortality. RESULTS After adjustment for age, sex, and several potential confounders, the hazard ratio for the highest versus the lowest quartile of consumption was 0.79 (95% CI: 0.62, 1.00; P for trend = 0.029) for fresh fruit, 0.72 (0.56, 0.91; P for trend = 0.006) for root vegetables, and 0.77 (0.60, 0.98; P for trend = 0.015) for fruiting vegetables (ie, vegetables that contain the "fruit" part of the plant, the seeds). The corresponding figures for antioxidant nutrients were 0.74 (0.58, 0.94; P for trend = 0.009) for vitamin C, 0.68 (0.53, 0.87; P for trend = 0.006) for provitamin A carotenoids, and 0.65 (0.51, 0.84; P for trend 0.001) for lycopene. The effect of vitamin C and provitamin A disappeared after adjustment for total antioxidant capacity in plant foods. CONCLUSIONS A high intake of fresh fruit, root vegetables, and fruiting vegetables is associated with reduced mortality, probably as a result of their high content of vitamin C, provitamin A carotenoids, and lycopene. Antioxidant capacity could partly explain the effect of ascorbic acid and provitamin A but not the association with lycopene.
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Affiliation(s)
- Antonio Agudo
- Unit of Epidemiology, Catalan Institute of Oncology, Institute of Biomedical Research of Bellvitge, L'Hospitalet de Llobregat, Spain.
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Galan P, Briançon S, Favier A, Bertrais S, Preziosi P, Faure H, Arnaud J, Arnault N, Czernichow S, Mennen L, Hercberg S. Antioxidant status and risk of cancer in the SU.VI.MAX study: is the effect of supplementation dependent on baseline levels? Br J Nutr 2007; 94:125-32. [PMID: 16115341 DOI: 10.1079/bjn20051462] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The SUpplementation en VItamines et Mineraux AntioXydants (SU.VI.MAX) study, a randomised double-blind, primary-prevention trial showed that after 7·5 years, low-dose antioxidant supplementation lowered the total cancer incidence in men, but not in women. To explain this difference in the impact of antioxidant supplementation in men and women, we hypothesised that the effect of supplementation is dependent on initial antioxidant status; 12 741 French adults (7713 females aged 35–60 years; 5028 males aged 45–60 years) received daily antioxidant supplementation (120 mg vitamin C, 30 mg vitamin E, 6 mg β-carotene, 100 μg Se, 20 mg Zn daily) or a matching placebo. Cut-off limits for baseline serum concentrations of the different antioxidant vitamins and minerals were defined as follows for both men and women: 0·3 μmol/l for β-carotene, 11·4 μmol/l for vitamin C, 15 μmol/l for vitamin E, 0·75 μmol/l for Se and 10·7 μmol/l for Zn. The percentage of men with serum concentrations under cut-off limits was higher for vitamins C and E and β-carotene in those who developed a cancer than in those who did not. The risk of cancer was higher in men with baseline concentrations of serum vitamin C or vitamin E under cut-off limits, but not in women. The effect of supplementation was greater in men with baseline serum concentrations of vitamin C, vitamin E and β-carotene below the cut-off limits compared with those above it. This effect was maintained only for vitamin E after adjustment for age, tobacco, and alcohol consumption and BMI. No effect of supplementation could be seen in women. Baseline antioxidant status is related to the risk of cancer in men but not in women and therefore does not entirely explain the differences observed in the effect of antioxidant supplementation on cancer risk between sexes in the SU.VI.MAX study.
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Affiliation(s)
- Pilar Galan
- U557 Inserm ( UMR Inserm/Inra/CNAM), Institute Scientifique et Technique de la Nutrition et de l' Alimentation/CNAM, F-75003 Paris, France.
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Hozawa A, Jacobs DR, Steffes MW, Gross MD, Steffen LM, Lee DH. Relationships of circulating carotenoid concentrations with several markers of inflammation, oxidative stress, and endothelial dysfunction: the Coronary Artery Risk Development in Young Adults (CARDIA)/Young Adult Longitudinal Trends in Antioxidants (YALTA) study. Clin Chem 2007; 53:447-55. [PMID: 17234732 PMCID: PMC2440581 DOI: 10.1373/clinchem.2006.074930] [Citation(s) in RCA: 123] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Serum carotenoid concentrations relate inversely to cardiovascular disease incidence. To clarify the effect of carotenoids on atherosclerotic risk factors, we examined the association of circulating carotenoids with inflammation, oxidative stress, endothelial dysfunction, and smoking. METHODS Black and white men and women in the Coronary Artery Risk Development in Young Adults study, ages 18 to 30 years at recruitment (1985-1986) from 4 US cities, were investigated over 15 years. We included 2048 to 4580 participants in analyses of the sum of serum alpha-carotene, beta-carotene, zeaxanthin/lutein, and beta-cryptoxanthin concentrations and of lycopene at year 0 and at year 7. RESULTS The year 0 sum of 4 carotenoids was inversely associated (all P <0.05) with year 0 leukocyte count (slope per sum carotenoid SD, -0.17); year 7 fibrinogen (slope, -0.10); year 7 and year 15 C-reactive protein (slope, -0.12 and -0.09); and year 15 F(2)-isoprostanes (slope, -13.0), soluble P-selectin (slope, -0.48), and soluble intercellular adhesion molecule-1 (sICAM1; slope, -5.1). Leukocyte counts and sICAM1 and F(2)-isoprostane concentrations had stronger associations in smokers than in nonsmokers, and sICAM1 concentrations were higher in the highest carotenoid quartile in smokers than in the lowest carotenoid quartile in nonsmokers. Superoxide dismutase was positively associated with the sum of 4 carotenoids (slope, 0.12; P <0.01). Lycopene was inversely associated only with sICAM1. The year 7 carotenoid associations with these markers were mostly similar to those at year 0. CONCLUSIONS Circulating serum carotenoids were associated, some interactively with smoking, in apparently beneficial directions with markers of inflammation, oxidative stress, and endothelial dysfunction.
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Affiliation(s)
- Atsushi Hozawa
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
- Division of Epidemiology and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - David R. Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
- Department of Nutrition, University of Oslo, Oslo, Norway
- Address correspondence to this author at: University of Minnesota, Division of Epidemiology and Community Health, School of Public Health, 1300 S. 2nd St., Ste. 300, Minneapolis, MN 55454. Fax 612-624-0315; e-mail
| | - Michael W. Steffes
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, University of Minnesota, Minneapolis, MN
| | - Myron D. Gross
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, University of Minnesota, Minneapolis, MN
| | - Lyn M. Steffen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Duk-Hee Lee
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
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Wright ME, Lawson KA, Weinstein SJ, Pietinen P, Taylor PR, Virtamo J, Albanes D. Higher baseline serum concentrations of vitamin E are associated with lower total and cause-specific mortality in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Am J Clin Nutr 2006; 84:1200-7. [PMID: 17093175 DOI: 10.1093/ajcn/84.5.1200] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND A meta-analysis of 19 trials suggested a small increase in the risk of all-cause mortality with high-dose vitamin E supplementation. Little is known, however, about the relation between mortality and circulating concentrations of vitamin E resulting from dietary intake, low-dose supplementation, or both. OBJECTIVE We examined whether baseline serum alpha-tocopherol concentrations are associated with total and cause-specific mortality. DESIGN A prospective cohort study of 29 092 Finnish male smokers aged 50-69 y who participated in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study was carried out. Fasting serum alpha-tocopherol was measured at baseline by using HPLC. Only 10% of participants reported vitamin E supplement use at baseline, and thus serum concentrations of vitamin E mainly reflected dietary intake and other host factors. Risks of total and cause-specific mortality were estimated by using proportional hazards models. RESULTS During up to 19 y of follow-up, 13 380 deaths (including 4518 and 5776 due to cancer and cardiovascular disease, respectively) were identified. Men in the higher quintiles of serum alpha-tocopherol had significantly lower risks of total and cause-specific mortality than did those in the lowest quintile [relative risk (RR) = 0.82 (95% CI: 0.78, 0.86) for total mortality and 0.79 (0.72, 0.86), 0.81 (0.75, 0.88), and 0.70 (0.63, 0.79) for deaths due to cancer, cardiovascular disease, and other causes, respectively; P for trend for all < 0.0001]. Cubic regression spline analysis of continuous serum alpha-tocopherol values indicated greater risk reductions with increasing concentrations up to approximately 13-14 mg/L, after which no further benefit was noted. CONCLUSION Higher circulating concentrations of alpha-tocopherol within the normal range are associated with significantly lower total and cause-specific mortality in older male smokers.
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Affiliation(s)
- Margaret E Wright
- Nutritional Epidemiology Branch and the Genetic Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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Vaisman N, Haenen GRMM, Zaruk Y, Verduyn C, Bindels JG, Verlaan S, Meijer EP. Enteral feeding enriched with carotenoids normalizes the carotenoid status and reduces oxidative stress in long-term enterally fed patients. Clin Nutr 2006; 25:897-905. [PMID: 17052809 DOI: 10.1016/j.clnu.2006.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2006] [Revised: 05/04/2006] [Accepted: 06/07/2006] [Indexed: 11/26/2022]
Abstract
BACKGROUND & AIMS Circulating carotenoid levels decrease progressively in patients receiving long-term enteral tube feeding with carotenoid-free formulas. Low dietary intake and low blood levels of carotenoids are associated with a higher risk of morbidity and mortality from chronic diseases. The aim of this study was to examine the effects of a low dose carotenoid mixture (3-mg/1500kcal) for 3 months on serum carotenoid levels and oxidative stress in patients receiving long-term enteral nutrition as the sole source of nutrition. METHODS This randomized, double blind, controlled study compared patients receiving enteral nutrition with carotenoids (N=26) and without carotenoids (control group; N=25). RESULTS Patients on long-term enteral nutrition had low baseline serum carotenoid levels. Three months of enteral feeding enriched with carotenoids significantly (P<0.01) increased serum carotenoid levels compared with the control group. Oxidative stress as measured by NF-kappaB levels was decreased at 3 months compared with the control group (P<0.05). No significant changes in MDA levels were observed during the study period in either group. CONCLUSIONS This study demonstrated that enteral nutrition containing small amounts of carotenoids (3-mg/1500kcal) in patients requiring long-term enteral feeding normalizes serum carotenoid levels to the lower end of the range found in age-matched controls. The NF-kappaB data indicate a reduction in oxidative stress in these patients. Therefore, the use of formulas containing a mixture of carotenoids should be recommended for long-term enteral nutrition.
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Affiliation(s)
- Nachum Vaisman
- Unit of Clinical Nutrition, Tel-Aviv Sourasky Medical Center, 6 Weizmann Street, Tel-Aviv, 64239, Israel
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Kim YN, Lora KR, Giraud DW, Driskell JA. Nonsupplemented children of Latino immigrants have low vitamin E intakes and plasma concentrations and normal vitamin C, selenium, and carotenoid intakes and plasma concentrations. ACTA ACUST UNITED AC 2006; 106:385-91. [PMID: 16503229 DOI: 10.1016/j.jada.2005.12.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2005] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study sought to determine and evaluate the intakes and plasma concentrations of vitamin E (alpha-tocopherol), gamma-tocopherol, vitamin C, selenium, and carotenoids (alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein/zeaxanthin, and lycopene) of nonsupplemented boys and girls, 4 to 8 years old, of Latino immigrants living in rural Nebraska. DESIGN Dietary intakes of the Latino children were estimated. Their plasma samples (fasting) were analyzed for vitamin E, vitamin C, selenium, and carotenoid concentrations. Data were evaluated by sex. SUBJECTS The subjects were a convenience sample of 4- to 8-year-old (n=29), apparently healthy, nonsupplemented children of Latino immigrants living in rural Nebraska. STATISTICAL ANALYSIS Sex differences in parameter values were determined using general linear models; Pearson r was used for determining correlations. RESULTS No significant differences in parameter values were observed by sex, with the exception of plasma lutein/zeaxanthin concentration. The majority (69%) had plasma vitamin E (alpha-tocopherol) concentrations<0.516 mg/dL (12 micromol/L), which is indicative of vitamin E inadequacy, and over half (59%) reported consuming less than the Estimated Average Requirement for vitamin E. All subjects had plasma vitamin C and selenium concentrations indicative of adequacy (>0.41 mg/dL or >23 micromol/L, and >6.32 microg/dL or >0.8 micromol/L, respectively), and consumed at least the Recommended Dietary Allowances for these nutrients. The plasma carotenoid concentrations of the children may be useful as norms. CONCLUSIONS These children of Latino immigrants who did not take supplements had low plasma vitamin E (alpha-tocopherol) concentrations but normal plasma vitamin C and selenium concentrations. IMPLICATIONS Dietetics professionals and others involved in health care need to work with Latino immigrant parents so that their children consume adequate amounts of vitamin E.
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Affiliation(s)
- Young-Nam Kim
- Department of Nutrition and Health Sciences, University of Nebraska, Lincoln 68583-0806, USA
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Abstract
PURPOSE OF REVIEW Dietary and blood carotenoids, including alpha-carotene, beta-carotene, lycopene, lutein/zeaxanthin, and beta-cryptoxanthin, have been examined in a number of epidemiological studies in recent years for the risk of cardiovascular disease. This review assimilated the existing and recent literature on carotenoids and cardiovascular disease and considered what research gaps may remain. RECENT FINDINGS Numerous large cohort studies have been published in largely American men and women that have examined dietary intake or blood levels of total or individual carotenoids with the risk of various cardiovascular endpoints. Overall, early, promising results have grown increasingly inconsistent over time. More recently, studies examining lycopene and lutein/zeaxanthin have offered more promising data on a possible, but not yet established, inverse association with the risk of cardiovascular disease. Recent epidemiological data on beta-cryptoxanthin and cardiovascular disease are lacking. Primary and secondary prevention trials have extensively examined beta-carotene, but not other carotenoids, for the risk of cardiovascular disease as either the primary or secondary endpoint with largely null results. More recent studies have focused on individual carotenoids in relation to cardiovascular disease and require a more careful evaluation of potential mechanisms of effect. SUMMARY The promise of early epidemiological studies on carotenoids and cardiovascular disease paved the way to largely disappointing results from several large prevention trials of beta-carotene. Emerging recent evidence of potential cardioprotective effects for lycopene and other carotenoids besides beta-carotene in the diet and blood suggest that there is more to be learned in the story of carotenoids and both atherosclerotic progression and clinically manifested cardiovascular disease.
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Affiliation(s)
- Howard D Sesso
- Department of Medicine, Brigham & Women's Hospital and Harvard Medical School and Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, Massachusetts 02215-1204, USA.
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Dietary intakes and plasma concentrations of vitamin C, selenium, and carotenoids of a group of preschool children. Nutr Res 2006. [DOI: 10.1016/j.nutres.2005.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Galan P, Viteri FE, Bertrais S, Czernichow S, Faure H, Arnaud J, Ruffieux D, Chenal S, Arnault N, Favier A, Roussel AM, Hercberg S. Serum concentrations of beta-carotene, vitamins C and E, zinc and selenium are influenced by sex, age, diet, smoking status, alcohol consumption and corpulence in a general French adult population. Eur J Clin Nutr 2005; 59:1181-90. [PMID: 16034362 DOI: 10.1038/sj.ejcn.1602230] [Citation(s) in RCA: 202] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To assess relationships between energy, nutrient and food intakes, alcohol consumption, smoking status and body mass index (BMI), and serum concentrations of beta-carotene, alpha-tocopherol, vitamin C, selenium and zinc. METHODS Data on health status, alcohol consumption, smoking habits, anthropometric data and biochemical measurements were obtained in 1821 women aged 35-60 y and 1307 men aged 45-60 y, participant to the SU.VI.MAX Study. Data on dietary intake were available on a subsample who reported six 24-h dietary records during the first 18 months of the study. RESULTS Women had higher baseline serum beta-carotene and vitamin C concentrations and lower concentration for serum vitamin E, zinc and selenium than men. In women, younger age was associated with lowered mean concentration of serum beta-carotene, vitamin E and selenium. In men, only differences were observed for serum zinc, which was lower in older men. Current smokers of both sexes had significantly lower concentrations of serum beta-carotene, vitamin C and selenium, and, only in women, of vitamin E, than nonsmokers. Alcohol consumers had lower concentrations of serum beta-carotene and higher selenium concentrations. Serum beta-carotene and vitamin C concentrations were lower in obese subjects. There were positive associations of dietary beta-carotene, vitamin C and E with their serum concentrations. Age, nutrient and alcohol intakes, serum cholesterol, BMI and smoking status explained 15.2% of the variance of serum beta-carotene in men and 13.9% in women, and 10.8 and 10.0% for serum vitamin C, and 26.3 and 28.6% for serum vitamin E, respectively. CONCLUSION Serum antioxidant nutrient concentrations are primarily influenced by sex, age, obesity, tobacco smoking, alcohol consumption and especially dietary intake of those antioxidant nutrients.
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Affiliation(s)
- P Galan
- U557 Inserm (UMR Inserm/Inra/CNAM), Institut Scientifique et Technique de la Nutrition et de l'Alimentation/CNAM, Paris, France.
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