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Böhm V, Lietz G, Olmedilla-Alonso B, Phelan D, Reboul E, Bánati D, Borel P, Corte-Real J, de Lera AR, Desmarchelier C, Dulinska-Litewka J, Landrier JF, Milisav I, Nolan J, Porrini M, Riso P, Roob JM, Valanou E, Wawrzyniak A, Winklhofer-Roob BM, Rühl R, Bohn T. From carotenoid intake to carotenoid blood and tissue concentrations - implications for dietary intake recommendations. Nutr Rev 2021; 79:544-573. [PMID: 32766681 PMCID: PMC8025354 DOI: 10.1093/nutrit/nuaa008] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
There is uncertainty regarding carotenoid intake recommendations, because positive and negative health effects have been found or are correlated with carotenoid intake and tissue levels (including blood, adipose tissue, and the macula), depending on the type of study (epidemiological vs intervention), the dose (physiological vs supraphysiological) and the matrix (foods vs supplements, isolated or used in combination). All these factors, combined with interindividual response variations (eg, depending on age, sex, disease state, genetic makeup), make the relationship between carotenoid intake and their blood/tissue concentrations often unclear and highly variable. Although blood total carotenoid concentrations <1000 nmol/L have been related to increased chronic disease risk, no dietary reference intakes (DRIs) exist. Although high total plasma/serum carotenoid concentrations of up to 7500 nmol/L are achievable after supplementation, a plateauing effect for higher doses and prolonged intake is apparent. In this review and position paper, the current knowledge on carotenoids in serum/plasma and tissues and their relationship to dietary intake and health status is summarized with the aim of proposing suggestions for a "normal," safe, and desirable range of concentrations that presumably are beneficial for health. Existing recommendations are likewise evaluated and practical dietary suggestions are included.
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Affiliation(s)
- Volker Böhm
- Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena, Germany
| | - Georg Lietz
- Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Begoña Olmedilla-Alonso
- Institute of Food Science, Technology and Nutrition, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - David Phelan
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, Waterford, Ireland
| | | | | | - Patrick Borel
- C2VN, INRAE, INSERM, Aix Marseille Univ, Marseille, France
| | - Joana Corte-Real
- Population Health Department, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Angel R de Lera
- Departmento de Química Orgánica, Centro De Investigaciones Biomédicas and Instituto de Investigación Biomédica de Vigo, Universidade de Vigo, Vigo, Spain
| | | | | | | | - Irina Milisav
- University of Ljubljana, Ljubljana, Slovenia
- University of Ljubljana, Faculty of Health Sciences, Ljubljana, Slovenia and with University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
| | - John Nolan
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, Waterford, Ireland
| | - Marisa Porrini
- Universitàdegli Studi di Milano, Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, Milan, Italy
| | - Patrizia Riso
- Universitàdegli Studi di Milano, Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, Milan, Italy
| | - Johannes M Roob
- Research Unit Chronic Inflammation in Nephrology, Clinical Division of Nephrology, Department of Internal Medicine, Medical University, Graz, Austria
| | | | - Agata Wawrzyniak
- Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Brigitte M Winklhofer-Roob
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University, Graz, Austria
| | - Ralph Rühl
- Paprika Bioanalytics BT, Debrecen, Hungary and with CISCAREX UG, Berlin, Germany
| | - Torsten Bohn
- Population Health Department, Luxembourg Institute of Health, Strassen, Luxembourg
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Schulz PJ, Nakamoto K. Patient behavior and the benefits of artificial intelligence: the perils of "dangerous" literacy and illusory patient empowerment. PATIENT EDUCATION AND COUNSELING 2013; 92:223-228. [PMID: 23743214 DOI: 10.1016/j.pec.2013.05.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 05/01/2013] [Accepted: 05/02/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Artificial intelligence can provide important support of patient health. However, limits to realized benefits can arise as patients assume an active role in their health decisions. METHODS Distinguishing the concepts of health literacy and patient empowerment, we analyze conditions that bias patient use of the Internet and limit access to and impact of artificial intelligence. RESULTS Improving health literacy in the face of the Internet requires significant guidance. Patients must be directed toward the appropriate tools and also provided with key background knowledge enabling them to use the tools and capitalize on the artificial intelligence technology. CONCLUSION Benefits of tools employing artificial intelligence to promote health cannot be realized without recognizing and addressing the patients' desires, expectations, and limitations that impact their Internet behavior. In order to benefit from artificial intelligence, patients need a substantial level of background knowledge and skill in information use-i.e., health literacy. PRACTICE IMPLICATIONS It is critical that health professionals respond to patient search for information on the Internet, first by guiding their search to relevant, authoritative, and responsive sources, and second by educating patients about how to interpret the information they are likely to encounter.
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Affiliation(s)
- Peter J Schulz
- Institute of Communication and Health, University of Lugano (Università della Svizzera italiana), Lugano, Switzerland.
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Wiswedel I, Keilhoff G, Dörner L, Navarro A, Böckelmann R, Bonnekoh B, Gardemann A, Gollnick H. UVB irradiation-induced impairment of keratinocytes and adaptive responses to oxidative stress. Free Radic Res 2007; 41:1017-27. [PMID: 17729119 DOI: 10.1080/10715760701531430] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
UVB irradiation of human skin is known to induce pathophysiological processes as oxidative stress and inflammation. HaCaT keratinocytes represent a well-established in vitro model system to investigate the influence of UVB irradiation on cell cultures. It was the aim of these investigations to study the effects of moderate UVB doses on cellular and mitochondrial integrity of HaCaT keratinocytes, biomarkers of oxidative stress and antioxidant protection by superoxide dismutases. F(2)-isoprostane concentrations were UVB dose-dependently enhanced reaching a plateau at 50 mJ/cm(2). Cell viability was reduced and apoptosis was enhanced with increasing UVB doses. The activities of the respiratory chain complexes were practically not altered at lower UVB doses, up to 50 mJ/cm(2), whereas remarkable decreases, also for the levels of cardiolipin species, were seen at 100 mJ/cm(2). As an adaptive response to the enhanced oxidative stress, protein levels of MnSOD increased about 3-fold at 50 mJ/cm(2) and decreased at higher doses. From the data it can be concluded that keratinocytes are sufficiently protected at low UVB doses, whereas higher doses lead to irreversible cell damage.
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Affiliation(s)
- Ingrid Wiswedel
- Department of Pathological Biochemistry, Institute of Clinical Chemistry and Pathological Biochemistry, Germany.
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Darvin M, Zastrow L, Sterry W, Lademann J. Effect of Supplemented and Topically Applied Antioxidant Substances on Human Tissue. Skin Pharmacol Physiol 2006; 19:238-47. [PMID: 16778456 DOI: 10.1159/000093979] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2005] [Accepted: 10/10/2005] [Indexed: 11/19/2022]
Abstract
Systemic and topical application of antioxidant substances for the medical treatment and prophylaxis of many diseases as well as additional protection of the skin against the destructive action of free radicals and other reactive species has become very popular during the past years. Stimulated by the positive results of a fruit and vegetable diet in supporting medical treatment and in cosmetics, artificial and extracted antioxidant substances have been broadly applied. Surprisingly, not only positive but also strong negative results have been obtained by different authors. According to study reports artificial and extracted antioxidant substances support different kinds of medical therapies, if they are applied in mixtures of different compounds at low concentration levels. In the case of the application of high concentration of some single compounds, side effects were often observed. Regarding skin treatment by systemically applied antioxidant substances for cosmetic purposes, positive cosmetic effects as well as no effects, but almost no side effects, apart from a number of allergic reactions, were reported. One reason for this seems to be the lower concentration of systemically applied antioxidant substances in comparison with a medical application. Topical application of antioxidant substances is closely related to cosmetic treatment for skin protection and anti-aging. Positive results were also obtained in this case. The present review is an attempt to classify and summarize the published literature concerning the efficiency of action of systemic and topical applications of antioxidant substances, such as carotenoids and vitamins, on human organism and especially on the skin. The available literature on this topic is very extensive and the results are often contradictory. Nevertheless, there are some clear tendencies concerning systemic and topical application of antioxidant substances in medicine and cosmetics, and we summarize them in the present paper.
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Affiliation(s)
- M Darvin
- Center of Experimental and Applied Cutaneous Physiology, Medical Faculty Charité, Humboldt University Berlin, Berlin, Germany.
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