Scientific Opinion on the re-evaluation of lutein (E 161b) as a food additive

A mechanistic review on growing multiple therapeutic applications of lutein and its global market research

Lutein is a naturally occurring carotenoid synthesized by plants and algae that has a beneficial effect on several biological processes and associated ailments. Its immediate application is in ophthalmology, where it significantly lowers the incidences of age-related macular degeneration (AMD). It also has anti-inflammatory action, treatment of diabetic retinopathy, and cataracts, and enhancement of visual contrast. To critically assess lutein biosynthesis, therapeutic applicability, and market research literature. We have discussed its theoretical frameworks, experimental evidence, limitations, as well as clinical trial results, and future research prospects. The literature for this review article was mined and compiled by collecting and analyzing articles from several databases, including ScienceDirect, Google Scholar, PubMed, Wiley Online Library, Patentscope, and ClinicalTrials.gov published until March 30, 2022. Patent publications were identified using the search terms like IC:(C07C67/56) AND EN_AB:(lutein) OR EN_TI:(lutein) OR EN_AB:(extraction) OR EN_TI:(process). According to the literature, lutein is an essential nutrient given that it cannot be synthesized in the human body and acts as an antioxidant, affecting AMD, diabetic retinopathy, Rheumatic diseases, inflammation, and cancer. Due to inadequate production and laborious extraction, lutein is expensive despite its high demand and applicability. Market research predicts a 6.3% compound annual growth rate for lutein by 2032. Optimizing lutein extraction for high yield and purity is necessary. Lutein has proven applicability in various ailments as well as cosmetics that can be developed as a candidate drug for various diseases discussed in the review.

Lutein and Zeaxanthin Supplementation Improves Dynamic Visual and Cognitive Performance in Children: A Randomized, Double-Blind, Parallel, Placebo-Controlled Study

INTRODUCTION

Supplementation with dietary neuro-pigments lutein (L) and zeaxanthin (Z) has been shown to improve many aspects of visual and cognitive function in adults. In this study, we tested whether a similar intervention could improve such outcomes in preadolescent children.

METHODS

Sixty children (age range 5-12 years) were randomized in a 2:1 ratio in this double-blind, placebo-controlled clinical trial. Subjects were supplemented with gummies containing either a combination of 10 mg lutein and 2 mg zeaxanthin (LZ) or placebo for 180 days. Macular pigment optical density (MPOD) was the primary endpoint. The secondary endpoints included serum levels of L and Z, and brain-derived neurotrophic factor (BDNF), critical flicker fusion (CFF), eye strain and fatigue using visual analogue scales (VAS), Children's Sleep Habits Questionnaire-Abbreviated (CSHQ-A), and Creyos Health cognitive domains like attention, focus/concentration, episodic memory and learning, visuospatial working memory, and visuospatial processing speed. Safety was assessed throughout the study on the basis of physical examination, vital signs, clinical laboratory tests, and monitoring of adverse events.

RESULTS

The LZ group showed significant increases in MPOD at all visits post-supplementation, with significant increases as early as day 42 compared to placebo. The LZ group showed significant increases in serum lutein levels, reduced eye strain and fatigue, and improved cognitive performance (focus, episodic memory and learning, visuospatial working memory) at days 90 and 180 compared to placebo. Further, the LZ group showed significant increases in processing speed (CFF), attention, visuospatial processing, and serum Z and BDNF levels on day 180 compared to placebo. No safety concerns were observed.

CONCLUSIONS

Supplementing LZ resulted in increased MPOD levels, along with increased serum levels of L, Z, and BDNF. These changes were associated with improved visual and cognitive performances and reduction in eye strain and eye fatigue in the children receiving LZ gummies. The investigational product was safe and well tolerated.

TRIAL REGISTRATION

http://ctri.nic.in/ Identifier CTRI/2022/05/042364.

Microalgal lutein: Advancements in production, extraction, market potential, and applications

Lutein, a bioactive xanthophyll, has recently attracted significant attention for numerous health benefits, e.g., protection of eye health, macular degeneration, and acute and chronic syndromes etc. Microalgae have emerged as the best platform for high-value lutein production with high productivity, lutein content, and scale-up potential. Algal lutein possesses numerous bioactivities, hence widely used in pharmaceuticals, nutraceuticals, aquaculture, cosmetics, etc. This review highlights advances in upstream lutein production enhancement and feasible downstream extraction and cell disruption techniques for a large-scale lutein biorefinery. Besides bioprocess-related advances, possible solutions for existing production challenges in microalgae-based lutein biorefinery, market potential, and emerging commercial scopes of lutein and its potential health applications are also discussed. The key enzymes involved in the lutein biosynthesizing Methyl-Erythritol-phosphate (MEP) pathway have been briefly described. This review provides a comprehensive updates on lutein research advancements covering scalable upstream and downstream production strategies and potential applications for researchers and industrialists.

Comprehensive Update on Carotenoid Colorants from Plants and Microalgae: Challenges and Advances from Research Laboratories to Industry

The substitution of synthetic food dyes with natural colorants continues to be assiduously pursued. The current list of natural carotenoid colorants consists of plant-derived annatto (bixin and norbixin), paprika (capsanthin and capsorubin), saffron (crocin), tomato and gac fruit lycopene, marigold lutein, and red palm oil (α- and β-carotene), along with microalgal Dunaliella β-carotene and Haematococcus astaxanthin and fungal Blakeslea trispora β-carotene and lycopene. Potential microalgal sources are being sought, especially in relation to lutein, for which commercial plant sources are lacking. Research efforts, manifested in numerous reviews and research papers published in the last decade, have been directed to green extraction, microencapsulation/nanoencapsulation, and valorization of processing by-products. Extraction is shifting from conventional extraction with organic solvents to supercritical CO2 extraction and different types of assisted extraction. Initially intended for the stabilization of the highly degradable carotenoids, additional benefits of encapsulation have been demonstrated, especially the improvement of carotenoid solubility and bioavailability. Instead of searching for new higher plant sources, enormous effort has been directed to the utilization of by-products of the fruit and vegetable processing industry, with the application of biorefinery and circular economy concepts. Amidst enormous research activities, however, the gap between research and industrial implementation remains wide.

Potential roles of dietary zeaxanthin and lutein in macular health and function

Lutein, zeaxanthin, and meso-zeaxanthin are three xanthophyll carotenoid pigments that selectively concentrate in the center of the retina. Humans cannot synthesize lutein and zeaxanthin, so these compounds must be obtained from the diet or supplements, with meso-zeaxanthin being converted from lutein in the macula. Xanthophylls are major components of macular pigments that protect the retina through the provision of oxidant defense and filtering of blue light. The accumulation of these three xanthophylls in the central macula can be quantified with non-invasive methods, such as macular pigment optical density (MPOD). MPOD serves as a useful tool for assessing risk for, and progression of, age-related macular degeneration, the third leading cause of blindness worldwide. Dietary surveys suggest that the dietary intakes of lutein and zeaxanthin are decreasing. In addition to low dietary intake, pregnancy and lactation may compromise the lutein and zeaxanthin status of both the mother and infant. Lutein is found in modest amounts in some orange- and yellow-colored vegetables, yellow corn products, and in egg yolks, but rich sources of zeaxanthin are not commonly consumed. Goji berries contain the highest known levels of zeaxanthin of any food, and regular intake of these bright red berries may help protect against the development of age-related macular degeneration through an increase in MPOD. The purpose of this review is to summarize the protective function of macular xanthophylls in the eye, speculate on the compounds' role in maternal and infant health, suggest the establishment of recommended dietary values for lutein and zeaxanthin, and introduce goji berries as a rich food source of zeaxanthin.

Minor bioactive lipids

Bioactive lipids-major and minor-comprise an array of compounds belonging to different chemical categories. Among the minor bioactive lipids carotenoids, sterols and tocochromanols attract continuously the interest of food scientists, nutritionists and medical doctors for their importance in food processing, preservation and for their health properties. Provitamin A and non-provitamin A carotenoids are found in various food sources of plant and animal origin and are added to foods as colorants. Their interactions with other food ingredients are critical because of their role against reactive oxygen species. The role of cholesterol through the diet after decades of disputes is better justified whereas at the same time emphasis is given to the technological and health aspects of phytosterols, which became very efficiently part of the daily diet for many population groups. Last but not least the importance of vitamin E is in a continuous debate for over 100years whereas studies on tocotrienols are intensified as a result of a transient to palm oil product consumption globally. Chemistry, natural occurrence, absorption and metabolism, dietary intake and dietary recommendations, major health impacts and key technological issues are updated and discussed with the support of recent findings.

Food Colour Additives: A Synoptical Overview on Their Chemical Properties, Applications in Food Products, and Health Side Effects

Colour is one of the most relevant organoleptic attributes that directly affects consumers' acceptance and food selection. However, as food colouring pigments are generally unstable and become modified during processing, in order to maintain or restore product colour uniformity, colourants are added to food products around the world. In this context, although they are still widely used, synthetic food colorants, due to their potential hazards, are being replaced by those obtained from natural origins. Indeed, numerous side effects and toxicities, at both the medium and long-terms-namely allergic reactions, and behavioral and neurocognitive effects-have been related to the use of synthetic colourants, whereas their naturally-derived counterparts seem to provide a somewhat high-quality and effective contribution as a health promoter. In order to further understand the implications of the use of synthetic and naturally derived food colourants, this review aims to provide a synoptical approach to the chemical characteristics, properties, uses and side effects on health of those which are currently allowed and applied during food processing.

Early Pediatric Benefit of Lutein for Maturing Eyes and Brain-An Overview

Lutein is a dietary carotenoid preferentially accumulated in the eye and the brain in early life and throughout the life span. Lutein accumulation in areas of high metabolism and oxidative stress such as the eye and the brain suggest a unique role of this ingredient during the development and maturation of these organs of common embryological origin. Lutein is naturally provided to the developing baby via the cord blood, breast milk and then infant diet. The presence of this carotenoid depends on fruit and vegetable intakes and its bioavailability is higher in breastmilk. This paper aims to review the anatomical development of the eye and the brain, explore the presence and selective deposition of lutein in these organs during pregnancy and infancy and, based on its functional characteristics, present the latest available research on the beneficial role of lutein in the pediatric population. The potential effects of lutein in ameliorating conditions associated with increase oxidative stress such as in prematurity will be also addressed. Since consumption of lutein rich foods falls short of government guidelines and in most region of the world infant formulas lack this bioactive, dietary recommendations for pregnant and breastfeeding women and their child can help to bridge the gap.

Carotenoids in Milk and the Potential for Dairy Based Functional Foods

Carotenoids are a family of over 1100 known natural pigments synthesized by plants, algae, fungi and bacteria. Dietary intake of carotenoids is necessary for mammals as they cannot be synthesized in the body. In cows, the nature of the diet consumed strongly influences the composition of milk produced and this includes carotenoid concentration and profile. Fresh forage is the richest source of carotenoids for cows. The main carotenoids identified in forages are lutein, β-carotene, zeaxanthin and epilutein. Manipulating cow feed via carotenoid supplementation increases the carotenoid content of bovine milk. In humans, carotenoids have anti-oxidant, anti-inflammatory and provitamin A activity. Lutein is a major carotenoid in human milk and the brain tissue of adults and infants. Lutein and zeaxanthin are linked to improved eye health and cognitive function. Traditionally for humans, fruit and vegetables have been the main source of carotenoid intake. Functional foods present an opportunity to incorporate these naturally occurring compounds into milk products for added health benefits, widening the range of dietary sources of carotenoids. We offer an overview of the literature to date on carotenoid-fortified dairy products and infant formula. This review will describe and summarize the key mechanisms by which the carotenoid profile of bovine milk can be manipulated. We present findings on the origin and role of carotenoids in bovine and human milk, outline factors that impact the carotenoid content of milk, evaluate carotenoid-fortified milk products and discuss the associated challenges, such as bioaccessibility and stability.

From carotenoid intake to carotenoid blood and tissue concentrations - implications for dietary intake recommendations

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.

Stabilisation of Lutein and Lutein Esters with Polyoxyethylene Sorbitan Monooleate, Medium-Chain Triglyceride Oil and Lecithin

Lutein is a challenging compound to incorporate into food, as it is poorly soluble and unstable in aqueous solutions. In this study, the aim was to prepare stable encapsulates of lutein and lutein esters using feasible and straightforward techniques. Fine suspensions based on polyoxyethylene sorbitan monooleate and medium-chain triglyceride oil micelle-like units with 3.45% lutein esters or 1.9% lutein equivalents provided high encapsulation efficiencies of 79% and 83%, respectively. Lutein encapsulated in fine suspensions showed superior stability, as 86% was retained within the formulation over 250 days at 25 °C in the dark. Under the same storage conditions, only 38% of lutein remained in corresponding formulations. Higher encapsulation efficiencies were achieved with lecithin emulsions, at up to 99.3% for formulations with lutein, and up to 91.4% with lutein esters. In lecithin emulsions that were stored for 250 days, 17% and 80% of lutein and lutein esters, respectively, were retained within the formulations.

An Integrated Strategy for Nutraceuticals from Haematoccus pluvialis: From Cultivation to Extraction

The aim of this study was to develop an effective integrated cultivation system for Haematococcus pluvialis as a source of bioactive compounds such as astaxanthin, lutein, proteins, and fatty acids (FAs). The Chlorophyta H. pluvialis was cultivated in a vertical bubble column photobioreactor (VBC-PBR) under batch mode, allowing switching from green to red phase for astaxanthin induction. The combined effect of light intensity and nutrients on bioactive compound formation was investigated. Results showed that growth under lower nutrients availability and light intensity led to a higher concentration of biomass. Growth under high light intensity with an appropriate concentration of nitrate, sulfate, phosphate and magnesium led to ~85% and ~58% higher production of total carotenoids and fatty acids, respectively. Under high stress conditions, ~90% nitrate and phosphate consumption were observed.

Optimization of Ultrasonic-Assisted Extraction and Purification of Zeaxanthin and Lutein in Corn Gluten Meal

Zeaxanthin and lutein have a wide range of pharmacological applications. In this study, we conducted systematic experimental research to optimize antioxidant extraction based on detection, extraction, process amplification, and purification. An ultrasonic-assisted method was used to extract zeaxanthin and lutein with high efficiency from corn gluten meal. Firstly, the effects of solid-liquid ratio, extraction temperature, and ultrasonic extraction time on the extraction of zeaxanthin were investigated in single-factor experiments. The optimization extraction parameters of zeaxanthin and lutein with ethanol solvent were obtained using the response surface methodology (RSM) as follows: liquid–solid ratio of 7.9:1, extraction temperature of 56 °C, and extraction time of 45 min. The total content of zeaxanthin and lutein was 0.501%. The optimum extraction experimental parameters were verified by process amplification, and we confirmed that the parameters of the extraction process optimized using the RSM design are reliable and precise. Zeaxanthin and lutein from crude extract of corn gluten were separated and purified using silica gel column chromatography with the purity of zeaxanthin increasing from 0.28% to 31.5% (about 110 times) and lutein from 0.25% to 16.3% (about 65 times), which could be used for large-scale industrial production of carotenoids.

Bench-Scale Cultivation of Microalgae Scenedesmus almeriensis for CO2 Capture and Lutein Production

In this study, Scenedesmus almeriensis as green microalga was cultivated on bench-scale for carbon dioxide (CO2) capture and lutein production. The autotrophic cultivation of S. almeriensis was carried out by using a vertical bubble column photo-bioreactor (VBC-PBR) with a continuous flow of a gaseous mixture of oxygen (O2), nitrogen (N2), and CO2, the latter in content of 0.0–3.0 %v/v. The liquid phase was batch. S. almeriensis growth was optimized. In addition, lutein extraction was carried out by using accelerated solvent extraction with ethanol as Generally Recognized as Safe (GRAS) solvent at 67 °C and 10 MPa. Upon optimization of CO2 concentration, the maximum biomass productivity, equal to 129.24 mg·L−1·d−1, was achieved during the cultivation by using a content of CO2 equal to 3.0 %v/v and it allowed to obtain a lutein content of 8.54 mg·g−1, which was 5.6-fold higher in comparison to the analogous process carried out without CO2 addition. The ion chemical analysis in the growth medium showed that by gradually increasing CO2 content, the nutrient consumption during the growth phase also increased. This study may be of potential interest for lutein extraction at industrial scale, since it is focused on pigment production from a natural source with a concomitantly CO2 capture.

An Overview of Carotenoids, Apocarotenoids, and Vitamin A in Agro-Food, Nutrition, Health, and Disease

Carotenoids are fascinating compounds that can be converted into many others, including retinoids that also play key roles in many processes. Although carotenoids are largely known in the context of food science, nutrition, and health as natural colorants and precursors of vitamin A (VA), evidence has accumulated that even those that cannot be converted to VA may be involved in health-promoting biological actions. It is not surprising that carotenoids (most notably lutein) are among the bioactives for which the need to establish recommended dietary intakes have been recently discussed. In this review, the importance of carotenoids (including apocarotenoids) and key derivatives (retinoids with VA activity) in agro-food with relevance to health is summarized. Furthermore, the European Network to Advance Carotenoid Research and Applications in Agro-Food and Health (EUROCAROTEN) is introduced. EUROCAROTEN originated from the Ibero-American Network for the Study of Carotenoids as Functional Food Ingredients (IBERCAROT).

Carotenoids: How Effective Are They to Prevent Age-Related Diseases?

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.

Safety and efficacy of lutein and lutein/zeaxanthin extracts from Tagetes erecta for poultry for fattening and laying (except turkeys)

The Panel on Additives and Products or Substances used in Animal Feed (FEEDAP) evaluated (i) lutein from a saponified extract from Tagetes erecta obtained via extraction and saponification (lutein not less than 85% of total carotenoids (TC)) and (ii) lutein/zeaxanthin extract from Tagetes erecta obtained via extraction, saponification and isomerisation (lutein not less than 45% and zeaxanthin not less than 35% of TC). The maximum proposed use level of 80 mg TC from saponified Tagetes extract/kg complete feed for chickens for fattening and laying hens is safe for these animal categories. This conclusion can be extrapolated to minor poultry species for fattening and laying. The conclusions on saponified Tagetes extract for poultry for fattening and laying are extended to the saponified/isomerised Tagetes extract. The maximum use level of the saponified/isomerised Tagetes extract in breeding minor poultry should not exceed 50 mg TC/kg feed, considering the toxicological potential of zeaxanthin on reproduction. The saponified Tagetes extract is not genotoxic. This conclusion is extended to the saponified/isomerised Tagetes extract. Consumer exposure related to the consumption of animal products is very low compared to the exposure from other sources. The active substance is a viscous paste and may be irritant to skin and eyes; no exposure by inhalation is expected. In the absence of data, the Panel cannot conclude on the safety for the user of commercial preparations. The use of Tagetes extracts in poultry feed raised no concern for the environment. Tagetes extracts at levels up to the proposed maximum use level of 80 mg TC/kg complete feed have the potential to colour the egg yolk of laying hens and the skin of chickens for fattening. This conclusion is extended to minor poultry species for laying and for fattening. The use of the additive in feed and water for drinking is considered bioequivalent.

The Effect of Lutein on Eye and Extra-Eye Health

Lutein is a carotenoid with reported anti-inflammatory properties. A large body of evidence shows that lutein has several beneficial effects, especially on eye health. In particular, lutein is known to improve or even prevent age-related macular disease which is the leading cause of blindness and vision impairment. Furthermore, many studies have reported that lutein may also have positive effects in different clinical conditions, thus ameliorating cognitive function, decreasing the risk of cancer, and improving measures of cardiovascular health. At present, the available data have been obtained from both observational studies investigating lutein intake with food, and a few intervention trials assessing the efficacy of lutein supplementation. In general, sustained lutein consumption, either through diet or supplementation, may contribute to reducing the burden of several chronic diseases. However, there are also conflicting data concerning lutein efficacy in inducing favorable effects on human health and there are no univocal data concerning the most appropriate dosage for daily lutein supplementation. Therefore, based on the most recent findings, this review will focus on lutein properties, dietary sources, usual intake, efficacy in human health, and toxicity.

Preliminary Data on the Safety of Phytoene- and Phytofluene-Rich Products for Human Use including Topical Application

The colorless carotenoids phytoene and phytofluene are comparatively understudied compounds found in common foods (e.g., tomatoes) and in human plasma, internal tissues, and skin. Being naturally present in common foods, their intake at dietary levels is not expected to present a safety concern. However, since the interest in these compounds in the context of many applications is expanding, it is important to conduct studies aimed at assessing their safety. We present here results of in vitro cytotoxicity and genotoxicity studies, revealing no significant cytotoxic or genotoxic potential and of short- and long-term human in vivo skin compatibility studies with phytoene- and phytofluene-rich tomato and Dunaliella salina alga extracts, showing a lack of irritancy or sensitization reactions. These results support the safe use of phytoene- and phytofluene-rich products in human topical applications.

The Pharmacological Effects of Lutein and Zeaxanthin on Visual Disorders and Cognition Diseases

Lutein (L) and zeaxanthin (Z) are dietary carotenoids derived from dark green leafy vegetables, orange and yellow fruits that form the macular pigment of the human eyes. It was hypothesized that they protect against visual disorders and cognition diseases, such as age-related macular degeneration (AMD), age-related cataract (ARC), cognition diseases, ischemic/hypoxia induced retinopathy, light damage of the retina, retinitis pigmentosa, retinal detachment, uveitis and diabetic retinopathy. The mechanism by which they are involved in the prevention of eye diseases may be due their physical blue light filtration properties and local antioxidant activity. In addition to their protective roles against light-induced oxidative damage, there are increasing evidences that L and Z may also improve normal ocular function by enhancing contrast sensitivity and by reducing glare disability. Surveys about L and Z supplementation have indicated that moderate intakes of L and Z are associated with decreased AMD risk and less visual impairment. Furthermore, this review discusses the appropriate consumption quantities, the consumption safety of L, side effects and future research directions.