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8 ß-Carotene and Other Carotenoids
Pages 325-382

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From page 325...
... A large body of observational epidemiological evidence suggests that higher blood concentrations of p-carotene and other carotenoids obtained from foods are associated with lower risk of several chronic diseases. This evidence, although consistent, cannot be used to establish a requirement for p-carotene or carotenoid intake because the observed effects may be due to other substances found in carotenoidrich food, or to other behavioral correlates of increased fruit and vegetable consumption.
From page 326...
... Carotenoicis have also been associated with various health effects: clecreasecT risk of macular degeneration and cataracts, clecreasecT risk of some cancers, and decreased risk of some cardiovascular events (Olson, 1999)
From page 327...
... (a .— o to a: .— ·5 ~0 Q To (a o ~0 a: .
From page 328...
... Once inside the mucosal cell, carotenoicis or their metabolic products (e.g., vitamin A) must also be incorporated into chylomicrons and released into the lymphatics.
From page 329...
... In aciclition to these forms of oc-carotene, ,3-carotene, lycopene, and zeaxanthin are also major serum carotenoids. The concentrations of various carotenoicis in human serum and
From page 330...
... (1996) reporteci that lower serum concentrations of oc-carotene, ,3-carotene, ,3cryptoxanthin, lutein, and zeaxanthin, but not lycopene, were generally associated with male gentler, smoking, younger age, lower non-HDL cholesterol, greater ethanol consumption, and higher body mass inclex.
From page 331...
... This information will be presented in a later Dietary Reference Intakes report. Markers of Antioxidant Activity The effect of increasing ,3-carotene intake on several markers of antioxidant activity has been investigated in a series of studies involving humans.
From page 332...
... In studies that involved clepletion followoci by repletion of body stores of ,3-carotene, as inclicateci by plasma concentrations, the biological markers that were negatively altered as a result of clepleteci body stores of ,3-carotene were restored to baseline values as a consequence of repletion (Table 8-2~. In summary, results from some studies show improvement of measures of antioxidant activity clue to intake of relatively high levels of ,3-carotene, while studies that investigated low to moclest levels of ,3carotene show no or inconsistent changes in the same activities.
From page 333...
... 0.1-1.0 (0.05-2.3 1lg/g) Some benefit of fouling increased amounts of ,3-carotene was observeci for several markers of antioxidant activity when body stores were relatively low or when an oxiciant-type stress was present.
From page 334...
... 334 DIETARY REFERENCE INTAKES TABLE 8-2 ,3-Carotene Intake and Measures of Antioxidant Activity in Selected Studies Reference, Country Subjects ,B-Carotene Dose Duratior Richards et al., 40 smokers, average age 33 y; 40 mg/d, Roche prep 6 wk 1990 received placebo and South Africa 20 received treatment Mobarhan et al., 15 healthy men, aged Carotene-free diet 2 wk 1990; Gottlieb 19-30 y; randomly (depletion) ; 4 wk et al., 1993 assigned repletion levels Repletion: 15 mg/d or United States 120 mg/d, Roche prep Van Poppel et al., 143 male smokers, average 40 mg/d first 2 wk 2 wk 1992a, 1992b, age 39 y; randomly 20 mg/d next 12 wk 12 wk 1995 assigned to placebo or Holland treatment Allard et al., 1994 38 male nonsmokers, 25 male 20 mg/d, Roche prep 4 wk Canada smokers, aged 20-75 y; randomly assigned to placebo or treatment Calzada et al., 12 healthy men and 7 women, 15 mg/d, Roche prep 14 d 1995 aged 21-50 y; randomly 56 d United States assigned to placebo or treatment Gaziano et al., 4 healthy men and 12 women, 100 mg/d load dose; 6 d load 1995 aged 25-47 y; randomly natural treatment, follow.
From page 335...
... only; God or Depletion 0.09 ~ Serum lipid peroxide levels, oche (5 1lg/dL) both repletion levels 15 mg/d 3.32 (178 1lg/dL)
From page 336...
... 336 TABLE 8-2 Continucci DIETARY REFERENCE INTAKES Reference, Country Subjects ,B-Carotene Dose Duratior Hininger et al., 11 healthy men and 10 mg/d additional as 2 wk 1997 11 females, aged 25-45 y; foods (primarily France 11 smokers and 11 carrots) nonsmokers Mosca et al., 1997 Coronary artery disease 12 mg/d + vit E and 12 wk United States patients; 39 men and vit C; or 24 mg/d 6 women, aged 39-80 y + vit E and vit C Pool-Zobel et al., 23 healthy men, aged 27-40 y Low carotenoid 2 wk deF 1997 depletion food diet; 4 wk add Germany followed by 22 mg/d contai as carrot juice ,B-caro Wang et al., 1997 192 healthy men; nonsmokers From foods; Japan and smokers, aged 18-58 y subjects grouped by plasma levels Dixon et al., 1998; 9 healthy women, < 0.58 mg/d as diet or 100 d de Lin et al., 1998 premenopausal, diet + small 20 d rep United States aged 18-45 y supplement for depletion; repletion 3.3 mg/d, Roche prep Rust et al., 1998 24 CF patients and 1 mg/kg BW/d to max 12 wk Austria 14 age-matched healthy of 50 mg/d children, average age 12.8 y Steinberg and 8 men and 12 women who Vegetable-based juice 4 wk Chait, 1998 smoked were in Trt group; + 30 mg ,B-Carotene/d United States average age 29 y + vit C & vit E SI Conversion factor used for ,B-carotene = ~mol/L .
From page 337...
... . Repletion ~ LDL oxidation rate below baseline Plasma MDA on high-dose ,BC Breath pentane, LDL oxidation No change in plasma total peroxyl radical trapping i SOD = superoxide dismutase.
From page 338...
... Relationship of Carotenoid Intake to Chronic Disease A vast number of observational studies, including both case-control and cohort studies, of carotenoicis and chronic disease risk have
From page 339...
... Persons in the lowest quartile of plasma ,3carotene haci a significant increase in their risk of crying compared to those with higher plasma concentrations of ,(-carotene. The adjusteci relative risk was lowest for persons with plasma ,3-carotene concentrations in the range of 0.34 to 0.53 ~mol/L (18 to 28 fig/ ciL)
From page 340...
... Thus, this prospective study emphasizes the inverse association between ,3carotene-rich foocis and the risk of all-cause mortality. Another cohort study of carotenoids and mortality examined both clietary intake of total carotenoicis and plasma concentrations of
From page 341...
... e CHD = coronary heart disease. total carotenoids as predictors of mortality (Sahyoun et al., 1996~.
From page 342...
... Observational Epidemiological Studies. The Basel Prospective Study evaluated the relationship between plasma carotene concentrations in blood samples obtained in 1971-1973 and subsequent cancer mortality up to 1985 (Stahelin et al., 1991~.
From page 343...
... The Multiple Risk Factor Intervention Trial (MRFIT) cohort study haci prediagnostic serologic ciata on 66 lung cancer cases and 131 control subjects (Connett et al., 1989~.
From page 344...
... . A prospective study of serum micronutrients and prostate cancer in Japanese men in Hawaii, however, found no difference in precliagnostic serum lycopene concentrations in 142 cases versus 142 matched control subjects (Nomura et al., 1997~.
From page 345...
... for ~ to 8 years leci to a higher incidence in lung cancer but haci no effect on the incidence of other major cancers occurring in this population (prostate, blacicler, colon or rectum, or stomach) (ATBC Cancer Prevention Study Group, 1994~.
From page 346...
... Higher consumption of carotenoici-containing fruits and vegetables and higher plasma concentrations of several carotenoicis, including ,3-carotene, are associated with a lower risk of many different cancers, especially lung, oral cavity, pharyngeal, laryngeal, and cervical cancers. These prospective blood concentration studies show that ,3-carotene concentrations in the range of 0.28 ~mol/L (15 ~g/ciL)
From page 347...
... Total serum carotenoicis, measured at baseline in the placebo group of the Lipid Research Clinics Coronary Primary Prevention Trial, were inversely related to subsequent coronary heart disease events (Morris et al., 1994~. Men in the highest quartile of total serum carotenoicis (more than 3.16 ~mol/L ~ 172 ~g/ciL]
From page 348...
... Those in the highest quintile of clietary carotenoici intake haci a 43 percent lower risk for macular degeneration compared with those in the lowest (OR = 0.57; 95 percent CI = 0.35-0.92~. Among the specific carotenoids, intake of lutein and zeaxanthin (grouped in the carotenoici food composition ciatabase)
From page 349...
... . Dietary intake of carotenoicis, fat, anci iron, as well as plasma concentrations of lutein anci zeaxanthin, were positively related with MPOD in men, but only plasma concentrations of lutein anci zeaxanthin were associateci with MPOD values for women (Hammonci et al., 1996~.
From page 350...
... ) had a 5.6folci increased risk of any senile cataract and a 7.2-folci increased risk of cortical cataract, compared with subjects with high plasma total carotenoid concentrations (greater than the eightieth percentile; more than 3.3 ~mol/L t177 ~g/ciL]
From page 351...
... Plasma and Tissue Concentrations As just detailed, plasma and tissue concentrations of carotenoids have been associated with a variety of health outcomes; that is, higher concentrations are associated with a lower risk of cancer, coronary heart disease, and all-cause mortality. This could be used as a possible indicator for establishing requirements for carotenoids.
From page 352...
... , or to the intake patterns found in native Americans in some arctic regions of the United States and Canada (Kuhnlein et al., 1996~. Fruits 3.1% Meat, poultry, fish 22.9% Dairy products 18.4% Fats, oils Eggs 1 3.2% 4.3% Other foods 1 .7% Vegetables ~ 36.4% FIGURE 8-2 Contributors to Vitamin A intake in the U.S.
From page 353...
... These data, although in varying populations, suggest that 3 to 6 mg/ciay of ,3-carotene from food sources is prudent to maintain plasma ,(-carotene concentrations in the range associated with a lower risk of various chronic disease outcomes (see Table 8-3~.
From page 354...
... formation of lipid micelles in the gastrointesVery high bioavailability Examples of Specific Components or Foods Formulated natural or synthetic carotenoids Foocl Matrix Formulated carotenoids in water-dispersible beadlets Natural or synthetic Carotenoids oil form Papaya, peach, melon Fruits Squash, yam, sweet potato Tubers Tomato juice Processed juice with fat containing meal Carrots, peppers Mildly cooked yellow/ orange vegetables Tomato Raw juice without fat Carrots, peppers Raw yellow/orange vegetables Spinach Raw green leafy vegetables Very low bioavailability (~10°/0) FIGURE 3-3 Effect of food matrix and processing on bioavailability of carotenoids.
From page 355...
... These differences were baseci on changes in plasma concentration of ,3-carotene or lutein. Daily supplementation of ciark-green leafy vegetables rich in carotenoicis to lactating Indonesian women with low vitamin A status clici not increase vitamin A status, whereas a similar amount of ,3carotene given in a wafer supplement leci to a significant increase in plasma retinal (cle Pee et al., 1995~.
From page 356...
... When subjects consumeci tomato juice (equivalent to a single lycopene close of 2.5 ~mol/kg body weight) that had been heated at 100°C for 1 hour with oil, they experienced a serum lycopene peak at 24 to 48 hours.
From page 357...
... Several investigators have examined the effeet of ciaily supplementation with high-close ,3-carotene on plasma concentrations of other carotenoids in participants in multiyear cancer prevention intervention trials (Albanes et al., 1997; Mayne et al., 1998; Nierenberg et al., 1997; Wahlqvist et al., 1994~. These studies suggest no overall adverse effect on other carotenoicis with
From page 358...
... Thus, consumption of carotenoici-containing foocis may have to be greater in these groups in order to achieve plasma carotenoici concentrations that are associated with a recluceci risk of chronic disease (Table 8-3~. Adolescents Serum carotenoid concentrations were measured in the Third National Health and Nutrition Examination Survey (NHANES III)
From page 359...
... While smokers ingest less ,3-carotene than nonsmokers, it is unclear at present whether or not the lower serum concentrations seen can be fully explained by the recluceci ,3-carotene intakes of smokers, as cliscusseci recently by Bracly et al.
From page 360...
... These very new ciata await confirmation and further development. Although smoking may result in a neeci for higher intakes of clietary carotenoicis to achieve optimal plasma carotenoici concentrations, caution is warranted because ,3-carotene supplements, but not ,3-carotene-rich foocis, have been suggested as causing adverse effects in smokers (see "Tolerable Upper Intake Levels".
From page 361...
... from the 19881992 Third National Health and Nutrition Examination Survey (NHANES III) based on an expanded food composition database
From page 362...
... et al., 1994 Canfield U.S. 12 et al., 1997 18 >1 mo Not reported <6 mo Dietary intake: ,B-carotene: 5.08 + 2.5 mg/d oc-carotene: 13.0 + 0.8 mg/d Lycopene: 2.8 + 2.6 mg/d ,B-Carotene supplements: Group 1: 60 mg/wk x 10 wk Group 2: 210 mg/wk x 3 wk Lycopen oc-Carote ,B-Carote Lutein: ]
From page 363...
... No significant increases in oc-carotene, ,B-cryptoxanthin, lutein/zeaxanthin, or lycopene noted .5 mg/d .8 mg/d mg/d ~ts: x lOwk k x 3 wk Spectrophotometric Spectrophotometric HPLCg Spectrophotometric TLCh, HPLC, and spectrophotometric HPLC HPLC HPLC continued
From page 364...
... Thus, they will be inclucleci in the appendix of the next DRI report that will include vitamin A However, dietary recall data from 1,102 adult women participating in the 1986 Continuing Survey of Food Intake by Individuals indicate mean intakes of ,(-carotene, oc-carotene, lutein, and lycopene of 1.8, 0.4, 1.3, and 2.6 mg/day, respectively, with total carotenoid intake from ,(-carotene, oc-carotene, ,(~-cryptoxanthin, lutein, zeaxanthin, and lycopene of approximately 6 mg/ciay (Chug-Ahuja et al., 1993~.
From page 365...
... Another survey, the Nutritional Factors in Eye Disease Study, with 2,152 adults responding to a food frequency questionnaire, reported median dietary carotenoid intakes or ranges of 1.3 mg/day of ,3-carotene, 0.2 mg/day of oc-carotene, 0.02-0.07 mg/day of ,(~-cryptoxanthin, 0.7-0.8 ma/ day of lutein and zeaxanthin, and 0.6-1.6 mg/day of lycopene (VandenLangenberg et al., 1996~. Intake levels of ,3-carotene for infants can be estimated using data on human milk concentrations of ,3-carotene (Table 8-7~.
From page 366...
... In addition, long-term supplementation with ,(-carotene to persons with acloquate vitamin A status floes not increase the concentration of serum retinal (Nierenberg et al., 1997~. However, two recent clinical trials reported an increase in lung cancer associated with supplemental ,3-carotene in current smokers (ATBC Cancer Prevention Study Group, 1994; Omenn et al., 1996a,b)
From page 367...
... , a multicenter lung cancer prevention trial of a nutrient combination versus placebo in asbestos workers and smokers (Omenn et al., 1996a,b) reported more lung cancer cases in the supplemented group.
From page 368...
... Carotenoclermia is characterized by yellowish cliscoloration of the skin that results from an elevation of plasma carotene concentrations. This condition has been reported in adults taking supplements containing 30 mg/ciay or more of ,3-carotene for long periods of time or consuming high levels of carotenoicirich foocis such as carrots (Benclich, 1988)
From page 369...
... at 3 years; this blood concentration was associated with an adverse effect (ATBC Cancer Prevention Study Group, 1994~. In CARET, the meclian postintervention plasma concentration of ,3carotene was 3.96 ~mol/L (210 ~g/dL)
From page 371...
... As an example, macular pigment optical density (MPOD) is a promising intermediate marker for age-relateci macular degeneration (AMD)
From page 372...
... 1997. Effects of supplemental beta-carotene, cigarette smoking, and alcohol consumption on serum carotenoids in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study.
From page 373...
... Am ~ Clin Nutr 59:884-890. ATBC (Alpha-Tocopherol, Beta Carotene)
From page 374...
... Am ~ Clin Nutr 66:52-61. Canfield LM, Giuliano AR, Neilson EM, Blashil BM, Graver El, Yap HH.
From page 375...
... Ami Clin Nutr57:787S-797S. Gey KF, Stahelin HB, Eichholzer M
From page 376...
... 1996. Sex differences in macular pigment optical density: Relation to plasma carotenoid concentrations and dietary patterns.
From page 377...
... Am ~ Clin Nutr 65:871-875. Krinsky NI.
From page 378...
... 1995. Plasma carotenoids as biomarkers of vegetable intake: The University of Minnesota Cancer Prevention Research Unit Feeding Studies.
From page 379...
... 1994. Serum carotenoids and coronary heart disease: The Lipid Research Clinics Coronary Primary Prevention Trial and Follow-up Study.
From page 380...
... Am J Clin Nutr 55:96-99. Rodriguez MS, Irwin MI.
From page 381...
... Am J Clin Nutr 70:261-268. van Poppel G
From page 382...
... 1995. Sucrose polyester and plasma carotenoid concentrations in healthy subjects.


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