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ABSTRACT: PURPOSE: The objective of this systematic review was to examine the evidence on zinc intake from foods and supplements in the primary prevention and treatment of Age-related macular degeneration (AMD). METHODS: Randomized controlled trials (RCTs), prospective cohort, retrospective cohort and case-control studies that investigated zinc intake from foods and/or supplements and AMD in men and women with a mean age of >50 y were included. Medline® and Cochrane Central were searched from inception to February 2012 and November 2012, respectively. Data extraction and quality appraisal were done on all eligible studies. RESULTS: Ten studies were included: 4 RCTs, 4 prospective cohort and 2 retrospective cohort studies. Age-related Eye Disease Study (AREDS) showed zinc treatment to significantly reduce the risk of progression to advanced AMD. The risk of visual acuity loss was of similar magnitude but not statistically significant. Two RCTs reported statistically significant increases in visual acuity in early AMD patients and one RCT showed no effect of zinc treatment on visual acuity in advanced AMD patients. Results from 6 cohort studies on associations between zinc intake and incidence of AMD were inconsistent. CONCLUSIONS: Current evidence on zinc intake for the prevention of AMD is inconclusive. Based on the strength of AREDS we can conclude that zinc treatment may be effective in preventing progression to advanced AMD. Zinc supplementation alone may not be sufficient to produce clinically meaningful changes in visual acuity.
Investigative ophthalmology & visual science 05/2013; · 3.43 Impact Factor
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Kristin J Meyers, Elizabeth J Johnson,
Paul S Bernstein,
Sudha K Iyengar,
Corinne D Engelman,
Chitra K Karki,
Zhe Liu,
Robert P Igo,
Barbara Truitt,
Michael L Klein,
D Max Snodderly,
Barbara A Blodi,
Karen M Gehrs,
Gloria E Sarto,
Robert B Wallace,
Jennifer Robinson,
Erin S Leblanc,
Gregory Hageman,
Lesley Tinker,
Julie A Mares
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ABSTRACT: PURPOSE: To investigate genetic determinants of macular pigment optical density in women from the Carotenoids in Age-Related Eye Disease Study (CAREDS), an ancillary study of the Women's Health Initiative Observational Study. METHODS: 1,585 of 2,005 CAREDS participants had macular pigment optical density (MPOD) measured noninvasively using customized heterochromatic flicker photometry and blood samples genotyped for 440 single nucleotide polymorphisms (SNPs) in 26 candidate genes related to absorption, transport, binding, and cleavage of carotenoids directly, or via lipid transport. SNPs were individually tested for associations with MPOD using least-squares linear regression. RESULTS: Twenty-one SNPs from 11 genes were associated with MPOD (P≤0.05) after adjusting for dietary intake of lutein and zeaxanthin. This includes variants in or near genes related to: zeaxanthin binding in the macula (GSTP1), carotenoid cleavage (BCMO1), cholesterol transport or uptake (SCARB1, ABCA1, ABCG5 and LIPC), long-chain omega-3 fatty acid status (ELOVL2, FADS1 and FADS2), and various maculopathies (ALDH3A2 and RPE65). The strongest association was for rs11645428 near BCMO1 (βA=0.029, P=2.2x10-4). Conditional modeling within genes and further adjustment for other predictors of MPOD, including waist circumference, diabetes, and dietary intake of fiber, resulted in 13 SNPs from 10 genes maintaining independent association with MPOD. Variation in these single gene polymorphisms accounted for 5% of the variability in MPOD (P=3.5x10-11). CONCLUSION: Our results support that MPOD is a multi-factorial phenotype associated with variation in genes related to carotenoid transport, uptake, and metabolism, independent of known dietary and health influences on MPOD.
Investigative ophthalmology & visual science 02/2013; · 3.43 Impact Factor
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ABSTRACT: OBJECTIVES: Xanthophyll pigments lutein and zeaxanthin cross the blood-retina barrier to preferentially accumulate in the macular region of the neural retina. There they form macular pigment, protecting the retina from blue light damage and oxidative stress. Lutein and zeaxanthin also accumulate in brain tissue. The objective of the study was to evaluate the relationship between retinal and brain levels of these xanthophylls in non-human primates. METHODS: Study animals included rhesus monkeys reared on diets devoid of xanthophylls that were subsequently fed pure lutein or pure zeaxanthin (both at 3.9 µmol/kg per day, n = 6/group) and normal rhesus monkeys fed a stock diet (0.26 µmol/kg per day lutein and 0.24 µmol/kg per day zeaxanthin, n = 5). Retina (4 mm macular punch, 4-8 mm annulus, and periphery) and brain tissue (cerebellum, frontal cortex, occipital cortex, and pons) from the same animals were analyzed by reverse-phase high-performance liquid chromatography. RESULTS: Lutein in the macula and annulus was significantly related to lutein levels in the cerebellum, occipital cortex, and pons, both in bivariate analysis and after adjusting for age, sex and n-3 fatty acid status. In the frontal cortex the relationship was marginally significant. Macular zeaxanthin was significantly related to zeaxanthin in the cerebellum and frontal cortex, while the relationship was marginally significant in the occipital cortex and pons in a bivariate model. DISCUSSION: An integrated measure of total macular pigment optical density, which can be measured non-invasively, has the potential to be used as a biomarker to assess brain lutein and zeaxanthin status.
Nutritional Neuroscience 07/2012; · 1.56 Impact Factor
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ABSTRACT: Oxidative damage and inflammation are related to the pathogenesis of age-related macular degeneration (AMD). Epidemiologic studies suggest that insufficient dietary lutein and zeaxanthin intake or lower serum zeaxanthin levels are associated with increased risk for AMD. The objective of this work is to test the protective effects of lutein and zeaxanthin against photooxidative damage to retinal pigment epithelial cells (RPE) and oxidation-induced changes in expression of inflammation-related genes. To mimic lipofuscin-mediated photooxidation in vivo, we used ARPE-19 cells that accumulated A2E, a lipofuscin fluorophore and photosensitizer, as a model system to investigate the effects of lutein and zeaxanthin supplementation. The data show that supplementation with lutein or zeaxanthin in the medium resulted in accumulation of lutein or zeaxanthin in the RPE cells. The concentrations of lutein and zeaxanthin in the cells were 2- to 14-fold of that detected in the medium, indicating that ARPE-19 cells actively take up lutein or zeaxanthin. As compared with untreated cells, exposure of A2E-containing RPE to blue light resulted in a 40-60% decrease in proteasome activity, a 50-80% decrease in expression of CFH and MCP-1, and an∼20-fold increase in expression of IL-8. The photooxidation-induced changes in expression of MCP-1, IL-8, and CFH were similar to those caused by chemical inhibition of the proteasome, suggesting that inactivation of the proteasome is involved in the photooxidation-induced alteration in expression of these inflammation-related genes. Incubation of the A2E-containing RPE with lutein or zeaxanthin prior to blue light exposure significantly attenuated the photooxidation-induced inactivation of the proteasome and photooxidation-induced changes in expression of MCP-1, IL-8, and CFH. Together, these data indicate that lutein or zeaxanthin modulates inflammatory responses in cultured RPE in response to photooxidation. Protecting the proteasome from oxidative inactivation appears to be one of the mechanisms by which lutein and zeaxanthin modulate the inflammatory response. Similar mechanisms may explain salutary effects of lutein and zeaxanthin in reducing the risk for AMD.
Free radical biology & medicine 06/2012; 53(6):1298-307. · 5.42 Impact Factor
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Jie Yu, Elizabeth J Johnson,
Fu Shang,
Apiradee Lim,
Haiying Zhou,
Lei Cui,
Jun Xu,
Torkel Snellingen,
Xipu Liu,
Ningli Wang,
Ningpu Liu
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ABSTRACT: Macular pigment may protect against age-related macular degeneration (AMD) by its capacity to absorb blue light and scavenge free radicals. Current information on human macular pigment density has been largely from studies on Caucasian populations. The purpose of this study was to assess macular pigment density and its determinant factors in a Chinese population sample.
Macular pigment optical density (MPOD) was measured in a healthy Chinese population using heterochromatic flicker photometry (HFP). Participants received a standard ophthalmic examination, and only subjects who were confirmed not to have any eye diseases except mild age-related cataract were included in the study. Demographic and lifestyle data and general health status were recorded by questionnaire.
A total of 281 unrelated healthy Chinese individuals, including 96 males and 185 females, with ages ranging from 17 to 85 years, participated in the study. The mean and standard deviation of MPOD levels were 0.56 ± 0.19, 0.49 ± 0.18, 0.36 ± 0.15, and 0.19 ± 0.12, respectively, at 0.25°, 0.5°, 1.0°, and 1.75° eccentricity points. A significant age-related decline in MPOD was observed at 0.25° (P = 0.014). Females tended to have relatively lower levels of MPOD than males at 0.25° (P = 0.21), 0.5° (P = 0.025), and 1.0° (P = 0.16). No statistically significant association of MPOD was observed with body mass index or smoking status.
Macular pigment density measured by HFP tended to decline with aging in this healthy Chinese population sample. Females may have lower levels of MPOD than males.
Investigative ophthalmology & visual science 03/2012; 53(4):2106-11. · 3.43 Impact Factor
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Haiying Zhou,
Xianfeng Zhao, Elizabeth J Johnson,
Apiradee Lim,
Erdan Sun,
Jie Yu,
Yinbo Zhang,
Xipu Liu,
Torkel Snellingen,
Fu Shang,
Ningpu Liu
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ABSTRACT: PURPOse: It has been hypothesized that the macular carotenoids protect against age-related macular degeneration (AMD). In this study, the association between serum concentrations of carotenoids and the presence of AMD was evaluated in a case-control sample of elderly Chinese subjects.
Two hundred sixty-three individuals aged between 50 and 88 years enrolled in the study. Subjects included 82 cases with exudative AMD, 92 cases with early AMD, and 89 control individuals. Serum carotenoids (lutein, zeaxanthin, lycopene, α- and β-carotenes, and β-cryptoxanthin) and retinol were measured with reversed-phase high-performance liquid chromatography (HPLC).
Serum levels of carotenoids and retinol were significantly lower in the cases with exudative AMD than in the controls. Median levels of lutein and zeaxanthin were 0.538 and 0.101 μM, respectively, in the control subjects, and 0.488 and 0.076 μM, respectively, in cases with exudative AMD. After adjustment for age, sex, smoking status, and body mass index (BMI), a significant inverse association was observed for exudative AMD with serum zeaxanthin (relative risk ratio [RRR], 0.04; 95% confidence interval [CI], 0-0.35), lycopene (RRR, 0.22; 95% CI, 0.1-0.48), and α-carotene (RRR, 0.24; 95% CI, 0.12-0.51). Early AMD was inversely associated only with lycopene (RRR, 0.49; 95% CI, 0.28-0.86) but was positively associated with α-carotene (RRR, 2.22; 95% CI, 1.37-3.58). No significant associations were observed between serum lutein and cases with early or exudative AMD.
The data suggest that higher levels of serum carotenoids, in particular zeaxanthin and lycopene, are associated with a lower likelihood of having exudative AMD. Serum levels of carotenoids were relatively higher in this Chinese cohort than in samples of other ethnicities in previous reports.
Investigative ophthalmology & visual science 06/2011; 52(7):4338-44. · 3.43 Impact Factor
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ABSTRACT: Blue-light photooxidative damage has been implicated in the etiology of age-related macular degeneration (AMD). The macular pigment xanthophylls lutein (L) and zeaxanthin (Z) and n-3 fatty acids may reduce this damage and lower the risk of AMD. This study investigated the effects of the lifelong absence of xanthophylls followed by L or Z supplementation, combined with the effects of n-3 fatty acid deficiency, on acute blue-light photochemical damage.
Subjects included eight rhesus monkeys with no lifelong intake of xanthophylls and no detectable macular pigment. Of these, four had low n-3 fatty acid intake and four had adequate intakes. Control subjects had typical L, Z, and n-3 fatty acid intake. Retinas received 150-μm-diameter exposures of low-power 476-nm laser light at 0.5 mm (∼2°) eccentricity, which is adjacent to the macular pigment peak, and parafoveally at 1.5 mm (∼6°). Exposures of xanthophyll-free animals were repeated after supplementation with pure L or Z for 22 to 28 weeks. Ophthalmoscopically visible lesion areas were plotted as a function of exposure energy, with greater slopes of the regression lines indicating greater sensitivity to damage.
In control animals, the fovea was less sensitive to blue-light-induced damage than the parafovea. Foveal protection was absent in xanthophyll-free animals but was evident after supplementation. In the parafovea, animals low in n-3 fatty acids showed greater sensitivity to damage than animals with adequate levels.
After long-term xanthophyll deficiency, L or Z supplementation protected the fovea from blue light-induced damage, whereas adequate n-3 fatty acid levels reduced the damage in the parafovea.
Investigative ophthalmology & visual science 01/2011; 52(7):3934-42. · 3.43 Impact Factor
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ABSTRACT: Lutein and zeaxanthin are carotenoids that are selectively taken up into the macula of the eye, where they may protect against development of age-related macular degeneration. Accurate assessment of their intakes is important in the understanding of their individual roles in eye health. Current dietary databases lack the appropriate information to ascertain valid dietary intakes of these individual nutrients. The purpose of this research is to determine intakes of lutein and zeaxanthin separately in the National Health and Nutrition Examination Survey (NHANES) 2003-2004. The top major food sources for lutein and zeaxanthin intake in NHANES 2003-2004 were analyzed for lutein and zeaxanthin by high-performance liquid chromatography from June to August 2006. Results were applied to dietary data from 8,525 participants in NHANES 2003-2004. Lutein and zeaxanthin food contents were separated into lutein and zeaxanthin in the nutrient database. Mean intakes from two nonconsecutive 24-hour recalls were grouped into food groups based on nutrient composition; these were matched to the new database, and lutein and zeaxanthin intakes were calculated separately. Among all age groups, both sexes, and all ethnicities, intakes of lutein were greater than of zeaxanthin. Relative intake of zeaxanthin to lutein decreased with age, with zeaxanthin to lutein ratios lower in females. Zeaxanthin to lutein ratios in Mexican Americans was considerably greater than other ethnicities (other Hispanics, non-Hispanic white, non-Hispanic black, other races). Lower zeaxanthin to lutein ratios were measured in groups at risk for age-related macular degeneration (eg, older participants, females). Our findings suggest that the relative intake of lutein and zeaxanthin may be important to age-related macular degeneration risk. Future studies are needed to assess the individual associations of lutein and zeaxanthin in eye health.
Journal of the American Dietetic Association 09/2010; 110(9):1357-62. · 3.59 Impact Factor
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Eliot L Berson,
Bernard Rosner,
Michael A Sandberg,
Carol Weigel-DiFranco,
Robert J Brockhurst,
K C Hayes, Elizabeth J Johnson,
Ellen J Anderson,
Chris A Johnson,
Alexander R Gaudio,
Walter C Willett,
Ernst J Schaefer
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ABSTRACT: To determine whether lutein supplementation will slow visual function decline in patients with retinitis pigmentosa receiving vitamin A.
Randomized, controlled, double-masked trial of 225 nonsmoking patients, aged 18 to 60 years, evaluated over a 4-year interval. Patients received 12 mg of lutein or a control tablet daily. All were given 15,000 IU/d of vitamin A palmitate. Randomization took into account genetic type and baseline serum lutein level.
The primary outcome was the total point score for the Humphrey Field Analyzer (HFA) 30-2 program; prespecified secondary outcomes were the total point scores for the 60-4 program and for the 30-2 and 60-4 programs combined, 30-Hz electroretinogram amplitude, and Early Treatment Diabetic Retinopathy Study acuity.
No significant difference in rate of decline was found between the lutein plus vitamin A and control plus vitamin A groups over a 4-year interval for the HFA 30-2 program. For the HFA 60-4 program, a decrease in mean rate of sensitivity loss was observed in the lutein plus vitamin A group (P = .05). Mean decline with the 60-4 program was slower among those with the highest serum lutein level or with the highest increase in macular pigment optical density at follow-up (P = .01 and P = .006, respectively). Those with the highest increase in macular pigment optical density also had the slowest decline in HFA 30-2 and 60-4 combined field sensitivity (P = .005). No significant toxic effects of lutein supplementation were observed.
Lutein supplementation of 12 mg/d slowed loss of midperipheral visual field on average among nonsmoking adults with retinitis pigmentosa taking vitamin A. Application to Clinical Practice Data are presented that support use of 12 mg/d of lutein to slow visual field loss among nonsmoking adults with retinitis pigmentosa taking vitamin A.
ClinicalTrials.gov Identifier: NCT00346333.
Archives of ophthalmology 04/2010; 128(4):403-11. · 3.86 Impact Factor
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ABSTRACT: Coronary heart disease (CHD) is a disease of the heart caused by atherosclerotic narrowing of the coronary arteries and is
likely to produce angina pectoris (chest pain). In atherosclerosis, commonly called hardening of the arteries, the artery
walls become thick and lose elasticity. Because of their ability to act as antioxidants (see Chapter 12), it has been proposed that carotenoids could be protective against CHD. One factor in the development of coronary vascular
disease is the oxidation of low-density lipoproteins (LDL). When LDL is oxidized it is readily taken up by foam cells in the
vascular endothelium where it contributes to the development of atherosclerotic lesions [1, 2]. The facts that LDL is a major transporter of β-carotene (3) and lycopene (31) in the circulation [3] and that these carotenoids have the capacity to trap peroxyl radicals and quench singlet oxygen lend support to the hypothesis
that the carotenoids may have a protective role.
12/2009: pages 287-300;
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ABSTRACT: Total antioxidant performance (TAP) measures antioxidant capacities in both hydrophilic and lipophilic compartments of serum and interactions known to exist between them. Our objective was to assess TAP levels in a subset of Jackson Heart Study (JHS) participants and to examine associations with dietary and total (diet + supplement) intakes of alpha-tocopherol, gamma-tocopherol (diet only), beta-carotene, vitamin C, fruit, vegetables, and nuts, and serum concentrations of alpha-tocopherol, gamma-tocopherol, and beta-carotene. We conducted a cross-sectional analysis of 420 (mean age 61 y; 254 women) African American men and women participating in the Diet and Physical Activity Sub-Study of the JHS in Jackson, Mississippi. In multivariate-adjusted models, we observed positive associations between total alpha-tocopherol, total and dietary beta-carotene, and total vitamin C intakes and TAP levels (P-trend < 0.05). Positive associations were also observed for vegetable, fruit, and total fruit and vegetable intakes (P-trend < 0.05). For serum antioxidant nutrients, alpha-tocopherol but not beta-carotene was associated with serum TAP levels. There were inverse associations for serum gamma-tocopherol and TAP levels. Associations for alpha-tocopherol were seen at intake levels much higher than the current Recommended Dietary Allowance. It may, therefore, be prudent to focus on increasing consumption of fruit, vegetables, nuts, and seeds to increase total antioxidant capacity.
Journal of Nutrition 09/2009; 139(10):1964-71. · 3.92 Impact Factor
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ABSTRACT: The effects of hepatitis and drug use on nutritional problems in HIV infection have rarely been examined despite the importance of drug use in the global HIV pandemic. We examined the effects of HIV, hepatitis C, and drug use on serum micronutrients in 300 US Hispanic adults. Chronic hepatitis C infection was associated with lower serum retinol (-8.2 microg/dl, P < 0.0001), alpha-tocopherol (-0.10 ln microg/dl, P = 0.024), and carotenoids (-19.8 microg/dl, P < 0.0001). HIV infection was associated with lower selenium (-6.1 microg/l, P = 0.028). Elevated triglycerides in HIV infection were associated with higher serum retinol and alpha-tocopherol. Drug use was not independently associated with micronutrient alterations. We conclude that hepatitis C is an important determinant of low serum micronutrients, and should be considered in any nutritional assessment of HIV infected populations. As the safety of micronutrient supplementation is not established, policy for appropriate HIV clinical care should distinguish between populations with and without hepatitis coinfection.
Journal of Public Health Policy 09/2009; 30(3):285-99. · 2.11 Impact Factor
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ABSTRACT: Dietary carotenoids are related to a decreased risk of certain diseases. Serum and adipose tissue carotenoid concentrations are used as biomarkers of intake.
The objectives of this study were to evaluate site-specific concentrations of carotenoids in adipose tissue and to examine relations between carotenoid concentrations in the diet, serum, and adipose tissue.
Healthy adults (12 women and 13 men) participated in this cross-sectional study. Dietary carotenoids over the past year were assessed with a food-frequency questionnaire. Serum and adipose tissue biopsy samples were collected from the abdomen, buttock, and inner thigh for the measurement of carotenoids by HPLC.
Many adipose carotenoids were inversely related to percentage body fat, although lycopene was the only carotenoid inversely correlated with all 3 sites. Most of the carotenoids were significantly higher in the abdominal adipose tissue than in the thigh (P < 0.05). Concentrations of alpha-carotene, beta-carotene, 5-cis-lycopene, and total carotenoids were significantly higher in the buttocks than in the thigh (P < 0.05). Concentrations of alpha-carotene, cis-lycopene, and lutein (with or without zeaxanthin) were significantly higher in the abdomen than in the buttocks (P < 0.05). Dietary intake was significantly correlated with serum concentrations of alpha-carotene, beta-carotene, beta-cryptoxanthin, and total carotenoids. Carotenoid intake was significantly correlated with adipose tissue concentrations of alpha-carotene, beta-carotene, beta-cryptoxanthin, cis-lycopene, and total carotenoids (P < 0.05) but varied by site. Of all the adipose tissue sites evaluated, the abdomen showed the strongest correlation with long-term dietary carotenoid intakes and with serum (indicator of short-term intake) for most carotenoids.
Body fat may influence the tissue distribution of carotenoids. Abdominal adipose tissue carotenoid concentrations may be a useful indicator of carotenoid status.
American Journal of Clinical Nutrition 08/2009; 90(3):533-9. · 6.67 Impact Factor
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ABSTRACT: Epigallocatechin gallate, a major component of green tea polyphenols, protects against the oxidation of fat-soluble antioxidants including lutein. The current study determined the effect of a relatively high but a dietary achievable dose of lutein or lutein plus green tea extract on antioxidant status. Healthy subjects (50-70 years) were randomly assigned to one of two groups (n=20 in each group): (1) a lutein (12 mg/day) supplemented group or (2) a lutein (12 mg/day) plus green tea extract (200 mg/day) supplemented group. After 2 weeks of run-in period consuming less than two servings of lightly colored fruits and vegetables in their diet, each group was treated for 112 days while on their customary regular diets. Plasma carotenoids including lutein, tocopherols, flavanols and ascorbic acid were analyzed by HPLC-UVD and HPLC-electrochemical detector systems; total antioxidant capacity by fluorometry; lipid peroxidation by malondialdehyde using a HPLC system with a fluorescent detector and by total hydroxyoctadecadienoic acids using a GC/MS. Plasma lutein, total carotenoids and ascorbic acid concentrations of subjects in either the lutein group or the lutein plus green tea extract group were significantly increased (P<.05) at 4 weeks and throughout the 16-week study period. However, no significant changes from baseline in any biomarker of overall antioxidant activity or lipid peroxidation of the subjects were seen in either group. Our results indicate that an increase of antioxidant concentrations within a range that could readily be achieved in a healthful diet does not affect in vivo antioxidant status in normal healthy subjects when sufficient amounts of antioxidants already exist.
The Journal of nutritional biochemistry 06/2009; 21(6):544-9. · 4.29 Impact Factor
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ABSTRACT: Intakes and biochemical concentrations of carotenoids and tocopherols have been associated with chronic diseases.
To describe dietary patterns in Jackson Heart Study participants and to determine if biochemical measurements of antioxidants differ across these.
Cross-sectional analysis of data for 373 African-American men and women (age 35 to 80 years), participating in the Diet and Physical Activity Substudy of the Jackson Heart Study.
Dietary intake was assessed with a region specific food frequency questionnaire. Patterns were defined by cluster analysis of food groups, as percent of energy intake.
Four dietary patterns were identified: fast food, Southern, prudent, and juice. Individuals in the fast-food pattern (n=153) had significantly lower serum concentrations of lutein plus zeaxanthin and beta-cryptoxanthin; those in the Southern cluster (n=99) had significantly lower serum alpha-carotene; and those in the prudent (n=63) and juice (n=58) clusters had significantly higher serum alpha-carotene and beta-cryptoxanthin (P<0.05) relative to those in at least one other cluster (all P<0.05). The juice cluster also had higher serum alpha-tocopherol concentrations relative to the fast-food cluster.
Diets high in fast foods, snacks, soft drinks, and meat were associated with relatively low concentrations of carotenoids and alpha-tocopherol. This pattern contained the largest number of participants, and could contribute to the extensive health disparities seen in this region.
Journal of the American Dietetic Association 01/2009; 108(12):2013-20. · 3.59 Impact Factor
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Elizabeth J. Johnson
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ABSTRACT: Lutein is a non-provitamin-A carotenoid found in dark green, leafy vegetables. Lutein, being fat-soluble, follows the same intestinal absorption path as dietary fat and is affected by the same factors that influence fat absorption. Unlike β-carotene, another major carotenoid in diet and tissue, the bioavailability of lutein appears to be less influenced by food processing. Lutein has been strongly implicated as being protective against age-related macular degeneration (AMD) and cataracts. In the eye, lutein may act as a blue-light filter, protecting the underlying tissues from phototoxic damage. The mechanism by which lutein is involved in the prevention of eye diseases and other diseases, such as breast cancer and cardiovascular heart disease (CHD), may also be related to its role as an antioxidant.
Nutrition in Clinical Care 10/2008; 3(5):289 - 296.
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ABSTRACT: Lutein and zeaxanthin are xanthophylls that can be found highly concentrated in the macula of the retina. They are thought to protect the macula through their role as blue-light filters and because of their antioxidant and singlet oxygen quenching properties. Examination of metabolites unique to lutein and zeaxanthin such as 3'-dehydro-lutein, and of their stereochemistry may provide insight to the mechanism by which they are formed and by which they exert protection. To evaluate the formation of such metabolites, eleven monkeys were raised on a xanthophyll-free diet, and supplemented with pure lutein or pure zeaxanthin (2.2 mg/kg body weight/d). The period of supplementation ranged between 12 and 92 weeks. At study start and throughout the study, serum samples were taken and analyzed for xanthophylls using different HPLC systems. Xanthophyll metabolites were identified using UV/VIS and HR-MS detection. Lutein and zeaxanthin metabolites were found in detectable amounts with 3'-dehydro-lutein being a common metabolite of both. Using chiral-phase HPLC, two diastereomers, (3R,6'R)-3'-dehydro-lutein and (3R,6'S)-3'-dehydro-lutein, were identified and shown to be present in nearly equimolar amounts. A pathway for their formation from either lutein or zeaxanthin is proposed. These findings were comparable to results obtained with human plasma.
Comparative Biochemistry and Physiology Part B Biochemistry and Molecular Biology 07/2008; 151(1):70-8. · 1.92 Impact Factor
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ABSTRACT: Low dietary intake of docosahexaenoic acid (DHA) and/or foods rich in lutein may be associated with increased risk of cognitive decline in the elderly.
The cognitive benefit of DHA and lutein in unimpaired elder women was explored in the context of a 4-month, double-blind, intervention trial of DHA and lutein supplementation for eye health. Forty-nine women (aged 60-80 years) were randomized to receive DHA (800 mg/day; n = 14), lutein (12 mg/day; n = 11), a combination of DHA and lutein (n = 14) or placebo (n = 10). Subjects underwent cognitive tests measuring verbal fluency, memory, processing speed and accuracy, and self-reports of mood at randomization and upon completion of the trial.
Following supplementation, verbal fluency scores improved significantly in the DHA, lutein, and combined treatment groups (P < 0.03). Memory scores and rate of learning improved significantly in the combined treatment group (P < 0.03), who also displayed a trend toward more efficient learning (P = 0.07). Measures of mental processing speed, accuracy and mood were not affected by supplementation.
These exploratory findings suggest that DHA and lutein supplementation may have cognitive benefit for older adults.
Nutritional Neuroscience 05/2008; 11(2):75-83. · 1.56 Impact Factor
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ABSTRACT: Lutein and docosahexaenoic acid (DHA) may protect against age-related macular degeneration (AMD). Lutein is a component of macular pigment. DHA is in the retina.
The objective of this 4-mo study was to determine the effects of lutein (12 mg/d) and DHA (800 mg/d) on their serum concentrations and macular pigment optical density (MPOD).
Forty-nine women (60-80 y) were randomly assigned to placebo, DHA, lutein, or lutein + DHA supplement. Serum was analyzed for lutein and DHA (0, 2, and 4 mo). MPOD was determined (0 and 4 mo) at 0.4, 1.5, 3, and 5 degrees temporal retinal eccentricities. Serum was analyzed for lipoproteins (4 mo).
There was no interaction between lutein and DHA supplementations for serum lutein and MPOD. The lutein supplementation x DHA supplementation x month interaction was significant for serum DHA response (P < 0.05). In the lutein group, serum lutein increased from baseline at 2 and 4 mo (P < 0.001), and MPOD increased at 3.0 degrees (P < 0.01). In the DHA group, serum DHA increased at 2 and 4 mo (P < 0.0001), and MPOD increased at 0.4 degrees (P < 0.05). In the lutein + DHA group, serum lutein and DHA increased at 2 and 4 mo (P < 0.01), and MPOD increased at 0.4, 1.5, and 3 degrees (P = 0.06, 0.08, and 0.09, respectively). Differences from placebo in lipoprotein subfractions were greatest for the lutein + DHA group (4 mo).
Lutein supplementation increased MPOD eccentrically. DHA resulted in central increases. These results may be due to changes in lipoproteins. Lutein and DHA may aid in prevention of age-related macular degeneration.
American Journal of Clinical Nutrition 05/2008; 87(5):1521-9. · 6.67 Impact Factor
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Suzen M Moeller,
Rick Voland,
Lesley Tinker,
Barbara A Blodi,
Michael L Klein,
Karen M Gehrs, Elizabeth J Johnson,
D Max Snodderly,
Robert B Wallace,
Richard J Chappell,
Niyati Parekh,
Cheryl Ritenbaugh,
Julie A Mares
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ABSTRACT: To evaluate associations between nuclear cataract (determined from slitlamp photographs between May 2001 and January 2004) and lutein and zeaxanthin in the diet and serum in patients between 1994 and 1998 and macula between 2001 and 2004.
A total of 1802 women aged 50 to 79 years in Iowa, Wisconsin, and Oregon with intakes of lutein and zeaxanthin above the 78th (high) and below the 28th (low) percentiles in the Women's Health Initiative Observational Study (1994-1998) were recruited 4 to 7 years later (2001-2004) into the Carotenoids in Age-Related Eye Disease Study.
Women in the group with high dietary levels of lutein and zeaxanthin had a 23% lower prevalence of nuclear cataract (age-adjusted odds ratio, 0.77; 95% confidence interval, 0.62-0.96) compared with those with low levels. Multivariable adjustment slightly attenuated the association (odds ratio, 0.81; 95% confidence interval, 0.65-1.01). Women in the highest quintile category of diet or serum levels of lutein and zeaxanthin as compared with those in the lowest quintile category were 32% less likely to have nuclear cataract (multivariable-adjusted odds ratio, 0.68; 95% confidence interval, 0.48-0.97; P for trend = .04; and multivariable-adjusted odds ratio, 0.68; 95% confidence interval, 0.47-0.98; P for trend = .01, respectively). Cross-sectional associations with macular pigment density were inverse but not statistically significant.
Diets rich in lutein and zeaxanthin are moderately associated with decreased prevalence of nuclear cataract in older women. However, other protective aspects of such diets may in part explain these relationships.
Archives of Ophthalmology 04/2008; 126(3):354-64. · 3.71 Impact Factor
