Goji Berry Intake Increases Macular Pigment Optical Density in Healthy Adults: A Randomized Pilot Trial

Age-related macular degeneration (AMD) is the third leading cause of blindness worldwide. Macular pigment optical density (MPOD), a biomarker for AMD, is a non-invasive measure to assess risk. The macula xanthophyll pigments lutein (L) and zeaxanthin (Z) protect against blue light and provide oxidant defense, which can be indexed by MPOD. This study examined the effects of Z-rich goji berry intake on MPOD and skin carotenoids in healthy individuals. A randomized, unmasked, parallel-arm study was conducted with 27 participants, aged 45–65, who consumed either 28 g of goji berries or a supplement containing 6 mg L and 4 mg Z (LZ), five times weekly for 90 days. After 90 days, MPOD was significantly increased in the goji berry group at 0.25 and 1.75 retinal eccentricities (p = 0.029 and p = 0.044, respectively), while no changes were noted in the LZ group. Skin carotenoids were significantly increased in the goji berry group at day 45 (p = 0.025) and day 90 (p = 0.006), but not in the LZ group. Regular intake of goji berries in a healthy middle-aged population increases MPOD may help prevent or delay the development of AMD.     

Macular Pigment Reflectometry: Developing Clinical Protocols,Comparison with Heterochromatic Flicker Photometry and Individual Carotenoid Levels

The study was designed to: (1) Analyze and create protocols of obtaining measurements using the Macular Pigment Reflectometry (MPR). (2) To assess the agreement of MPOD measurements obtained using the heterochromatic flicker photometry (MPS II) and MPR. (3) To obtain the lutein and zeaxanthin optical density obtained using the MPR in the central one-degree of the macula. The measurements were performed using the MPR and heterochromatic flicker photometry. The MPR measurements were performed twice without pupillary dilation and twice following pupillary dilation. The MPR measurements were performed for a 40-s period and the spectrometer signal was parsed at different time points: 10–20, 10–30, 10–40, 20–30, 20–40, and 30–40 s. The MPR analyzes the high-resolution spectrometer signal and calculates MPOD, lutein optical density and zeaxanthin optical density automatically. The MPR-MPOD data was compared with MPPS II-MPOD results. The MPR-MPOD values are highly correlated and in good agreement with the MPS II-MPOD. Of the various parsing of the data, the data 10–30 interval was the best at obtaining the MPOD, lutein, and zeaxanthin values (8–12% coefficient of repeatability). The lutein to zeaxanthin ratio in the central one-degree of the macula was 1:2.40. Dilation was not needed to obtain the MPOD values but provided better repeatability of lutein and zeaxanthin optical density. MPR generates MPOD measurements that is in good agreement with MPS II. The device can produce lutein and zeaxanthin optical density which is not available from other clinical devices.     

Carotenoid Profile in Maternal/Cord Plasma and Changes in Breast Milk along Lactation and Its Association with Dietary Intake: A Longitudinal Study in a Coastal City in Southern China

In this study, changes of carotenoids in breast milk were observed longitudinally for up to one year. Our study aimed to analyze the profile of carotenoids in breast milk and maternal/cord plasma and its correlation with dietary intake in Guangzhou. Plasma and breast milk samples of five stages during lactation (i.e., colostrum; transitional milk; and early, medium, and late mature milk) were collected from lactating mothers. The food frequency questionnaire (FFQ) was used for collecting data on dietary intake in the corresponding stages. Levels of lutein, zeaxanthin, β-cryptoxanthin, β-carotene, and lycopene were analyzed by high-performance liquid chromatography. We found that the total carotenoid level decreased gradually with the extension of lactation and eventually stabilized. Among them, the content of lutein increased from colostrum to transitional milk and decreased thereafter until it plateaued in the mature milk. Furthermore, lutein was reported as the dominant nutrient in maternal plasma, cord plasma, transitional milk, and mature milk at up to 400 days postpartum, while beta-carotene was predominant in colostrum. The content of β-carotenoid in middle and late mature breast milk was related to dietary intake (r = 1.690, p < 0.05). Carotenoid level in cord blood was lower than that in the mother’s plasma and was related to the carotenoid intake in the mother’s diet. Correlation of carotenoids between maternal and umbilical cord blood, breast milk, and maternal blood could well reflect the transport of carotenoids. These findings may help to guide mothers’ diets during breastfeeding.     

The ALGOVUE Clinical Trial: Effects of the Daily Consumption of Eggs Enriched with Lutein and Docosahexaenoic Acid on Plasma Composition and Macular Pigment Optical Density

Background. Carotenoids and docosahexaenoic acid (DHA) were identified as essential components for eye health and are both naturally present in eggs. Objective. We aimed to evaluate the effect of the daily consumption of two eggs enriched with lutein/zeaxanthin and DHA on macular pigment optical density (MPOD) and on circulating xanthophyll and fatty acid concentrations in healthy participants. Methods. Ninety-nine healthy volunteers consumed either two standard eggs or two enriched eggs per day for 4 months. MPOD was measured at baseline (V0) and at follow-up (V4) using a modified confocal scanning laser ophthalmoscope (primary outcome). Blood samples were collected to determine total plasma and lipoprotein fatty acids and lutein/zeaxanthin compositions at V0 and V4 (secondary outcomes). Results. A slight but significant increase in MPOD was observed for all study participants consuming two eggs per day for 4 months at all eccentricities (0.5°, 1°, 2°, and 4°). Plasma and lipoprotein lutein, zeaxanthin, and DHA concentrations significantly increased in both groups but were greater in the enriched group (for the enriched group (V0 vs. V4): lutein, 167 vs. 369 ng/mL; zeaxanthin, 17.7 vs. 29.2 ng/mL; DHA, 1.89 vs. 2.56% of total fatty acids). Interestingly, lutein from high-density lipoprotein (HDL) was strongly correlated with MPOD at 0.5 and 1° eccentricities (rho = 0.385, p = 0.008, and rho = 0.461, p = 0.001, respectively). Conclusions. MPOD was slightly increased in both groups. Lutein, zeaxanthin, and DHA plasma concentrations were strongly enhanced in the enriched group compared with the standard group. A significant correlation was found between MPOD level and lutein concentration in HDL.     

Changes in Lutein Status Markers (Serum and Faecal Concentrations,Macular Pigment) in Response to a Lutein-Rich Fruit or Vegetable (Three Pieces/Day) Dietary Intervention in Normolipemic Subjects

Lutein is mainly supplied by dietary fruit and vegetables, and they are commonly jointly assessed in observational and interventional studies. Lutein bioavailability and health benefits depend on the food matrix. This study aimed to assess the effect of dietary intervention with lutein-rich fruit or vegetables on lutein status markers, including serum and faecal concentrations (by high pressure liquid chromatography), dietary intake (24 h recalls ×3), and macular pigment optical density (MPOD) and contrast threshold (CT) as visual outcomes. Twenty-nine healthy normolipemic subjects, aged 45–65 y, consumed 1.8 mg lutein/day supplied from fruits (14 subjects, 500 g/day of oranges, kiwi and avocados) or vegetables (15 subjects, 180 g/day of green beans, pumpkin, and sweet corn) for four weeks. Serum lutein concentration increased by 37%. The effect of the food group intervention was statistically significant for serum lutein+zeaxanthin concentration (p = 0.049). Serum α- and β-carotene were influenced by food type (p = 0.008 and p = 0.005, respectively), but not by time. Serum lutein/HDL-cholesterol level increased by 29% (total sample, p = 0.008). Lutein+zeaxanthin/HDL-cholesterol increased, and the intervention time and food group eaten had an effect (p = 0.024 and p = 0.010, respectively) which was higher in the vegetable group. The MPOD did not show variations, nor did it correlate with CT. According to correlation matrixes, serum lutein was mainly related to lutein+zeaxanthin expressed in relation to lipids, and MPOD with the vegetable group. In faecal samples, only lutein levels increased (p = 0.012). This study shows that a relatively low amount of lutein, supplied by fruit or vegetables, can have different responses in correlated status markers, and that a longer intervention period is needed to increase the MPOD. Therefore, further study with larger sample sizes is needed on the different responses in the lutein status markers and on food types and consumption patterns in the diet, and when lutein in a “pharmacological dose” is not taken to reduce a specific risk.     

Night Vision and Carotenoids (NVC): A Randomized Placebo Controlled Clinical Trial on Effects of Carotenoid Supplementation on Night Vision in Older Adults

Twilight and low luminance levels are visually challenging environments for the elderly, especially when driving at night. Carotenoid rich diets are known to increase macular pigment optical density (MPOD), which in turn leads to an improvement in visual function. It is not known whether augmenting MPOD can lead to a decrease in vision related night driving difficulties. Additionally, it is unknown if carotenoid supplementation provides additional measurable benefits to one’s useful field of view (UFOV) along with a decreased composite crash risk score. The aim of the study was to evaluate changes in night vision function and UFOV in individuals that took carotenoid vitamin supplements for a six-month period compared to a placebo group. Methods: A prospective, randomized, double-blind, six-month trial of a 14 mg zeaxanthin/7 mg lutein-based supplement was carried out. Participants were randomized into active or placebo group (approx 2:1). Results: n = 33 participants (26 males/7 females) participated with 93% capsule intake compliance in the supplemented group (n = 24) and placebo group (n = 9). MPOD (mean/standard error SE) in the active group increased in the Right eye from 0.35 density units (du)/0.04 SE to 0.41 du/0.05 SE; p < 0.001 and in the Left eye from 0.35 du/0.05 SE to 0.37 du, p > 0.05). The supplemented group showed significant improvements in contrast sensitivity with glare in both eyes with improvements in LogMAR scores of 0.147 and 0.149, respectively (p = 0.02 and 0.01, respectively), monocularly tested glare recovery time improved 2.76 and 2.54 s, respectively, (p = 0.008 and p = 0.02), and we also noted a decreased preferred luminance required to complete visual tasks (p = 0.02 and 0.03). Improvements in UFOV scores of divided attention (p < 0.001) and improved composite crash risk score (p = 0.004) were seen in the supplemented group. The placebo group remained unchanged. Conclusions: The NVC demonstrates that augmenting MPOD in individuals with difficulty in night vision showed measurable benefits in numerous visual functions that are important for night vision driving in this small sample RCT. Additionally, we observed an improvement in UFOV divided attention test scores and decreased composite risk scores.     

Serum distribution of lipoprotein(a) in African Americans and Nigerians: Potential evidence for a genotype-environmental effect

Differences in lipoprotein(a) [Lp(a)] levels across populations have been described and blacks are known to have higher Lp(a) values compared to whites. However, environmental factors which influence Lp(a) levels have been difficult to identify. We took advantage of the large environmental contrast which exists against a common genetic background between U.S. and Nigerian blacks to examine the relationship between Lp(a) and apolipoprotein(a) [apo(a)] isoforms. Although the distribution of Lp(a) and apo(a) isoforms was nearly Gaussian in both populations, mean serum Lp(a) values were significantly higher in the United States than in Nigeria (20.5 vs. 12.7 mg/dl; P = 0.0001) and U.S. blacks had a higher frequency of the large molecular weight isoforms compared to Nigerians. Similar trends in the relationship between apo(a) isoform and Lp(a) concentration were seen in both populations; however, the magnitude of the effect was different. Compared to the Nigerians, U.S. blacks had significantly higher mean Lp(a) values for the same apo(a) isoform. The association of Lp(a) with low density lipoprotein-cholesterol (LDL-C) level was not significant after correcting for the contribution of Lp(a) cholesterol to LDL-C in both populations. Surprisingly, the association between Lp(a) and total-C remained significant (r = 0.20, P = 0.04) after similar correction for the contribution of Lp(a) cholesterol in the U.S. sample. Understanding the relationship between other factors including lifestyle characteristics capable of influencing total-C may help explain the unusually high Lp(a) level observed in this U.S. population. Genet. Epidemiol. 14:157–168,1997. © 1997 Wiley-Liss, Inc.     

Whole-Body Magnetic Resonance Angiography (WBMRA) as a tool for driving efficiency in the cost and treatment of Claudication Co-morbities

The Whole-Body Magnetic Resonance Angiography (WBMRA) consists of a contrast-enhanced Magnetic Resonance Angiogram (MRA) scan of the entire body in a single step. In the diagnosis of cardiovascular co-morbidities in Peripheral Arterial Disease (PAD), the utilization of WBMRA can streamline the diagnostic process by minimizing the usage of MRA, CT, and Angiograms. In this work, the potential cost savings to the hospital by using WBMRA in PAD are modeled based on collected data that accounts for all interventions in the radiological department of a set of 50 patients with Claudication in the period 2008–2012 at Ninewells Hospital (NHS Tayside). As the application of WBMRA is only marginally more expensive than lower-limb MRA, a large gain in efficiency is possible by eliminating unneeded MRA by 25% and Angiograms by 30% as well as several steps of consultations. We estimate that this can save up to £1.2M in NHS Tayside and Fife, £7.5M in Scotland and £90M in UK per annum. In addition, WBMRA can save £20M per year in the UK in the treatment of Diabetes.     

Analysis of urinary N-acetyl-S-(propionamide)-cysteine as a biomarker for the assessment of acrylamide exposure in smokers

Acrylamide, classified by the IARC as a probable human carcinogen (Group 2A), is present in cigarette mainstream smoke and also some high-temperature-processed foods, thus smokers and consumers of certain foods are at risk of acrylamide exposure. The objectives of this study were to analyze N-acetyl-S-(propionamide)-cysteine (NASPC), an acrylamide metabolite, in the urine of smokers and nonsmokers, and to investigate the association between acrylamide exposure and urinary NASPC levels in smokers and nonsmokers in order to validate NASPC as a biomarker for the assessment of acrylamide exposure. Urine samples from 63 male military officers were collected as well as background personal information and smoking habits using questionnaires. Acrylamide exposure from tobacco smoke was represented by self-reported daily cigarette consumption and urinary cotinine levels. NASPC and cotinine were analyzed using our newly developed liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) methods. Our results reveal a statistically significant linear relationship between urinary NASPC and cotinine levels for smokers (Spearman correlation coefficient r=0.402, P=0.028), but insignificantly so for nonsmokers. These results verify our suggestion that urinary NASPC could serve as a sensitive, specific, noninvasive, and easily accessible biomarker for low-dose acrylamide exposure as also exposure to carcinogens in tobacco smoke. Routine monitoring of urinary NASPC could be used to assess human exposures to acrylamide in the living environment and the workplace.     

Predominance of influenza A(H3N2) virus genetic subclade 3C.2a1 during an early 2016/17 influenza season in Europe – Contribution of surveillance data from World Health Organization (WHO) European Region to the WHO vaccine composition consultation for northern hemisphere 2017/18

During the European 2016/17 influenza season, A(H3N2) viruses have predominated and the majority clustered in genetic subclade 3C.2a1. Genetic analyses showed that circulating viruses have undergone considerable genetic diversification of the haemagglutinin gene from the current vaccine virus A/Hong Kong/4801/2014 (clade 3C.2a), but the antigenic data that is limited by the challenges with the antigenic characterisation of currently circulating A(H3N2) viruses, showed no clear evidence of antigenic change. The recommended A(H3N2) vaccine component for the northern hemisphere 2017/18 influenza season remained unchanged. However, early and mid-season vaccine effectiveness (VE) estimates were suggestive of reduced VE against A(H3N2) viruses.