Circulating levels of retinol, tocopherol and carotenoid in Nepali pregnant and postpartum women following long-term beta-carotene and vitamin A supplementation

OBJECTIVE: To characterize circulating carotenoid and tocopherol levels in Nepali women during pregnancy and post-partum and to determine the effects of beta-carotene and vitamin A supplementation on their concentration in serum. DESIGN: Randomized community supplementation trial. SETTING: The study was carried out from 1994 to 1997 in the Southern, rural plains District of Sarlahi, Nepal. SUBJECTS: A total of 1431 married women had an ascertained pregnancy, of whom 1186 (83%) provided an analyzable serum sample during pregnancy; 1098 (77%) provided an analyzable 3-4 months post-partum serum sample. INTERVENTIONS: Women received a weekly dose of vitamin A (7000 microg RE), beta-carotene (42 mg) or placebo before, during and after pregnancy. Serum was analyzed for retinol, alpha-tocopherol, gamma-tocopherol, beta-carotene, alpha-carotene, lycopene, lutein + zeaxanthin, and beta-cryptoxanthin concentrations during mid-pregnancy and at approximately 3 months post-partum. RESULTS: Compared to placebo, serum retinol, beta-carotene, gamma-tocopherol, beta-cryptoxanthin and lutein + zeaxanthin concentrations were higher among beta-carotene recipients during pregnancy and, except for beta-cryptoxanthin, at postpartum. In the vitamin A group, serum retinol and beta-cryptoxanthin were higher during pregnancy, and retinol and gamma-tocopherol higher at postpartum. Lutein + zeaxanthin was the dominant carotenoid, regardless of treatment group, followed by serum beta-carotene. Serum lycopene level was lowest, and very low compared to the US population. Serum retinol was higher, and carotenoid and alpha-tocopherol lower, at postpartum than during pregnancy in all groups. CONCLUSIONS: Pregnant and lactating Nepali women have lower serum carotenoid and tocopherol levels than well-nourished populations. beta-carotene supplementation appeared to increase levels of tocopherol and other carotenoids in this population.     

Concentrations of tocopherols and carotenoids in maternal and cord blood plasma.

OBJECTIVES: To determine the levels of tocopherols, retinol and carotenoids in maternal and umbilical cord blood plasma and to investigate the relationships between them. DESIGN: Venous blood plasma concentrations of alpha, gamma and delta-tocopherol, retinol, lutein, lycopene, zeaxanthin, beta-cryptoxanthin, alpha and beta-carotene were determined by HPLC in healthy pregnant women and in pair-matched umbilical cords. Plasma levels of triglycerides and cholesterol were also measured. SUBJECTS: Sixty-six women, between 10 and 20 weeks gestation, were recruited randomly during their first antenatal appointment. From this group, 40 pair-matched umbilical cord blood samples were obtained. RESULTS: Tocopherols, retinol, carotenoids and lipids were present in significantly higher (P < 0.001) concentrations in maternal plasma than in cord plasma. There was a significant correlation (r = 0.45, P < 0.005) between maternal and cord levels of gamma-tocopherol, but not of alpha-tocopherol, retinol or carotenoids. Tocopherols and carotenoids were significantly correlated with each other (P < 0.05) in maternal and cord plasma. CONCLUSIONS: Plasma levels of tocopherols, carotenoids and lipids are substantially lower at birth than in adulthood. There is a clear relationship between gamma-tocopherol levels in maternal and cord plasma. The importance of gamma-tocopherol in human nutrition should be further investigated. There are no significant relationships between plasma alpha-tocopherol and carotenoids in pregnant mothers and cords. More research is needed to elucidate the maternal-foetal transfer of tocopherols and carotenoids, and to examine the impact of maternal antioxidant nutrient status on neonatal antioxidant capacity. It is important to determine if a low level of tocopherols and carotenoids at birth is a normal stage of human development or indicative of deficiency.     

Serum concentrations of carotenoids and vitamins A, E, and C in control subjects from five European countries

High intakes of fruits and vegetables, or high circulating levels of their biomarkers (carotenoids, vitamins C and E), have been associated with a relatively low incidence of cardiovascular disease, cataract and cancer. Exposure to a high fruit and vegetable diet increases antioxidant concentrations in blood and body tissues, and potentially protects against oxidative damage to cells and tissues. This paper describes blood concentrations of carotenoids, tocopherols, ascorbic acid and retinol in well-defined groups of healthy, non-smokers, aged 25-45 years, 175 men and 174 women from five European countries (France, UK (Northern Ireland), Republic of Ireland, The Netherlands and Spain). Analysis was centralised and performed within 18 months. Within-gender, vitamin C showed no significant differences between centres. Females in France, Republic of Ireland and Spain had significantly higher plasma vitamin C concentrations than their male counterparts. Serum retinol and alpha-tocopherol levels were similar between centres, but gamma-tocopherol showed a great variability being the lowest in Spain and France, and the highest in The Netherlands. The provitamin A: non-provitamin A carotenoid ratio was similar among countries, whereas the xanthophylls (lutein, zeaxanthin, beta-cryptoxanthin) to carotenes (alpha-carotene, beta-carotene, lycopene) ratio was double in southern (Spain) compared to the northern areas (Northern Ireland and Republic of Ireland). Serum concentrations of lutein and zeaxanthin were highest in France and Spain; beta-cryptoxanthin was highest in Spain and The Netherlands; trans-lycopene tended to be highest in Irish males and lowest in Spanish males; alpha-carotene and beta-carotene were higher in the French volunteers. Due to the study design, the concentrations of carotenoids and vitamins A, C and E represent physiological ranges achievable by dietary means and may be considered as 'reference values' in serum of healthy, non-smoking middle-aged subjects from five European countries. The results suggest that lutein (and zeaxanthin), beta-cryptoxanthin, total xanthophylls and gamma-tocopherol (and alpha- : gamma-tocopherol) may be important markers related to the healthy or protective effects of the Mediterranean-like diet.     

Beta-carotene supplementation increases antioxidant capacity of plasma in older women

The antioxidant effect of dietary beta-carotene supplementation on the peroxidation potential of plasma was investigated in a randomized double-blind, placebo-controlled study. Twelve healthy women (62-80 y) supplemented their usual daily diet with 90 mg of beta-carotene (n = 6) or placebo (n = 6) capsules for 3 wk. Plasma concentrations of beta-carotene, alpha- and gamma-tocopherol, ascorbate, urate, bilirubin and in vitro production of phosphatidylcholine hydroperoxides (PC-OOH) and utilization of plasma antioxidants in the presence of 50 mmol/L 2,2'-azobis (2-aminopropane) hydrochloride (AAPH), a free radical generator, at 37 degrees C were measured before and after dietary treatment. Plasma beta-carotene increased from 0.76 +/- 0.16 to 6.45 +/- 1.16 micromol/L (P < 0.05) in supplemented but not placebo-treated subjects. The plasma concentrations of other antioxidants did not change significantly in either group. beta-Carotene supplementation did not affect basal levels of plasma PC-OOH as measured by HPLC post-column chemiluminescence but did affect AAPH-induced production of PC-OOH. Before supplementation, the induction period of plasma PC-OOH production was 2.4 +/- 0.4 h, with levels reaching 5.39 +/- 1.50 micromol/L after 6 h of incubation. After supplementation, the induction period increased significantly to 4.2 +/- 0.4 h (P < 0.01), with a lower PC-OOH production of 2.16 +/- 0.90 micromol/L after 6 h (P < 0.05). In this system, plasma ascorbate concentrations were depleted first, followed by loss of bilirubin and alpha-tocopherol and then by the sequential loss of gamma-tocopherol, urate and beta-carotene. These results indicate that beta-carotene supplementation increases the plasma antioxidant capacity of older women.     

Smoking and exposure to environmental tobacco smoke decrease some plasma antioxidants and increase gamma-tocopherol in vivo after adjustment for dietary antioxidant intakes

BACKGROUND: Free radicals in cigarette smoke may cause oxidative damage to macromolecules, contributing to cardiovascular diseases and cancer. Decreased plasma antioxidant concentrations may indicate cigarette smoke-related oxidative stress. OBJECTIVE: We compared the effects on plasma antioxidant concentrations in cotinine-confirmed active and passive smokers with those in nonsmokers, independent of differences in dietary intakes and other covariates. DESIGN: Plasma samples from 83 smokers, 40 passive smokers, and 36 nonsmokers were analyzed for total ascorbic acid, alpha- and gamma-tocopherols, 5 carotenoids, retinol, and cotinine. Groups were compared by using analysis of variance with adjustment for sex, age, race, body mass index, alcohol intake, triacylglycerol concentration, fruit and vegetable intakes, and dietary antioxidants. RESULTS: After adjustment for dietary antioxidant intakes and other covariates, smokers and passive smokers had significantly lower plasma beta-carotene concentrations than did nonsmokers (0.15, 0.17, and 0.24 micro mol/L, respectively) and significantly higher gamma-tocopherol concentrations (7.8, 7.8, and 6.5 micro mol/L, respectively). Smokers had significantly lower plasma ascorbic acid and beta-cryptoxanthin concentrations than did nonsmokers and passive smokers (ascorbic acid: 43.6, 54.5, and 54.6 micro mol/L, respectively; beta-cryptoxanthin: 0.12, 0.16, and 0.16 micro mol/L, respectively) and significantly lower concentrations of lutein and zeaxanthin than did nonsmokers (0.33 compared with 0.41 micro mol/L). The P values for all the differences described above were < 0.05. No significant differences in plasma concentrations of alpha-tocopherol, alpha-carotene, total carotenoids, lycopene, or retinol were observed. CONCLUSIONS: These results indicate that cigarette smokers and nonsmokers exposed to cigarette smoke have a significantly lower plasma antioxidant status than do unexposed nonsmokers, independent of differences in dietary antioxidant intakes. Further research is required to explain why plasma gamma-tocopherol concentrations were significantly higher in smokers and passive smokers than in nonsmokers.     

Vitamin A inadequacy observed in a group of 2- to 6-year-old children living in Kwangju, Republic of Korea

Dietary intakes and plasma concentrations of retinol and carotenoids were estimated in assessing the vitamin A status of young children in Kwangju, Republic of Korea. Three consecutive 24-hour food recalls and fasting blood samples were obtained from 123 healthy children (58 boys, 65 girls), aged 2-6 years. The daily vitamin A intake (mean +/- SD) was 355.9 +/- 178.1 microg retinol equivalents or 239.0 +/- 111.2 microg retinol activity equivalents. Provitamin A carotenoid intakes were 1211.2 +/- 840.0 microg/day beta-carotene, 234.6 +/- 231.7 microg/day alpha-carotene, and 149.1 +/- 160.7 microg/day beta-cryptoxanthin. Approximately 15-26% of subjects consumed < Korean Estimated Average Requirements (EAR) for vitamin A; whereas, 57-64% consumed < EAR for vitamin A for USA/Canadians. The mean plasma retinol concentration was 1.108 +/- 0.244 micromol/L. There were no significant correlations between intakes and plasma concentrations of retinol and carotenoids. Only 2.4% of children were vitamin A-deficient based on having plasma retinol concentrations <0.70 micromol/L. Plasma retinol concentrations of 42.3% of subjects were 0.70 - <1.05 micromol/L, which is considered indicative of potentially suboptimal vitamin A status. Therefore, some children may be at risk of inadequate vitamin A status in Kwangju, Republic of Korea.     

Carotenoid composition of human milk during the first month postpartum and the response to beta-carotene supplementation

BACKGROUND: Information is lacking regarding normal changes in milk carotenoid concentrations in healthy, well-nourished women during the first month of lactation. OBJECTIVES: This study investigated milk carotenoid concentrations during days 4-32 postpartum and assessed the effects of maternal beta-carotene supplementation. DESIGN: Subjects (n = 21; aged 19-39 y) were randomly assigned to receive beta-carotene (30 mg/d) or placebo from days 4 to 32 postpartum. Each subject provided 8 diet records and 8 milk samples during the study. Diet records were analyzed for energy, macronutrients, vitamins A and E, and carotenoids. Milk samples were analyzed with HPLC for concentrations of carotenoids, retinol, and alpha-tocopherol. Data were analyzed by using repeated-measures analysis and orthogonal contrasts. RESULTS: No significant differences in average dietary intakes, body mass index, age, or parity were found between groups at baseline or after supplementation. Milk carotenoid concentrations decreased over time (P < 0.01), as did retinol and alpha-tocopherol concentrations (P < 0.003). Concentrations of most carotenoids decreased to those reported for mature milk by day 32 postpartum. Milk lutein concentrations remained elevated throughout the study compared with values reported for mature milk, whereas plasma lutein concentrations decreased significantly over time. beta-carotene supplementation did not significantly change the milk concentrations of beta-carotene, the other carotenoids, retinol, or alpha-tocopherol. CONCLUSIONS: The lack of increase in milk beta-carotene despite supplementation suggests that transitional milk may be already nearly saturated with beta-carotene. The elevated milk lutein concentration and simultaneous decrease in plasma lutein suggest that lutein metabolism may be altered during early lactation.     

Plasma concentrations of carotenoids, retinol, and tocopherols in preeclamptic and normotensive pregnant women

This case-control study was conducted in Lima, Peru, from June 1997 through January 1998 to assess whether plasma concentrations of carotenoids (alpha-carotene, beta-carotene, lycopene, lutein, zeaxanthin, beta-cryptoxanthin), retinol, and tocopherols (alpha-tocopherol and gamma-tocopherol) are decreased in women with preeclampsia. A total of 125 pregnant women with preeclampsia and 179 normotensive pregnant women were included. Plasma concentrations of antioxidants were determined using high performance liquid chromatography. After adjusting for maternal demographic, behavioral, and reproductive characteristics and total plasma lipid concentrations, the authors found a linear increase in risk of preeclampsia with increasing concentrations of alpha-tocopherol (odds ratio of the highest quartile = 3.13; 95% confidence interval: 1.06, 9.23, with the lowest quartile as the reference group; p value of the test of linear trend = 0.040). The risk of preeclampsia decreased across increasing quartiles of concentrations for retinol (odds ratio of the highest quartile = 0.32; 95% confidence interval: 0.15, 0.69, with the lowest quartile as the reference group; p value of the test of linear trend = 0.001). Some of these results are inconsistent with the prevailing hypothesis that preeclampsia is an antioxidant-deficient state. Preliminary findings confirm an earlier observation of increased plasma concentrations of alpha-tocopherol among women with preeclampsia as compared with normotensive pregnant women.     

Effect of beta-carotene supplementation on the concentrations and distribution of carotenoids,vitamin E,vitamin A,and cholesterol in plasma lipoprotein and non-lipoprotein fractions in healthy older women.

We studied the effect of beta-carotene supplementation on the concentrations and distribution in plasma lipoprotein and non-lipoprotein fractions of carotenoids, alpha-tocopherol, retinol, and cholesterol.

Ten women ingested either 90 mg of beta-carotene or placebo daily for 3 weeks while residing in their homes and eating their usual meals. Carotenoids (beta-carotene, lycopene, lutein/zeaxanthin), retinol, alpha-tocopherol, and cholesterol were measured in plasma lipoprotein and non-lipoprotein fractions before and after treatment.

In the beta-carotene-supplemented group, total plasma beta-carotene increased 14-fold from 0.48 +/? 0.13 to 6.83 +/? 2.12 mumol/L (p = 0.04). Although the greatest increase in beta-carotene was in low-density-lipoproteins (LDL), the magnitude of increase was similar in LDL, high-density-lipoproteins (HDL), and very-low-density-lipoproteins (VLDL). Thus, the relative distribution of beta-carotene in lipoproteins was unchanged: approximately 71% was in LDL, approximately 15% in HDL and approximately 12% in VLDL, before and after beta-carotene supplementation. There were no changes in amounts and distribution in lipoproteins of the other carotenoids, alpha-tocopherol, and cholesterol. There was no change in the amount of retinol in lipoprotein-deficient plasma. There were no changes in total plasma triglycerides. Significant positive correlations were found between LDL- or VLDL-cholesterol and alpha-tocopherol in LDL or VLDL, respectively; between LDL- or VLDL-cholesterol and lutein/zeaxanthin in LDL or VLDL, respectively; and between HDL-cholesterol and beta-carotene in HDL.

beta-Carotene supplementation (90 mg/day for 3 weeks) in healthy older women results in an enrichment of all plasma lipoprotein fractions with beta-carotene, but does not alter the relative distribution of beta-carotene in lipoproteins. beta-Carotene supplementation has no effect on the amounts and relative distribution of lycopene, lutein/zeaxanthin, and alpha-tocopherol in lipoproteins, or of retinol in the non-lipoprotein fraction of plasma. Short-term beta-carotene supplementation has no effect on the concentrations of plasma total triglycerides, total cholesterol, HDL-, LDL-, and VLDL-cholesterol.     

Frequent intake of tropical fruits that are rich in beta-cryptoxanthin is associated with higher plasma beta-cryptoxanthin concentrations in Costa Rican adolescents

Dietary tocopherols and carotenoids may play a role in preventing cancer and cardiovascular diseases. Because these may begin to develop during adolescence, dietary patterns during this period could influence long-term risk. The objective of this study was to examine the intake and plasma concentrations of the major carotenoids and tocopherols in 159 adolescents (mean +/- SD, 15.5 +/- 2.5 y old) living in Costa Rica. All participants completed a 135-item food-frequency questionnaire and provided a fasting blood sample. Carotenoid and tocopherol intakes were adjusted for total energy and plasma concentrations for total cholesterol. The relative abundance of carotenoids in the diet was similar to their distribution in plasma; lycopene was the most abundant, followed by beta-carotene and lutein + zeaxanthin. gamma-Tocopherol was more abundant than alpha-tocopherol in the diet, but alpha-tocopherol was approximately sevenfold higher in plasma. The highest diet-plasma correlations (adjusted for age, sex and body mass index) were 0.38 for beta-cryptoxanthin, 0.33 for gamma-tocopherol and 0.17 for lutein + zeaxanthin (all P < 0.05). All other correlations were r < 0.15. Papaya intake was the best food predictor of plasma beta-cryptoxanthin concentrations (r = 0.41). Subjects that frequently (> or =3/d) consumed tropical fruits with at least 50 micro g/100 g beta-cryptoxanthin (papaya, tangerine, orange and watermelon) had twofold the plasma beta-cryptoxanthin concentrations of those with intakes of <4/wk (P for trend = 0.0009). In sum, the diet-plasma carotenoid and tocopherol correlations were generally low in Costa Rican adolescents. Intakes of beta-cryptoxanthin and papaya, a tropical fruit frequently consumed in Latin America, were the best predictors of beta-cryptoxanthin concentrations in plasma.     

Retinol, carotenoids, and tocopherols in the milk of lactating adolescents and relationships with plasma concentrations

OBJECTIVE: We determined the concentrations of retinol, carotenoids, and tocopherols in breast milk of adolescents and evaluated their associations with plasma levels and with maternal characteristics (period of lactation, body mass index, age of menarche, and years postmenarche). METHODS: This was a single cross-sectional survey of retinol, carotenoid, and tocopherol composition of milk and plasma of lactating adolescent mothers (n = 72; 30-120 d postpartum) attending public daycare clinics in Rio de Janeiro, Brazil. Milk and plasma components were analyzed by high-performance liquid chromatography. RESULTS: Nutrient concentrations (micromoles per liter, mean +/- SE) in plasma and milk were, respectively, retinol 2.1 +/- 0.5 and 0.62 +/- 0.44, beta-carotene 0.18 +/- 0.19 and 0.016 +/- 0.017, alpha-carotene 0.05 +/- 0.04 and 0.0035 +/- 0.002, lutein plus zeaxanthin 0.15 +/- 0.11 and 0.025 +/- 0.024, lycopene 0.1 +/- 0.11 and 0.016 +/- 0.025, alpha-tocopherol 10.8 +/- 5.3 and 2.7 +/- 1.8, gamma-tocopherol 2.6 +/- 2.3 and 0.37 +/- 0.15. The milk/plasma molar ratios of retinol and tocopherols were two times higher than those of carotenoids. Significant correlations (P < 0.001) between milk and plasma nutrient levels were observed for beta-carotene (r = 0.41), alpha-carotene (r = 0.60), and lutein plus zeaxanthin (r = 0.57), but not for lycopene, retinol, and tocopherols. Nutrient concentrations in plasma and in milk were not associated with the maternal characteristics investigated. CONCLUSION: Concentrations of the nutrients studied, especially retinol and alpha-tocopherol, in mature milk of lactating adolescents were, in general, lower than in milk of adult lactating women. Milk concentrations were associated with plasma concentrations only for beta-carotene, alpha-carotene, and lutein plus zeaxanthin.     

Carotenoid intakes, assessed by dietary questionnaire, are associated with plasma carotenoid concentrations in an elderly population

High intakes of fruits and vegetables and of carotenoids are associated with a lower risk for a variety of chronic diseases. It is therefore important to test the validity of dietary questionnaires that assess these intakes. We compared intakes of five carotenoids, as calculated from responses to the Willett 126-item food-frequency questionnaire, with corresponding biochemical measures. Subjects included 346 women and 201 men, aged 67-93 y, in the Framingham Heart Study. Unadjusted correlations were higher among women than men as follows: alpha-carotene 0.33 and 0.18, beta-carotene, 0.36 and 0.25; beta-cryptoxanthin, 0.44 and 0.32; lycopene, 0.35 and 0.21; and lutein + zeaxanthin, 0.27 and 0.10, respectively. Adjustment for age, energy intake, body mass index (BMI, kg/m2), plasma cholesterol concentrations and smoking reduced the gender differences, respectively, to the following: alpha-carotene 0.30 and 0.28; beta-carotene, 0.34 and 0.31; beta-cryptoxanthin, 0.45 and 0.36; lycopene, 0.36 and 0.31; and lutein + zeaxanthin, 0.24 and 0.14. Plots of adjusted mean plasma carotenoid concentration by quintile of respective carotenoid intake show apparent greater responsiveness among women, compared with men, to dietary intake of alpha- and beta-carotene and beta-cryptoxanthin, but similar blood-diet relationships for lycopene and lutein + zeaxanthin. Reported daily intake of fruits and vegetables correlated most strongly with plasma beta-cryptoxanthin and beta-carotene among women and with plasma alpha- and beta-carotene among men. With the exception of lutein + zeaxanthin, this dietary questionnaire does provide reasonable rankings of carotenoid status among elderly subjects, with the strongest correlations for beta-cryptoxanthin. Appropriate adjustment of confounders is necessary to clarify these associations among men.     

Plasma vitamin A, E, and beta-carotene levels in adult post-partum Algerian women.

Vitamins A and E are essential for foetal growth, reproduction, and lactation. In this article we report the results of a study, lead in three Eastern Algeria cities, that involved 786 post-partum women and 250 control. Plasma levels of vitamins A, E, beta-carotene, and some nutritional indexes were measured in both groups. In control women, plasma retinol and beta-carotene levels were significantly lower in Algeria than in France (retinol: 1.4 +/- 0.42 vs. 1.78 +/- 0.53 mumol/l; beta-carotene: 0.35 +/- 0.261 vs. 0.94 +/- 0.611). These differences could be the consequence of different beta-carotene and retinol intakes. In Algeria, comparisons between post-partum women and controls, showed that plasma vitamin A and beta-carotene levels were significantly lower in post-partum than in control women. This fact, and the lower level of retinol in control women, raises the question of supplementation for pregnant women in Algeria, at least for those with the lowest standard of living whose protein and zinc levels are also very low after delivery. Plasma vitamin E levels and vitamin E/total lipid ratios were not different in Algeria and in France. Vitamin E concentration was higher during pregnancy, but the vitamin E/total lipid ratio was significantly lower, which shows a relative deficiency at the end of pregnancy. Comparisons of plasma vitamin E levels, at delivery, in primiparous and in multiparous women reveal a better tocopherol status in multiparous women. This difference could reflect an adaptive response to oxidative stress in multiparous women.     

Plasma carotenoids, retinol, and tocopherols and risk of breast cancer

The roles of carotenoids, retinol, and tocopherols in breast cancer etiology have been inconclusive. The authors prospectively assessed the relations between plasma alpha-carotene, beta-carotene, beta-cryptoxanthin, lycopene, lutein/zeaxanthin, retinol, alpha-tocopherol, and gamma-tocopherol and breast cancer risk by conducting a nested case-control study using plasma collected from women enrolled in the Nurses' Health Study. A total of 969 cases of breast cancer diagnosed after blood draw and prior to June 1, 1998, were individually matched to controls. The multivariate risk of breast cancer was 25-35% less for women with the highest quintile compared with that for women with the lowest quintile of alpha-carotene (odds ratio (OR) = 0.64, 95% confidence interval (CI): 0.47, 0.88; p(trend) = 0.01), beta-carotene (OR = 0.73, 95% CI: 0.53, 1.02; p(trend) = 0.01), lutein/zeaxanthin (OR = 0.74, 95% CI: 0.55, 1.01; p(trend) = 0.04), and total carotenoids (OR = 0.76, 95% CI: 0.55, 1.05; p(trend) = 0.05). The inverse association observed with alpha-carotene and breast cancer was greater for invasive cancers with nodal metastasis. The authors conclude that some carotenoids are inversely associated with breast cancer. Although the association was strongest for alpha-carotene, the high degree of collinearity among plasma carotenoids limits our ability to conclude that this association is specific to any individual carotenoid.     

Correlations of vitamin A and E intakes with the plasma concentrations of carotenoids and tocopherols among American men and women.

The authors investigated the association of diet and other factors with the plasma concentrations of carotenoids, retinol and tocopherols in a sample of 121 men and 186 women participating in two prospective investigations of dietary etiologies of chronic diseases. Lycopene (mean concentration, 0.82 mumol/L in men, 0.76 mumol/L in women), beta-carotene (mean 0.46 mumol/L in men, 0.58 mumol/L in women) and lutein (mean 0.28 mumol/L in men, 0.27 mumol/L in women) were the major circulating carotenoids. Among nonsmokers, dietary carotenoid, as typically calculated in epidemiologic studies, was significantly correlated with plasma beta-carotene (r = 0.34 in men, r = 0.30 in women), alpha-carotene (r = 0.52 in men, r = 0.37 in women) and lutein (r = 0.36 in men, r = 0.19 in women), but not with plasma zeaxanthin (r = 0.11 and r = 0.02) or lycopene (r = 0.13 and r = 0.01) after adjusting for plasma cholesterol and triglycerides, body mass index and energy intake. Total vitamin E intake was positively associated with plasma concentrations of alpha-tocopherol (r = 0.51 in men, r = 0.41 in women) and inversely associated with plasma concentrations of gamma-tocopherol (r = -0.51 in men r = -0.42 in women), but this was primarily due to use of vitamin E supplements. Measurements of specific carotenoids can provide independent information beyond the usual calculation of carotene intake in epidemiologic studies.     

Serum concentrations of micronutrient antioxidants in an adult Arab population

Serum concentrations of retinol, alpha-tocopherol, beta-carotene and lycopene were measured by reversed-phase high-performance liquid chromatography (r-P HPLC) in 260 randomly selected healthy adult Kuwaitis (159 men and 101 women) aged 18-63 years (mean 33.3 years) to established reference ranges of the micronutrient antioxidants. Total cholesterol concentrations were assayed by an enzymatic method to determine alpha-tocopherol: cholesterol ratios. The mean +/- SEM (micromol/L) for retinol, alpha-tocopherol, beta-carotene and lycopene were 1.76+/-0.02, 20.0+/-0.5, 0.52+/-0.03, 0.95+/-0.05, respectively. Compared to other populations, these data showed, on the whole, ordinary concentrations of beta-carotene, comparatively low concentrations of retinol and alpha-tocopherol and high concentrations of lycopene. Retinol concentrations were similar for both sexes, whereas alpha-tocopherol concentration was significantly (P < 0.0001) lower and the carotenoid levels (beta-carotene and lycopene) significantly higher (P < 0.0001) in women. Of the micronutrient antioxidants, alpha-tocopherol was most correlated with cholesterol (r = 0.492, P < 0.0001). beta-Carotene and lycopene were highly correlated with each other (r =0.744, P< 0.0001). Age was positively associated with beta-carotene (r = 0.214, P = 0.001) and lycopene (r = 239, P< 0.0001). Our data enabled us to establish a gender non-specific reference range for retinol and gender-specific reference ranges for alpha-tocopherol, beta-carotene and lycopene.     

Dietary and serum alpha-tocopherol,beta-carotene and retinol,and risk for colorectal cancer in male smokers

OBJECTIVE: To study the association between dietary and serum antioxidant vitamins and carotenoids and risk for colorectal cancer in male smokers. DESIGN: A prospective cohort study within a randomised, double-blind, placebo-controlled trial testing supplementation with alpha-tocopherol (50 mg/day), beta-carotene (20 mg/day) or both in preventing cancer. SUBJECTS AND METHODS: Participants of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study with complete dietary data and serum samples available from baseline. These included 26,951 middle-aged male smokers among whom 184 colorectal cancer cases were diagnosed during 8 y of follow-up. Relative risks were calculated with Cox proportional hazards models adjusting for trial supplementation, age, body mass index, serum cholesterol, cigarettes smoked per day and physical activity. RESULTS: There was no significant association between dietary vitamin C or E, alpha-or gamma-tocopherol, retinol, alpha- or beta-carotene, lycopene or lutein+zeaxanthin and risk for colorectal cancer. Serum alpha-tocopherol, beta-carotene or retinol was also not associated with the risk, neither did the season when baseline blood was drawn modify the relationship between serum beta-carotene and colorectal cancer risk. CONCLUSIONS: Our data support the results from previous studies in which no association between dietary antioxidant vitamins and carotenoids and risk for colorectal cancer has been observed. Likewise, no association between baseline serum antioxidant concentrations and colorectal cancer risk was evident. SPONSORSHIP: The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study was supported by a contract with the US National Cancer Institute (N01-CN-45165).     

Plasma concentrations of carotenoids and vitamin C are better correlated with dietary intake in normal weight than overweight and obese elderly subjects

Carotenoid and vitamin C intakes, assessed by FFQ, have been positively associated with plasma concentrations in different populations. However, the influence of BMI on these associations has not been explored in detail. We explored in a cross-sectional study the relation between dietary carotenoid and vitamin C intakes, using a 135-item FFQ, with their plasma concentrations by BMI categories in 252 men and 293 women, 65 years and older. For men and women combined, significant (P < 0.05) Pearson correlations were observed between energy-adjusted dietary intakes and plasma concentrations (carotenoids adjusted for cholesterol) for: alpha-carotene 0.21, beta-carotene 0.19, lycopene 0.18, beta-cryptoxanthin 0.20 and vitamin C 0.36. Multiple linear regression analyses showed that the intake of carotenoids and vitamin C were significant predictors of their respective plasma concentration (P<0.01), and that BMI was inversely associated with plasma concentration of carotenoids (P< or =0.01) but not with plasma vitamin C. In addition, we observed significant interactions between BMI and the intakes of alpha-carotene and lutein + zeaxanthin, and to a lower extent beta-carotene, suggesting that these intakes in subjects with high BMI were not good predictors of their plasma concentration. The present data suggest that plasma carotenoids and vitamin C may be good markers of dietary intake in elderly subjects, but not so for alpha-carotene, beta-carotene and lutein + zeaxanthin in obese subjects.     

Status of lipidsoluble antioxidants and TRAP in patients with Crohn's disease and healthy controls.

OBJECTIVE: To assess the status of lipidsoluble antioxidants (carotenoids, tocopherols, ubiquinone), retinol and their correlation with TRAP (total radical-trapping antioxidant potential) in patients with Crohn's disease. DESIGN: Prospective case-control study. SETTING: Clinic of Internal Medicine IV/Department of Gastroenterology and Hepatology, University of Vienna Medical School. SUBJECTS/METHODS: Plasma antioxidant concentrations were determined in patients with Crohn's disease (n = 24) to evaluate the antioxidant capacity compared to healthy controls (n = 33). Additionally, plasma TRAP (total radical-trapping antioxidant potential) was measured in 13 patients and 22 controls. RESULTS: All investigated carotenoids (alpha-carotene, beta-carotene and cryptoxanthin) were significantly decreased in patients with Crohn's disease (10.2 +/- 9.3, 16.2 +/- 12.4 and 7.8 +/- 5.5 microg/dl) compared to controls (13.3 +/- 5.1, 34.7 +/- 18.8 and 48.5 +/- 38.4 microg/dl respectively), whereas gamma-tocopherol and ubiquinone were significantly elevated in patients (0.14 +/- 0.07 microg/dl and 82.3 +/- 41.5 microg/dl, controls: 0.09 +/- 0.04 microg/dl and 60.8 +/- 30.0 microg/dl, respectively). Retinol and alpha-tocopherol did not significantly differ from controls. The total radical-trapping antioxidant potential (TRAP) was significantly lower in patients (1.11 +/- 0.28 micromol/l) compared to controls (1.34 +/- 0.26 micromol/l). Antioxidants were neither related to duration or severity of disease nor to disease activity. CONCLUSIONS: In patients with Crohn's disease several plasma antioxidant parameters are altered and the total radical-trapping antioxidant potential is decreased.     

Hypo- and hyperresponse to egg cholesterol predicts plasma lutein and beta-carotene concentrations in men and women

The purpose of this study was to determine whether the plasma response to dietary cholesterol from eggs is associated with the plasma carotenoid response and whether gender influences the carotenoid response. Using a crossover design, 40 subjects classified as either hyper- (10 men and 10 women) or hyporesponders (10 men and 10 women) to dietary cholesterol consumed an egg (EGG, 640 mg/d additional dietary cholesterol and 600 microg lutein + zeaxanthin) or placebo (SUB, 0 mg/d cholesterol, 0 microg lutein + zeaxanthin and 568 microg beta-carotene) diet for 30 d, followed by a 3-wk washout period and the alternate diet. Plasma concentrations of lutein and beta-carotene after each dietary period were then examined to determine whether the response to carotenoid intake was similar to that seen for dietary cholesterol. After the EGG period, the increase in plasma lutein in female hyperresponders (mean increase +/- SD; 0.32 +/- 0.19 micromol/L) and male hyperresponders (0.26 +/- 0.11 micromol/L) was significantly greater than that of their hyporesponsive counterparts (0.16 +/- 0.18 micromol/L for women and 0.14 +/- 0.11 micromol/L men). Gender was not a significant factor influencing lutein response. Both men and women classified as hyperresponders significantly increased plasma beta-carotene after the SUB period, whereas their hyporesponsive counterparts were not affected. The increase in plasma beta-carotene in female hyperresponders (0.29 +/- 0.48 micromol/L) was significantly greater than that in male hyperresponders (0.07 +/- 0.07 micromol/L). We conclude that plasma responses to cholesterol and carotenoids are related and that gender influences the beta-carotene response to a greater degree than the lutein response.