Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-25T12:57:48.229Z Has data issue: false hasContentIssue false
  • English
  • Français

Nutritional and clinical relevance of lutein in human health

Published online by Cambridge University Press:  09 March 2007

F. Granado ,
B. Olmedilla  and
I. Blanco
F. Granado*
Affiliation:
Unidad de Vitaminas, Servicio de Endocrinología y Nutrición, Hospital Univesitario Puerta de Hierro, C/ San Martín de Porres, 4, 28017-Madrid, Spain
B. Olmedilla
Affiliation:
Unidad de Vitaminas, Servicio de Endocrinología y Nutrición, Hospital Univesitario Puerta de Hierro, C/ San Martín de Porres, 4, 28017-Madrid, Spain
I. Blanco
Affiliation:
Unidad de Vitaminas, Servicio de Endocrinología y Nutrición, Hospital Univesitario Puerta de Hierro, C/ San Martín de Porres, 4, 28017-Madrid, Spain
*
*Corresponding author: Dr F. Granado, fax +34 91 3737667, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Lutein is one of the most widely found carotenoids distributed in fruits and vegetables frequently consumed. Its presence in human tissues is entirely of dietary origin. Distribution of lutein among tissues is similar to other carotenoids but, along with zeaxanthin, they are found selectively at the centre of the retina, being usually referred to as macular pigments. Lutein has no provitamin A activity in man but it displays biological activities that have attracted great attention in relation to human health. Epidemiological studies have shown inconsistent associations between high intake or serum levels of lutein and lower risk for developing cardiovascular disease, several types of cancer, cataracts and age-related maculopathy. Also, lutein supplementation has provided both null and positive results on different biomarkers of oxidative stress although it is effective in increasing macular pigment concentration and in improving visual function in some, but not all, subjects with different eye pathologies. Overall, data suggest that whereas serum levels of lutein have, at present, no predictive, diagnostic or prognostic value in clinical practice, its determination may be very helpful in assessing compliance and efficacy of intervention as well as potential toxicity. In addition, available evidence suggests that a serum lutein concentration between 0·6 and 1·05 μmol/l seems to be a safe, dietary achievable and desirable target potentially associated with beneficial impact on visual function and, possibly, on the development of other chronic diseases. The use of lutein as a biomarker of exposure in clinical practice may provide some rationale for assessing its relationship with human health as well as its potential use within the context of evidence-based medicine.

Keywords

LuteinBiomarkersMacular pigmentsEvidence-based medicine
Type
Review article
Information
British Journal of Nutrition , Volume 90 , Issue 3 , September 2003 , pp. 487 - 502
Copyright
Copyright © The Nutrition Society 2003

References

Agudo, A, Amiano, P, Barcos, A, et al. (1999) Dietary intake of vegetables and fruits among adults in five regions of Spain. Eur J Clin Nutr 53, 174–180.CrossRefGoogle ScholarPubMed
AIR Study Final Report (1997) AIR2-CT93-0888 (DG12), CEC, Final Consolidation Report Project. Brussels, Belgium.Google Scholar
Albanes, D (1999) B-carotene and lung cancer: A case study. Am J Clin Nutr 69, Suppl., 1345S–1351S.CrossRefGoogle Scholar
Aleman, TS, Duncan, JL, Bieber, ML, et al. (2001) Macular pigment and lutein supplementation in retinitis pigmentosa and Usher syndrome. Invest Ophthalmol Vis Sci 42, 1873–1881.Google ScholarPubMed
Ascherio, A, Rimm, EB, Hernán, M, et al. (1999) Relation of consumption of vitamin E, vitamin C and carotenoids to risk for stroke among men in the United States. Ann Intern Med 130, 963–970.CrossRefGoogle ScholarPubMed
Ascherio, A, Stampfer, M, Colditz, GA, Rimm, EB, Litin, L & Willett, WC (1992) Correlations of vitamin A and E intakes with plasma concentrations of carotenoids and tocopherols among American men and women. J Nutr 122, 1792–1801.CrossRefGoogle Scholar
Bates, CJ, Chen, SJ, MacDonald, A & Holden, R (1996) Quantitation of vitamin E and a carotenoid pigment in cataractous human lenses and the effect of a dietary supplement. Int J Vitam Nutr Res 66, 316–321.Google Scholar
Beatty, S, Boulton, M, Henson, D, Koh, HH & Murray, IJ (1999) Macular pigment and age-related macular degeneration. Br J Ophthalmol 83, 867–877.CrossRefGoogle ScholarPubMed
Beatty, S, Murray, IJ, Henson, DB, Carden, D, Koh, HH & Boulton, ME (2001) Macular pigment and risk for age-related macular degeneration in subjects from a Northern European population. Invest Ophthalmol Vis Sci 42, 439–446.Google ScholarPubMed
Bendich, A & Olson, JA (1989) Biological actions of carotenoids. FASEB J 3, 1927–1932.CrossRefGoogle ScholarPubMed
Bernstein, PS, Khachik, F, Carvalho, LS, et al. (2001) Identification and quantitation of carotenoids and their metabolites in the tissues of the human eye. Exp Eye Res 72, 215–223.CrossRefGoogle ScholarPubMed
Bernstein, PS, Yoshida, MD, Katz, NB, McClane, RW & Gellermann, W (1998) Raman detection of macular carotenoid pigments in intact human retina. Invest Ophthalmol Vis Sci 39, 2003–2011.Google ScholarPubMed
Bernstein, PS, Zhao, DY, Wintch, SW, Ermakov, IV, McClane, RW & Gellermann, W (2002) Resonance Raman measurement of macular carotenoids in normal subjects and in age-related macular degeneration patients. Ophthalmology 109, 1780–1787.CrossRefGoogle ScholarPubMed
Bertram, JS (1994) The chemoprevention of cancer by dietary carotenoids: Studies in mouse and human cells. Pure Appl Chem 66, 1025–1032.CrossRefGoogle Scholar
Bone, RA, Landrum, JT, Friedes, LM, et al. (1997) Distribution of lutein and zeaxanthin stereoisomers in the human retina. Exp Eye Res 64, 211–218.CrossRefGoogle ScholarPubMed
Bone, RA, Landrum, JT & Tarsis, SL (1985) Preliminary identification of the human macular pigment. Vision Res 25, 1531–1535.CrossRefGoogle ScholarPubMed
Botterweck, AAM, van den Brandt, PA & Goldbohm, RA (2000) Vitamins, carotenoids, dietary fiber, and the risk of gastric carcinoma. Cancer 88, 737–748.3.0.CO;2-H>CrossRefGoogle ScholarPubMed
Broekmans, WMR, Berendschot, TTJM, Klöpping-Ketelaars, IAA, et al. (2002) Macular pigment density in relation to serum and adipose tissue concentrations of lutein and serum concentrations of zeaxanthin. Am J Clin Nutr 76, 595–603.CrossRefGoogle ScholarPubMed
Brown, L, Rimm, EB, Seddon, JM, et al. (1999) A prospective study of carotenoid intake and risk of cataract extraction in US men. Am J Clin Nutr 90, 517–524.CrossRefGoogle Scholar
Bruch-Gerharz, D, Stahl, W, Gerharz, CD, et al. (2001) Accumulation of the xanthophyll lutein in skin amyloid deposits of systemic amyloidosis (al type). J Invest Dermatol 116, 196–197.CrossRefGoogle ScholarPubMed
Castenmiller, JJM & West, C (1998) Bioavailability and biocon-version of carotenoids. Annu Rev Nutr 18, 19–39.CrossRefGoogle ScholarPubMed
Chasan-Traber, L, Willett, WC, Seddon, JM, et al. (1999) A prospective study of carotenoid and vitamin A intakes and risk of cataract extraction in US women. Am J Clin Nutr 70, 509–516.CrossRefGoogle Scholar
Chopra, M & Thurnham, DI (1993) In vitro antioxidant activity of lutein. In Food and Cancer Prevention: Chemical and Biological Aspects, pp. 125–129 [Waldron,, KW, Johnson, IT and Fenwick, GR, editors]. London: Royal Society of Chemistry.Google Scholar
Chug-Ahuja, JK, Holden, JM, Forman, MR, Mangels, AR, Beecher, GR & Lanza, E (1993) The development and application of a carotenoid database for fruits, vegetables and selected multicomponent foods. J Am Diet Assoc 93, 318–323.CrossRefGoogle ScholarPubMed
Collins, AR (2001) Carotenoids and genomic stability. Mutat Res 475, 21–28.CrossRefGoogle ScholarPubMed
Collins, AR, Gedik, CM, Olmedilla, B, Southon, S & Bellizzi, M (1998 a) Oxidative DNA damage measured in human lymphocytes: large differences between sexes and between countries, and correlations with heart disease mortality rates. FASEB J 12, 1397–1400.CrossRefGoogle ScholarPubMed
Collins, AR, Olmedilla, B, Southon, S, Granado, F & Duthie, S (1998 b) Serum carotenoids and oxidative DNA damage in human lymphocytes. Carcinogenesis 9, 2159–2162.CrossRefGoogle Scholar
Curran-Celentano, J, Hammond, BR, Ciulla, TA, Cooper, DA, Pratt, LM & Danis, RB (2001) Relation between dietary intake, serum concentrations and retinal concentrations of lutein and zeaxanthin in adults in a Midwest population. Am J Clin Nutr 74, 796–802.CrossRefGoogle Scholar
Dagnelie, G, Zorge, IS & McDonald, TM (2000) Lutein improves visual function in some patients with retinal degeneration: a pilot study via the Internet. Optometry 71, 147–164.Google ScholarPubMed
Deharveng, G, Charrondiere, UR, Slimani, N, Southgate, DAT & Riboli, E (1999) Comparison of nutrients in the Food Composition Tables available in the nine European countries participating in the EPIC. Eur J Clin Nutr 53, 60–79.CrossRefGoogle ScholarPubMed
D'Odorico, A, Martines, D, Kiechl, S, et al. (2000) High plasma levels of alpha- and beta-carotene are associated with a lower risk of atherosclerosis: Results from the Bruneck Study. Atherosclerosis 153, 231–239.CrossRefGoogle ScholarPubMed
Dorgan, JF, Sowell, A, Swanson, CA, et al. (1998) Relationships of serum carotenoids, retinol, a-tocopherol and selenium with breast cancer risk: Results from a prospective study in Columbia, Missouri (United States). Cancer Causes Control 9, 89–97.CrossRefGoogle Scholar
Dwyer, JH, Navab, M, Dwyer, KM, et al. (2001) Oxygenated carotenoid lutein and progression of early atherosclerosis. The Los Angeles Atherosclerosis Study. Circulation 103, 2922–2927.CrossRefGoogle ScholarPubMed
Eye Disease Case-Control Study Group (1993) Antioxidant status and neovascular age-related macular degeneration. Arch Ophthalmol 111, 104–109.CrossRefGoogle Scholar
Erdman, JW Jr, Bierer, TL & Gugger, ET (1993) Absorption and transport of carotenoids. Ann N Y Acad Sci 691, 76–85.CrossRefGoogle ScholarPubMed
Flood, V, Smith, W, Wang, JJ, Manzi, F, Webb, K & Mitchell, P (2002) Dietary antioxidant intake and incidence of early age-related maculopathy: the Blue Mountains Eye Study. Ophthalmology 109, 2272–2278.CrossRefGoogle ScholarPubMed
Gale, CR, Hall, NF, Phillips, DIW & Martyn, CN (2001) Plasma antioxidant vitamins and carotenoids and age-related cataract. Ophthalmology 108, 1992–1998.CrossRefGoogle ScholarPubMed
García, R, González, CA, Agudo, A & Riboli, E (1999) High intake of specific carotenoids and flavonoids does not reduce the risk of bladder cancer. Nutr Cancer 35, 212–214.CrossRefGoogle Scholar
Giovannucci, E, Ascherio, A, Rimm, EB, Stampfer, MJ, Colditz, GA & Willett, WC (1995) Intake of carotenoids and retinol in relation to risk of prostate cancer. J Natl Cancer Inst 87, 1767–1776.CrossRefGoogle ScholarPubMed
Goodwin, TW & Britton, G (1988) Distribution and analysis of carotenoids. In Plant Pigments, pp. 61–127 [Goodwin, TW, editor].] New York, NY: Academic Press Limited.Google Scholar
Granado, F, Olmedilla, B, Blanco, I, Gil-Martínez, E & Rojas-Hidalgo, E (1997) Variability in the intercomparison of food carotenoid content data: A user's point of view. Crit Rev Food Sci Nutr 37, 621–633.CrossRefGoogle Scholar
Granado, F, Olmedilla, B, Blanco, I & Rojas-Hidalgo, E (1992) Carotenoid composition in raw and cooked Spanish vegetables. J Agric Food Chem 40, 2135–2140.CrossRefGoogle Scholar
Granado, F, Olmedilla, B, Blanco, I & Rojas-Hidalgo, E (1996) Major fruit and vegetables contributors to the main serum carotenoids in Spanish diet. Eur J Clin Nutr 50, 246–250.Google Scholar
Granado, F, Olmedilla, B, Gil-Martínez, E & Blanco, I (1998) Lutein ester in serum after lutein supplementation in human subjects. Br J Nutr 80, 445–459.CrossRefGoogle ScholarPubMed
Guerra-Romero, L (1996) La medicina basada en la evidencia: Un intento de acercar la ciencia al arte de la práctica clínica (Medicine based on the evidence: An attempt to approach science with the art of clinical practice). Med Clin (Barc) 107, 377–382.Google Scholar
Hammond, BR Jr, Jonhson, EJ, Russell, RM, et al. (1997) Dietary modification of human macular pigment density. Invest Ophthalmol Vis Sci 38, 1795–1801.Google ScholarPubMed
Hammond, BR, Wooten, BR & Snodderly, DM (1998) Preservation of visual sensitivity of older subjects: association with macular pigment density. Invest Ophthalmol Vis Sci 39, 397–406.Google ScholarPubMed
Handelman, GJ, Dratz, EA, Reay, CC & van, Kuijk JGM (1988) Carotenoids in the human macula and whole retina. Invest Ophthalmol Vis Sci 29, 850–855.Google ScholarPubMed
Hart, DJ & Scott, KJ (1995) Development and evaluation of an HPLC method for the analysis of carotenes in vegetables and fruits in the UK. Food Chem 54, 101–111.CrossRefGoogle Scholar
Heinonen, M, Ollilainen, V, Linkola, EK, Varo, PT & Koivistoinen, PE (1989) Carotenoids in Finnish foods. Vegetables, fruits and berries. J Agric Food Chem 37, 655–659.CrossRefGoogle Scholar
Hercberg, S, Preziosi, P, Galán, P, et al. (1994) Vitamin status of a healthy French population: dietary intakes and biochemical markers. Int J Vitam Nutr Res 64, 220–232.Google ScholarPubMed
Hininger, I, Meyer-Werner, A, Moser, U, et al. (2001) No significant effects of lutein, lycopene or b-carotene supplementation on biological markers of oxidative stress and LDL oxidability in healthy adult subjects. J Am Coll Nutr 20, 232–238.CrossRefGoogle ScholarPubMed
Hirvonen, T, Virtamo, J, Khorhonen, P, Albanes, D & Pietinen, P (2000) Intake of flavonoids, carotenoids, vitamins C and E and risk of stroke in male smokers. Stroke 31, 2301.CrossRefGoogle Scholar
Holden, JM, Eldridge, AL, Beecher, GR, et al. (1999) Carotenoid content of U.S. foods: An update of the database. J Food Comp Anal 12, 169–196.CrossRefGoogle Scholar
Howard, AN, Williams, NR, Palmer, CR, et al. (1996) Do hydroxycarotenoids prevent coronary heart disease? A comparison between Belfast and Toulouse. Int J Vitam Nutr Res 66, 113–118.Google ScholarPubMed
Iribarren, C, Folsom, AR, Jacobs, DR Jr, Gross, MD, Belcher, JD & Eckfeldt, JH (1997) Association of serum vitamin levels, LDL susceptibility to oxidation and autoantibodies against MDA-LDL with carotid atherosclerosis. A case-control study. Arterioscler Thromb Vasc Biol 17, 1171–1177.CrossRefGoogle ScholarPubMed
Ito, Y, Ochiai, J, Sasaki, R, Suzuki, S, Kasuhara, Y & Morimitsu, Y (1990) Serum concentrations of carotenoids, retinol and a-tocopherol in healthy persons determined by high performance liquid chromatography. Clin Chim Acta 194, 131–144.CrossRefGoogle Scholar
Jenkins, MY, Mitchell, GV & Grundel, E (2001) A dietary supplement containing lutein and natural tocopherols modulates tissue levels of retinoids. 2001 FDA Science Forum. http// www.cfsan.fda.gov/frf/forum01/A143PPO.htmGoogle Scholar
Johnson, E, Hammond, BR, Yeum, KJ, et al. (2000) Relation among serum and tissue concentrations of lutein and zeaxanthin and macular pigment density. Am J Clin Nutr 71, 1555–1562.CrossRefGoogle ScholarPubMed
Johnson-Down, L, Saundy-Unterberger, H & Gray-Donald, K (2002) Food habits of Canadians: lutein and lycopene intake in the Canadian population. J Am Diet Assoc 102, 988–991.CrossRefGoogle ScholarPubMed
Kaplan, LA, Lau, JM & Stein, EA (1990) Carotenoid composition, concentrations and relationships in various human organs. Clin Physiol Biochem 8, 1–10.Google ScholarPubMed
Khachik, F, Beecher, GR, Goli, MB, Lusby, WR & Smith, JC Jr (1992) Separation and identification of carotenoids and their oxidation products in the extracts of human plasma. Anal Chem 64, 211–222.CrossRefGoogle ScholarPubMed
Khachik, F, Beecher, GR & Lusby, WR (1989) Separation, identification and quantification of the major carotenoids in extracts of apricots, peaches, cantaloupe and pink grapefruit by liquid chromatography. J Agric Food Chem 37, 1465–1473.CrossRefGoogle Scholar
Khachik, F, Beecher, G & Smith, JC Jr (1995) Lutein, lycopene and their oxidative metabolites in chemoprevention of cancer. J Cell Biochem 22, 236–246.CrossRefGoogle ScholarPubMed
Khachik, F, Bernstein, PS & Garland, DL (1997 a) Identification of lutein and zeaxanthin oxidation products in human and monkey retinas. Invest Ophthalmol Vis Sci 38, 1802–1811.Google ScholarPubMed
Khachik, F, Spangler, CJ, Smith, JC, Canfield, LM, Steck, A & Pfander, H (1997 b) Identification, quantification and relative concentrations of carotenoids and their metabolites in human milk, and serum. Anal Chem 69, 1873–1881.CrossRefGoogle ScholarPubMed
King, TJ, Khachik, F, Bortkiewicz, H, Fukushima, LH, Morioka, S & Bertram, JS (1997) Metabolites of dietary carotenoids as potential cancer preventive agents. Pure Appl Chem 69, 2135–2140.CrossRefGoogle Scholar
Klaui, H & Bauerfeind, JC (1981) Carotenoids as food colors. In Carotenoids as Colorants and Vitamin A Precursors. Techological and Nutritional Applications, pp. 48–292 [Bauerfeind, JC, editor]. New York, NY: Academic Press.Google Scholar
Klipstein-Grobush, K, Launer, LJ, Geleijnse, JM, Boeing, H, Hofman, A & Witteman, JC (2000) Serum antioxidant and atherosclerosis. The Rotterdam Study. Atherosclerosis 148, 49–56.Google Scholar
Kohlmeier, L, Kark, JD, Gómez-Aracena, E, et al. (1997) Lycopene and myocardial infarction risk in EURAMIC Study. Am J Epidemiol 146, 618–626.CrossRefGoogle ScholarPubMed
Kushi, LH (1999) Vitamin E and heart disease: A case study. Am J Clin Nutr 69, Suppl., 1322S-1329S.CrossRefGoogle Scholar
Landrum, JT, Bone, RA, Joa, H, Kilburn, MD, Moore, L & Sprague, K (1997) A one year study of the macular pigment: The effect of 140 days of a lutein supplement. Exp Eye Res 65, 57–62.CrossRefGoogle ScholarPubMed
Landrum, JT, Bone, RA, Moore, LL & Gomez, CM (1999) Analysis of zeaxanthin distribution within individual human retinas. Meth Enzymol 299, 457–467.CrossRefGoogle ScholarPubMed
Lee, CM, Boileau, AC, Boileau, TWM, et al. (1999) Review of animal models in carotenoid research. J Nutr 129, 2271–2277.CrossRefGoogle ScholarPubMed
Lindsay, DG (2002) Food chemical safety. Limitations in current approaches to its assessment. Free Radic Res 36, Suppl. 1, 25–27.Google Scholar
Lyle, BJ, Mares-Perlman, JA, Klein, BEK, Palta, M, Bowen, P & Greger, JL (1999) Serum carotenoids and tocopherols and incidence of age-related nuclear cataract. Am J Clin Nutr 69, 272–277.CrossRefGoogle ScholarPubMed
Mangels, AR, Holden, JM, Beecher, GR, Forman, MR & Lanza, E (1993) Carotenoid content of fruits and vegetables: An evaluation of analytical data. J Am Diet Assoc 93, 284–296.CrossRefGoogle Scholar
Mares-Perlman, JA, Brady, WE, Klein, BE, et al. (1995 a) Serum carotenoids and tocopherols and severity of nuclear and cortical opacities. Invest Ophthalmol Vis Sci 36, 276–288.Google ScholarPubMed
Mares-Perlman, JA, Brady, WE, Klein, R, et al. (1995 b) Serum antioxidants and age-related macular degeneration in a population-based case-control study. Arch Ophthalmol 113, 1518–1523.CrossRefGoogle Scholar
Michaud, DS, Feskanich, D, Rimm, EE, et al. (2000) Intake of specific carotenoids and risk of lung cancer in 2 prospective US cohorts. Am J Clin Nutr 72, 990–997.CrossRefGoogle ScholarPubMed
Murkovic, M, Gams, K, Draxl, S & Pfannhauser, W (2000) Development of an Austrian Carotenoid Database. J Food Comp Anal 13, 435–440.CrossRefGoogle Scholar
National Academy of Sciences Institute of Medicine (2000) Dietary Reference Intake for Vitamin C, Vitamin E, Selenium and Carotenoids. Washington, DC: National Academy Press.Google Scholar
Nieremberg, DW & Nann, SL (1992) A method for determination of concentrations of retinol, tocopherol and five carotenoids in human plasma and tissue samples. Am J Clin Nutr 56, 417–426.CrossRefGoogle Scholar
Nussbaum, JJ, Pruett, RC & Delori, FC (1981) Macular yellow pigment. The first 200 years. Retina 1, 296–310.CrossRefGoogle ScholarPubMed
Olmedilla, B, Granado, F, Blanco, I, Gil-Martínez, E & Rojas-Hidalgo, E (1996) Contenido de Carotenoides en Verduras y Frutas de Mayor Consumo en España. Instituto Nacional de la Salud (INSALUD). Madrid, Spain: Secretaría General.Google Scholar
Olmedilla, B, Granado, F, Blanco, I & Rojas-Hidalgo, E (1994) Seasonal and sex-related variations in six serum carotenoids, retinol and a-tocopherol. Am J Clin Nutr 60, 106–110.CrossRefGoogle Scholar
Olmedilla, B, Granado, F, Blanco, I, Vaquero, M & Cagigal, C (2001 a) Lutein in patients with cataracts and age-related macular degeneration: A long-term supplementation study. J Sci Food Agric 81, 904–909.CrossRefGoogle Scholar
Olmedilla, B, Granado, F, Blanco, I & Vaquero, M (2003) Lutein, but not a-tocopherol, supplementation improves visual function in patients with age-related cataracts: A 2-y double blind, placebo-controlled study. Nutrition 19, 21–25.CrossRefGoogle ScholarPubMed
Olmedilla, B, Granado, F, Gil-Martínez, E & Blanco, I (1997 a) Supplementation with lutein (4 months) and a-tocopherol (2 months), in separate or combined oral doses, in control men. Cancer Lett 114, 179–181.CrossRefGoogle ScholarPubMed
Olmedilla, B, Granado, F, Gil-Martínez, E, Blanco, I & Rojas-Hidalgo, E (1997 b) Reference levels of retinol, a-tocopherol and main carotenoids in serum of control and insulin-dependent diabetic Spanish subjects. Clin Chem 43, 1066–1071.CrossRefGoogle Scholar
Olmedilla, B, Granado, F, Southon, S, et al. (2001 b) Baseline serum concentrations of carotenoids, vitamins A, E and C in control subjects from five European countries. Br J Nutr 85, 227–238.CrossRefGoogle Scholar
Olmedilla, B, Granado, F, Southon, S, et al. (2002) A European multicentre, placebo-controlled supplementation study with a-tocopherol, carotene-rich palm oil, lutein or lycopene: Analysis of serum responses. Clin Sci 102, 447–456.CrossRefGoogle ScholarPubMed
Omenn, GS (1998) Chemoprevention of lung cancer: the rise and demise of b-carotene. Ann Rev Public Health 19, 73–99.CrossRefGoogle Scholar
O'Neill, ME, Carroll, Y, Corridan, B, et al. (2001) A European Carotenoid Database to assess carotenoid intakes and its use in a five-country comparative study. Br J Nutr 85, 499–507.CrossRefGoogle Scholar
Park, JS, Chew, BP & Wong, TS (1998) Dietary lutein from marigold extract inhibits mammary tumor development in BALB/c mice. J Nutr 128, 1650–1656.CrossRefGoogle ScholarPubMed
Parker, RS (1996) Absorption, metabolism, and transport of carotenoids. FASEB J 10, 542–551.CrossRefGoogle ScholarPubMed
Parker, RS, Swanson, JE, You, C, Edwards, AJ & Huang, T (1999) Bioavailability of carotenoids in human subjects. Proc Nutr Soc 58, 155–162.CrossRefGoogle ScholarPubMed
Poorvliet, EJ & West, CE (1993) The Carotenoid Content of Foods with Special Reference to Developing Countries. Vitamin A Field Support Project (VITAL). Arlington, VA: International Science and Technology Institute, Inc.Google Scholar
Rapp, LM, Maple, SS & Choi, JH (2000) Lutein and zeaxanthin concentrations in rod outer segment membranes from perifo-veal and peripheral human retina. Invest Ophthalmol Vis Sci 41, 1200–1209.Google ScholarPubMed
Ratnasinghe, D, Forman, MR, Tangrea, JA, et al. (2000) Serum carotenoids are associated with increased lung cancer risk among alcohol drinkers, but not among non-drinkers in a cohort of tin miners. Alcohol Alcohol 35, 355–360.CrossRefGoogle ScholarPubMed
Richer, S (1999) Part II. ARMD-pilot (case series) environmental intervention data. J Am Optom Assoc 70, 24–36.Google Scholar
Rodriguez-Amaya, DB (1997) Carotenoids and Food Preparation: The Retention of Provitamin A Carotenoids in Prepared, Processed and Stored Foods. Arlington, VA: U.S. Agency for International Development.Google Scholar
Rojas-Hidalgo, E (1987) Alteraciones metabólicas (Metabolic alterations). In La Mano del Diabético, pp. 57–61Madrid, Spain: ARAN Ediciones.Google Scholar
Schmitz, HH, Poor, CL, Gugger, ET & Erdman, JW (1993) Analysis of carotenoids in human and animal tissues. Methods Enzymol 213, 102–117.CrossRefGoogle Scholar
Scott, KJ, Thurham, DI, Hart, D, et al. (1996) The correlation between the intake of lutein, lycopene and β-carotene from vegetables and fruits and blood plasma concentrations in a group of women aged 50-66 years in the UK. Br J Nutr 75, 409–418.CrossRefGoogle Scholar
Seddon, JM, Ajani, UA, Sperduto, RD, et al. (1994) Dietary carotenoids, vitamins A, C and E and age-related macular degeneration. Eye disease case-control study group. J Am Diet Assoc 272, 1413–1420.CrossRefGoogle Scholar
Seddon, JM & Hennekens, CH (1994) Vitamins, minerals and macular degeneration. Promising but unproven hypothesis. Arch Ophthalmol 112, 176–179.CrossRefGoogle Scholar
Sharpless, D & Duewer, DL (1995) Population distributions and intralaboratory reproducibility for fat-soluble vitamin-related compounds in human serum. Anal Chem 67, 4416–4422.CrossRefGoogle ScholarPubMed
Sies, H, Stahl, W & Sundquist, A (1992) Antioxidant functions of vitamins: Vitamins E and C, b-carotene and other carotenoids. Ann N Y Acad Sci 669, 7–21.CrossRefGoogle Scholar
Simpson, KLS (1983) Relative value of carotenoids as precursors of vitamin A. Proc Nutr Soc 42, 7–17.CrossRefGoogle ScholarPubMed
Slattery, ML, Benson, J, Curtin, K, Ma, K-N, Schaeffer, D & Potter, JD (2000) Carotenoids and colon cancer. Am J Clin Nutr 71, 575–582.CrossRefGoogle ScholarPubMed
Sommerburg, O, Keunen, JEE, Bird, AC & van, Kuijk FJGM (1998) Fruits and vegetables that are sources for lutein and zeaxanthin: the macular pigment in human eyes. Br J Ophthalmol 82, 907–910.CrossRefGoogle ScholarPubMed
Stahl, W, Schwarz, W & Sundquist, A (1992) Cis-trans isomers of lycopene and β-carotene in human serum and tissues. Arch Biochem Biophys 294, 173–177.CrossRefGoogle Scholar
Stahl, W, Sundquist, AR, Hanusch, M, Schwarz, W & Sies, H (1993) Separation of b-carotene and lycopene geometrical isomers in biological samples. Clin Chem 39, 810–814.CrossRefGoogle Scholar
Street, DA, Comstock, GW, Salkeld, RM, Schuep, W & Klag, M (1994) Serum antioxidants and myocardial infarction: Are low levels of carotenoids and a-tocopherol risk factors for myocardial infarction? Circulation 90, 1154–1161.CrossRefGoogle Scholar
Su, LC, Bui, M, Kardinaal, A, et al. (1998) Differences between plasma and adipose tissue biomarkers of carotenoids and tocopherols. Cancer Epidemiol Biomarkers Prev 7, 1043–1048.Google ScholarPubMed
Surai, PF, MacPherson, A, Speake, BK & Sparks, NHC (2000) Designer egg evaluation in a controlled trial. Eur J Clin Nutr 54, 298–305.CrossRefGoogle ScholarPubMed
Taylor, A & Hobbs, M (2001) 2001 Assessment of nutritional influences on risk for cataract. Nutrition 17, 845–858.CrossRefGoogle ScholarPubMed
Taylor, A, Jacques, PF, Chylack, LT, et al. (2002) Long-term intake of vitamins and carotenoids and odds of early age-related cortical and posterior subcapsular lens opacities. Am J Clin Nutr 75, 540–549.CrossRefGoogle ScholarPubMed
Tee, ES & Lim, CL (1991) Carotenoid composition and content of Malaysian vegetables and fruits by AOAC and HPLC methods. Food Chem 41, 309–339.CrossRefGoogle Scholar
Thurnham, DI (1988) Do higher vitamin A requirements in men explain the difference between sexes in plasma provitamin A carotenoids and retinal? Proc Nutr Soc 47, 181.Google Scholar
Thurnham, DI, Northrop-Clewes, CA & Chopra, M (1998) Bio-markers of vegetable and fruit intakes. Am J Clin Nutr 68, 756–757.CrossRefGoogle Scholar
Toniolo, P, Van Poppel, AL, Akhmedkhanov, A, et al. (2001) Serum carotenoids and breast cancer. Am J Epidemiol 153, 1142–1147.CrossRefGoogle ScholarPubMed
Tos, TJM, Berendschot, R, Goldbohm, A, et al. (2000) Influence of lutein supplementation macular pigment assessed with two objective techniques. Invest Ophthalmol Vis Sci 41, 3322–3326.Google Scholar
Van den, Berg H, Faulks, R, Granado, F, et al. (2000) The potential for the improvement of carotenoid levels in foods and the likely systemic effects. J Sci Food Agric 80, 880–913.3.0.CO;2-1>CrossRefGoogle Scholar
Van den, Berg H, Heseker, H, Lamand, M, et al. (1993) Flair concerted action No 10 status papers. Introduction, conclusions and recomendations. Int J Vitam Nutr Res 63, 247–251.Google Scholar
Van't, Veer P & Kok, FJ (2000) Human studies to substantiate health effects of antioxidants: What is needed. Free Radic Res 33, S109–S115.Google Scholar
Voorrips, LA, Goldbohm, A, Brants, HAM, et al. (2000) A prospective cohort study on antioxidant and folate intake and male lung cancer risk. Cancer Epidemiol Biomarkers Prev 9, 357–365.Google ScholarPubMed
Yemelyanov, AY, Katz, NB & Bernstein, PS (2001) Ligand-binding characterization of xanthophyll carotenoids to solubilized membrane proteins derived from human retina. Exp Eye Res 72, 381–392.CrossRefGoogle ScholarPubMed
Yeum, K-J, Ahn, S-H, Rupp, de, Paiva, SA, Lee-Kim, Y-Ch, Krinsky, NI & Russell, RM (1998) Correlation between carotenoid concentrations in serum and normal breast adipose tissue of women with benign breast tumor or breast cancer. J Nutr 128, 1920–1926.CrossRefGoogle ScholarPubMed
Yeum, K-J, Taylor, A, Tang, G & Russell, RM (1995) Measurement of carotenoids, retinoids and tocopherols in human lenses. Invest Ophthalmol Vis Sci 36, 2756–2761.Google ScholarPubMed
Yong, L-Ch., Forman, M, Beecher, GR, et al. (1994) Relationship between dietary intake and plasma concentrations of carotenoids in premenopausal women: Application of the USDA-NCI carotenoid food-composition database. Am J Clin Nutr 60, 223–230.CrossRefGoogle ScholarPubMed
Zechmeister, L (1962) Cis-trans Isomeric Carotenoids and Arylpolyenes. New York, NY: Academic Press.CrossRefGoogle Scholar
Zeegers, MPA, Goldbohm, RA & van den Brandt, PA (2001) Are retinal, vitamin C, vitamin E, folate and carotenoids intake associated with bladder cancer risk? Results from the Netherlands Cohort Study. Br J Cancer 85, 977–983.CrossRefGoogle Scholar