Table of Contents
Carotenoids are fat-soluble plant pigments, some of which are important to human health. The most common carotenoids in the diet of North Americans are alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein, zeaxanthin, and lycopene.
The role carotenoids play in human health is not well understood. Carotenoids are antioxidants that react with free radicals. Molecules called free radicals form during normal cell metabolism and with exposure to ultraviolet light or toxins such as cigarette smoke. Free radicals cause damage by reacting with fats and proteins in cell membranes and genetic material. This process is called oxidation. Antioxidants are compounds that attach themselves to free radicals so that it is impossible for the free radical to react with, or oxidize, other molecules. In this way, antioxidants may protect cells from damage. Although carotenoids have antioxidant activity in the laboratory, it is not clear how much they function as antioxidants in the body. Claims that carotenoids can protect against cancer and cardiovascular disease are primarily based on their antioxidant properties.
One subgroup of carotenoids that includes alpha-carotene, beta-carotene, and beta-cryptoxanthine is converted into vitamin A (retinol) by the body. Vitamin A affects is important for maintaining good vision, a healthy immune system, and strong bones. Vitamin A also helps turn on and off certain genes (gene expression) during cell division and differentiation. The degree to which this group of provitamin A carotenoids is converted into vitamin A appears to depend on whether or not the body is getting enough vitamin A in other forms. Only 10% of all carotenoids can be converted into vitamin A.
Carotenoids are highly colored red, orange, and yellow pigments found in many vegetables. A German scientist isolated the first carotenoid in 1826 from carrots and named it beta-carotene. Since then, more than 600 carotenoids have been identified in plants, algae, fungi, and bacteria. Carotenoids must be dissolved in a small amount of fat to be absorbed from the intestine. Dietary supplements of carotenoids contain oil, which makes them more readily available to the body than carotenoids in food. Carotenoids in.
(Illustration by GGS Information Services/Thomson Gale.)
vegetables are best absorbed if they are cooked in oil or eaten in a meal that contains at least some fat. (A very tiny amount of fat is adequate)
The United States Institute of Medicine (IOM) of the National Academy of Sciences develops values called Dietary Reference Intakes (DRIs) for vitamins and minerals. The DRIs define the amount of a nutrient a person needs toconsume daily and the largest daily amount from food or dietary supplements that can be taken without harm. The IOM has not developed any DRIs for carotenoids because not enough scientific information is available and because no diseases have been identified as being caused by inadequate intake of carotenoids. The IOM, the American Cancer Society, and the American Heart Association all recommend that people get all their antioxidants, including carotenoids, from a diet high in fruits, vegetables, and whole grains rather than from dietary supplements.
Health claims for carotenoids
Many health claims for carotenoids are based on laboratory and animal studies. Results from human studies are often inconsistent and confusing. One difficulty in evaluating these studies comes from the variety of ways in which they are conducted. When increased carotenoid intake comes from eating foods high in carotenoids, it is hard to separate the effects of the carotenoids from the effects of other vitamins and minerals in the food. When a dietary supplement is given to increase the level of a specific carotenoid, the outcomes often differ from those that occur in a diet of carotenoid-rich vegetables. In addition, the fact that some carotenoids are converted into vitamin A blurs the line between their effects and that of vitamin A from other sources. More controlled research needs to be done on these compounds. Many clinical trials are underway to determine safety and effectiveness of different carotenoids, both alone and in combination with other drugs and supplements.
BETA-CAROTENE. Beta-carotene is a yellow-orange provitamin A carotenoid. Good sources of beta-carotene include carrots, sweet potatoes, winter squash, pumpkin, spinach, kale, and broccoli. When vitamin A stores are low, the body can convert beta-carotene into vitamin A to prevent symptoms of vitamin A deficiency. It takes 12 mcg of beta-carotene to make 1 mcg of retinol, the active form of vitamin A. Therefore, vitamin A deficiency is usually more effectively treated by eating more foods high in vitamin A and/or taking a vitamin A supplement than by increasing beta-carotene intake.
The only use for beta-carotene dietary supplements proven in well-controlled clinical trials is to treat a rare genetic disorder called erythropoietic protoporphyria. This disorder causes the skin to be painfully sensitive to sunlight and causes the development of gallstones and problems with liver function. Symptoms are relieved by giving beta-carotene supplements under the supervision of a physician.
A diet high in vegetables rich in beta-carotene appears to reduce the risk of developing certain cancers. However, in a large study of 29,000 men, when a beta-carotene dietary supplement was taken by men who smoked, they developed lung cancer at a rate 18% higher and died at a rate 8% higher than men who did not take the supplement. Another study that gave men dietary supplements of beta-carotene and vitamin A was stopped when researchers found the men receiving the beta-carotene had a 46% greater chance of dying from lung cancer than those who did not take it. The official position of the IOM is that “beta-carotene supplements are not advisable for the general population.”
ALPHA-CAROTENE. Alpha-carotene is the lesser-known cousin of beta-carotene. It also is a provitamin A carotenoid, but it takes 24 mcg of alpha-carotene to make 1 mcg of retinol. Good sources of alpha-carotene include pumpkin, carrots, winter squash, collard greens, raw tomatoes, tangerines, and peas. Less research has been done on alpha-carotene than beta-carotene, but it is not recommended as a dietary supplement.
BETA-CRYPTOXANTHIN. Beta-cryptoxanthin is also a provitamin A carotenoid. It takes 24 mcg of beta-cryptoxanthin to make 1 mcg of retinol. Good sources of beta-cryptoxanthin include pumpkin, red bell peppers, papaya, tangerines, nectarines, oranges and orange juice, carrots, yellow corn, and watermelon.
LUTEIN AND ZEAXANTHIN Lutein and zeaxanthin do not have vitamin A activity. They are the only carotenoids found in the human eye. It has been proposed, but not proven, that they may help slow the development of cataracts. Cataracts are changes in the lens of the eye that result in clouding and vision loss. These carotenoids are also found in the retina. They absorb light in the blue wavelength range. It is theorized that they can help slow or prevent age-related breakdown of the retina (age-related macular degeneration), a common cause of vision loss in the elderly. Good sources of lutein and zeaxanthin include spinach, kale, turnip, collard, and mustard greens, summer squash, peas, broccoli, Brussels sprouts, and yellow corn.
LYCOPENE Lycopene is the carotenoid that gives tomatoes, watermelons, and guavas their reddish color. In the American diet, almost all dietary lycopene comes from tomato products.
The relationship between dietary intake of lycopene and the risk of men developing prostate cancer is of great interest to researchers. One large study of 58,000 Dutch men found no relationship between the two. However, an analysis of 21 studies examining the relationship between lycopene intake and prostate cancer found that men with the highest dietary intake.
of lycopene were less likely to develop prostate cancer. The reduction appeared real, but modest—11–19%.
The relationship between lung cancer and beta-carotene strongly suggests that all carotenoids should be obtained through diet and not through dietary supplements. There is also no information on the safety of carotenoid dietary supplements in children or women who are either pregnant or breastfeeding.
Interactions of specific carotenoids with drugs, herbs, and dietary supplements have not been well studied. In general, cholesterol-lowering drugs, orli-stat (Xenical or Alli), and mineral oil reduce the absorption of carotenoids from the intestine, but it is not known whether this has an effect on health.
There are no identified complications from carotenoid deficiency.
Beta-carotene supplements of 30 mg per day or more or excessive consumption of carrots and other beta-carotene rich food can cause the skin to become yellow, a condition called carotenodermia. Caroteno-dermia is not associated with any health problems and disappears when beta-carotene intake is reduced.
Lycopene supplements or excessive intake of tomatoes and tomato products can cause the skin to turn orange, a condition called lycopenodermia. This condition disappears when lycopene intake is reduced.
No recommendations have been set about the maximum daily intake of carotenoids from diet, but dietary supplements of carotenoids are not recommended by the IOM, the American Heart Association or the American Cancer Society.
Parents should encourage their children to eat a healthy and varied diet high in fruits, vegetables, and whole grains. There is no need to give children dietary supplements of carotenoids. The safety of these supplements in children has not been studied.
Challem, Jack, and Marie Moneysmith. Basic Health Publications User’s Guide to Carotenoids & Flavonoids: Learn How to Harness the Health Benefits of Natural Plant Antioxidants North Bergen, NJ: Basic Health Publications, 2005.
Gaby, Alan R., ed. A-Z Guide to Drug-Herb-Vitamin Interactions Revised and Expanded 2nd Edition: Improve Your Health and Avoid Side Effects When Using Common Medications and Natural Supplements Together New York: Three Rivers Press, 2006.
Krinsky, Norman, Susan T. Mayne, Helmut Sies, eds. Carotenoids in Health and Disease New York: Marcel Dekker, 2004.
Lieberman, Shari, and Nancy Bruning. The Real Vitamin and Mineral Book: The Definitive Guide to Designing Your Personal Supplement Program 4th ed. New York: Avery, 2007.
Pressman, Alan H., and Sheila Buff. The Complete Idiot’s Guide to Vitamins and Minerals 3rd ed. Indianapolis, IN: Alpha Books, 2007.
Rucker, Robert B., ed. Handbook of Vitamins Boca Raton, FL: Taylor & Francis, 2007.
Kushi, Lawrence H., Tim Byers, Colleen Doyle, et al.
“American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention.” CA: Cancer Journal for Clinicians. 56(2006): 254-281. [cited May 2, 2007]. <http://caonline.amcancersoc.org/cgi/content/full/56/5/254>.
Voutilainen, Sari, Tarja Nurmi, Jaakko Mursu, et al.
“Carotenoids and Cardiovascular Health.” American Journal of Clinical Nutrition83, no.6 (June 2006): 1265-71. [cited May 2, 2007]. <http://www.ajcn.org/cgi/content/full/83/6/1265>.
American Cancer Society. 1599 Clifton Road NE, Atlanta GA 30329-4251. Telephone: 800 ACS-2345. Website: <http://www.cancer.org>
American Heart Association. 7272 Greenville Avenue, Dallas, TX 75231. Telephone: (800) 242-8721. Website: <http://www.americanheart.org>
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>
Linus Pauling Institute. Oregon State University, 571 Weniger Hall, Corvallis, OR 97331-6512. Telephone: (541) 717-5075. Fax: (541) 737-5077. Website: <http://lpi.oregonstate.edu>
Office of Dietary Supplements, National Institutes of Health. 6100 Executive Blvd., Room 3B01, MSC 7517, Bethesda, MD 20892-7517 Telephone: (301)435-2920. Fax: (301)480-1845. Website: <http://dietary-supplements.info.nih.gov>
Medline Plus. “Beta-carotene.” U. S. National Library of Medicine, August 1, 2006. [cited May 2, 2007]. <http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-betacarotene.html>.
Office of Dietary Supplements. “Dietary Supplement Fact Sheet: Vitamin A and Carotenoids.” National Institutes of Health, April 23, 2006. [cited May 2, 2007]. <http://ods.od.nih.gov/factsheets/vitaminA.asp>.
Tish Davidson, A.M.