beta-carotene and Chronic-Disease

Oxidative damage to cells and tissues is considered involved in the aging process and in the development of chronic diseases in humans, including cancer and cardiovascular diseases, the leading causes of death in high-income countries. This has stimulated interest in the preventive potential of antioxidant supplements. Today, more than one half of adults in high-income countries ingest antioxidant supplements hoping to improve their health, oppose unhealthy behaviors, and counteract the ravages of aging.. Older observational studies and some randomized clinical trials with high risks of systematic errors ('bias') have suggested that antioxidant supplements may improve health and prolong life. A number of randomized clinical trials with adequate methodologies observed neutral or negative results of antioxidant supplements. Recently completed large randomized clinical trials with low risks of bias and systematic reviews of randomized clinical trials taking systematic errors ('bias') and risks of random errors ('play of chance') into account have shown that antioxidant supplements do not seem to prevent cancer, cardiovascular diseases, or death. Even more, beta-carotene, vitamin A, and vitamin E may increase mortality. Some recent large observational studies now support these findings. According to recent dietary guidelines, there is no evidence to support the use of antioxidant supplements in the primary prevention of chronic diseases or mortality.. Antioxidant supplements do not possess preventive effects and may be harmful with unwanted consequences to our health, especially in well-nourished populations. The optimal source of antioxidants seems to come from our diet, not from antioxidant supplements in pills or tablets.

Topics: Antioxidants; beta Carotene; Cardiovascular Diseases; Chronic Disease; Dietary Supplements; Dose-Response Relationship, Drug; Humans; Meta-Analysis as Topic; Neoplasms; Observational Studies as Topic; Randomized Controlled Trials as Topic; Vitamin A; Vitamin E

The role of plant antioxidants as factors of civilization diseases prevention was described. The free-radical theory as a mechanism of action of antioxidants was mentioned. The main substances e.g. polyphenols including flavonoids, ascorbic acid, carotenoids and tocoferols were presented. Resveratrol of wine, as an example of possible health beneficial agent was stressed. On the other handsome doubts of beneficial effects of antioxidants e.g. beta-carotene, as supplement of diet, were mentioned. It is possible, that supplementation with flavonoids might create some health risk. But there was highlighted, that vegetables as a source of natural antioxidants are beneficial for health.

Topics: Antioxidants; Ascorbic Acid; beta Carotene; Chronic Disease; Dietary Supplements; Flavonoids; Health Promotion; Humans; Neoplasms; Phenols; Phytotherapy; Plant Extracts; Polyphenols; Resveratrol; Stilbenes

To review and synthesize published literature on the efficacy of multivitamin/mineral supplements and certain single nutrient supplements in the primary prevention of chronic disease in the general adult population, and on the safety of multivitamin/mineral supplements and certain single nutrient supplements, likely to be included in multivitamin/mineral supplements, in the general population of adults and children.. All articles published through February 28, 2006, on MEDLINE, EMBASE, and the Cochrane databases.. Each article underwent double reviews on title, abstract, and inclusion eligibility. Two reviewers performed data abstraction and quality assessment. Differences in opinion were resolved through consensus adjudication.. Few trials have addressed the efficacy of multivitamin/mineral supplement use in chronic disease prevention in the general population of the United States. One trial on poorly nourished Chinese showed supplementation with combined Beta-carotene, vitamin E and selenium reduced gastric cancer incidence and mortality, and overall cancer mortality. In a French trial, combined vitamin C, vitamin E, Beta-carotene, selenium, and zinc reduced cancer risk in men but not in women. No cardiovascular benefit was evident in both trials. Multivitamin/mineral supplement use had no benefit for preventing cataract. Zinc/antioxidants had benefits for preventing advanced age-related macular degeneration in persons at high risk for the disease. With few exceptions, neither Beta-carotene nor vitamin E had benefits for preventing cancer, cardiovascular disease, cataract, and age-related macular degeneration. Beta-carotene supplementation increased lung cancer risk in smokers and persons exposed to asbestos. Folic acid alone or combined with vitamin B12 and/or vitamin B6 had no significant effects on cognitive function. Selenium may confer benefit for cancer prevention but not cardiovascular disease prevention. Calcium may prevent bone mineral density loss in postmenopausal women, and may reduce vertebral fractures, but not non-vertebral fractures. The evidence suggests dose-dependent benefits of vitamin D with/without calcium for retaining bone mineral density and preventing hip fracture, non-vertebral fracture and falls. We found no consistent pattern of increased adverse effects of multivitamin/mineral supplements except for skin yellowing by Beta-carotene.. Multivitamin/mineral supplement use may prevent cancer in individuals with poor or suboptimal nutritional status. The heterogeneity in the study populations limits generalization to United States population. Multivitamin/mineral supplements conferred no benefit in preventing cardiovascular disease or cataract, and may prevent advanced age-related macular degeneration only in high-risk individuals. The overall quality and quantity of the literature on the safety of multivitamin/mineral supplements is limited.

Topics: beta Carotene; Calcium; Chronic Disease; Dietary Supplements; Folic Acid; Humans; Selenium; Trace Elements; Vitamin A; Vitamin B Complex; Vitamin D; Vitamin E; Vitamins

Oxidation of lipid, nucleic acids or protein has been suggested to be involved in the etiology of several chronic diseases including cancer, cardiovascular disease, cataract, age-related macular degeneration and aging in general. A large body of research has investigated the potential role of antioxidant nutrients in the prevention of these and other chronic diseases. This review concentrates on the following antioxidant nutrients: beta-carotene and other carotenoids, vitamin E, vitamin C and selenium. The first part of the review emphasizes the utility of biological markers of exposure for these nutrients and the relationship to dietary intake data. The second part considers functional assays of oxidative stress status in humans including the strengths and limitations of various assays available for use in epidemiologic research. A wide variety of functional assays both in vivo and ex vivo, are covered, including various measures of lipid oxidation (thiobarbituric acid reactive substances, exhaled pentane/ethane, low-density lipoprotein resistance to oxidation, isoprostanes), DNA oxidation (oxidized DNA bases such as 8-OHdG, autoantibodies to oxidized DNA, modified Comet assay) and protein oxidation (protein carbonyls). Studies that have examined the effects of antioxidant nutrients on these functional markers are included for illustrative purposes. The review concludes with a discussion of methodologic issues and challenges for studies involving biomarkers of exposure to antioxidant nutrients and of oxidative stress status.

Topics: alpha-Tocopherol; Antioxidants; Ascorbic Acid; beta Carotene; Biomarkers; Chronic Disease; Diet; DNA; Humans; Lipid Peroxidation; Nutritional Physiological Phenomena; Nutritional Status; Oxidative Stress; Selenium

Topics: alpha-Tocopherol; Antioxidants; beta Carotene; Chronic Disease; Coronary Disease; Dietary Supplements; Humans; Lung Neoplasms; Risk Factors; Selenium

Recent evidence introduces the possibility that lutein and zeaxanthin may protect against the development of the two common eye diseases of aging, cataract and macular degeneration. This potential and the lack of other effective means to slow the progression of macular degeneration have fueled high public interest in the health benefits of lutein and zeaxanthin and the proliferation of supplements containing them on pharmacy shelves. An understanding of the biologic consequences of limiting or supplementing with these carotenoids is only beginning to emerge. Some epidemiologic evidence supports a role in eye disease and, to a lesser extent, cancer and cardiovascular disease. However, the overall body of evidence is insufficient to conclude that increasing levels of lutein and zeaxanthin, specifically, will confer an important health benefit. Future advances in scientific research are required to gain a better understanding of the biologic mechanisms of their possible role in preventing disease. Additional research is also required to understand the effect of their consumption, independent of other nutrients in fruits and vegetables, on human health. The newly advanced ability to measure levels of lutein and zeaxanthin in the retina in vivo creates a unique opportunity to contribute some of this needed evidence.

Topics: Aging; beta Carotene; Cataract; Chronic Disease; Fruit; Heart Diseases; Humans; Lutein; Macular Degeneration; Neoplasms; Stroke; Tissue Distribution; Vegetables; Xanthophylls; Zeaxanthins

Many recent papers show the important role of bioactive phytochemicals to maintain a good health status. Among them the carotenoids are the best known. About 637 have been described and possibly 70 of them could have an important role in human health, 16 have been found in human brain in high amounts. Most of the studies have found relations between the carotenoids and chronic non-communicable diseases like several types of cancer, atherogenic disease and some degenerative pathology of the eye. This relation is mediated by genes and age. Studies of carotenoids are of scientific and economic interest for Latin America as many tropical products are high sources of these compounds. Therefore the first task is to analyze them and iniciate some evaluation on its metabolic availability. A coordinated regional work is proposed, in which 40 or 50 fruits and vegetables are analyzed in terms of the seven carotenoids most related to human health. At the same time it will be important to start epidemiological studies that will compare groups with different levels of consumption of fruits and vegetables and make chronic disease risk analysis. In some countries of the Latin American region, with the support of FAO and INFOODS, some courses and meetings are taking place so that in a short time period the carotenoid composition of the important regional foods will be completed and a carotenoid regional food composition table be published.

Topics: Antioxidants; beta Carotene; Biological Availability; Carotenoids; Chronic Disease; Fruit; Humans; Latin America; Nutrition Disorders; Nutritional Physiological Phenomena; Research; Vegetables

Recent data suggest the possible benefits of α-tocopherol and β-carotene supplementation on liver cancer and chronic liver disease (CLD), but the long-term trial data are limited.. We evaluated the efficacy of supplemental 50 mg day(-1) α-tocopherol and 20 mg day(-1) β-carotene on incident liver cancer and CLD mortality in a randomised trial of 29,105 Finnish male smokers, who received supplementation for 5-8 years and were followed for 16 additional years for outcomes.. Supplemental α-tocopherol, β-carotene, or both, relative to placebo, did not reduce the risk of liver cancer or CLD, either overall, during the intervention or during the post-intervention period.. Long-term supplemental α-tocopherol or β-carotene had no effect on liver cancer or CLD mortality over 24 years of follow-up.

Topics: Aged; alpha-Tocopherol; beta Carotene; Chronic Disease; Humans; Incidence; Liver Diseases; Liver Neoplasms; Male; Middle Aged

Chronic inflammation contributes to the pathophysiology of many chronic diseases. Dietary fibers and antioxidants may exert anti-inflammatory effects. The objective of this study was to determine whether meals with different fibers and antioxidants may elicit a different response in inflammatory markers in healthy volunteers. On 3 separate days, subjects (n = 8) consumed one of three isocaloric meals with different antioxidant (vitamin E, selenium and β-carotene) and fiber content (high, intermediate and low) in a randomized crossover design. Blood samples were collected at different times: 0 min (before the meal), and 30 and 240 min after the meal. Plasma interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-α, glucose and insulin content were evaluated at each time point. There were no significant differences for any of the parameters at baseline. Furthermore, plasma levels of TNF-α, IL-6 and IL-10 were unchanged at the 30- and 240-min time points whatever meal consumed. Moreover, the cytokine responses to glucose and insulin intake were not significantly different between experimental conditions. In conclusion, isocaloric meals with different fiber, β-carotene, vitamin E and selenium contents do not acutely affect inflammatory markers in healthy young males.

Topics: Adolescent; Antioxidants; beta Carotene; Biomarkers; Blood Glucose; Chronic Disease; Cross-Over Studies; Dietary Carbohydrates; Dietary Fats; Dietary Fiber; Dietary Proteins; Humans; Inflammation; Insulin; Interleukin-10; Interleukin-6; Male; Meals; Selenium; Single-Blind Method; Tumor Necrosis Factor-alpha; Vitamin E; Young Adult

Synthetic retinoids are one of the mainstay treatments of psoriasis. However, their use is occasionally limited by adverse effects, especially mucocutaneous, hepatic, and lipid profile toxicity. Thus, a search for retinoid metabolites that are both safe and active is essential. The alga Dunaliella bardawil is a natural source of the retinoid precursor 9-cis β-carotene that has a good adverse effect profile.. To test the effect of the alga Dunaliella bardawil on psoriasis.. Thirty-four adult patients with mild, chronic, plaque-type psoriasis were included in this monocentric, prospective, randomized, double-blinded pilot study. Patients received either capsules of the alga D. bardawil or starch powder capsules, as the placebo, for 12 weeks. The response to treatment was evaluated by changes in Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) scores. Safety of the treatment was evaluated.. At the end of 6 weeks, the reduction in the mean PASI score was significantly higher in the Dunaliella group than in the placebo group (61.3% vs 34%, respectively, p = 0.002). The DLQI change did not reach significance (8.5% and 5.9% in the Dunaliella and in the control group, respectively, p = 0.9). We observed no significant change in the liver function tests or in the lipid profile.. 9-cis β-carotene, in the form of D. bardawil, is an effective and safe treatment for patients with mild, chronic, plaque-type psoriasis. A larger study is warranted.

Topics: Adult; Aged; beta Carotene; Chlorophyta; Chronic Disease; Double-Blind Method; Drug Evaluation; Female; Humans; Male; Middle Aged; Pilot Projects; Powders; Prospective Studies; Psoriasis; Quality of Life; Severity of Illness Index; Treatment Outcome

High blood pressure (BP) has been associated with a decrease in kidney function. However, it remains unclear which BP measure best predicts impaired kidney function.. We compared systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP) and mean arterial pressure (MAP) in predicting risk of chronic kidney disease (CKD). We prospectively followed 8093 male participants in the Physicians' Health Study, without a known history of kidney disease at baseline, who provided BP values on the baseline and 24-month questionnaires, and for whom we had creatinine measures after 14 years of follow-up. Reported BP was averaged from both questionnaires. The main outcome was CKD, defined as an estimated glomerular filtration rate <60 mL/min/1.73 m(2). We used multivariable-adjusted logistic regression to evaluate the association between BP measures and CKD and compared models using the likelihood ratio test.. After 14 years of follow-up, 1039 men (12.8%) had CKD. An increase of 10 mmHg had corresponding multivariable-adjusted odds ratios (95% confidence intervals) of 1.11 (1.03-1.19) for SBP, 1.11 (1.00-1.23) for MAP, 1.14 (1.05-1.25) for PP and 1.05 (0.93-1.17) for DBP. SBP and PP were the strongest predictors of chronic kidney function, with equal predictive abilities. Combining BP measures did not add significantly to the prediction.. Increases in SBP, PP and MAP were significantly associated with CKD. SBP may be the most clinically useful predictor of CKD, since no further calculations are required.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Aspirin; beta Carotene; Blood Pressure; Blood Pressure Determination; Cardiovascular Diseases; Chronic Disease; Confidence Intervals; Creatinine; Disease Progression; Drug Therapy, Combination; Follow-Up Studies; Humans; Kidney Diseases; Male; Massachusetts; Middle Aged; Odds Ratio; Platelet Aggregation Inhibitors; Predictive Value of Tests; Prognosis; Prospective Studies; Risk Assessment; Risk Factors; Severity of Illness Index; Surveys and Questionnaires; Time Factors; Vitamins

Patients with chronic pancreatitis (CP) typically suffer intractable abdominal pain that is resistant to most analgesic strategies. Recent research indicates that the pain of CP may be in part due to oxygen free radical induced pancreatic damage. Using a randomized, double-blind, placebo-controlled crossover trial, we evaluated the efficacy of a combined antioxidant preparation in the management of CP. Patients with confirmed chronic pancreatitis (N = 36) were randomized to receive treatment with either Antox, which contains the antioxidants selenium, betacarotene, L-methionine, and vitamins C and E, or placebo for 10 weeks. Each group of patients then switched to receive the alternative treatment for a further 10 weeks. Markers of antioxidant status were measured by blood sampling, whereas quality of life and pain were assessed using the SF-36 questionnaire. Nineteen patients completed the full 20 weeks of treatment. Treatment with Antox was associated with significant improvements in quality of life in terms of pain (+17 antioxidant vs. -7 placebo), physical (+9 vs. -3) and social functioning (+8 vs. -7), and general health perception (+10 vs. -3). We conclude that treatment with antioxidants may improve quality of life and reduce pain in patients suffering from chronic pancreatitis.

Topics: Abdominal Pain; Adult; Aged; Antioxidants; Ascorbic Acid; Attitude to Health; beta Carotene; Chronic Disease; Cross-Over Studies; Double-Blind Method; Drug Combinations; Female; Follow-Up Studies; Humans; Male; Methionine; Middle Aged; Pain Measurement; Pain, Intractable; Pancreatitis; Placebos; Quality of Life; Selenium; Treatment Outcome; Vitamin E

A randomized double blind placebo-controlled trial of the drug karinat was carried out in patients with chronic multifocal atrophic gastritis. Karinat contains beta-carotene 2.5 mg, alpha-tocopherol 5 mg, ascorbic acid 30 mg and garlic powder 150 mg per tablet. Out of 66 patients, 34 received karinat, 32--placebo. Both karinat and placebo were administered for 6 months, one tablet twice a day. Karinat therapy improved digestion, the fibrogastroscopic pattern of mucosa, inhibited Helicobacter pylori infection, stimulated stomach activity, mitigated intestinal metaplasia and interfered with the epithelial proliferation of gastric mucosa. These therapeutic effects were more pronounced in the study group. On the whole, the effectiveness of the drug was significantly higher (29%). Karinat should be recommended for the management of chronic atrophic gastritis, a precursor of stomach cancer.

Topics: alpha-Tocopherol; Anticarcinogenic Agents; Antioxidants; Ascorbic Acid; beta Carotene; Chronic Disease; Double-Blind Method; Drug Combinations; Female; Garlic; Gastritis, Atrophic; Helicobacter Infections; Humans; Male; Middle Aged; Plant Extracts; Stomach Neoplasms; Treatment Outcome

The aim of this study was to investigate the relations between plasma levels of antioxidants, beta-carotene and alpha-tocopherol, and chronic respiratory symptoms in Dutch adults who never smoked or were long-term former smokers. Cases (who reported one or more respiratory symptoms) and controls were selected from a population-based cross-sectional study. Plasma concentrations of antioxidants were determined in 491 cases and 496 controls. ORs for the presence of chronic respiratory symptoms were estimated for quintiles of plasma antioxidant concentration after adjustment for age, gender, and body mass index. The OR of respiratory symptoms in all but the highest quintile of plasma beta-carotene decreased and were slightly below one. We saw no meaningful relation with plasma alpha-tocopherol.

Topics: Adult; Antioxidants; beta Carotene; Biomarkers; Chromatography, High Pressure Liquid; Chronic Disease; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Netherlands; Odds Ratio; Prevalence; Respiratory Tract Diseases; Retrospective Studies; Smoking; Surveys and Questionnaires; Urban Population; Vitamin E

The peptic ulcer of stomach and duodenum are the more often occuring complications of steroid treatment in children with chronic glomerulonephrite. Dinamic investigation has shown that the using of beta-carotin oily solution in therapy of this complications increases the efficiency of traditional treatment. It has been shown that beta-carotene administration speeds the reparation of stomach and duodenum ulcers, saves adequate serum concentration of beta-carotene and retinol. The data obtained demonstrate that beta-carotene administration in the complex therapy of chronic glomerulonephrite patient with gastroenteropathy should be recommended.

Topics: Administration, Oral; Adolescent; Anti-Inflammatory Agents; Antioxidants; beta Carotene; Child; Child, Preschool; Chronic Disease; Diet, Protein-Restricted; Duodenal Ulcer; Endoscopy; Gastric Mucosa; Glomerulonephritis; Humans; Prednisolone; Stomach Ulcer

Topics: Antiprotozoal Agents; beta Carotene; Child; Chronic Disease; Female; Giardiasis; Humans; Male; Metronidazole; Treatment Outcome; Vitamin A

A randomized chemoprevention trial on precancerous lesions of the stomach is being conducted in Tachira State, Venezuela. The aims of the study are to evaluate the efficacy of vitamin supplementation in preventing the progression rate of precancerous lesions. Here we report on the pilot phase of the study in which two antioxidant preparations were evaluated on their ability to raise antioxidant levels in plasma and in gastric juice. The study aimed also to determine the antibiotic sensitivity profiles of Helicobacter pylori isolates prevalent in the area. Forty-three subjects with precancerous lesions (chronic gastritis, chronic atrophic gastritis, intestinal metaplasia and dysplasia) of the stomach were randomized to one of two antioxidant treatments. Treatment 1 (250 mg of standard vitamin C, 200 mg of vitamin E and 6 mg of beta-carotene three times a day) or treatment 2 (150 mg of standard vitamin C, 500 mg of slow release vitamin C, 75 mg of vitamin E and 15 mg of beta-carotene once a day) for 7 days. Blood levels of total vitamin C, beta-carotene and alpha-tocopherol and gastric juice levels of ascorbic acid and total vitamin C were measured before and after treatment on day 8. Both treatments increased the plasma levels of total vitamin C, beta-carotene and alpha-tocopherol/cholesterol but not those of ascorbic acid or total vitamin C in gastric juice. Treatment 1 was the best choice and resulted in a greater increase in the plasma levels of beta-carotene and alpha-tocopherol. H. pylori was cultured from 90% of the gastric biopsies; 35 isolates were identified which were highly resistant to metronidazole, a front-line antibiotic recommended against H. pylori in other settings.

Topics: Adult; Aged; Antioxidants; Ascorbic Acid; beta Carotene; Carotenoids; Chemoprevention; Chronic Disease; Disease Progression; Female; Gastric Juice; Gastritis; Gastritis, Atrophic; Helicobacter Infections; Helicobacter pylori; Humans; Male; Metaplasia; Middle Aged; Pilot Projects; Precancerous Conditions; Stomach Neoplasms; Venezuela; Vitamin E; Vitamins

Eleven HIV-positive patients with chronic oral candidiasis were supplemented with 60 to 120 mg of beta-carotene daily for 3 to 7 months. Lymphocyte profiles were evaluated at intervals to help assess immune competence. Although there was a modest increase in some lymphocyte values at 2 months, there was a significant decrease in numbers of CD4 and CD8 cells and CD4 percentage of lymphocytes after 6 months of beta-carotene supplementation. Serum triglyceride and liver enzyme levels were not affected by the beta-carotene supplementation. No improvement was observed in the control of the oral candidiasis. Under the conditions of the study, there was no indication that daily beta-carotene supplements enhanced immune competence or was of benefit in managing oral candidiasis.

Topics: Adult; AIDS-Related Opportunistic Infections; Analysis of Variance; beta Carotene; Candidiasis, Oral; Carotenoids; CD4 Lymphocyte Count; Chronic Disease; Female; HIV Seropositivity; Humans; Lipids; Lymphocyte Count; Lymphocytes; Male; Middle Aged; Treatment Outcome

This intervention trial carried out in Uzbekistan (former USSR) in an area with a high incidence of oral and esophageal cancer involved random allocation of 532 men, 50 to 69 years old, with oral leukoplakia and/or chronic esophagitis to one of four arms in a double-blind, two-by-two factorial design, with active arms defined by the administration of (a) riboflavin; (b) a combination of retinol, beta-carotene, and vitamin E; or (c) both. Weekly doses were 100,000 IU of retinol, 80 mg of vitamin E, and 80 mg of riboflavin. The dose of beta-carotene was 40 mg/d. Men in the trial were followed for 20 months after randomization. The aim of the trial was to determine whether treatment with these vitamins or their combination could affect the prevalence of oral leukoplakia and/or protect against progression of oral leukoplakia and esophagitis, conditions considered to be precursors of cancer of the mouth and esophagus. A significant decrease in the prevalence odds ratio (OR) of oral leukoplakia was observed after 6 months of treatment in men receiving retinol, beta-carotene, and vitamin E (OR = 0.62; 95% confidence interval (CI): 0.39 to 0.98). After 20 months of treatment, no effect of vitamin supplementation was seen when the changes in chronic esophagitis were compared in the four different treatment groups, although the risk of progression of chronic esophagitis was lower in the subjects allocated to receive retinol, beta-carotene and vitamin E (OR = 0.65; 95% CI: 0.29 to 1.48) A secondary analysis not based on the randomized design revealed a decrease in the prevalence of oral leukoplakia in men with medium (OR = 0.45; 95% CI: 0.21 to 0.96) and high (OR = 0.59; 95% CI: 0.29 to 1.20) blood concentrations of beta-carotene after 20 months of treatment. Risk of progression of chronic esophagitis was also lower in men with a high blood concentration of beta-carotene, odds ratios being 0.30 (95% CI: 0.10 to 0.89) and 0.49 (95% CI: 0.15 to 1.58) for medium and high levels, respectively. A decrease in risk, also statistically not significant, was observed for high vitamin E levels (OR = 0.39; 95% CI: 0.14 to 1.10). These results were based on levels of vitamins in blood drawn after 20 months of treatment.

Topics: Aged; beta Carotene; Carotenoids; Chronic Disease; Double-Blind Method; Esophageal Neoplasms; Esophagitis; Humans; Incidence; Leukoplakia, Oral; Male; Middle Aged; Mouth Neoplasms; Odds Ratio; Precancerous Conditions; Prevalence; Riboflavin; Risk Factors; Uzbekistan; Vitamin A; Vitamin E; Vitamins

To evaluate the efficacy of low-dose aspirin in the primary prevention of myocardial infarction among patients with chronic stable angina.. A randomized, double-blind, trial.. The study included 333 men with baseline chronic stable angina but with no previous history of myocardial infarction, stroke, or transient ischemic attack who were enrolled in the Physicians' Health Study, a trial of aspirin among 22,071 male physicians.. Patients were randomly assigned to receive alternate-day aspirin therapy (325 mg) or placebo and were followed for an average of 60.2 months for the occurrence of myocardial infarction, stroke, or cardiovascular death.. During follow-up, 27 patients had confirmed myocardial infarctions; 7 were among the 178 patients with chronic stable angina who received aspirin therapy and 20 were among the 155 patients who received placebo (relative risk, 0.30; 95% CI, 0.14 to 0.63; P = 0.003). While simultaneously controlling for other cardiovascular risk factors in a proportional hazards model, an overall 87% risk reduction was calculated (relative risk, 0.13; CI, 0.04 to 0.42; P less than 0.001). For the subgroup of patients with chronic stable angina but no previous coronary bypass surgery or coronary angioplasty, an almost identical reduction in the risk for myocardial infarction was found (relative risk, 0.14; CI, 0.04 to 0.56; P = 0.006). Of 13 strokes, 11 occurred in the aspirin group and 2 in the placebo group (relative risk, 5.4; CI, 1.3 to 22.1; P = 0.02). No stroke was fatal, but 4 produced some long-term impairment of function. One stroke, in the aspirin group, was hemorrhagic.. Our data indicated that alternate-day aspirin therapy greatly reduced the risk for first myocardial infarction among patients with chronic stable angina, a group of patients at high risk for cardiovascular death (P less than 0.001). Although our results for stroke were based on small numbers, they suggested an apparent increase in frequency of stroke with aspirin therapy; this finding requires confirmation in randomized trials of adequate sample size.

Topics: Adult; Aged; Aged, 80 and over; Angina Pectoris; Aspirin; beta Carotene; Cardiovascular Diseases; Carotenoids; Cerebrovascular Disorders; Chronic Disease; Double-Blind Method; Drug Administration Schedule; Drug Therapy, Combination; Humans; Male; Middle Aged; Myocardial Infarction; Risk; Statistics as Topic

Topics: Aged; beta Carotene; Carotenoids; Chronic Disease; Clinical Trials as Topic; Drug Therapy, Combination; Esophageal Neoplasms; Esophagitis; Humans; Male; Middle Aged; Placebos; Precancerous Conditions; Riboflavin; Vitamin A

A randomised study of beta-carotene/canthaxanthin or placebo in chronic plaque psoriasis has failed to show any significant difference in the time to clearing and in the total accumulative dose required. Orange discolouration and hyperpigmentation of the skin occurred in the test group. In patients studied outside the randomised comparison, 2 patients who had not been able to tolerate PUVA therapy because of burning were subsequently able to do so when beta-carotene/canthaxanthin was added to their treatment regimen.

Topics: Adolescent; Adult; beta Carotene; Canthaxanthin; Carotenoids; Chronic Disease; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Photochemotherapy; Placebos; Psoriasis; PUVA Therapy; Time Factors

We recently presented associations between serum-based biomarkers of carotenoid and tocopherol intake and chronic disease risk in a Women's Health Initiative (WHI) Measurement Precision subcohort (n = 5488). Questions remain as to whether self-reported dietary data can usefully augment such biomarkers or can be calibrated using biomarkers for reliable disease association estimation in larger WHI cohorts.. The aims were to examine the potential of FFQ data to explain intake variation in a WHI Feeding Study and to compare association parameter estimates and their precision from studies based on biomarker-calibrated FFQ intake in larger WHI cohorts, with those previously presented.. Serum-based intake measures were augmented by using FFQ data in a WHI Feeding Study (n = 153). Corresponding calibration equations were generated, both in a companion Nutritional Biomarker Study (n = 436) and in the previously mentioned subcohort (n = 5488), by regressing these intake measures on dietary data and participant characteristics, for α- and β-carotene, lutein plus zeaxanthin, and α-tocopherol. The supplemental value of FFQ data was considered by examining the fraction of feeding study intake variation explained by these regression models. Calibrated intake and disease association analyses were evaluated by comparisons with previously reported subcohort results.. The inclusion of FFQ data led to some increases in feeding study intake variation explained (total R2 of ∼50%). Calibrated intake estimates explained 25-75% of serum-based intake variation, whether developed using either of the 2 cohort subsamples. Related disease associations for micronutrients were precisely estimated in larger WHI cohorts (n = 76,691) but were often closer to the null compared with previously reported associations.. FFQ data may usefully augment blood concentrations in estimating the intake of carotenoids and tocopherols. Calibrated intake estimates using FFQ, dietary supplement, and participant characteristics only may require further justification to ensure reliable estimation of related disease associations.

Topics: Aged; alpha-Tocopherol; beta Carotene; Biomarkers; Carotenoids; Chronic Disease; Cohort Studies; Female; Humans; Micronutrients; Middle Aged; Nutritional Status; Women's Health

The porphyrias are a group of rare metabolic disorders that result from defects in heme biosynthesis. Erythropoietic protoporphyria (EPP) is the most common inherited porphyria in children and is diagnosed in most individuals after the onset of cutaneous manifestations. Hepatobiliary disease affects the minority of individuals with EPP and usually manifests in patients with an established diagnosis of EPP. We report on a classic but rare case of EPP that masqueraded as cholestasis. An 8-year-old boy was referred to the Hepatology Clinic after an abrupt onset of jaundice with a longstanding history of dermatitis. The diagnosis of EPP was established with liver biopsy, which revealed dense, dark-brown pigment in hepatocytes and Kupffer cells that, on polarization, displayed bright-red birefringence and centrally located Maltese crosses. Plasma total porphyrins and erythrocyte protoporphyrin were elevated and confirmed a diagnosis of EPP. We hope to raise awareness of this diagnosis among pediatricians, hepatologists, and pathologists and increase the consideration of EPP in patients with cholestatic liver disease and chronic dermatitis.

Topics: beta Carotene; Child; Cholagogues and Choleretics; Cholestasis; Cholestyramine Resin; Chronic Disease; Diagnosis, Differential; Humans; Male; Photosensitivity Disorders; Protoporphyria, Erythropoietic; Provitamins; Pruritus; Ursodeoxycholic Acid

This study's objective was to investigate healthy aging in older French adults 5 years after a period of daily nutritional-dose supplementation with antioxidant nutrients. The study was based on the double-blind, randomized trial, Supplementation with Antioxidant Vitamins and Minerals (SU.VI.MAX) Study (1994-2002) and the SU.VI.MAX 2 Follow-up Study (2007-2009). During 1994-2002, participants received a daily combination of vitamin C (120 mg), β-carotene (6 mg), vitamin E (30 mg), selenium (100 µg), and zinc (20 mg) or placebo. Healthy aging was assessed in 2007-2009 by using multiple criteria, including the absence of major chronic disease and good physical and cognitive functioning. Data from a subsample of the SU.VI.MAX 2 cohort, initially free of major chronic disease, with a mean age of 65.3 years in 2007-2009 (n = 3,966), were used to calculate relative risks. Supplementation was associated with a greater healthy aging probability among men (relative risk = 1.16, 95% confidence interval: 1.04, 1.29) but not among women (relative risk = 0.98, 95% confidence interval: 0.86, 1.11) or all participants (relative risk = 1.07, 95% confidence interval: 0.99, 1.16). Moreover, exploratory subgroup analyses indicated effect modification by initial serum concentrations of zinc and vitamin C. In conclusion, an adequate supply of antioxidant nutrients (equivalent to quantities provided by a balanced diet rich in fruits and vegetables) may have a beneficial role for healthy aging.

Topics: Adult; Aged; Aging; Antioxidants; Ascorbic Acid; beta Carotene; Chronic Disease; Dietary Supplements; Female; Follow-Up Studies; France; Fruit; Health Promotion; Humans; Male; Medical Records Systems, Computerized; Middle Aged; Randomized Controlled Trials as Topic; Reproducibility of Results; Research Design; Risk Assessment; Risk Factors; Sampling Studies; Trace Elements; Vegetables; Vitamin E; Vitamins; Zinc Compounds

Periodontitis is a chronic inflammatory disease and a significant risk factor for tooth loss. Although a link between diet and periodontal health exists, the relation between diet and healing after periodontal therapy has yet to be investigated.. The objective was to determine whether higher intakes of fruits and vegetables or nutrients with antioxidant or anti-inflammatory activity are associated with greater healing, measured as reduced probing depth (PD), after scaling and root planing (SRP), a cost-effective treatment to manage periodontal disease and prevent tooth loss.. Patients (63 nonsmokers, 23 smokers) with chronic generalized periodontitis who were undergoing SRP participated. Healing was evaluated based on PD, assessed at baseline and 8-16 wk after SRP. Intakes of fruits, vegetables, β-carotene, vitamin C, α-tocopherol, α-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) were estimated using the Block 2005 food frequency questionnaire and a supplement questionnaire. Serum 25-hydroxyvitamin D concentrations were also measured. PD (% sites >3 mm) was modeled in multiple linear regression and analysis of covariance by tertile of intake and adjusted for age, sex, body mass index (BMI), baseline PD, examiner, gingival bleeding, and study duration.. In nonsmokers, PD was associated with fruit and vegetable, β-carotene, vitamin C, α-tocopherol, EPA, and DHA intakes (P < 0.05). PD was not significantly associated with ALA intake or serum 25-hydroxyvitamin D concentration. Significant associations that included supplements (β-carotene, vitamin C, α-tocopherol) were attenuated or lost, depending on the statistical model used. There were no significant associations within the group of smokers.. Dietary intakes of fruits and vegetables, β-carotene, vitamin C, α-tocopherol, EPA, and DHA are associated with reduced PD after SRP in nonsmokers, but not smokers, with chronic generalized periodontitis. These findings may lead to the development of dietary strategies to optimize healing after periodontal procedures. This trial was registered at clinicaltrials.gov as NCT02291835.

Topics: Adult; Aged; Aged, 80 and over; alpha-Linolenic Acid; alpha-Tocopherol; Antioxidants; Ascorbic Acid; beta Carotene; Body Mass Index; Chronic Disease; Cross-Sectional Studies; Dietary Supplements; Docosahexaenoic Acids; Eicosapentaenoic Acid; Energy Intake; Female; Fruit; Humans; Inflammation; Linear Models; Male; Middle Aged; Nutrition Assessment; Periodontitis; Risk Factors; Smoking; Surveys and Questionnaires; Vegetables; Vitamin D

Micronutrients may influence the development or progression of liver cancer and liver disease. We evaluated the association of serum α-tocopherol, β-carotene, and retinol with incident liver cancer and chronic liver disease (CLD) mortality in a prospective cohort of middle-aged Finnish male smokers.. Baseline and 3-year follow-up serum were available from 29,046 and 22,805 men, respectively. After 24 years of follow-up, 208 men were diagnosed with liver cancer and 237 died from CLD. Hazards ratios and 95% confidence intervals were calculated for highest vs lowest quartiles from multivariate proportional hazards models.. Higher β-carotene and retinol levels were associated with less liver cancer (β-carotene: 0.35, 0.22-0.55, P-trend <0.0001; retinol: 0.58, 0.39-0.85, P-trend=0.0009) and CLD mortality (β-carotene: 0.47, 0.30-0.75, P-trend=0.001; retinol: 0.55, 0.38-0.78, P-trend=0.0007). α-Tocopherol was associated with CLD mortality (0.63, 0.40-0.99, P-trend=0.06), but not with liver cancer (1.06, 0.64-1.74, P-trend=0.77). Participants with higher levels of β-carotene and retinol, but not α-tocopherol, at both baseline and year 3 had lower risk of each outcome than those with lower levels.. Our findings suggest that higher concentrations of β-carotene and retinol are associated with incident liver cancer and CLD. However, such data do not indicate that supplementation should be considered for these diseases.

Topics: Aged; alpha-Tocopherol; beta Carotene; Chronic Disease; Humans; Incidence; Liver Diseases; Liver Neoplasms; Male; Middle Aged; Vitamin A

Deficiencies of essential nutrients have been responsible for many epidemic outbreaks of deficiency diseases in the past. Large observational studies point at possible links between nutrition and chronic diseases. Low intake of antioxidant vitamins e. g. have been correlated to increased risk of cardiovascular diseases or cancer. The main results of these studies are indications that an intake below the recommendation could be one of the risk factors for chronic diseases. There was hardly any evidence that amounts above the RDA could be of additional benefit. Since observational studies cannot prove causality, the scientific community has been asking for placebo-controlled, randomized intervention trials (RCTs). Thus, the consequences of the epidemiological studies would have been to select volunteers whose baseline vitamin levels were below the recommended values. The hypothesis of the trial should be that correcting this risk factor up to RDA levels lowers the risk of a disease like CVD by 20 - 30 %. However, none of the RCTs of western countries was designed to correct a chronic marginal deficiency, but they rather tested whether an additional supplement on top of the recommended values would be beneficial in reducing a disease risk or its prognosis. It was, therefore, not surprising that the results were disappointing. As a matter of fact, the results confirmed the findings of the observational studies: chronic diseases are the product of several risk factors, among them most probably a chronic vitamin deficiency. Vitamin supplements could only correct the part of the overall risk that is due to the insufficient vitamin intake.

Topics: Antioxidants; Ascorbic Acid; Avitaminosis; beta Carotene; Cardiovascular Diseases; Chronic Disease; Dietary Supplements; Dose-Response Relationship, Drug; Female; Humans; Male; Nutrition Policy; Prognosis; Randomized Controlled Trials as Topic; Risk Factors; Vitamin E; Vitamins

Encouraged by the potential health benefits of higher dietary intake of substances with beneficial properties, the use of supplements containing these compounds has increased steadily over recent years. The effects of several of these, many of which are antioxidants, have been supported by data obtained in vitro, in animal models, and often by human studies as well. However, as carefully controlled human supplementation trials have been conducted, questions about the efficacy and safety of these supplements have emerged. In this Educational Paper, three different supplements were selected for consideration of the benefits and risks currently associated with their intake. The selected supplements include β-carotene, selenium, and genistein. The use of each is discussed in the context of preclinical and clinical data that provide evidence for both their use in reducing disease incidence and the possible liabilities that accompany their enhanced consumption. Variables that may influence their impact, such as lifestyle habits, baseline nutritional levels, and genetic makeup are considered and the application of these issues to broader classes of supplements is discussed.

Topics: Animals; Antioxidants; beta Carotene; Chemoprevention; Chronic Disease; Dietary Supplements; Feeding Behavior; Genistein; Health; Humans; Life Style; Meta-Analysis as Topic; Nutritional Physiological Phenomena; Primary Prevention; Randomized Controlled Trials as Topic; Selenium

The authors performed a matched case-control study (1982-2007) nested in a prospective cohort of 22,071 US men to determine the prevalence of chronic diseases of aging in those with newly diagnosed cancer. They matched one control by age to each of 5,622 men who developed cancer over the 25 years of follow-up, as of the date of cancer diagnosis. A modified Charlson score was calculated that reflected comorbidities prior to the matching date, and the authors used conditional logistic regression to determine the odds ratios of various diseases. No substantial differences were found between the scores of cases and controls overall, by cancer subtype, or by age at diagnosis. Overall, men who developed cancer were less likely to have had hypercholesterolemia (odds ratio (OR) = 0.79, 95% confidence interval (CI): 0.72, 0.87) or coronary artery disease (OR = 0.85, 95% CI: 0.77, 0.96). Compared with controls, men with cancers for which there is routine screening had fewer diseases, whereas those with smoking-related cancers had more. Prostate cancer was inversely associated with both coronary artery disease (OR = 0.72, 95% CI: 0.62, 0.84) and diabetes (OR = 0.72, 95% CI: 0.58, 0.89). Overall, men who developed cancer had no more comorbidity or frequent history of chronic disease than their age-matched controls.

Topics: Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; beta Carotene; Cardiovascular Diseases; Case-Control Studies; Chronic Disease; Comorbidity; Drug Administration Schedule; Health Status; Humans; Male; Middle Aged; Neoplasms; Prevalence; Risk Factors; Smoking

Individual plasma carotenoids have been associated with various chronic diseases but little is known about the relationship between total plasma carotenoids and risk factors for chronic diseases. In the Physicians' Health Study, we examined 492 men free of CVD and cancer for the relationship between total plasma carotenoids (the sum of alpha-carotene, beta-carotene, lycopene, zeaxanthin, lutein and beta-cryptoxanthin) and a wide variety of factors that predict chronic disease. Multivariate linear and logistic regression was performed to calculate parameter estimates (95% CI) and OR (95% CI) for total plasma carotenoids. In linear regression models, BMI, hypertension, alcohol intake and plasma levels of each lipid parameter and a-tocopherol significantly predicted levels of total plasma carotenoids. Upon adjustment for multiple chronic disease risk factors, the OR for levels of total plasma carotenoids greater than or equal to the median (> or=1.301 micromol/l) was statistically significant for current smoking (OR 0.21; 95% CI 0.06, 0.77), weekly alcohol ingestion (OR 2.30; 95% CI 1.06, 4.99), daily alcohol ingestion (OR 2.46; 95% CI 1.29, 4.67), each 100 mg/l increase in total cholesterol (OR 0.73; 95% CI 0.58, 0.91), LDL-cholesterol (OR 1.48; 95% CI 1.17, 1.89) and HDL-cholesterol (OR 1.58; 95% CI 1.26, 1.99), each 100 mg/ml increase in intercellular adhesion molecule-1 (OR 0.70; 95% CI 0.53, 0.93) and each 10 micromol/l increase in alpha-tocopherol (OR 1.33; 95% CI 1.12, 1.57), using logistic regression. Few lifestyle and clinical risk factors appear to be related to levels of total plasma carotenoids; however, levels of biomarkers such as plasma lipids and alpha-tocopherol may be strongly related.

Topics: Aged; Alcohol Drinking; alpha-Tocopherol; beta Carotene; Cardiovascular Diseases; Carotenoids; Cholesterol; Chronic Disease; Cross-Sectional Studies; Cryptoxanthins; Humans; Life Style; Logistic Models; Lutein; Lycopene; Male; Middle Aged; Risk; Risk Factors; Smoking; Vitamins; Xanthophylls; Zeaxanthins

Low circulating levels of carotenoids have been associated with cardiovascular disease. The distribution of different carotenoids in blood may have an impact on the cardioprotective capacity. The aim of the present study was to determine the plasma levels of 6 major carotenoids in patients with coronary artery disease (CAD) and relate the findings to clinical, metabolic and immune parameters.. Plasma levels of oxygenated carotenoids (lutein, zeaxanthin, beta-cryptoxanthin) and hydrocarbon carotenoids (alpha-carotene, beta-carotene, lycopene) were determined in 39 patients with acute coronary syndrome, 50 patients with stable CAD and 50 controls. Serological assays for inflammatory activity and flow cytometrical analysis of lymphocyte subsets were performed. Both patient groups had significantly lower plasma levels of oxygenated carotenoids, in particular lutein+zeaxanthin, compared to controls. Low levels of oxygenated carotenoids were associated with smoking, high body mass index (BMI), low high density lipoprotein (HDL) cholesterol and, to a minor degree, inflammatory activity. Plasma levels of lutein+zeaxanthin were independently associated with the proportions of natural killer (NK) cells, but not with other lymphocytes, in blood.. Among carotenoids, lutein+zeaxanthin and beta-cryptoxanthin were significantly reduced in CAD patients independent of clinical setting. The levels were correlated to a number of established cardiovascular risk factors. In addition, the relationship between NK cells and lutein+zeaxanthin may indicate a particular role for certain carotenoids in the immunological scenario of CAD.

Topics: Acute Disease; Aged; Angina Pectoris; beta Carotene; Biomarkers; C-Reactive Protein; Carotenoids; Chronic Disease; Coronary Artery Disease; Cryptoxanthins; Female; Humans; Interleukin-6; Killer Cells, Natural; Lutein; Lycopene; Lymphocyte Count; Male; Middle Aged; Myocardial Ischemia; Xanthophylls; Zeaxanthins

Human serum contains many different antioxidants which may be important in the maintenance of antioxidant status. beta-carotene and lycopene are carotenoids with potent antioxidant activity. Carotenoids intake probably protects against cancers and may affect the risk of several chronic conditions. alpha-tocopherol is well known for its function as antioxidant and in reduction of heart disease and cancer risk. We aimed to establish baseline values for serum beta-carotene, lycopene and alpha-tocopherol concentrations in healthy northeast Thais. Fasting serum beta-carotene, lycopene and alpha-tocopherol levels from 294 subjects aged 23-75 years old in northeast Thailand were determined by high performance liquid chromatography (HPLC). The mean serum beta-carotene, lycopene and alpha-tocopherol levels were 0.53 +/- 0.32 micromol/L, 0.57 +/- 0.37 micromol/L, and 26.64 +/- 14.85 micromol/L respectively. Serum beta-carotene and lycopene levels in females (N = 118) were significantly higher than the value for males (N = 176), ie 0.60 +/- 0.31 micromol/L versus 0.48 +/- 0.32 micromol/L (p = 0.002) for beta-carotene and 0.74 +/- 0.38 micromol/L versus 0.46 +/- 0.33 micromol/L (p<0.001) for lycopene whereas alpha-tocopherol level in males (28.60 +/- 14.34 micromol/L) was significantly higher than in females (23.72 +/- 15.16 micromol/L) (p = 0.006). beta-carotene level was positively correlated with alpha-tocopherol (r = 0.22, p<0.001) and lycopene levels (r = 0.63, p<0.001). The results from this study give the baseline data of serum beta-carotene, lycopene and alpha-tocopherol levels in healthy northeast Thai population and also suggest future study on the relationship of dietary intake.

Topics: Adult; Aged; alpha-Tocopherol; Antioxidants; beta Carotene; Carotenoids; Chromatography, High Pressure Liquid; Chronic Disease; Diet; Fasting; Female; Health Status; Humans; Lycopene; Male; Middle Aged; Sex Factors; Thailand

We report for the first time the antioxidant and antimutagenic activities of fractions from Randia echinocarpa fruit, which is a Rubiaceae plant native to Sinaloa, Mexico. This fruit has been traditionally used in the prevention or treatment of cancer, among other diseases. The pulp of the fruit was sequentially extracted with solvents of different polarity (i.e. hexane, chloroform, methanol and water). A high extraction yield was obtained with methanol (72.17% d.w.). The aqueous extract showed the highest content of phenolics (2.27 mg/g as ferulic acid equivalents) and the highest antioxidant activity based on the beta-carotene bleaching method (486.15). The commercial antioxidant BHT was used as control (835.05). Antimutagenic activity of the aqueous extract (0-500 microg/tube) was evaluated using the Salmonella microsuspension assay (YG1024 strain) and 1-NP as the mutagen (50 and 100 ng/tube). The aqueous extract was neither toxic nor mutagenic and the percentage of inhibition on 1-NP mutagenicity was 32 and 53% at doses of 50 and 100 ng/tube, respectively. The results of the double incubation assay suggest that the extract inhibited the mutagenicity of 1-NP by a combination of desmutagenic and bioantimutagenic effects.

Topics: Antimutagenic Agents; Antioxidants; beta Carotene; Chronic Disease; DNA Damage; Dose-Response Relationship, Drug; Fruit; Mutagenicity Tests; Mutagens; Mutation; Plant Extracts; Rubiaceae; Salmonella typhimurium

Overweight and obesity are well-established risk factors for cardiovascular disease and decline in kidney function in individuals with existing chronic kidney disease (CKD). Conversely, their association with the development of CKD is less clear.. We evaluated the association between body mass index (BMI) and risk for CKD in a cohort of 11,104 initially healthy men who participated in the Physicians' Health Study and provided a blood sample after 14 years. BMI was calculated from self-reported weight and height. We estimated glomerular filtration rate (GFR) by using the abbreviated equation from the Modification of Diet in Renal Disease Study and defined CKD as GFR less than 60 mL/min/1.73 m2 (<1 mL/s/1.73 m2).. After an average 14-year follow-up, 1,377 participants (12.4%) had a GFR less than 60 mL/min/1.73 m2 (<1 mL/s/1.73 m2). Higher baseline BMI was associated consistently with increased risk for CKD. Compared with participants in the lowest BMI quintile (<22.7 kg/m2), those in the highest quintile (>26.6 kg/m2) had an odds ratio (OR) of 1.45 (95% confidence interval [CI], 1.19 to 1.76; P trend <0.001) after adjusting for potential confounders. We found similar associations by using different categories of BMI. Compared with men who remained within a +/-5% range of their baseline BMI, those who reported a BMI increase greater than 10% had a significant increase in risk for CKD (OR, 1.27; 95% CI, 1.06 to 1.53).. In this large cohort of initially healthy men, BMI was associated significantly with increased risk for CKD after 14 years. Strategies to decrease CKD risk might include prevention of overweight and obesity.

Topics: Adult; Aspirin; beta Carotene; Body Mass Index; Cardiovascular Diseases; Chronic Disease; Cohort Studies; Diabetes Complications; Follow-Up Studies; Glomerular Filtration Rate; Humans; Hypercholesterolemia; Hypertension; Kidney Diseases; Male; Middle Aged; Neoplasms; Obesity; Overweight; Prospective Studies; Randomized Controlled Trials as Topic; Risk Factors; Smoking; United States

The aim of the study was to determine oxidative stress in patients with acute and chronic viral hepatitis B.. 23 (11 F, 12 M) healthy controls, 23 (8 F, 15 M) patients with acute viral hepatitis B (AVHB) and 25 (9 F, 16 M) patients with chronic viral hepatitis B (CVHB) were studied. Serum malondialdehyde (MDA), conjugated dienes (CD), ALT, AST, total and direct bilirubins, beta-carotene and whole blood reduced glutathione (GSH) levels of all subjects were measured. In patients with CVHB, these parameters were measured both before and 6 months after treatment with interferon-alpha (IFN-alpha).. MDA, CD, ALT, AST and total and direct bilirubin levels of the patients with AVHB and CVHB before treatment were significantly higher (P<0.001) whereas GSH and beta-carotene levels were lower (P<0.001) than those of the controls. MDA, CD, GSH, beta-carotene, ALT, AST and total and direct bilirubin levels of the patients with CVHB returned approximately to normal levels 6 months after treatment with IFN-alpha.. Our results clearly show that patients with AVHB and CVHB are under the influence of increased oxidative stress (MDA and CD were increased) associated with lower levels of some antioxidants (beta-carotene and GSH). These impairments return to normal levels after IFN-alpha treatment of CVHB patients. These findings suggest that antioxidant supplementation might be considered in patients with acute or chronic hepatitis B.

Topics: Acute Disease; Adult; Alkadienes; Antioxidants; beta Carotene; Chronic Disease; Female; Glutathione; Hepatitis B; Humans; Interferon-alpha; Male; Malondialdehyde; Oxidative Stress

The results of sterilized milk enriched with beta-carotene usage for nutrition of children under school age in Kursk town is presented. 140 weakened children at the age of 1.5-7 years old attending the children dispensary were tested within the period of 3 years. It was stated that under the influence of beta-carotene in the children allowance acute and chronic diseases including diseases of breathe organs, blood system and the level of respiratory diseases have been reduced. The wide usage of dairy products enriched with beta-carotene in medical-prophylactic nutrition of children under school age is recommended.

Topics: Acute Disease; Animals; beta Carotene; Child; Child, Preschool; Chronic Disease; Food, Fortified; Humans; Infant; Milk; Nutritional Status; Respiratory Tract Diseases; Russia; Sterilization

Inclusion of vitamin-containing soft drink and oil solution of beta-carotene in the diet of the 4-14 years old children suffering from gastrointestinal diseases lead to vitamin and antioxidant status improvement with simultaneous positive effects on their clinical condition. Polyhypovitaminosis frequency had decreased. Thus, there is every reason to fortify diets of the patients suffering from gastrointestinal diseases with vitamins-antioxidants.

Topics: Adolescent; Avitaminosis; beta Carotene; Beverages; Child; Child, Preschool; Chronic Disease; Duodenitis; Gastritis; Humans; Lipid Peroxidation; Vitamins

Chronic heart failure (CHF) seems to be associated with increased oxidative stress. However, the hypothesis that antioxidant nutrients may contribute to the clinical severity of the disease has never been investigated.. To examine whether antioxidant nutrients influence the exercise capacity and left ventricular function in patients with CHF.. Dietary intake and blood levels of major antioxidant nutrients were evaluated in 21 consecutive CHF patients and in healthy age- and sex-matched controls. Two indexes of the severity of CHF, peak exercise oxygen consumption (peak VO2) and left ventricular ejection fraction (LVEF), were measured and their relations with antioxidants were analysed.. Whereas plasma alpha-tocopherol and retinol were in the normal range, vitamin C (P=0.005) and beta-carotene (P=0.01) were lower in CHF. However, there was no significant association between vitamins and either peak VO2 or LVEF. Dietary intake (P<0.05) and blood levels of selenium (P<0.0005) were lower in CHF. Peak VO2 (but not LVEF) was strongly correlated with blood selenium: r=0.76 by univariate analysis (polynomial regression) and r=0.87 (P<0.0005) after adjustment for age, sex and LVEF.. Antioxidant defences are altered in patients with CHF. Selenium may play a role in the clinical severity of the disease, rather than in the degree of left ventricular dysfunction. Further studies are warranted to confirm the data in a large sample size and to investigate the mechanisms by which selenium and other antioxidant nutrients are involved in CHF.

Topics: Adult; Aged; Antioxidants; Ascorbic Acid; beta Carotene; Cardiomyopathies; Chronic Disease; Feeding Behavior; Female; Heart Failure; Humans; Male; Middle Aged; Oxidative Stress; Selenium; Ventricular Function, Left

Vitamin status was assessed in 26 recently institutionalized elderly subjects by combining dietary and biochemical measurements of thiamin, riboflavin, niacin, beta-carotene, vitamins C, A, D and E at admission (P1), and 1.5 (P2), 3.0 (P3), 4.5 (P4), 6.0 (P5), 12 (P6) months later. At admission, except for vitamin A, mean vitamin intakes were lower than the 1992 French Recommended Dietary Allowance. Thiamin, vitamins C, A and E status seemed nearly satisfactory as less than one-fourth of the population sample had blood values lower than the cut-off point for thiamin (erythrocyte thiamin pyrophosphate < 0.17 mumol/l), vitamin A (serum retinol < 1.05 mumol/l), vitamin C (serum vitamin C < 11.3 mumol/l) and vitamin E (serum alpha-tocopherol < 9.3 mumol/l) or higher than the cut-off point for thiamin (erythrocyte transketolase activity coefficient > 1.19). Almost half of the subjects for riboflavin, and almost all non supplemented subjects for vitamin D were in risk of vitamin deficiency (46% had an erythrocyte glutathione reductase activity coefficient > 1.19 and 72% had a plasma 25(OH)D3 < 25 nmol/l). During the study, vitamins status remained unchanged for riboflavin, niacin, vitamins A, D and E, improved for vitamin C (P = 0.004) or impaired for thiamin (P = 0.008). Thus, institutionalization seemed to have no effect on riboflavin, niacin, vitamins A, D and E status and a slight effect on thiamin and vitamin C status.

Topics: Aged; Aged, 80 and over; Aging; Alcohol Drinking; Ascorbic Acid; beta Carotene; Chronic Disease; France; Humans; Institutionalization; Niacin; Nutrition Policy; Nutritional Status; Riboflavin; Smoking; Thiamine; Vitamin A; Vitamin D; Vitamin E; Vitamins

Oxidation stress and decreased antioxidative capacity participate in the progression and complications of renal diseases such as hyperlipoproteinemia or cardiovascular diseases. Many data have been collected on oxidation stress in dialysed patients, however a shortage of information is evident in conservatively treated patients.. To determine the blood and/or plasma levels of MDA and the selected antioxidants, i.e. Coenzyme Q10 (CoQ), alpha-tocoferol, beta-carotene in conservatively treated patients with kidney diseases.. Fifty five patients (45 with interstitial nephritis and 10 with glomerulonephritis) were included. They were divided into 3 subgroups on the basis of their clearance of creatinine (Ckr). Only validated methods have been exploited for the determination of variables.. MDA plasma levels were increased (5.37 +/- 0.10, reference range (rr.) < 4.5 mumol/l) with the highest levels in patients treated by immunosuppression. CoQ plasma (0.35 +/- 0.04, rr. 0.4-1.0 mumol/l) and blood (0.30 +/- 0.03 mol/l) were decreased, notably in patients with interstitial nephritis. No correlation with Ckr was apparent. alpha-tocopherol plasma levels (42.1 +/- 3.04, rr. 15-40 mumol/l) were increased, but the concentrations increased further with the decreasing kidney function. beta-carotene plasma (2.14 +/- 0.39, rr. > 0.8 mumol/l) were in reference range but decreased with the decrease of kidney function.. CoQ plasma levels are decreased and MDA levels increased in conservatively treated kidney disease patients even in just slightly decreased renal function. beta-carotene levels decrease only in advanced renal failure. These changes could participate in kidney disease progression and it is suggested that their correction opens the possibility of progression inhibition. (Tab. 3, Ref. 27.)

Topics: Adolescent; Adult; Aged; Antioxidants; beta Carotene; Chronic Disease; Glomerulonephritis; Humans; Immunosuppressive Agents; Malondialdehyde; Middle Aged; Nephritis, Interstitial; Ubiquinone; Vitamin E

This study investigated whether a high dietary intake or serum concentration of antioxidant (pro-) vitamins could attenuate the acute respiratory effects of air pollution in panels of adults (n = 227) aged 50-70 yrs with chronic respiratory symptoms in two winters starting in 1993/1994. Subjects performed daily peak expiratory flow (PEF) measurements in the morning and evening and reported the occurrence of respiratory symptoms in two regions (urban and nonurban) each winter. Logistic regression analysis was used with the prevalences of large PEF decrements as dependent variables and air pollution levels as independent variables. Analyses were performed separately for subjects below and above the median levels of serum beta-carotene and the intake of dietary vitamin C and beta-carotene. Subjects with low levels of serum beta-carotene more often had large PEF decrements when particles <10 microm in diameter or black smoke levels which were higher compared to subjects with high levels of serum beta-carotene. The same results tended to be observed for dietary vitamin C or beta-carotene, but there were less significant air pollution effects in the low dietary antioxidant group. The results suggest that serum beta-carotene and to a lesser extent dietary vitamin C and beta-carotene may attenuate peak expiratory flow decrements due to air pollution in subjects with chronic respiratory symptoms.

Topics: Aged; Air Pollution; Antioxidants; Ascorbic Acid; beta Carotene; Chronic Disease; Diet; Female; Humans; Male; Middle Aged; Netherlands; Peak Expiratory Flow Rate; Respiratory Tract Diseases; Seasons; Smoke; Urban Health

Epidemiological evidence indicates that aflatoxin B1 (AFB1) intake is associated with an increased risk of hepatocellular carcinoma (HCC). The hepatocarcinogenesis is initiated by covalent binding of AFB1 to cellular DNA. To determine whether nutritional factors and hormonal status may influence the binding of AFB1 to hepatic DNA, a cross-sectional study was performed on a total of 42 male asymptomatic hepatitis B surface antigen (HBsAg) carriers and 43 male non-carriers in a cohort study on the multistage development of HCC in Taiwan. The major AFB1-DNA adduct in vivo, AFB1-N7-guanine, was measured by high-performance liquid chromatography in urine. Urinary AFB1-N7-guanine was detectable in 40% of the subjects. HBsAg carriers had a higher detection rate of urinary AFB1-DNA adducts than non-carriers and the difference was statistically significant after multivariate adjustment. After taking into account the total AFB1 urinary metabolite level, chronic HBsAg carrier status, and other potential confounders, plasma levels of cholesterol, alpha-tocopherol, and alpha- and beta-carotene were positively associated with the detection rate of the AFB1-DNA adducts in a dose-dependent manner, whereas plasma lycopene level was inversely related to the presence of the adducts in urine. The association of urinary AFB1-DNA adducts with the plasma levels of cholesterol, alpha-tocopherol, lycopene, and alpha- and beta-carotene was observed at both low and high exposure levels of AFB1. There was a synergistic interaction of plasma alpha-tocopherol with alpha- and beta-carotene on the adduct levels. No association with the adducts was found for plasma levels of retinol and testosterone. This study demonstrated different associations of antioxidant vitamins with AFB1-DNA adduct formation. The data consistent with our previous finding in cultured woodchuck hepatocytes that alpha-tocopherol and beta-carotene enhanced AFB1-DNA adduct formation suggest that prospective investigation of the relationship between plasma micronutrients and risk of AFB1-related HCC is warranted.

Topics: Adult; Aflatoxin B1; Aged; Antioxidants; beta Carotene; Carotenoids; Chronic Disease; DNA; DNA Adducts; Guanine; Hepatitis B; Hepatitis B Surface Antigens; Hepatitis B virus; Humans; Liver; Liver Neoplasms; Male; Middle Aged; Testosterone; Vitamin E; Vitamins

48 patients from flying personnel with chronic diseases of the liver have been studied. Considering poor effectiveness of the available hepatotropic drugs, a new B-caratinoid, veteron, was used at different daily doses. Findings of this study allowed us to draw inferences not only about more efficient clinical effect of this preparation beginning from a daily dose of 160 mg/day but also about its immunomodulating and pro-oxidant action. Thus, veteron is optimal for patients with chronic disorders of the immunologic and antioxidant systems and can be effectively used in treatment of these diseases.

Topics: Adult; Antibody Formation; beta Carotene; Chronic Disease; Drug Evaluation; Hepatitis; Humans; Immunity, Cellular

It has been asserted that clinical trials hold the answer to questions about the role of nutrients in preventing chronic diseases. This is not the case. Clinical trials give us rigorous answers to restricted questions. Rarely can more than one or two substances be tested, usually at a single dose. Subjects usually have to be persons with precancerous conditions or an extremely high risk of the disease in question. Rarely can any diseases other than the most common ones be studied. Most important, clinical trials test the efficacy of an agent that is administered for a limited time, beginning fairly late in life. Few trials will tell us anything about whether dietary amounts of nutrients might contribute to prevention of long-term chronic diseases. They also tell us nothing about whether agents at high doses might reduce disease risk if taken throughout the lifetime. Furthermore, they tell us nothing about other antioxidants, other combinations, or other doses. Clinical trials were developed for therapeutic situations to determine which treatment was better for curing a specific disease. However, the questions about prevention that are of interest may involve persons with no unusual risk of disease, lifetimes of exposure, enormously complex interactions among nutrients, and the effects of these nutrients on hundreds of often uncommon disease conditions. Clinical trials simply cannot answer these questions. Only a solid examination of the laboratory and epidemiologic evidence can approximate the answers to most of the questions of interest.

Topics: beta Carotene; Carotenoids; Chronic Disease; Clinical Trials as Topic; Humans; Neoplasms

Biochemical assessments of micronutrient antioxidant status were done in 14 consecutive black patients with calcific chronic pancreatitis and 15 controls at Soweto, near Johannesburg in southern Africa. The patients showed subnormal levels of vitamin C in plasma; selenium, beta-carotene and alpha-tocopherol in serum; and inorganic sulphate (as an index of long-term sulphur amino acid intake) in urine (P < 0.001 for each): furthermore, among the patients ascorbate constituted a lower fraction of vitamin C (P < 0.002), indicating heightened oxidation of the bioactive form. By comparing the results in Sowetan controls with reference ranges from Manchester, UK, the markedly lower vitamin C and, hence, ascorbate levels in the Sowetans was underlined (P < 0.001) and their selenium levels were also lower (P < 0.001), but beta-carotene, alpha-tocopherol and inorganic sulphate levels were comparable. The very low bioavailability of ascorbate among Sowetan controls is reminiscent of our previous finding in outwardly healthy people at Madras in southern India: in both these areas chronic pancreatitis is currently endemic, has a propensity to pancreatic calculi and runs a virulent course towards premature death from diabetes, malnutrition or pancreatic cancer. Considering that low ascorbate levels are a feature in patients with chronic pancreatitis who develop pancreatic calculi at Manchester and that antioxidant supplements ameliorate painful symptoms, we suggest that poor antioxidant intake may predispose underprivileged tropical communities to the disease. If so, there could be an opportunity for prophylaxis through a daily tablet containing vitamin C, perhaps along with selenium at Soweto and beta-carotene at Madras.

Topics: Adult; Antioxidants; Ascorbic Acid; beta Carotene; Black People; Carotenoids; Chronic Disease; Female; Humans; Male; Micronutrients; Middle Aged; Pancreatitis; Reference Values; Selenium; South Africa; Sulfates; Vitamin E

Chronic gamma irradiation of rats at a dose rate of 12.9 rad/day for 155 days (total dose 20 Gy) did not change the cholesterol level in the brush border membrane of the small intestine. Maintenance of rats on a beta-carotene-enriched diet (daily throughout the irradiation period, at a diurnal dose of 3 mg/kg body weight produced an increase in cholesterol levels in the small intestinal brush border membranes. The phospholipid level after gamma irradiation alone did not change, but it was increased in gamma-irradiated rats fed with carotene, this increase being most pronounced for sphingomyelin. Beta-carotene decreased the cholesterol/phospholipid ratio in the brush border membrane of irradiated rats. Activation of lipid synthesis (as seen from inclusion of 2-14C-acetate in the epitheliocyte lipids of irradiated animals) and no influence of beta-carotene on the inclusion of the label in small intestine epitheliocytes of irradiated animals have been revealed. In the presynaptic membranes of brain nerve endings, chronic gamma irradiation of animals produced a deep fall of cholesterol and phospholipid levels. Also, a tendency was revealed for stimulation of transport of the neurotransmitter amino acids GABA and L-glutamate across the presynaptic membranes of nerve endings. Beta-carotene normalized the phospholipid and cholesterol levels in brain presynaptic membranes of irradiated rats, as well as decreased L-glutamate transport. It is assumed that the modifying and normalizing effects of beta-carotene on the lipid exchange of plasma membranes upon chronic irradiation of animals and permanent introduction of the drug are associated with the radioprotector activity of beta-carotene.

Topics: Animals; beta Carotene; Brain; Carotenoids; Chronic Disease; Epithelium; Gamma Rays; Intestinal Mucosa; Intestine, Small; Intracellular Membranes; Membrane Lipids; Microvilli; Neurons; Radiation Injuries, Experimental; Radiation Tolerance; Rats

Topics: Adult; beta Carotene; Cardiovascular Diseases; Carotenoids; China; Chronic Disease; Deficiency Diseases; Diet; Humans; Neoplasms; Selenium; Vitamin E

The supplementation of an enteral feeding formula on soya-basis specially designed for geriatric patients with 1,5 mg to 2 mg beta-carotene per day increases its corresponding plasmatic concentration from 20 mcg/L to normal to optimal levels near 500 mcg/L. This intake is much lower than the proposed safe intake of 6-20 mg beta-carotene per day. A close incorporation of beta-carotene in the lipid moiety of the ready-to-use formula might increase its bioavailability. The other anti-oxidative vitamins A and E remain to their respective normal levels at a supplemental daily intake of 2500 IU vitamin A and 12,5 mg vitamin E. The new enteral feeding formula for geriatric patients seems to cover their global nutritional needs.

Topics: Adult; Aged; beta Carotene; Carotenoids; Chronic Disease; Enteral Nutrition; Humans; Middle Aged; Nutritional Requirements; Pilot Projects; Vitamin A; Vitamin E

In a prospective study, several parameters of small intestinal function have been assessed in 20 patients with chronic relapsing pancreatitis with and without steatorrhoea. By and large all routine parameters of small intestinal function were found to be normal. In particular, neither a previously reported high incidence of lactase deficiency, nor D-xylose malabsorption or vitamin B12 depletion was observed. However, there was a high incidence of abnormal 14C-cholylglycine breath tests (40%), suggesting the presence of mild bacterial overgrowth. Occasionally, this condition was associated with diarrhoea and steatorrhoea, thus indicating that steatorrhoea remaining after high-dosage pancreatin supplementation might sometimes be due to bacterial overgrowth.

Topics: Alcoholism; beta Carotene; Breath Tests; Carotenoids; Chronic Disease; Fats; Feces; Folic Acid; Glycocholic Acid; Humans; Intestinal Absorption; Intestine, Small; Pancreatitis; Prospective Studies; Recurrence; Vitamin B 12

Actinic prurigo is a chronic photodermatitis found predominantly in North American Indians. Other terms have been used to describe similar cases in Central and South America and in Europe. Relatively little has been written about this condition in the English literature, and confusion exists over whether this is a form of polymorphic light eruption. Actinic prurigo can be considered a unique variant of polymorphic light eruption; however, we believe that certain differences help to distinguish actinic prurigo as a separate disease entity. Herein we report three cases of this disease and review the related literature. Characteristic clinical features include prurigolike papules and cheilitis. Pruritus is the predominant symptom, and a familial tendency and an early age at onset are usually noted. Results of karyotyping and analysis of sister chromatid exchanges were normal in two of our patients so tested. Skin testing for photosensitivity has yielded inconsistent results, and use of light testing for diagnosing actinic prurigo does not seem to be a predictable procedure. Actinic prurigo is a chronic disease that often is refractory to therapy.

Topics: Adult; beta Carotene; Carotenoids; Child; Chronic Disease; Female; Furocoumarins; Humans; Indians, North American; Karyotyping; Male; Photosensitivity Disorders; Prurigo; Sunlight