Table 2.
Evidence of the effects of carotenoids on CVD health from randomized controlled trials.
| Carotenoids | Study Design | Intervention | Outcome | References |
|---|---|---|---|---|
| Classical CVD Risk Factors | ||||
| Lutein | RCT, parallel, double-blinded, Healthy subjects (n = 117) |
10, 20 mg lutein for 12 weeks | ↔ TG, LDL-C, HDL-C | [38] |
| RCT, parallel, double-blinded, Early atherosclerosis patients (n = 65) |
20 mg lutein for 12 weeks | ↓ TG, LDL-C ↔HDL |
[36] | |
| Zeaxanthin | RCT, parallel, Metabolic syndrome patients (n = 50) |
14 g Goji berry for 45 days | ↓ TC, LDL-C, VLDL-C ↑ HDL-C |
[37] |
| β-cryptoxanthin | RCT, parallel, double-blinded, Healthy subjects (n = 117) |
β-cryptoxanthin-rich satsuma mandarin juice for 12 weeks | ↔ LDL-C, HDL-C, TG, SBP, DBP | [39] |
| Astaxanthin | Meta-analysis | Astaxanthin | ↔ TC, LDL-C, HDL-C, TG | [42] |
| Lycopene | RCT, crossover, double-blinded, Hypertensive subjects (n = 46) |
Tomato nutrient complex (equivalent to 5, 15 and 30 mg lycopene) for 8 weeks | ↓ SBP | [45] |
| Meta-analysis | Lycopene or lycopene-rich foods | ↓ LDL-C ↔ TC, HDL-C, TG |
[41] | |
| Meta-analysis | Lycopene | ↓ SBP ↔ DBP, TC, LDL-C, HDL-C, TG |
[40] | |
| Meta-analysis | Tomato | ↓ LDL-C, ↔ SBP, DBP, TC, HDL-C, TG |
[40] | |
| Oxidative Stress | ||||
| LDL oxidation | ||||
| Astaxanthin | RCT, parallel, open labeled, Healthy subjects (n = 24) |
1.8, 3.6, 14.4, 21.6 mg astaxanthin for 2 weeks | ↑ LDL lag-time | [57] |
| Lycopene | RCT, parallel, double-blinded, CVD patients (n = 36), Healthy subjects (n = 36) |
7 mg Lycopene for 2 months | ↔ ox-LDL | [52] |
| RCT, parallel, single-blinded, Healthy subjects (n = 225) |
Tomato or 10 mg lycopene capsules for 12 weeks | ↔ ox-LDL | [53] | |
| RCT, parallel, double-blinded, Healthy subjects (n = 77) |
6.5, 15, 30 mg lycopene for 8 weeks | ↔ LDL oxidation rate | [54] | |
| Meta-analysis | Lycopene | ↔ LDL lag-time | [55] | |
| Carotenoid mixture | RCT, crossover, double-blinded, Healthy subjects (n = 31) |
4.4 mg lutein, 6.0 mg β-carotene, 1.4 mg α-carotene, 4.5 mg lycopene, 11.7 mg bixin and 2.2 mg paprika for 3 weeks | ↑ LDL lag-time | [56] |
| Lipid oxidation/peroxidation products | ||||
| Lutein | RCT, parallel, double-blinded, Healthy subjects (n = 117) |
10, 20 mg lutein for 12 weeks | ↓ MDA | [38] |
| Zeaxanthin | RCT, parallel, Metabolic syndrome patients (n = 50) |
14 g Goji berry for 45 days | ↓ MDA | [37] |
| RCT, parallel, double-blinded, Healthy subjects (n = 40) |
15 g Goji berry for 16 weeks | ↓ 8-iso-PGF2α, ↔ MDA |
[63] | |
| Astaxanthin | RCT, parallel, double-blinded, Healthy subjects (n = 58) |
12 mg astaxanthin for 12 months | ↔ F2-isoPs | [91] |
| β-carotene | RCT, parallel, Healthy male workers exposed to lead (n = 82) |
10 mg β-carotene for 12 weeks | ↓ MDA, LHP | [60,62] |
| Lycopene | RCT, parallel, double-blinded, Healthy subjects (n = 77) |
6.5, 15, 30 mg lycopene for 8 weeks | ↔ MDA, HNE | [54] |
| RCT, parallel, double-blinded, Healthy males (n = 105) |
30 mg lycopene for 3 weeks | ↔ MDA | [61] | |
| RCT, parallel, Postmenopausal females (n = 60) |
Regular, lycopene-rich tomato juice (equivalent to 30 and 70 mg lycopene), 30 mg lycopene capsules for 6 months | ↓ MDA | [65] | |
| RCT, crossover, double-blinded, Healthy subjects (n = 26) |
Tomato-based drink for 26 days | ↔ 8-iso-PGF2α | [64] | |
| Total antioxidant capability | ||||
| Lutein | RCT, parallel, double-blinded, Healthy subjects (n = 117) |
10, 20 mg lutein for 12 weeks | ↑ TAOC | [38] |
| Zeaxanthin | RCT, parallel, Metabolic syndrome patients (n = 50) |
14 g Goji berry for 45 days | ↑ TAOC | [37] |
| Lycopene | RCT, parallel, Postmenopausal females (n = 60) |
Regular juice, lycopene-rich tomato juice (equivalent to 30 and 70 mg lycopene), 30 mg lycopene capsules for 6 months | ↑ TAOC | [65] |
| Carotenoid mixture | RCT, crossover, double-blinded, Healthy subjects (n = 31) |
4.4 mg lutein, 6.0 mg β-carotene, 1.4 mg α-carotene, 4.5 mg lycopene, 11.7 mg bixin and 2.2 mg paprika for 3 weeks | ↔ ORAC | [56] |
| Antioxidant enzymes | ||||
| Lutein | RCT, parallel, double-blinded, Healthy subjects (n = 117) |
10, 20 mg lutein for 12 weeks | ↔ SOD, GPx, CAT | [38] |
| Zeaxanthin | RCT, parallel, Metabolic syndrome patients (n = 50) |
14 g Goji berry for 45 days | ↓ SOD ↑ CAT |
[37] |
| β-carotene | RCT, parallel, Healthy male workers exposed to lead (n = 82) |
10 mg β-carotene for 12 weeks | ↑ SOD, EC-SOD, CAT, G6PD ↓ GPx ↔ GR, GST |
[60,62] |
| Lycopene | RCT, parallel, Postmenopausal females (n = 60) |
Regular, lycopene-rich tomato juice (equivalent to 30 and 70 mg lycopene), 30 mg lycopene capsules for 6 months | ↔ SOD, GPx, CAT | [65] |
| RCT, parallel, double-blinded, Healthy males (n = 126) |
6, 15 mg lycopene for 8 weeks | ↑ SOD | [71] | |
| DNA damage | ||||
| Lutein | RCT, crossover, Healthy subjects (n = 8) |
15 mg lutein for 1 week | ↔ DNA tail intensity | [75] |
| RCT, parallel, double-blinded, Postmenopausal females (n = 37) |
12 mg lutein for 56 days | ↓ DNA tail length | [74] | |
| β-carotene | RCT, parallel, double-blinded, Postmenopausal females (n = 37) |
12 mg β-carotene for 56 days | ↓ DNA tail length | [74] |
| RCT, crossover, Healthy subjects (n = 8) |
15 mg β-carotene for 1 week | ↓ DNA tail intensity | [75] | |
| Lycopene | RCT, parallel, double-blinded, Postmenopausal females (n = 37) |
12 mg lycopene for 56 days | ↓ DNA tail length | [74] |
| RCT, crossover, Healthy subjects (n = 8) |
15 mg lycopene for 1 week | ↓ DNA tail intensity | [75] | |
| RCT, parallel, double-blinded, Healthy males (n = 105) |
30 mg lycopene for 3 weeks | ↔ 8-OHdG | [61] | |
| Meta-analysis | Lycopene | ↓ DNA tail length | [55] | |
| Carotenoid mixture | RCT, parallel, double-blinded, Postmenopausal females (n = 37) |
4 mg lutein, 4 mg β-carotene and 4 mg lycopene for 56 days | ↓ DNA tail length | [74] |
| RCT, crossover, double-blinded, Healthy subjects (n = 31) |
4.4 mg lutein, 6.0 mg β-carotene, 1.4 mg α-carotene, 4.5 mg lycopene, 11.7 mg bixin and 2.2 mg paprika for 3 weeks | ↓ 8-OHdG: creatinine | [56] | |
| Inflammatory Markers | ||||
| Lutein/zeaxanthin | Meta-analysis | Lutein/zeaxanthin | ↓ CRP ↔ IL-6, TNF-α |
[80] |
| Astaxanthin | Meta-analysis | Astaxanthin | ↓ CRP ↔ IL-6, TNF-α |
[80] |
| β-cryptoxanthin | Meta-analysis | β-cryptoxanthin | ↓ CRP ↔ IL-6, TNF-α |
[80] |
| β-carotene | Meta-analysis | β-carotene | ↔ CRP, IL-6 | [80] |
| Lycopene | Meta-analysis | Lycopene | ↓ IL-6 ↔ CRP, TNF-α |
[80] |
| Crocin | Meta-analysis | Crocin | ↔ CRP, IL-6, TNF-α | [80] |
| Overall carotenoids | Meta-analysis | Overall carotenoids | ↓ CRP, IL-6 ↔ TNF-α |
[80] |
| Vascular Health Markers | ||||
| Endothelial function | ||||
| Zeaxanthin | RCT, parallel, double-blinded, Healthy subjects (n = 40) |
15 g Goji berry for 16 weeks | ↔ FMD | [85] |
| Lycopene | Meta-analysis | Tomato | ↑ FMD | [40] |
| RCT, parallel, double-blinded, Healthy males (n = 126) |
6, 15 mg lycopene for 8 weeks | ↑ RH-PAT | [71] | |
| Arterial stiffness | ||||
| β-cryptoxanthin | RCT, parallel, double-blinded, Healthy subjects (n = 117) |
β-cryptoxanthin–rich satsuma mandarin juice for 12 weeks | ↔ PWV | [39] |
| Astaxanthin | RCT, parallel, double-blinded, Healthy subjects (n = 58) |
12 mg astaxanthin for 12 months | ↔ PWV, AI | [91] |
| Lycopene | RCT, parallel, double-blinded, CVD patients (n = 36), Healthy subjects (n = 36) |
7 mg lycopene for 2 months | ↔ PWV, AI | [52] |
| RCT, parallel, single-blinded, Healthy subjects (n = 225) |
Tomato or 10 mg lycopene capsules for 12 weeks | ↔ PWV | [53] | |
| Vascular structure | ||||
| Lutein | RCT, parallel, double-blinded, Subjects with subclinical atherosclerosis (n = 144) |
20 mg lutein for 12 months | ↓ IMT | [94] |
| Zeaxanthin | RCT, parallel, double-blinded, Healthy subjects (n = 40) |
15 g Goji berry for 16 weeks | ↔ IMT | [85] |
| Astaxanthin | RCT, parallel, double-blinded, Healthy subjects (n = 58) |
12 mg astaxanthin for 12 months | ↔ IMT | [91] |
| Carotenoid mixture | RCT, parallel, double-blinded, Subjects with subclinical atherosclerosis (n = 144) |
20 mg lutein and 20 mg lycopene for 12 months | ↓ IMT | [94] |
Abbreviations: RCT, randomized controlled trial; TG, triglycerides; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; TC, total cholesterol; VLDL-C, very low-density lipoprotein cholesterol; SBP, systolic blood pressure; DBP, diastolic blood pressure; ox-LDL, oxidized low-density lipoprotein; LDL, low-density lipoprotein; MDA, malondialdehyde; 8-iso-PGF2α, 8-iso-prostaglandin F2α; LHP, lipid hydroperoxides; HNE, hydroxyl nonenal; F2-isoPs, F2-isoprostanes; ORAC, oxygen radical absorbance capacity; TAOC, total antioxidant capacity; SOD, superoxide dismutase; EC-SOD, extracellular superoxide dismutase; CAT, catalase; G6PD, glucose-6 phosphate dehydrogenase; GPx, glutathione peroxidase; GR, glutathione reductase; GST, glutathione-S-transferase; DNA, deoxyribonucleic acid; 8-OHdG, 8-hydroxy-2′-deoxyguanosine; CRP, C-reactive protein; IL-6, interleukin-6; TNF-α, tumor necrosis factor-α; FMD, flow-mediated dilatation; RH-PAT, reactive hyperemia–peripheral arterial tonometry; PWV, pulse wave velocity; AI, augmentation index; IMT, carotid artery intima–media thickness.