Beta-Carotene and Carotenoids

Assessment and Plan: Beta-Carotene and Carotenoids

• Beta carotene intake in the form of fruits and vegetables was associated with a lower risk of cardiovascular and cancer mortality and with a lower risk for death from all causes. Do not consume beta-carotene supplements as no benefit was seen and supplements increased levels excessively which may be harmful. Eating 5 fruits and vegetables per day provides the individual with about 5.2 to 6 mg/day of food based beta-carotene. This amount allows plasma carotenoid levels to rise to a plasma level of 0.37 umol/L associated with a lower risk of cancer, cardiovascular and all-cause mortality. A beta-carotene level of 0.34 to 0.52 umol/L is ideal. When food based beta carotene was consumed in amounts over 42 mg per day, levels increased to 0.83 umol/L which is higher than necessary.

• Upon any sign of new or worsening vision problems: As recommended by the National Eye Institute, have an eye care professional evaluate your eyes for signs of Age-related Macular Degeneration (AMD) using a dilated eye exam. If you are high risk for AMD or have signs of AMD, ask your physician whether you would benefit from the antioxidants taken as part of the Age-Related Eye Disease Study (AREDS) including vitamin C, 500 mg; vitamin E, 400 IU; beta carotene, 15 mg; and zinc, 80 mg as zinc oxide with 2 mg of cupric oxide. Contraindications to beta-carotene supplements include smoking or previous smoker, and possible contraindications to vitamin E supplements include prostate cancer of increased risk of prostate cancer. Of note, beta-carotene may increase risk of late AMD and is currently being investigated.

• If any prior diagnosis of AMD, consider enhancement of dietary intake of vitamin C, vitamin E, beta carotene, zinc, copper, omega 3 fatty acids, lutein, and zeaxanthin from foods. A reference which shows foods containing high amounts of these nutrients is available at: Nutritive Value of Foods, United States Department of Agriculture, Agricultural Research Service, Home and Garden Bulletin Number 72. May be accessed at: https://www.ars.usda.gov/SP2UserFiles/Place/12354500/Data/SR25/nutrlist/sr25w421.pdf  and http://www.nal.usda.gov/fnic/foodcomp/Data/HG72/hg72_2002.pdf

• Beta-carotene supplementation at a dose of 30 mg per day was found to be beneficial in improving skin health and function that were impaired by photo-aging, but beta carotene supplements are not recommended due to increased risk of some cancers and mortality. Instead, consume beta-carotene in the form of fruits and vegetables.

• Elderly individuals with specifically low lutein and zeaxanthin levels may be at an increased risk of atrial fibrillation and confirmatory studies are needed.