Carotenoid Absorption and Metabolism From Green-leafy Vegetable Matrices - a Explorative Study in Short-bowel Patients and Healthy Controls - The "Popeye-study"
Reduced absorption capacity in patients with intestinal resections (IR) could result in malabsorption of fat-soluble components like carotenoids, which are of clinical interest in relation to visual health. In this case cohort, we investigated the association between IR and serum lutein, zeaxanthin, β-carotene and macular pigment optical density, when compared with healthy controls. Ten patients with IR and twelve healthy controls were included in the study. Baseline characteristics were comparable between groups, except for higher serum TAG (P < 0·05) and shorter bowel length (P < 0·0001) in the group with IR. Serum lutein, zeaxanthin, β-carotene and macular pigment optical density were >15 % lower in the patient group compared with healthy controls (P < 0·05, adjusted for age) and, in the case of serum lutein and zeaxanthin, also for dietary intake of carotenoids. Results suggest that for a test of macular carotenoid supplementation, subjects with a potentially clinically significant carotenoid deficit could be recruited among patients with IR.
Serum concentration of lutein and beta-carotene. Difference in serum concentration of lutein and beta-carotene between baseline and the end of each intervention period.
Absorption and metabolism of carotenoids from two types of spinach preparations will be investigated in two study groups, short bowel/ileostomy and healthy, respectively.
The study will be conducted as a randomised, controlled, 2-way crossover study, using the baseline data in 24 participants (12 in each group). The serum, chylomicron and fecal/effluent levels of lutein and beta-carotene will be determined.
The present study found lower serum carotenoids and lower macular pigment optical densities in patients with intestinal resection than in healthy subjects. While there is no certain knowledge about the effects of having low serum carotenoid levels, there are important indications that low retinal carotenoid levels may have a deleterious effect on retinal health. Our findings suggest that patients with intestinal resection or even short bowel disease should be examined, in a scientific context, for signs of poor retinal health. Our results should be validated in larger studies.
- Intestinal diseases (among healthy controls), systemic infections, psychiatric disorders, metabolic diseases (incl. diabetes), and any clinical condition/circumstance which assessed by the study official makes the person unfit for participation in the trial.
- Patients diagnosed with short bowel syndrome (SBS).
- Chronic or frequent use of medication. Primarily consumption of drugs with known effect/side effects on fat absorption. Further, anticoagulants (Marevan) and systemic treatment with glucocorticoids.
- Have or have had a drug addiction
- Smokers
- Alcohol consumption beyond the recommended (7/14 units per week for women/men, respectively)
- Intake of vitamins or other supplements (3 months before the study and during the study) (healthy controls). Subjects from the patient group included only with stable intake of dietary supplements through the last 3 months.
- Sampling or donation of larger amount of blood e.g. as blood donors or to other scientific experiments from 3 months before the study until its completion.
- allergy or intolerance to any of the foods included in the study.
- Women who are nursing, pregnant or planning pregnancy
- Not able to comply with the procedures protocol.
- Macular degeneration to a degree greeter than or equal to a surface area with one or more drusen larger than 125 microns in diameter in at least one eye.
- Cataracts, macular- or other ocular disease, preventing depiction of xanthophyll pigment.
Healthy adults (18-80 years old)
Body Mass Index (BMI) between 18,9-28
Normal fasting blood glucose (BS) (1,9-5,6 mmol/L)
Tolerates: Potatoes, rice, chicken, meat (non vegan/vegetarian).
Healthy adults (18-80 years old)
Body Mass Index (BMI) between 18,9-28
Normal fasting blood glucose (BS) (1,9-5,6 mmol/L)
Tolerates: Potatoes, rice, chicken, meat (non vegan/vegetarian).
Researchdesign
Blinding
Blinding method
The recruitment methodology is described in detail in the study by JN Eriksen et al. (unpublished results) and in the Supplementary material. In brief, we recruited twelve healthy subjects and ten patients with intestinal resections (140–350 cm small intestine left) from a pool of volunteers and from the Department of Gastroenterology of the Rigshospitalet, respectively, to participate in a cross-over study of carotenoid supplementation. The data presented here are from the baseline examination. Subjects were matched by age (±5 years) and sex.
Recruitment start year
Recruitment end year
Number of volunteers
Number of volunteers terminated
Number of treatments
Number of factors
Number of arms