Invited Speaker Abstracts
001Recent studies on algal carotenoids in the context of sustainability and health-promotion
Antonio J. Meléndez-Martínez
Food Colour and Quality Laboratory, Faculty of Pharmacy, Universidad de Sevilla, Seville, Spain
Research Highlights: In this work, recent studies on the ultrasound assisted extraction of carotenoids from microalgae are summarized. The biosolvent 2-methyltetrahydrofuran (2-MeTHF) exhibited a very good extraction capacity in C. sorokiniana matrices. A mill pre-treatment allowed a higher recovery of carotenoids in certain matrices. In Dunaliella bardawil matrices the milling had no significant effect on carotenoid extraction. 2-MeTHF along with ethanol and methanol, excelled in the extraction of carotenoids in this microalga (Morón-Ortiz, Mapelli-Brahm, León-Vaz, Benitez-González, León & Meléndez-Martínez, 2024; Morón-Ortiz, Mapelli-Brahm, León-Vaz, Benitez-González, Martín-Gómez, León & Meléndez-Martínez, 2024). The effect of phytoene on Caenorhabditis elegans models is also discussed. It was observed that supplementation with pure phytoene or phytoene-rich microalgal extracts protect the worm against oxidative stress, amyloid-β42proteotoxicity (a pathology in Alzheimer’s disease) and lengthens lifespan (Morón-Ortiz, Karamalegos, Mapelli-Brahm, Ezcurra & Meléndez-Martínez, 2024). These studies contribute to the harnessing of microalgae for the production of sustainable and health-promoting products, an important pillar in the new Blue Economy scenario.
Methodology: The hypotheses of the studies reviewed were that carotenoids can be sustainably extracted from microalgae and that microalgal carotenoid extracts can exert health-promoting biological actions.
Control and phytoene-accumulating Chlorella sorokiniana and Dunaliella bardawil were cultured. Phytoene accumulation was achieved by treating with norflurazon. Three matrices were tested: fresh, freeze-dried and encapsulated. They were subjected to ultrasound assisted extraction (UAE, 2 min, 30% - 70% amplitude, 20 kHz frequency) with or without a prior ball-mill pre-treatment (5 min, 30 Hz). Ethanol, methanol, ethyl lactate, MeTHF and DMSO were tested.
C. elegans strains used in this study included N2 (for juglone-induced oxidative stress and longevity studies) and GMC101 (that expresses the amyloid-β42 peptide and was used to assess the proteotoxicity). The plates were treated with either 50 µL of DMSO (control), or 50 µL of 0.2 µg/mL, 1 µg/mL, 2 µg/mL phytoene-rich microalgal extracts (C. sorokiniana, D. bardawil) or phytoene standard.
Results: The use of 2-MeTHF resulted in equal or higher total carotenoid contents relative to the other solvents tested in control and phytoene-rich encapsulated matrices and control freeze-dried C. sorokiniana. This biosolvent performed similarly to methanol or ethanol in phytoene-rich fresh and freeze-dried microalgae, proving efficient for the extraction of phytoene in phytoene-acumulating Chlorella matrices. Milling led to significant (p < 0.05 ) higher carotenoid extractions in freeze-dried and encapsulated matrices. In Dunaliella bardawil milling did not significantly affect carotenoid extraction. 2-MeTHF, ethanol and methanol, excelled in the extraction of microalgal carotenoids.
Supplementation with 1 and 2 µg/mL of the extracts and pure phytoene enhanced the resistance of C. elegans to the oxidant juglone by 39–53%. Additionally, 1 µg/mL phytoene and phytoene-rich extracts reduced proteotoxic effects by 30–40% and 1 µg/mL phytoene and phytoene-rich extracts increased lifespan by 10–18.6%.
It can be argued that the microalgae tested can be used to obtain carotenoid-rich extracts with a green technology and an emerging biosolvent. Additionally, phytoene-rich microalgal extracts exhibited positive effects in different models of C. elegans. Thus, the tested hypotheses can be accepted.
002Optimizing visual performance with nutrition for sporting performance
Fraser Horn
Pacific University College of Optometry, Forest Grove, USA
Research Highlights: We assessed the foundational visual skills of incoming student-athletes (freshmen and transfer students) from Pacific University, a private University that is a NCAA Division 3 program. In addition to the foundation visual skills, we also assessed skin carotenoid levels. By performing these assessments, our goal is to identify areas of opportunity for improved visual performance. We have observed trends when it comes to visual skills, including skin carotenoid results.
Methodology: We assessed 214 student-athletes with a basic visual assessment battery including, but not limited to, case history, visual acuity (OD, OS, and OU), cover test (distance and near), extra-ocular motilities, near-point of convergence, confrontational visual fields, pupils, auto-refraction, and skin carotenoid levels by utilizing the LifeMeter (Macuhealth, LLC). Student-athletes results were provided, verbally, to the student-athlete with communication to the sports medicine team. Student-athletes were recommended for urgent intervention (< 1 month), important intervention (1-6 months), and routine care (6-12 months).
In addition to our incoming student athletes, we assessed the skin carotenoid levels of 88 returning American football players. The carotenoid levels for each athlete were discussed at the end of the LifeMeter testing. We provided encouragement for those with “high” levels as well as a brief discussion on diet and nutritional supplementation for those with reduced scores.
Results: The most common reasons for a non-routine (urgent or important) eye exam referral were due to either the time since their last eye exam or reduced visual acuity in one or both eyes. Some student-athletes had non-routine referrals for specific needs identified during the basic assessment (ex. Pathology, contact lens issues, etc.).
When looking at skin carotenoid results, we have identified an opportunity for intervention. The average skin carotenoid level, for all athletes (n=302), was 282.15 (st dev=69.287). Skin carotenoid levels ranged from 100 to a high of 709.
When comparing sports, there is no statistical significance (P>0.05). When comparing between males and females, there is no statistical significance (P>0.05). One limitation within the study is the varied amounts of participants in each sport. The range was between one student-athlete (ex. Golf, Men’s swimming) up to 132 student-athletes for American Football.
For most sports, athletes rely on various visual skills, including contrast sensitivity, eye-hand reaction time, glare recovery, and more. Studies have demonstrated that nutritional supplementation with lutein, zeaxanthin, and meso-zeaxanthin resulted in improved visual skills relative to sporting performance. This study demonstrates that our overall student-athlete population has reduced skin carotenoid measurements and this presents an opportunity for discussion and intervention that can lead to improved visual skills and, hopefully, improved performance in competition. A larger study that includes assessment and intervention of student-athletes from NCAA division 1, 2, and 3 is recommended by the author.
003What Exactly is Visual Performance…and Does Nutrition Matter?
Jim Stringham
MacuHealth, Phoenix, USA
Research Highlights: The definition of the term “visual performance” is strongly dependent on perspective: Are you an eye doctor, an athlete, or perhaps someone who spends the majority of their day in front of a computer screen? With each of these contexts comes a set of expectations of – or demands on – visual performance. In the clinic, the emphasis tends to center on visual acuity, where resolution of a relatively small, high-contrast target is the goal. In addition to acuity, the athlete is concerned with higher-order visual abilities such as processing speed / reaction time, contrast sensitivity, and the ability to perform well in different lighting conditions. Lastly, while the individual with high “screen time” certainly values visual acuity, they may be less concerned with parameters that the athlete values, in favor of reduced eye strain, eye fatigue, dry eyes, and blue light exposure. Over twenty years of research has demonstrated significant links between nutrition and many aspects of visual performance. Key nutrients include the xanthophyll carotenoids lutein, zeaxanthin, and meso-zeaxanthin, and the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
Methodology: Data from published studies demonstrating significant effects of macular carotenoid supplementation on many aspects of visual performance will be covered. Performance parameters include vision in glare, contrast sensitivity, speed of processing, photostress recovery, eye strain, and eye fatigue. Illustration of how the accumulation of macular carotenoids in the foveal retina (i.e., the macular pigment) can reduce blue light exposure to the underlying photoreceptors and retinal pigmented epithelium will also be provided. Lastly, visual performance and dry eye-relieving effects of EPA and DHA will be summarized.
Results: Nutritional status, specifically the macular carotenoids (lutein, zeaxanthin, and meso-zeaxanthin), and omega-3 fatty acids (EPA and DHA), significantly enhance several aspects of visual performance. Curiously, these effects reside outside the realm of visual acuity. The implications of these findings will be discussed in terms of visual health, safety, performance, and patient care.
004Innovative Food Processing: Leveraging on Texture for Healthier Eating
Vincenzo Fogliano
Wageningen University, Wageningen, Netherlands
Research Highlights: Throughout history, food processing has been pivotal in transforming raw materials into safer, more digestible foods by eliminating toxins, extending shelf life, and enhancing palatability. These advancements have supported human survival and societal evolution. In modern times, processing has democratized access to affordable, long-lasting food while drastically reducing perishable waste—a critical step toward sustainability.
Beyond these recognized benefits lies an untapped opportunity: leveraging industrial processing to improve public health. Traditional strategies for designing healthier foods focus on nutrient balance or bioactive enrichment, often overlooking a pressing issue in Western diets—excessive calorie intake. Here, reducing calorie density without compromising sensory appeal emerges as a paramount objective. Current reformulation efforts face limitations, as calorie reduction frequently clashes with taste and texture expectations.
Methodology: This lecture proposes an innovative approach: multi-scale texture engineering. By manipulating food structure at macro-, meso-, and micro-levels, processing can create satiating, sensorially satisfying products that inherently lower calorie consumption.
Results: In this lecture some examples will be used to demonstrate how strategic texture design aligns with consumer preferences while promoting mindful eating.
Ultimately, engaging the current debate on the so called ultraprocessed foods, I will show how food processing can be a tool for both health and sustainability offering a dual-pathway solution to contemporary dietary and environmental crises.
005Updated Evaluation of AREDS & AREDS2 Data: How Oral Antioxidants Slow the Progress of Geographic Atrophy in Age-Related Macular Degeneration
Tiarnan Keenan
National Eye Institute, Bethesda, USA
Research Highlights: The only treatments approved to slow geographic atrophy (GA) progression in age-related macular degeneration (AMD) require frequent intraocular injection and suffer from modest efficacy, important risks, and high costs. The purpose of this study was to determine whether oral antioxidant supplements slow GA progression in AMD, by post hoc analyses of the Age-Related Eye Diseases Study (AREDS) and AREDS2. In eyes with non-central GA, oral antioxidant supplementation (comprising very high daily doses of vitamin C, vitamin E, and β-carotene) and oral lutein/zeaxanthin supplementation each led to slower progression of GA towards the central macula, with a total effect size of ∼55%. Overall, oral micronutrient supplementation appears to slow GA progression towards the central macula, likely by augmenting the natural phenomenon of foveal sparing. These findings justify a prospective randomized controlled trial of oral antioxidant and lutein/zeaxanthin supplementation in eyes of individuals with non-central GA.
Methodology: The AREDS and AREDS2 were multi-center randomized placebo-controlled trials of oral micronutrient supplementation, each with 2x2 factorial design. AREDS participants were randomly assigned to oral antioxidants (500 mg vitamin C; 400 IU vitamin E; 15 mg β-carotene); 80 mg zinc; combination; or placebo. AREDS2 participants were randomly assigned to 10 mg lutein/2 mg zeaxanthin; 350 mg docosahexaenoic acid/650 mg eicosapentaenoic acid; combination; or placebo. Consenting AREDS2 participants were also randomly assigned to alternative AREDS formulations: original; no beta-carotene; 25 mg zinc instead of 80 mg; both. The main outcome measures were: (1) change in GA proximity to central macula over time, and (2) change in square root GA area over time, each measured from color fundus photographs at annual visits and analyzed by mixed-model regression according to randomized assignments.
Results: The study populations comprised 392 eyes (of 318 participants) with GA in AREDS and 1210 eyes (of 891 participants) with GA in AREDS2. In AREDS eyes with non-central GA (n=208), proximity-based progression towards the central macula was significantly slower with randomization to antioxidants versus none, at 50.7 µm/year (95% CI 38.0-63.4 µm/year) versus 72.9 µm/year (95% CI 61.3-84.5 µm/year; p=0.012), respectively. In AREDS2 eyes with non-central GA, in participants assigned to AREDS antioxidants without β-carotene (n=325 eyes), proximity-based progression was significantly slower with randomization to lutein/zeaxanthin versus none, at 80.1 µm/year (95% CI 60.9-99.3 µm/year) versus 114.4 µm/year (95% CI 96.2-132.7 µm/year; p=0.011), respectively. In AREDS eyes with any GA (n=392), area-based progression was not significantly different with randomization to antioxidants versus none (p=0.63). In AREDS2 eyes with any GA, in participants assigned to AREDS antioxidants without β-carotene (n=505 eyes), area-based progression was not significantly different with randomization to lutein/zeaxanthin versus none (p=0.64).
006Nutritional Studies to Improve Retinal Health Throughout the Lifespan
Paul Bernstein
Moran eye Center, University of Utah, Salt Lake City, USA
Research Highlights: My laboratory has been devoted to providing evidence-based basic science and clinical studies to support nutritional recommendations to enhance ocular health throughout the lifespan. We have focused on two key nutrients that are naturally concentrated in retinal tissue at the highest levels found anywhere in the human body, the macular pigment (MP) carotenoids (lutein, zeaxanthin, and meso-zeaxanthin) and very-long-chain polyunsaturated fatty acids (VLC-PUFAs). For the MP carotenoids, our basic science studies have established many of the mechanisms underlying the specific uptake and stabilization in the macula, while our VLC-PUFA work has focused on establishing animal and organoid models to elucidate the retinal protective roles of these important but dietarily rare ocular lipids. More recently, we have directed considerable effort to conducting single-site randomized clinical studies to guide the design of future large-scale multi-center clinical trials to establish best-practices for next generation prenatal vitamins to decrease incidence of ocular and systemic complications of pregnancy in the mother and her child and for supplements designed to prevent or slow the progression of age-related macular degeneration (AMD).
Methodology: In the last few years, we have conducted two clinical trials at the Moran Eye Center. The Lutein and Zeaxanthin in Pregnancy (L-ZIP) study examined whether supplementation with MP carotenoids at an AREDS2 dose of 10 mg/day of lutein and 2 mg/day of zeaxanthin would be safe and well tolerated in low-risk pregnancies and would enhance carotenoid status in the mother and her newborn child (47 randomized subjects). The Moran AMD Genetic Testing Assessment (MAGENTA) study tested whether knowledge of future genetic risk of vison loss from AMD would encourage high-risk individuals to adopt a healthier lifestyle, exemplified by increased consumption of carotenoid-rich fruits and vegetables (80 subjects). Both studies measured carotenoid biomarkers in the blood by HPLC, in the skin by resonance Raman and reflectance spectroscopy, and in the eye by autofluorescence and reflectance imaging.
Results: The L-ZIP study met its primary and secondary endpoints of safety and efficacy in pregnancy. The supplemented mothers and their babies had significant increases of nearly all biomarkers of carotenoid status relative to baseline and to unsupplemented controls, but we could not find any significant carotenoid depletion in controls at the time of delivery. The MAGENTA study did not demonstrate any detectable change in nutritional status in the high genetic risk subjects relative to low-risk subjects or to subjects whose genetic testing results were not disclosed until the completion of the study at one year, but despite the disclosure of bad news to over one-third of participants, all subjects appreciated learning their genetic risk, as evidenced by a lack of reported anxiety or depression. These two studies’ Phase 2 results provide invaluable data for the design and conduct of future large-scale multi-center Phase 3 L-ZIP and AREDS trials focused on high-risk pregnancies and on individuals genetically predisposed to develop AMD later in life, respectively.
007Undernutrition and cognitive decline: findings from the PROMED-COG European project
Nicola Ward1, Federica Prinelli2, Giuseppe Sergi3, Caterina Trevisan3, Lorraine Brennan4, Lisette deGroot5, Dorothee Volkert6, Claire McEvoy1
1Queen's University Belfast, Belfast, United Kingdom. 2National Research Council (CNR), Milan, Italy. 3University of Padova, Padova, Italy. 4University College Dublin, Dublin, Ireland. 5Wageningen University, Wageningen, Netherlands. 6Friedrich-Alexander-University of Erlangen-Nürnberg, Munich, Germany
Research Highlights: Undernutrition in older age was associated with accelerated cognitive decline and increased dementia risk. We also showed that early intervention with a high protein Mediterranean diet reversed undernutrition risk and improved cognitive performance in older community dwelling adults with subjective cognitive decline. PROMED-COG advances scientific knowledge on the relations between undernutrition and cognitive impairment that are both major contributors to mortality and disability during aging.
Methodology: Data from four Italian cohorts of community-dwelling adults from midlife to older age were harmonized. Cox proportional hazard regression assessed the associations between undernutrition, defined by the Global Leadership Initiative on Malnutrition (GLIM) criteria, and cognitive decline measured by the Mini-Mental State Examination (MMSE), as well as dementia incidence. Additionally, a single-blind randomized controlled trial (PROMED-EX) was conducted to evaluate the effects of a protein-enriched Mediterranean diet (MD), with and without exercise. Participants were randomly assigned to one of three groups: 1) PROMED-EX (protein-enriched MD plus home-based exercise), 2) PROMED (protein-enriched MD only), or 3) control (written healthy eating advice). Outcomes, including nutritional status via the Mini Nutritional Assessment (MNA score 0–30) and global cognitive function using a neurocognitive test battery (NTB composite z-score), were assessed at baseline, 3 months, and 6 months.
Results: In pooled data of 9,326 community-dwelling adults (52% female), aged 72.4±9.5 years (range 40-101), undernutrition was significantly associated with cognitive decline (median follow-up: 8.3 years; HR=1.20, 95% CI 1.02-1.41) and dementia incidence (median follow-up: 8.6 years; HR=1.57, 95% CI 1.01-2.43). In the PROMED-EX trial, 105 participants (69% female, age 67.7 years [range 60-87], BMI 23.8±3.4 kg/m²) at risk of undernutrition and cognitive decline were randomized into PROMED-EX, PROMED, or Control groups. At 6 months, both intervention groups showed significant increases in MNA scores compared to control (PROMED-EX: +2.9, 95% CI 1.5-4.3; PROMED: +2.7, 95% CI 1.3-4.2; p<0.001). Diet quality significantly improved in both intervention groups relative to control (p<0.0001), with increased intake of fruit, dairy, oily fish, wholegrains, nuts, and olive oil. Intervention groups also showed significantly improved intake of protein, fibre, and micronutrients (vitamins C, D, B-group, calcium, iron, zinc, selenium, iodine) compared to control, despite stable energy intake. Global cognitive performance significantly improved in both intervention groups (PROMED-EX: +0.23, p=0.021; PROMED: +0.26, p=0.009) compared to the Control, largely driven by improvement in executive function. Exercise provided no additional cognitive benefit, likely due to poor adherence.
008Update on Omega-3 in Brain and Eye Health
William Harris
Fatty Acid Research Institute, Sioux Falls, USA. Sanford School of Medicine, Univ of South Dakota, SIOUX FALLS, USA
Research Highlights: Blood levels of the long-chain marine omega-3 fatty acids EPA and DHA are now known to be directly associated with better cognitive function, lower risk for dementia in general, and Alzheimer’s Disease in particular; and evolving evidence supports a role in lowering risk for macular degeneration as well.
Methodology: These conclusions were derived largely from blood biomarker-based studies in which large populations were followed for disease outcomes over many years. In some cases, randomized controlled trial data was available.
Results: In the original Framingham Heart Study, participants with the highest quartile of blood omega-3 levels were about 50% less likely to develop dementia between ages 76 and 85 than those in the lower 3 quartiles. In the Framingham Offspring Study, subjects were 50% less likely to develop AD between age 73 and 80 if their omega-3 levels were in the top vs the bottom quintile. In Framingham Generation III, people with an average age of 46, a higher RBC omega-3 level had larger hippocampal volumes and better abstract reasoning independent of vascular risk factors. Higher hippocampal volumes were also directly related to the Omega-3 Index in the Women’s Health Initiative Memory Study in women, mean age 78. Finally, risk for macular degeneration was reduced by 27% in a randomized trial with 840 mg EPA+DHA per day for 5 years in about 26,000 healthy subjects.
009Lutein - From Bench to Bedside: Translating Research into Patient Care
Joseph Allen
Vision Excellence Eye Consulting LLC, Richmond, USA
Research Highlights: Despite robust evidence linking nutrition to visual and neurological health, nutritional interventions—such as lutein supplementation—are significantly underutilized in clinical eye care. This lecture explores the systemic, educational, and perceptual barriers limiting the adoption of evidence-based nutrition in practice. Using lutein as a key case study, the session aims to equip clinicians with strategies to bridge the gap between research and clinical application, ultimately positioning nutrition as a core component of patient care for vision preservation and cognitive support.
Methodology: This lecture is based on a comprehensive review of current literature, primarily sourced through PubMed searches of peer-reviewed papers, meta-analyses, and clinical trials relevant to lutein’s effects on ocular and neurological health. Additionally, insights and observations from real-world clinical experience have been integrated to contextualize how nutrition counseling is (or is not) currently implemented in daily practice. Barriers to adoption were identified through clinical encounters, patient discussions, and informal surveys among peers in the optometric and ophthalmologic communities.
Results: Review of the literature demonstrates that lutein, a carotenoid selectively accumulated in the macula and brain, plays a significant role in reducing oxidative stress, filtering high-energy blue light, slowing the progression of macular degeneration, and enhancing visual performance and cognitive function. Despite this, clinical integration remains limited due to factors including lack of nutrition education during professional training, skepticism regarding supplement efficacy, concerns about time constraints during patient encounters, and perceived complexity of nutritional counseling. The lecture will propose practical, time-efficient communication strategies for discussing nutrition with both health care practitioners and patients, emphasize the importance of framing nutrition as preventative care, and provide clinicians with evidence-based recommendations to confidently integrate lutein education into routine practice.
010Using MRI to Visualize Brain Changes from Nutrition: from Neurotransmitters to Stiffness
Brad Sutton
University of Illinois Urbana Champaign, Urbana, IL, USA
Research Highlights: Nutrition is critical for the development and maintenance of brain health, resulting in complex cognitive and behavioral functions. As nutrition interventions seek to drive changes in performance, neuroimaging with magnetic resonance imaging (MRI) provides a look at the underlying changes to brain structure, function, and composition that may provide an earlier signature of individual changes. In addition, the mechanistic changes seen in neuroimaging measures provide insights into the functionally specific regions and networks that may lead to behaviors impacted by the interventions. We will demonstrate this sensitivity to changes through examination of several standard imaging methodologies along with a newly developing methodology that non-invasively measures brain mechanical properties.
Methodology: MRI is a non-invasive and safe imaging modality that can be used throughout the lifespan to visualize many characteristics of the brain during the course of an intervention. In this work, I will review the basic physics behind several of the imaging modalities to explain how they are related to underlying brain structure and function. We will review several past nutrition-related findings demonstrating sensitivity to changes or correlations with nutrition profiles in cross sectional studies. Further, I will discuss a developing and sensitive measure of brain tissue integrity, called magnetic resonance elastography (MRE), that has shown high sensitivity to functionally related changes in brain tissue mechanical properties and will give preliminary results in application of this technique to nutrition studies.
Results: In this talk, I will provide a short overview of different characteristics of the brain measured with MRI that have been shown to be sensitive to nutrition interventions. Several biomarkers are available through neuroimaging with MRI providing a rich data space to delineate the impact of nutrition on the brain. These biomarkers can range from anatomical structural changes (volume), to neuronal wiring changes using diffusion weighted imaging, functional network connectivity changes, metabolic composition modulations, along with other measures of tissue integrity. Further, MRE is a developing measure that provides, in combination with diffusion weighted imaging measures, a sensitive measure of white matter health. These techniques can provide quantitative measures of the brain for both intervention and cross-sectional studies.
011Serum total carotenoid, lutein, and zeaxanthin concentrations increase across pregnancy in healthy participants from Houston, TX, USA
Nancy E. Moran, Megumi H. Seese, Katelyn E. Senkus, Matthew Sun, Joshua M. Wade, Ada Nayeli Caja Rodriguez, Brianna Alexander, Miranda Sosa
Baylor College of Medicine, Houston, USA
Research Highlights: Carotenoids support maternal and infant nutritional health. However, there are mixed results on whether maternal carotenoid status changes across pregnancy, and if carotenoid status relates to maternal memory function. The objective of this study was to determine if pregnancy status and time points were determinants of carotenoid status in adult women, and to conduct a pilot test of the relationship between carotenoid status and memory function in pregnancy. Serum concentrations of some but not all carotenoids significantly differed by pregnancy status and/or time points. This was not explained by changes in dietary intake but did correspond with changes in serum cholesterol concentrations. Pilot tests suggest carotenoid exposure is inversely associated with memory complaints in early pregnancy. Additional research examining the determinants and consequences of maternal carotenoid status is warranted.
Methodology: Pregnant and non-pregnant 18–40-year-old females were recruited from Houston, TX, USA. Pregnant participants completed assessments at 8-13, 23-24-, and 33-34-weeks’ gestation, and 7-8 weeks post-partum. Non-pregnant participants attended parallel, time-matched visits. Carotenoid concentrations in serum, skin, and the macula were determined by HPLC, pressure-mediated reflection spectroscopy, and heterochromatic flicker photometry, respectively. Dietary carotenoid intake was assessed by 24-hr dietary recalls and self-reported memory was assessed by a questionnaire (MAC-Q). Mixed-effects models tested the effect of pregnancy status and time points on carotenoid biomarkers. Bivariate correlations tested the relationship between macular, skin, serum, and dietary carotenoids with memory function.
Results: Dietary carotenoid intake was greater in pregnancy but when adjusted for energy intake, did not differ by time or pregnancy status. Baseline total serum carotenoids were similar between groups, and significantly increased across pregnancy, but not in the non-pregnant group (Pinteraction<0.0001). Serum lutein and zeaxanthin concentrations were higher in pregnant than non-pregnant women (p<0.01) and increased across pregnancy (p<0.0001), specifically with higher concentrations in the 2nd and 3rd trimesters than in the 1st trimester or postpartum. The effect of time significantly differed by pregnancy status for serum lutein and zeaxanthin (p<0.0001, both), with serum carotenoids increasing across pregnancy but not in the non-pregnant state. Serum cholesterol concentrations similarly increased across pregnancy but were stable in non-pregnant participants (Pinteraction<0.0001). Neither skin nor macular carotenoids differed by pregnancy status or time point. Memory complaints were stable over time in non-pregnant women but nominally increased from 1st to 3rd trimester and decreased postpartum in pregnant participants. At 3rd trimester, the pregnant group reported greater memory complaints compared to the non-pregnant group (p=0.04). In pregnant women, there was an inverse relationship between macular and dietary carotenoids with memory complaints in 1st (R=-0.477, p=0.03) and 2nd trimester (R=-0.499, p=0.02), respectively.
012Impact of ultra-processed diet on neuroinflammation and obesity development
Edwin Martínez-Leo
Mexican College Dietitian, Mexico, Mexico
Research Highlights: Currently, 1 in 3 people are obese. Diet plays an important role in the development of biochemical alterations that lead to obesity. Specifically, it has been shown that an ultra-processed diet leads to alterations in the redox, pro-inflammatory and dysbiotic state of the body. Obesity is a complex, relapsing disease whose pro-oxidative, pro-inflammatory, and dysbiotic alterations are related to the dysregulation of musculoskeletal, nervous, and gastrointestinal tissue. This review analyzes the role of ultra-processed diets in the development of neuroinflammation in obesity.
Methodology: Studies on ultra-processed diet, nutrition, oxidative stress, inflammation, neuroinflammation, obesity, metabolic disease and evidence supporting new trends in the nutritional intervention were selected. Research presented in this review were identified through searches of PubMed / Medline, EMBASE and the Cochrane Library databases.
Results: Recently, several studies have shown that components of ultra-processed diets significantly alter the abundance and diversity of microorganisms present in the intestinal microbiota, leading to alterations in the production of short-chain fatty acids, disruption of the intestinal barrier, and production of proinflammatory cytokines. Alterations to the intestinal microbiota are described as a crucial point for the decrease in neurochemistry and neuroplasticity, mediated by the gut-brain axis. Studies show that obese people have significant concentrations of proinflammatory mediators in all structures of the nervous system, which leads to neuroinflammation and neurodegeneration. Neuroinflammatory processes are linked to hypothalamic changes in hunger and satiety, which is related to increased caloric intake and dysregulation of adipose tissue. Likewise, neuroinflammatory processes are related to signs of depression and anxiety, which are more common in obese people. The connection between diet, neuroinflammation, and obesity constitutes a strategy for the development of future therapeutic targets, and a greater understanding of the clinical presentation of obesity.
013Carotenoid Bioavailability – Old and New Aspects
Torsten Bohn
Nutrition and Health Research Group, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
Research Highlights: Despite the recommendation to consume a diet rich in carotenoids, preferably via fruits and vegetables, their absorption, distribution, metabolism and excretion, in short their bioavailability, has been shown to be very variable and rather low, owing to their low water-solubility and poor incorporation into mixed micelles, resulting in poor bioaccessibiliy (the amount released from the food matrix that becomes available for absorption), an assumed pre-requisite for their absorption.
Recent investigations with respect to carotenoid bioavailability has focussed on additional dietary and host factors that could impact carotenoid bioavailability, e.g. proteins, minerals, and various types of dietary fiber, also including food processing techniques such as high pressure homogenization or encapsulation strategies, and for instance single nucleotide polymorphisms (SNPs) and adipose tissue regarding host factors. It is apparent that carotenoid bioavailability is strongly depending on such conditions, and that large inter-individual differences exist.
Methodology: Within this presentation, findings from literature and own research are presented that highlight main factors impacting carotenoid bioavailability, emphasizing new insights, and proposing alternative strategies that could aid in increasing their availability from our diet. Apart from scientific articles in Scopus and Pubmed, own research is based on in vitro digestion experiments (e.g. INFOGEST static model of gastro-intestinal digestion), cellular uptake studies employing Caco-2 cell models, as well as human bioavailability studies, i.e. postprandial trials.
Results: It has become accepted that a certain amount of lipids per meal, even when present in a subsequent one, can improve carotenoid availability. More recently, it was shown that proteins of high solubility can also improve carotenoid bioavailability. Contrarily, especially soluble, polymer-forming dietary fibres such as pectin and also divalent ions at high concentrations (reducing the amount of FFA available for emulsification) could hamper bioavailability, in addition to other micronutrients such as tocopherols competing for micellization. Food processing has the potential to enhance carotenoid bioavailability, given that the matrix is partly broken down (such as heating or pureeing), while some techniques such as high pressure homogenisation may reduce their availability, due to stabilizing the matrix network of tightly bound carotenoids. Encapsulation into micro-or even nano-capsules may be an alternative for boosting carotenoid availability.
With respect to host factors, genetic factors have also clearly shown to account for a large fraction of the bioavailability variability encountered. For example, combinations of SNPs were shown to explain approx. 70% of the variability of the bioavailability of lutein or beta-carotene, such as SNPs related to digestion and transport of carotenoids. Less clear is the role the adipose tissue plays as a major storage organ for carotenoids, though recent findings also show that SNPs related to adipose function are related to bioavailability in that tissue. Interesting, recently also epigenetic aspects were associated with carotenoid absorption. Combining these aspects (genetics, epigenetics, and possibly other host or even other exposure aspects of life) is likely to further strengthen the predictability for carotenoid bioavailability. Finally, a factor that still eludes our thorough understanding is gut microbiota, and whether colonic aspects can impact carotenoid bioavailability or status.
014Carotenoids – Independent Predictors of Cognitive Decline in Ageing Participants of the Northern Ireland PRIME Study
Gareth McKay1, Gerry Linden1, Chris Patterson1, Peter Passmore1, Claire McEvoy1, Jayne Woodside1, Clive Holmes2, Bernadette McGuinness1
1Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom. 2University of Southampton, Southampton, United Kingdom
Research Highlights: Lower carotenoid levels have previously been implicated in poorer cognitive functioning but data from longitudinal studies is limited. This study investigated the neuroprotective effects of serum carotenoids in a prospective cohort of older men to identify associations with cognitive outcomes, independent of traditional risk factors.
Our data identifies higher levels of serum carotenoids as factors that reduce the risk of mild cognitive impairment (MCI)/dementia before overt symptom manifestation, independent of traditional risk factors. As such, early intervention may limit the rate of cognitive decline. These findings are consistent with hypotheses supportive of neuroprotective carotenoid properties and previously reported higher serum carotenoid levels associated with better cognition in older individuals, likely due to their potent antioxidant and anti-inflammatory properties. Furthermore, individuals homozygous for the BCMO1 rs6564851 T allele had significantly reduced MCI risk. Our data, and that of others, showed the rs6564851 T allele was associated with lower serum α-carotene, β-carotene and β-cryptoxanthin levels in contrast to the G allele which was associated with higher serum concentrations. This intergenic variant resides in a potential intestine-specific homeobox (ISX) binding site, a transcription factor that down-regulates BCMO1 expression, possibly explaining why the G allele leads to reduced BCMO1 activity. Inter-individual genetic variation may partly predispose some individuals with low circulating carotenoid concentrations to adverse health outcomes. Further studies are necessary to determine if genetic testing may help identify individuals who could benefit from increased dietary carotenoid intake to limit the rate of cognitive decline.
Methodology: This cohort study included 873 cognitively normal men from Northern Ireland nested within the PRIME (Prospective Epidemiological Study of Myocardial Infarction) study who were followed up for at least 15 years. Mini Mental State Examination (MMSE) and the Addenbrooke’s Cognitive Examination-R were performed at baseline and follow-up. A consensus diagnosis of normal cognition for age, MCI or dementia was made using recognised clinical criteria. Serum concentrations of retinol, two forms of vitamin E (α- and ϒ-tocopherol) and six carotenoids measured from baseline samples were quantified by high-performance liquid chromatography and assessed by multiple logistic regression to estimate odds ratios (OR) associated with change in cognitive status. Several genetic variants previously associated with serum antioxidant levels were also evaluated.
Results: There were 163 men identified with MCI and 46 with dementia after 15 years of follow-up; 664 participants were considered cognitively normal controls. In unadjusted analyses, serum carotenoids levels of α-carotene, β-carotene, lycopene and β-cryptoxanthin were significantly lower in MCI/dementia cases than controls; in contrast, ϒ-tocopherol, was significantly higher. Following adjustment for traditional risk factors including age, height, APOε4 genotype, diastolic blood pressure, smoking status and the presence of (pre)diabetes or depression, the effect size of significantly associated carotenoids was somewhat attenuated; only α-carotene remained significant in the fully adjusted model (OR = 0.52; confidence interval: 0.28-0.96; P=0.035). Furthermore, we identified significant associations between individuals homozygous for the BCMO1 gene rs6564851 T allele and lower cognitive impairment risk (OR= 0.38; CI = 0.19-0.75; p= 0.005).
015New imaging analytics expand the biology of macular xanthophyll carotenoids in aging and age-related macular degeneration: ALSTAR2 baseline
Christine Curcio, Mark Clark, Liyan Gao, Jason Crosson, Sarah Kim, Gerald McGwin, Cynthia Owsley, Andreas Berlin, Lukas Goerdt, Kenneth Sloan
Univ Alabama at Birmingham, Birmingham, USA
Research Highlights: In human retina, macular xanthophyll carotenoids (MXC) from diet localize to photoreceptors and Müller glia in the foveal center, plexiform, and nerve fiber layers. Two-wavelength autofluorescence (2WAF) imaging quantifies MXC as macular pigment optical density (MPOD) via log10 ratio of emissions to green and blue excitation lights. We developed ImageJ-based automation tools (ms in review) to center and classify previously described MXC distribution patterns (PMID 31989400) and incorporate variable foveal structure into maps (PMID 40162950). These new tools revealed that AMD eyes in a large and well characterized cohort are not lacking in MXC. Supplements of these compounds, previously shown to be useful in preventing AMD progression, may act in a manner different from what has been thought. Quantifying the in vivo distribution of MXC in more detail and beyond commonly used imaging metrics will allow thorough study of MXC’s role in vision, diet, prevention of advanced retinal disease, and relation to the HDL pathway of AMD genetics, in aging, AMD onset, and early progression.
Methodology: 2WAF images (Spectralis) were acquired from baseline visit of participants in the Alabama Study on Early Age-related Macular Degeneration 2 (ALSTAR2, NCT04112667). Participants were ≥60 years of age and enrolled from a comprehensive ophthalmology clinic. Confounding ocular conditions (except early cataracts), neurological disorders, and conditions preventing informed consent were excluded. AMD status was determined by color fundus photographs according to the AREDS 9-step classification system. 2WAF images were subjected to quality review for focus and lack of obscuring features. Four newly programmed methods for automated centration of the MXC distribution (HILLCLIMB, CENTROID, MAX, CONTOUR algorithms) were compared to manual centration. zScore maps displayed intensity in units of mean/ standard deviation of all eyes at each pixel within zones of the Early Treatment of Diabetic Retinopathy Study (ETDRS) grid.
Results: By lowest variance, HILLCLIMB best agreed with a manually determined ground truth (651 included eyes); 445 (68.4%) showed Peaks, 118 (18.1%) Rings, 41 (6.3%) Mixed, and 47 (7.2%) Dips. Women (n=408)/ blacks (n=76) have proportionally fewer Peaks and more Rings than men/ whites (both p<0.01). The ETDRS central subfield and inner ring has higher integrated MPOD in early and intermediate AMD eyes than in normal eyes (p<0.01), supporting our previous measures (PMID 36864830).
016Expression profile of the gut microbiota, its relationship with diet and the consumption of ultra-processed foods, and its impact on carotenoid and Omega-3 levels in patients with age-related macular degeneration
J. Jans Fromow-Guerra1,2, Guillermo Salcedo-Villanueva1, Agustín Lammoglia-Kirsch1,3, Ramses Rosales-Díaz1,3
1Asociacion Para Evitar la Ceguera en México, México, Mexico. 2Universidad Nacional Autónoma de México, Mexico, Mexico. 3Universidad Nacional Autónoma de México, México, Mexico
Research Highlights: Despite the recognized importance of diet and gut health in the pathophysiology of age-related macular degeneration (AMD), the relationship between the expression profile of the gut microbiota, macular pigment levels, and the consumption of ultra-processed foods in AMD patients has not been fully elucidated. Research to date suggests that the gut microbiota may influence low-grade chronic inflammation, a significant factor in AMD progression, but studies clearly demonstrating this connection are lacking. This gap in knowledge limits the ability to develop nutritional interventions or therapies based on gut microbiota modification that could slow AMD progression or improve visual prognosis in patients. Therefore, it is necessary to further explore this interrelationship, which could lead to more personalized preventive or therapeutic strategies for individuals at risk of developing advanced AMD. Identifying the expression profile of the gut microbiota and its relationship with macular pigment levels and the consumption of ultra-processed foods in AMD patients could offer new perspectives in the prevention and treatment of this disease. Studying this relationship is particularly relevant in the search for non-invasive, diet- based interventions that could reduce AMD progression and improve patients' quality of life. Establishing this relationship could also have significant implications for public health policies related to AMD prevention through the promotion of healthy diets and balanced gut microbiota. Therefore, this study addresses the urgent need to expand understanding of the dietary and microbial factors influencing visual health, providing a scientific basis for developing new management strategies for AMD patients.
Methodology: Comparative cohort study, prospective, observational, and cross-sectional. Best-corrected visual acuity, contrast sensitivity, systemic macular pigment levels measured with Lifemeter, gut microbiota profile, omega-3 levels, dietary profile for ultraprocessed vs no ultraprocessed diets.
Results: This study will determine and compare the expression profile of the gut microbiota in AMD patients classified as AREDS 3 and 4 and healthy individuals, and its relationship with best-corrected visual acuity, contrast sensitivity, macular pigment measurement, and dietary profile.
017The Unsustainability of Food Systems: Life Cycle Assessment
Dario Caro
University of Siena, Siena, Italy
Research Highlights: As the global population continues to expand, it exerts greater pressure on existing food systems, leading to challenges related to food production, distribution, and sustainability. This presentation examines the role of LCA in assessing the unsustainability of current food systems, highlighting the key research where interventions are needed to reduce resource use, greenhouse gas emissions, and environmental degradation.
Methodology: Life Cycle Assessment (LCA) has emerged as a valuable tool to evaluate the sustainability of food systems by analyzing their environmental impacts across the entire supply chain, from production to consumption. This presentation will introduce LCA and analyze important case studies where LCA is developed.
Results: Through case studies and recent research, this presentation explores how LCA can inform policies and practices that promote sustainable. For instance results concerning the environmental impacts of different human diets will be presented showing how vegan and vegetarian diets represents the most sustainable alternative to traditional diets.
018One-year results of a randomized controlled trial for lifestyle intervention in age-related macular degeneration: AMD-Life
Caroline Klaver1,2,3, Alexandra e Koning-Backus1, AMD-Life Team1, Magda Smoor1
1Erasmus Medical Center, Rotterdam, Netherlands. 2Radboud university medical center, Nijmegen, Netherlands. 3Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
Research highlights: It is known that lifestyle improvement can reduce the risk of Age-related Macular Degeneration (AMD) by 50%, but adherence to recommendations is often low. The first randomized controlled trial for lifestyle intervention in AMD shows that patients with AMD who still have good eye sight can make significant changes to their lifestyle if they receive personalized risk assessment together with coaching. Our findings may introduce a shift in clinical management strategies to promote risk-reducing behavior in AMD effectively.
Methodology: 150 AMD patients were randomized into three groups: (A) standard recommendations: no smoking, BMI <25, Mediterranean diet; regular physical exercise; (B) standard recommendations plus personalized risk profiling based on genetics and lifestyle; and (C) the same as B, with additional coaching using behavioral change techniques (BCT) and motivational interviewing (MI). Lifestyle and diet data were assessed by comprehensive questionnaires at month 3, 6, 9, and 12. Adherence was measured using a 13-point Total Lifestyle Score (TLS), which awarded points for each of the lifestyle exposures. Changes in TLS within groups were assessed using Wilcoxon signed-rank tests, while between-group differences were analyzed with Kruskal-Wallis tests. Post-hoc analyses were performed using Mann-Whitney U-tests with Bonferroni correction.
Results: Of the 150 participants (Group A: N=49, Group B: N=52, Group C: N=49), 3 (2.0%) were lost to follow-up, and 11 (7.3%) dropped out during the first year. After 1 year, Group A did not improve in TLS (baseline 7 [5–8]; 1-yr 7 [6–8]; P = 0.35); Group B improved from TLS 6 [5–7] to TLS 7 [5–8]; P = 0.027); and Group C improved from TLS 6 [4–7] to TLS 8 [6–10]; P < 0.001). Between-group analysis revealed significant differences between Group A and Group C (P < 0.001); differences between Group A and B were not statistical significant (P = 0.593).
019Macular Pigments in the Optometry Clinic – An Informed Story
Timothy Earley
Regional Eye Associates, Cumberland, MD, USA
Research Highlights: The conversation around macular carotenoids and their use in clinical practice has been central in the management of patients with Age-related Macular Degeneration (AMD) for most of my professional career. The ongoing research into the pathophysiology of this sight-threatening disease has changed my approach to diagnosing, managing and discussing AMD. Conversations around supplementation, lifestyle decisions, and diet as well as taking a proactive approach to disease prevention have supported a paradigm shift that many in our profession are just now starting to embrace. As with all chronic diseases, the most important step is finding the disease state prior to irreversible tissue damage. This discussion will review the diagnostic testing, functional testing, and patient education I’ve employed in my AMD clinic for the past decade; inspired by my mother’s AMD diagnosis at the age of 64
Methodology: Over the course of 4 years (October 2018 through December 2021), I followed hundreds of patients in my AMD Center of Excellence. For each patient over the age of 55, a detailed patient history was collected. This history included a lifestyle questionnaire, diet-related questions, and discussion around AMD risk factors (unprotected UV exposure, family history of AMD, smoking status, etc.). Patients were screened using a dark adaptometer, optical coherence tomography (OCT), and fundus photography. We also collected the names of the various macular supplements each patient was using. We followed each patient with repeat testing based on their baseline numbers (Rod-intercept time, drusen numbers) and their subjective response to any vision changes noticed while on high-quality macular carotenoid supplements.
Results: Over the course of several years (the clinical approach remains little changed to this day), I observed profound improvements in dark adaptation times, drusenoid changes, and subjective patient responses in patients who committed to taking high-quality macular pigment supplements daily. The addition of carotenoids to many patients’ diets resulted in better subjective night-time driving vision, an improved ability to adjust to changing lighting conditions, and the excitement of knowing that they were actively engaged in their visual improvement. This approach to patient care has convinced me that early detection and intervention with macular carotenoids, and a proactive approach in addressing this chronic disease, can be sight-saving.
020Clinical Experience with Carotenoid Supplementation in Axial Myopia, Epiretinal Membranes, and Macular Holes
Guillermo Salcedo-Villanueva
Asociación Para Evitar la Ceguera en México, Mexico City, Mexico
Research Highlights: This study explores the role of macular pigment (MP) supplementation in three distinct conditions: epiretinal membranes (ERM), macular holes (MH), and high axial myopia.
Surgical interventions for ERM and MH may cause foveal microtrauma, potentially altering MP distribution. High axial myopia, characterized by retinal surface area changes, might also affect MP spatial distribution.
Preliminary findings suggest that MP supplementation improves visual performance in high axial myopia, but not following surgical interventions for ERM or MH.
Methodology: This ongoing investigation consists of three parallel experiments:
- Patients with ERM after recent, successful membrane removal.
- Patients with MH following successful surgical closure.
- High axial myopia patients without comorbid ocular conditions and with relatively preserved visual acuity.
In Experiments 1 and 2, participants were randomized to receive either a soft-gel capsule containing 10 mg lutein, 10 mg meso-zeaxanthin, and 2 mg zeaxanthin daily, or a placebo (sunflower oil capsule). Outcomes assessed at baseline, 3 months, and 6 months included best-corrected visual acuity (BCVA; logMAR), contrast sensitivity (CS; log units), and skin carotenoid levels (SK).
In Experiment 3, participants were randomized into a supplementation group or a control group (observation only). Evaluations included BCVA, CS, SK, and macular microperimetry assessing average threshold (AT) and the macular integrity index (MII).
This abstract presents the results of a 3-month interim analysis.
Results: Experiments 1 and 2: No statistically significant differences were observed between the supplemented and placebo groups at 3 months across all measured outcomes.
For ERM, at 3 months follow-up (3MFU):
Median BCVA control group: 0.49; experimental group 0.48 (P= 0.805).
Median CS control: 1.15; experimental: 1.15 (P= 0.902).
Median SK control: 311; experimental: 391 (P= 0.383)
For MH, at 3MFU:
Median BCVA control: 0.48; experimental: 0.48 (P= 0.603).
Mean CS control: 1.15; experimental: 1.35 (P= 0.40)
Mean SK control: 409; experimental: 436 (P= 0.968)
For High Axial Myopia, at 3MFU, interesting findings were observed.
Median BCVA control: 0.30; experimental: 0.30.
Median CS control: 1.40; experimental: 1.35.
Median SK control: 302; experimental: 514 (P= 0.004)
Median AT control: 23.9; experimental: 27.4.
Median MII control: 99.55; experimental: 89.1 (P= 0.05)
Preliminary findings at 3 months suggest that macular carotenoid supplementation may not confer visual benefits in the postoperative recovery of ERM and MH patients. However, in high axial myopia, a statistically significant improvement in MII and SK was observed, indicating a possible enhancement in visual performance. Final outcomes at 6 months will provide further insight into the role of supplementation in these conditions.
021An adaptable method for establishing future bioactive intake recommendations
Taylor C. Wallace
Think Healthy Group, LLC, Washington, DC, USA. School of Medicine and Health Sciences, George Washington University, Washington, DC, USA. Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
Research Highlights: Dietary bioactive compounds (bioactives) hold significant promise for disease prevention and health promotion, yet the lack of standardized methods to establish intake recommendations has hindered their integration into evidence-based clinical practice, policy, and public health messaging. This presentation describes a newly proposed framework, which, if implemented, will allow for expanded development of evidence-based bioactive intake recommendations (where appropriate) that incorporate continuously emerging technologies and a resiliency-centric approach to health and disease prevention.
Methodology: The proposed adaptable framework was informed from decades of scholarly deliberation and through our work as former members of an expert panel tasked with developing the first-ever evidence-based bioactive intake recommendation for flavan-3-ols to support cardiometabolic health.1 The approach builds upon established transparent processes for evidence synthesis to delineate a more flexible, cutting-edge, and resiliency-centric framework with enhanced clinical application for personalized prevention.
Results: We recommend integrating a prespecified proactive safety protocol into the GRADE evidence-to-decision framework that uses systematic tools to identify relevant clinical and real-world adverse event surveillance data, and in vitro and in silicoscreening tools to evaluate hepatotoxicity and drug interaction potential of a bioactive.2 These data can also be used to establish tolerable upper intake levels (ULs), which is of particular need in the dietary supplement space, where high-dose and often isolated compounds have the potential to exert increased pharmacokinetic and pharmacodynamic activity. Along these lines, we extend the dialogue by Lupton et al. (2014)3 by recommending the specific use of omics technologies (particularly HPLC-MS metabolomics platforms) to identify and validate exposure biomarkers, prior to developing intake recommendations. Further, studies that employ these technologies to assess baseline and longitudinal exposure, and/or to monitor treatment adherence should be considered ascendant within several components of both risk-of-bias and strength-of-evidence assessments. We anticipate these technologies to help overcome challenges in fully characterizing the complex mixtures of bioactives that vary even among individual foods (e.g. flavan-3-ols in green tea) and the reliance on often imprecise food composition databases to assess population exposure. Lastly, we recommend future intake recommendations consider biomarker-based composites, validated across well-designed longitudinal cohorts to correlate with pace of disease development or progression, be used as a “predicative endpoint” or resiliency approach to measure the dose-response potential of a bioactive over time. Machine learning and AI tools have the ability to help us pinpoint and overcome individual response variations due to factors such as the food matrix, gut microbiota, metabolism (or metabolic conditions), and genetic predispositions (e.g. nutrigenomics). Several algorithms have already been proposed and validated to generate clinically applicable biomarker-based composites that are highly correlated with pace of biological and organ specific aging, as well as cardiovascular, neurological, oncological, and musculoskeletal diseases, among others, using physiological, biochemical, epigenetic, metabolomic, and/or lipidomic measures. Publication of the proposed framework described within this presentation is forthcoming.
References:
Adv. Nutr. Bethesda Md 13, 2070–2083 (2022).
J. Diet. Suppl. 22, 162–192 (2025).
Eur. J. Nutr. (2014) doi:10.1007/s00394-014-0666-3.
022Effect of oral polyunsaturated fatty acid, EPA/DHA, omega 3 supplementation on dry eye
Fernando Peniche, Maria C Jimenez-Martinez
Instituto de Oftalmología, Conde de Valenciana, Universidad Nacional Autónoma de México, UNAM, CDMX, Mexico
Research Highlights: To study the impact and efficacy of EPA/DHA, omega 3 supplementation on inflammation and anti oxidant response on dry eye.
Methodology: 50 patients, between 19 and 80 years, both sexes, with dry eye diagnosis, according to OSDI test, Ocular Surface Disease Index, participated in this cross sectional, open, prospective and longitudinal study, all of them received TG Omega 3s/1100mg EPA/1100mg DHA per day for twelve months; modifications on OSDI test, tear film brake up time (TFBT) and fluorescein clearance test (FCT) were analyzed at 30,60, 90,180 and 360 days, we used scatter plots, violin, before and after charts, Kruskall Wallis Anova test for statistical data reports.
Results: A total of 41 patients completed the study, in osdi test 91% present changes in their qualification, improve group report at 60 and 180 days was 52.47%, exponential report, <0.0001, 360 days will be available shortly; TFBT improve 0.35 seconds on one month to 3.5 seconds on the sixth month <0.0001; FCT report 0.46mm (16%) of tear film basal secretion improve and 1.12mm (40.14%) on the sixth month
Daily dietary supplementation with TG Omega 3s/1100mg EPA/1100mg DHA polyunsaturated fatty acid,, improves OSDI test, TFBT and FCT in patients with dry eye.
023Anatomically informed imaging and quantification of macular pigments in the living human eye with visible light Optical Coherence Tomography
Vivek Srinivasan, Alo Gupta
NYU Grossman School of Medicine, New York, USA
Research Highlights: Here we present a novel approach for imaging macular pigments (MPs) in the living human retina with visible light Optical Coherence Tomography (OCT). The benefits of the approach include the ability to clearly select (with depth resolution) retinal layers from which to determine optical density (OD), co-registration of MPs with retinal anatomical landmarks and/or pathological features depicted by OCT, as well as determination of eccentricity-dependent MP spectra. Measurements in eyes without ocular pathology, eyes with intermediate age-related macular degeneration, and finally, preliminary measurements in eyes of individuals with incipient neurodegeneration, will be presented.
Methodology: Several generations of visible light OCT prototypes for measuring MPs and retinal anatomy have been developed at the NYU Langone Eye Center. The latest iteration uses a combined superluminescent diode (SLD) source, comprising center wavelengths of 488 nm, 495 nm, 505 nm and 510 nm. Another SLD (red, center wavelength: 650 nm) was used for alignment. Eighteen eyes (aged 23-68 years, without pathology, referred from general ophthalmology and optometry) were analyzed out of a cohort of >20 subjects, with recruitment ongoing. Horizontal and vertical scans across the macula, intersecting the center of fixation, were performed. We choose to analyze signal from band 2 (also called the ellipsoid zone or inner segment / outer segment junction) in the full spectrum image, i.e. without shaping or spectral filtering. The selection of a single layer in depth avoids retinal pigment epithelium and photopigment absorption, which is impossible with fundus imaging techniques that aim to measure MP. For data analysis, we first performed wavelength referencing, which subtracts the single pass optical density (SPOD) of the longest wavelength sub-band (521.4 nm) from that of the full spectrum image, to yield a relative SPOD. We then performed peripheral referencing, which derives a linear fit of the relative SPOD from data at >2.6 mm eccentricity, then subtracts the fit from all eccentricities across the macula. A linear regression versus age was performed for the areal SPOD (integral of SPOD across the scan) for both the horizontal and vertical macular scans individually.
Results: Generally the peak SPOD was found to coincide with the foveal pit (minimum of retinal thickness defined by OCT). Horizontal and vertical areal SPODs for the same eye are correlated (r=0.5, p=0.036). Horizontal (p=0.003) and vertical (p=0.025) areal SPODs decrease with age. Imaging in two subjects with intermediate AMD did not show lower SPOD levels than would be expected based on the normative data. These results are likely to be refined as more subjects are recruited, and as foveolar centering is verified from anatomical landmarks available in the OCT data set. It is also noted that SPOD spectra varied across eccentricity, suggesting that the full spectrum image may miss subtle details. We are currently investigating the relationship of this finding, if any, to eccentricity-dependent distributions of lutein and zeaxanthin.
024Carotenoids and Omega-3 Fatty Acids in Neurodegenerative Diseases
Riona Mulcahy1,2,3, Alice O'Donoghue1, Millie O'Gorman1, Chris Reidy1,3, Ciara Lyons4, John M. Nolan2
1University Hospital Waterford, Dunmore Road, X91 ER8E, Waterford, Ireland. 2Nutrition Research Centre Ireland, South East Technological University, Waterford, Ireland. 3Royal College of Surgeons, 123 St Stephen’s Green, Dublin, Ireland. 4University College Galway, University Road, H91 TK33, Galway, Ireland
Research Highlights: We have previously shown that patients with Alzheimer’s disease have lower levels of serum carotenoids, macular pigment and visual function compared to age-matched controls. We also reported a 24-month randomized clinical trial involving cognitively healthy individuals aged 65 and older that showed supplementation with a combination of omega-3 fatty acids, carotenoids, and vitamin E had positive outcomes on cognitive performance and memory compared to placebo. Similarly, supplementation with the same formulation in patients with mild cognitive impairment (MCI) had positive outcomes on cognition compared to placebo. This work led to a double-blind placebo-controlled trial (ReMind ISRCTN11892249) which showed that the supplement improved quality of life and functional ability for patients with mild to moderate Alzheimer’s disease compared to placebo. We are currently investigating the link between skin and serum carotenoids in patients with Parkinson’s disease compared to age matched controls. Preliminary data from a pilot study confirms low skin carotenoids in the Parkinson’s disease group similar to what we have seen in patients with Alzheimer’s disease, which therefore represents an opportunity to enhance these bioactive nutrients for these patients with dietary modification and supplementation.
Methodology: This research has been made possible because of a unique collaboration between the Nutrition Research Centre Ireland (NRCI) and University Hospital Waterford (UHW). The NRCI provides state of the art carotenoid, vision and cognitive function testing protocols. UHW provides access to patients with confirmed neurodegenerative diseases with clinical care protocols established.
Results: As the global population ages, the prevalence of age-related degenerative diseases will continue to increase exponentially. Cell degeneration occurs due to a combination of increasing age, genetic predisposition and exposure to accumulated lifestyle and comorbidity factors. The challenges of maintaining health and preventing or delaying disease onset is a priority for researchers, health care professionals and governments.
Dietary macronutrients and micronutrients are increasingly targeted as modifiable lifestyle factors to sustain health and reduce disease burden. A recently published review of 8 specific dietary patterns on improved health outcomes has highlighted the positive effects of adhering to a healthy diet. Population studies in areas such as the blue zones showing the positive correlation between lower disease prevalence and healthy diet patterns rich in plant based foods including fruit, vegetables, nuts, seeds and fish further supports the importance of diet. Our work demonstrating a positive role of carotenoids in supporting brain health and treating disease may be explained by their mechanism of action including inhibition of neuro-inflammation, microglial activation, modulation of autophagy and attenuation of oxidative damage through activation of antioxidant enzymes. Omega 3 fatty acids are essential components of cell membranes influencing synaptic function, neurotransmission, and neuroplasticity. They work synergistically and positively with carotenoids in promoting brain health. The focus of future health care planning must include diet as a key modifiable factor and ongoing research is required to determine specific dietary constituents and their optimal delivery to ensure the best outcomes for both disease prevention and treatment.
025Drug Zzz. The most ancient and the most modern of elixirs for brain health and performance
Richard Swinbourne
1,2
1Nutrition Research Centre Ireland, South East Technological University, Waterford, Ireland. 2Saudi Olympic Training Centre, Riyadh, Saudi Arabia
Research Highlights: Success in sport (and arguably in life) is generally attributed to a unique combination of talent, physical fitness, specific skills and psychological qualities (Xiao et al., 2003). Whilst physical fitness maybe perceived as the most important of these performance variables (Gabbet, Kelly & Pezet, 2007), cognitive factors are becoming an increasingly important focus in achieving peak athletic performance (Kirby et al., 2024). Furthermore, nutrition and sleep are viewed as two of the most crucial components for maintaining an optimum level of both physical and mental health (Venter, 2008). It is recognised that poor sleep health is now a global epidemic, affecting upwards of 45% of the world’s population (IPSOS Expert Consensus, 2023). Furthermore, greater than one third of Americans obtain insufficient sleep and one in three experience symptoms of insomnia (National Council on Aging, 2024).
Methodology: Beyond the traditional application of improving sleep behaviour and consuming caffeine to improve alertness and mitigate fatigue, science continues to further understand the many interesting ergogenic nutrients available to athletes (and non-athletes) for heightened brain function (Ekstrand et al., 2023).
Results: While there are hypnotic medications to address sleeplessness, the ingestion of melatonin affects sleep propensity and has hypnotic effects enhancing sleep duration and quality (Brzezinski, 1997). Beyond pharmaceutical measures, nutritional interventions that may manipulate sleep patterns offer a relatively unexplored method of enhancing sleep related health. Sleep-nutrient interactions, including melatonin containing foods, hold the potential to enhance sleep quality (Brzezinski, 1997; Garrido et al., 2009; Garrido et al., 2010; Howatson et al., 2011) and there is a demand for natural alternatives to address insomnia, or improve overall sleep (D’Anci, 2011). Specifically, natural alternatives include tart cherry juice (a source of melatonin) (Garrido et al., 2009; Garrido et al., 2010; Howatson et al., 2011), L-Theanine for relaxation before sleep (Bulman et al., 2025), carotenoids as potent sources of anti-oxidants (Deng et al., 2023), omega 3 LC_PUFAs (Kaori et al., 2024) and L-Ergothioneine that may exert a beneficial effect on sleep quality via multiple mechanisms (Shimizu, Kuramochi & Hayamizu, 2022).
026
Walter Willett
Harvard T.H. Chan School of Public Health, Boston, USA
Review: Healthy Diets and Sustainable Food Systems. The world is facing a health crisis due to increasing rates of obesity and diabetes, and the consequences of this pandemic will accumulate over the coming decades. Simultaneously, climate change is accelerating and is already having devastating effects that will undermine our ability to feed the world's growing population. In turn, our food systems contribute importantly to greenhouse gas emissions, water and land use, and multiple forms of pollution. Thus, a solution to feeding what will be about 10 billion people by 2050 diets that are both healthy and environmentally sustainable presents an opportunity to mitigate many global challenges. The EAT-Lancet commission addressed this challenge stepwise by defining healthy diets quantitatively, determining whether these can be produced within planetary boundaries for greenhouse gas emissions and other environmental factors, and identifying strategies to achieve these goals. Any solution must assume that we rapidly shift from fossil fuels to green energy. The commission found that global adoption of a flexitarian dietary pattern that could include up to about two servings per day ofanimal sourced foods, together with improvements in agriculturalpractices and reductions in food waste, would have major benefits for human health and allow us to stay within planetary boundaries. Achieving this will require the engagement of governments at all levels, civil society, and individuals.
ELECTRONIC POSTER ABSTRACTS
027The Effect of Presymptomatic Genetic Testing for AMD on Carotenoid Status in the Moran AMD Genetic Testing Assessment (MAGENTA) Trial
Emmanuel Kofi Addo1, Lucia Lucci1, Marcela Pasaye1, Jens Nilson1, Emily Spoth1, Amani Jridi2, Lisa Ord1, Benjamin Brintz2, M. Elizabeth Hartnett3, Paul Bernstein1
1Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, USA. 2Department of Internal Medicine, Division of Epidemiology, University of Utah, Salt Lake City, USA. 3Department of Ophthalmology and Visual Sciences, Byers Eye Institute, Stanford University, Palo Alto, USA
Research Highlights: The Moran AMD Genetic Testing Assessment (MAGENTA) trial investigated the impact of age-related macular degeneration (AMD) genetic risk disclosure on promoting healthier lifestyle choices. Although no significant differences in carotenoid biomarkers were found between the immediate and deferred disclosure groups over 12 months, participants showed strong interest in knowing their AMD risk, and sharing this information was safe and well-tolerated. Our findings could guide future larger trials with extended biomarker assessment to demonstrate the value of AMD genetic testing in preventive health strategies.
Age-related macular degeneration is a leading cause of irreversible vision loss in older adults. Genetic testing offers insights into individual risk profiles. However, an American Academy of Ophthalmology (AAO) expert panel in 2012 discouraged routine AMD genetic testing as no evidence exists to prove the clinical and public health value of such information for symptomatic or presymptomatic individuals. Contrary to AAO’s position, individuals still patronize commercially available genetic testing services. Hence, we sought to determine whether knowledge of AMD risk could inform the adoption of a healthier lifestyle that could lower the incidence of AMD later in life.
Methodology: The MAGENTA trial is a Phase 2, single-site, prospective randomized trial (NCT05265624) that enrolled 80 presymptomatic Caucasians aged 18-64 years stratified into high-, medium-, and low-AMD risk groups by Mendelian randomization. We then randomized participants 3:1 to immediate disclosure and one-year deferred disclosure groups. We assessed skin, serum, and macular carotenoids over a year as biomarkers of healthier lifestyle adoption, using resonance Raman spectroscopy, HPLC, and autofluorescence imaging, respectively. We also assessed participants’ emotional and nutritional status through validated surveys as an exploratory outcome. We fitted a linear mixed effects model estimating the effect of early disclosure vs. deferred disclosure groups by risk group at each time point on skin, serum, and macular carotenoids with a random effect for subjects to account for within-subject correlation over time.
Results: Of the 80 enrolled subjects, 94% had a family history of AMD, and the AMD genetic risk distribution was 36% high, 24% intermediate, and 40% low. We found no statistically significant difference in skin, serum, and macular carotenoids between the study groups at 12 months from their baseline (p > 0.05 for all comparisons). Participants’ compliance was high, as shown by the 95% subject study completion rate, and there was no evidence of exacerbation of anxiety or depression following AMD genetic risk disclosure to the subjects.
The study demonstrated strong participant interest and safety in disclosing AMD genetic risk information. Our findings can support the feasibility of future larger studies to assess the potential value of AMD genetic testing.
028Exploring Carotenoids Status, Visual Functions, Body Composition, and Sleep Health in Precision Sports Athletes and Players
Parimala Sivaperuman1,2, James M. Stringham1, Warren Roche1, Richard Swinbourne1, John M. Nolan1
1Nutrition Research Centre Ireland, South East Technological University, Waterford, Ireland. 2Singapore Sport Institute, Singapore, Singapore
Research Highlights: Carotenoids have been linked to improved visual performance and sleep. Insufficient levels of carotenoid may impact visual and cognitive function, tissue repair, and metabolism, which are crucial for training, recovery, health, and overall performance in sports. However, there is limited information regarding carotenoid association in precision sports. This is the first study that aims to explore any potential relationships between carotenoid levels, visual functions, sleep health, and body fat percentage in precision sports. A significant difference in visual function was observed, with athletes and players in archery and esport or egame showing superior visual capabilities in low-light conditions compared to shooting athletes. In contrast, shooting athletes exhibited better visual function in well-lit environments. Additionally, the results indicated an association between higher body fat percent and poorer sleep health. This ongoing study will further investigate how enhancing carotenoid levels can improve visual functions, sleep health, and sports performance of athletes and players in precision sports.
Methodology: Visual function was assessed by measuring visual acuity and contrast sensitivity for the dominant eye at 6 CPD and 12 CPD under both photopic and mesopic conditions with and without glare. Carotenoid status was evaluated by analysing dietary intake of lutein and zeaxanthin along with measuring skin carotenoid concentration. Sleep health was measured using the validated RU-SATED questionnaire to calculate the total sleep score. Additionally, skinfold measurements and waist circumference were taken to determine the percentage of body fat for all participants.
Results: A total of seventy-two precision sports athletes and players, mean age was 29.3 (±9.09) years for 29 shooting athletes, 25.8 years (±5.93) for 22 archery athletes and 26.9 years (±7.32) for 21 esport or egame athletes and players. There were no significant differences between sports for dietary intake of lutein and zeaxanthin (p=0.631), skin carotenoid concentration (p=0.0.549), total sleep score (p= 0.550), percentage of body fat (p= 0.507), and visual acuity (p= 0.324). There was a statistically significant difference in photopic contrast sensitivity under glare condition at 6 CPD [χ2(2) = 15.83, p = <0.001], at 12 CPD [χ2(2) = 8.47, p = 0.014] and mesopic contrast sensitivity at 12 CPD [χ2(2) = 8.47, p= 0.021] between the three sports. An inverse correlation was observed between total sleep score and percentage of body fat for precision sport (r = -0.238, p=0.045).
029Are Fluorescence Lifetime Imaging Ophthalmoscopy (FLIO) and two-wavelength autofluorescence (2WAF) similarly useful in detecting Macular Xanthophyll Pigment (MXP)? ALSTAR2
Lukas Goerdt1,2, Mark E. Clark1, Tracy Thomas1, Liyan Gao1, Gerald McGwin1, Martin Hammer3, Kenneth R. Sloan1, Cynthia Owsley1, Christin A. Curcio1
1Department of Ophthalmology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, USA. 2University of Bonn, Bonn, Germany. 3University of Jena, Jena, Germany
Research Highlights: FLIO measures the time a fluorophore stays energetically elevated after excitation with 473 nm (blue) wavelength light, adding a time dimension to autofluorescence imaging of the human ocular fundus. The contribution of individual retinal fluorophores to the FLIO signal is actively investigated. The signal is captured in short (SSC: 498-560 nm) and long spectral channels (LSC: 560-720 nm). Previously, SSC signal was attributed entirely to MXP, as it correlated with macular pigment optical density (MPOD) via two-wavelength autofluorescence (2WAF) of young adult eyes, disappeared in full-thickness macular holes, and responded to supplementation (PMID: 30025128, 27775222, 37344061). We found a weak association between MPOD and SSC FLIO in normal-aged (≥ 60 years), early (e), and intermediate (i) AMD eyes in the central subfield (1 mm diameter) of the Early Treatment Diabetic Retinopathy Study (ETDRS) grid but not in its entirety (6 mm), inner (1-3 mm) or outer ring (3-6 mm). This suggests that SSC FLIO may detect additional signal sources in MXP-containing cells, such as flavoproteins, and not exclusively MXP.
Methodology: Pseudophakic eyes from the Alabama Study on Early Age-Related Macular Degeneration 2 (ALSTAR2) follow-up visit were included in this study. Eyes were imaged using color fundus photography (CFP), 2WAF, and FLIO. Eyes were stratified in AMD stages according to the AREDS 9-step classification system. MPOD (arbitrary units) was extracted using ImageJ. FLIO images were processed using a three-exponential fit (SPCImage). Custom Image J plug-ins were used to extract mean FLIO lifetimes for the central subfield, inner, and outer ETDRS ring. Linear regression analyzed the association between MPOD, SSC, and LSC FLIO signal for the entire ETDRS grid, central subfield, inner-, and outer rings.
Results: 155 eyes of 155 patients (age 75.0 yr, 60.7 % female; 66 normal, 38 eAMD, 51 iAMD) were analyzed. Mean SSC lifetimes were longer in e- and iAMD compared to normals in inner (239.4 vs 253.6 vs 299.6) and outer rings (254.5 vs 282.8 vs 334.6; both p < 0.01), not in the central subfield (165 vs 163.6 vs 174.0; p = 0.74). Mean MPOD differed significantly between disease stages in the central subfield (0.40, vs 0.44 vs 0.51; p < 0.01), not in the inner (0.12 vs 0.14 vs 0.14; p = 0.11) and outer rings (0.02 vs 0.02 vs 0.02; p = 0.73). Linear regression revealed a significant but weak association between SSC FLIO and MPOD in the central subfield (R = 0.2, p = 0.01), and not in the entire grid (R = 0.06, p = 0.431), inner (R = 0.09, p = 0.27), or outer ring (R = 0.08, p = 0.33). The weaker correlation in the central subfield compared to previous studies may be due to our larger, older, and more heterogenous population. Regional and stage-specific effects on SSC lifetimes can be contrasted with similar but stronger effects for LSC, generally attributed to fluorophores within retinal pigment epithelium. Accordingly, LSC FLIO was not correlated to MPOD (R = 0.01; 0.04; 0.05; 0.08; p = 0.89; 0.59; 0.51; 0.27) in the same regions.
030The Identification and Quantification of Astaxanthin in Human Serum using High-Performance Liquid Chromatography
Gary Cullinane, Alfonso Prado-Cabrero, John M. Nolan
Nutrition Research Centre Ireland, South East Technological University, Waterford, Ireland
Research Highlights: Previous literature has described methods for identifying and quantifying Astaxanthin (AX) in human serum (Mercke-Odeberg et al., 2003), however, replicating the results detailed in this literature has proven difficult as the resulting AX peak has a retention time similar to that of other carotenoids usually present in human serum. This research will provide value to the carotenoid science community by publishing a new methodology for accurately identifying and quantifying AX in human serum. Furthermore, this new methodology will reduce the volume of solvent used during HPLC analysis, helping mitigate the harmful impact of waste materials on the environment and helping create a more cost-effective process for AX analysis. Previous literature published by Osterlie et al. (2000) and Coral-Hinostroza et al. (2004) has highlighted the ability of cis-AX isomers to selectively accumulate in human plasma at a higher ratio than all-trans AX. This experiment provides further evidence of the ratios at which AX isomers derived from Haematococcus pluvialis can be absorbed into human serum.
Methodology: A single male volunteer participated in this preliminary experiment. A dose of 16 mg/d of AX from Haematococcus pluvialis was administered to the participant over 4 weeks. Control blood samples used in this experiment consisted of pooled samples from 6 individuals not supplementing with AX. Following the completion of the 4-week supplementation period, blood samples were collected from the participant. All-trans, 9-cis, and 13-cis AX were quantified in the supplement and serum samples using HPLC under conditions previously described by Mitrowska et al. (2012), who implemented these conditions for the analysis of 15 carotenoids used as food additives in agriculture and aquaculture. A Suplex pKb-100 column, 5 µm, 250 mm x 4.6 mm, was used for analysis. Mobile phase A consisting of ACN, tBME, and H2O (696:200:104; v:v:v) and mobile phase B consisting of ACN and tBME (700:300; v:v) were used with the following gradient elution: 100 % mobile phase A was held for 10 min, decreased elution to 40% at 14 min, and held for 14 min. From 28 to 45 min the system was re-equilibrated with the initial composition of mobile phase A (100%). The flow rate of the mobile phase was 0.5 mL/min-1.
Results: This research has shown that the oral administration of AX derived from Haematococcus pluvialis successfully leads to the absorption of AX into human serum. Following supplementation, AX was detected on the resulting chromatograms, and the separation of all-trans and cis-AX isomers was observed without interference from other carotenoids. AX serum concentrations were elevated from non-detectable at control to 0.188 µmol/L following AX supplementation at day 28. Furthermore, serum samples highlighted a distribution of AX isomers different from the supplement. Specifically, AX isomer distribution in serum was 31.1 % for all-trans AX and 68.9 % for total cis-AX isomers. AX isomer distribution in the supplement was 58.1 % for all-trans AX and 41.9 % for total cis-AX.
031Effect Size Analysis of Six-Month Micronutrient Supplementation in Diabetic Patients Reveals Medium to Large Clinical Impact on Retinal Function
Franziska Wirth1, Warren Roche2, Maciej Osęka3, Anna Gębka4, Krystyna Raczyńska5, Karolina Ciszewska6, Anna Swiech6, Malgorzata Mulak7, Robert Kuchling1
1ebiga-VISION GmbH, Greifswald, Germany. 2Nutrition Research Centre Ireland, South East Technological University, Waterford, Ireland. 3Oftalabs Sp. z o.o, Wałbrzych, Poland. 4Department of Ophthalmology, Medical Center, Starogard Gdański, Poland. 5Department of Ophthalmology, Medical University of Gdańsk, Gdańsk, Poland. 6Department of Retinal and Vitreous Surgery, Medical University Lublin, Lublin, Poland. 7Department of Ophthalmology, Wroclaw Medical University, Wroclaw, Poland
Research Highlights: Diabetes mellitus (DM) is the leading cause of blindness in developed countries, with diabetic retinopathy (DR) as its most severe complication, often resulting in permanent vision loss. DR’s pathogenesis is driven by hyperglycaemia-induced oxidative stress, which damages retinal capillary endothelial, nervous, and glial cells, leading to vascular abnormalities and increased cell death.
Recent research has explored the potential of antioxidant and antiglycating micronutrients to address this complex pathology. This study summarizes three clinical trials evaluating the effect of six months of micronutrient supplementation on visual and retinal function and morphology in diabetic patients, revealing significant improvements.
Innovation of this work is the effect size analysis, which provides a more robust understanding of the clinical relevance of the observed effects.
The effect sizes varied across parameters and disease stages. For example, patients with pathological macular integrity index (MI) demonstrated a large improvement, while contrast sensitivity in type 1 diabetics without DR showed a medium effect.
These findings highlight the clinical meaningful impact of a targeted micronutrient containing alpha-lipoic acid, vitamins B1 and B2, and rutin in supporting retinal health (function and morphology) and visual function.
Methodology: We summarized the statistically significant results presented by three clinical trails - Gebka 2014, Ciszewska 2017, Mulak 2019 - on the effect of six-months daily oral supplementation with 150 mg (R)-alpha lipoic acid, 1.1 mg vitamin B1, 1.4 mg vitamin B2 and 25 mg rutin on visual and retinal function and morphology and used the original data to determine the effect size.
improved CS: randomized controlled trial, 46 type 1 (38±10 years) + 51 type 2 diabetics (59±9 years), 22 type1 (44 eyes) + 24 type 2 (43 eyes) on supplementation, examined at baseline, 3 and 6 months (Gebka 2014)
improved MI: single-arm subgroup analysis, 38 diabetics – 44 eyes (17 eyes MI>40 – 59.0+/-10.5 years; 27 eyes MI≤40 – 62.3+/-7.0 years) on supplementation - examined at baseline, 3 and 6 months (Ciszewska 2017)
improved best-corrected visual acuity (BCVA) and retinal thickness: single-arm subgroup analysis, 25 diabetics with non-proliferative DR (grade 1+2) (64.1 ± 12.6 years) on supplementation - 50 eyes examined at baseline, 3 and 6 months (Mulak 2019)
Effect size was calculated for the six-months supplementation using Cohen’s d metric:
d=(M2-M1)/(√((SD12+ SD22)/2))
M1: Mean baseline; M2: Mean six-months; SD1: Standard deviation baseline; SD2: Standard deviation six-months
0.2≤d<0.5 indicates a small clinical effect; 0.5≤d<0.8 indicates a medium clinical effect and d≥0.8 indicates a large clinical effect.
Results: Effect size analysis revealed a moderate effect on contrast sensitivity in type 1 (at special frequence 3cpd: M1=4.8; M2=5.9; SD1=1.7; SD2=1.7; d=0.647) and a small effect in type 2 diabetics without DR (at special frequence 3cpd: M1=5.5; M2=6.0; SD1=1.6; SD2=1.6; d=0.313). In patients with pathological MI, supplementation led to a large improvement in retinal sensitivity (M1=67.5; M2=43.1; SD1=20.2; SD2=27.2; d=-1.018). Diabetics with non-proliferative DR (grade 1+2) experienced a medium effect on BCVA (M1=0.8; M2=0.9; SD1=0.1; SD2=0.2; d=0.632) and a small effect on retinal thickness (M1=225; M2=210; SD1=49; SD2=18; d=-0.406).
032Nutritional Intervention in Floaters: Evaluating the Efficacy of VitroCap®N from the Perspective of Eye Care Professionals
Franziska Wirth1, Warren Roche2, Maciej Osęka3, Robert Kuchling1, Thomas Kaercher4, John M. Nolan2
1ebiga-VISION GmbH, Greifswald, Germany. 2Nutrition Research Centre Ireland, South East Technological University, Waterford, Ireland. 3Oftalabs Sp. z o.o, Wałbrzych, Poland. 4Private Practice, Heidelberg, Germany
Research Highlights: Visual disturbance caused by floaters is a significant eye-health concern, often prompting patients to seek professional care. Traditionally, the approach has been watchful waiting and rely on floaters settling naturally. The alternate treatments—YAG-laser-vitreolysis and vitrectomy—are highly invasive. A targeted micronutrient complex (TMNC, commercially available as VitroCap®N), containing 125 mg L-lysine, 100 mg citrus fruit extract, 40 mg vitamin C, 26.3 mg grape seed extract and 5 mg zinc, provides a clinically proven, non-invasive option for managing floaters. Its efficacy has been demonstrated in five clinical trials, including the gold-standard, double-blind, placebo-controlled Floater Intervention Study (FLIES). This study showed improvements in subjective vision-related quality of life and a reduction in objectively measured opacity areas and contrast sensitivity.
To evaluate its practical application, a survey was conducted among 96 eye care professionals in Germany and Austria. Results showed that 83.1% of respondents, with an average of 4.18 years’ experience using the TMNC, rated it as moderately to extremely helpful for floater patients.
This analysis highlights the growing acceptance and clinical utility of targeted micronutrient supplementation in floater management.
Methodology: A survey was distributed to 96 eye care professionals in Germany and Austria to assess their perspectives on the TMNC for floater management. The questionnaire included seven key questions on the doctors` experience with vitreous floaters, the duration of therapy, its usefulness, the degree of improvement from the patients` side, different stages of vitreous degeneration, side effects of the therapy and recommendations for the therapy cycle.
Results: The average experience with the TMNC was 4.18 ± 3.18 years. Most respondents (75%) had at least 2 years’ experience, with 10% reporting over 9 years.
58.9% of the doctors rated TMNC as helpful, 24.2 % as extremely helpful.
The suggested duration of therapy was a minimum of 6 months for 41,7% of the doctors. 31.3% of the doctors tailored the therapy individually.
The vitreous degeneration is characterized by different stages. They include early symptoms, acute floaters, and posterior vitreous detachment. 72.6 % of the doctors do not specify different stages of the disease.
The TMNC was shown to be a safe therapy, with 96.9% of respondents reporting no side effects.
033Macular Pigment Optical Volume, cognitive performance and temporal vision in children: Findings from the ICONIC Study
Emmanuella Esi Dadzie1, John S. Butler2, Annalisa Setti3, James Loughman4
1Centre for Eye Research Ireland, School of Physics, Clinical & Optometric Sciences, Technological University Dublin, Dublin, Ireland. 2Centre for Eye Research Ireland, School of Mathematical Sciences, Technological University Dublin, Dublin, Ireland. 3School of Applied Psychology, University College Cork, Cork, Ireland. 4Centre for Eye Research Ireland, School of Physics, Clinical & Optometric Sciences, Technological University Dublin,, Dublin, Ireland
Research highlights: Macular pigment optical volume (MPOV) metric is a viable biomarker of diet quality in children. In children aged 7–10, MP levels measured with dual-wavelength autofluorescence imaging were lower than previously reported adult values. Higher MP levels are linked to a greater speed-accuracy tradeoff during multitasking in children, supporting its role in executive functioning. MPOV status and cognitive profiles highlight the clinical significance of higher MP levels in neural functioning. Observed lower MP levels indicate potential issues with dietary intake in children and macular carotenoids status, potentially in the brain and the eye, and therefore provide a rationale for developing interventions aimed at enhancing status.Future strategies emphasising the need to optimise dietary intake, potentially through dietary supplementation with MP’s constituent carotenoids, are needed.
Methodology: Baseline data of 65 healthy children aged 7-10yrs (53.8% male, 78.5% white) in the investigating ocular nutrition and cognition in children (ICONIC) study were analysed. MP was measured (central macular 1°and macular 9°) using fundus autofluorescence (Spectralis HRA + OCT). Neurocognitive functions were evaluated with CANTAB tests including (a) attention and psychomotor speed (reaction time [RTI]), (b) visual memory (paired associate learning [PAL], spatial span[SSP]) and (c) executive function (stop signal task[SST], multitasking task[MTT]). Temporal contrast sensitivity function was measured at 1, 2.5, 5, 10, 15 Hz under mesopic (∼3 cd/m2) conditions using Metropsis. Dietary intake was assessed using the LZQ screening tool. Statistical correlation and regression analyses were conducted using R.
Results: Mean MPOV within 1° and 9° eccentricities were 333.05±117.69 and 6903±2925.81, respectively. Central MPOV was associated with ethnicity (t=3.52, p<0.001), but no other demographic variable (age, sex, socio-economic status; P>0.05 for all). MPOV 9° was positively associated with breastfeeding duration (Beta coefficient[ß]=125.3, R²=0.158, P<0.001) and carotenoid intake (ß=86.6, R²=0.177, P<0.001). The relationship with MPOV 1° approached significance for total errors in multitasking (r=-0.20, p=0.09) and short-term visual memory (r=0.22, p =0.07) tasks. MPOV 9° was positively associated with response delay time (latency score) for multitasking (r=0.23, p=0.05). Following adjustment for demographic factors and dietary intake, MPOV 1° was a significant negative predictor of error rates in multitasking (ß=-0.025, R²=0.27, P<0.05). During the multitasking task, the response delay time was longer for conflicting stimuli (incongruent trial) but shorter for matching stimuli (congruent trial) and was positively associated with MPOV 9° (ß=0.007, R²=0.088, P<0.05). No significant correlation was found between temporal vision and MPOV (n = 59, r = -0.12 to 0.14, P = 0.15 to 0.81).
034MADEOS Study: Omega-3s Show Promise for Vision in Eye Disorders
Ekatherine Prokopiou1,2, Panagiotis Kolovos1, Haritini Tsangari3, Saddek Mohand-Said4, Luca Rossetti5, Leonardo Mastropasqua6, Francesco Bandello7, Tassos Georgiou1,8
1Ophthalmos Research and Educational Institute, Nicosia, Cyprus. 2University of Nicosia Medical School, Nicosia, Cyprus. 3School of Business, University of Nicosia, Nicosia, Cyprus. 4Centre Hospitalier National d′Ophtalmologie des Quinze-Vingts, Paris, France. 5Centre for Clinical Trials at San Paolo Hospital, University of Milan Faculty of Medicine and Surgery, Milano, Italy. 6Ophthalmology Clinic, Regional Center of Excellence in Ophthalmology, Gabriele d′Annunzio University of Chieti and Pescara, Chieti, Italy. 7Department of Ophthalmology, Vita-Salute San Raffaele University Faculty of Medicine and Surgery, Milano, Italy. 8School of Medicine, European University Cyprus, Nicosia, Cyprus
Research Highlights: This pilot study demonstrates that supplementation with eicosapentaenoic acid (EPA)-rich omega-3 fatty acids may improve both objective and subjective vision outcomes in individuals with dry age-related macular degeneration (AMD) or Stargardt disease. The use of omega-3 supplements led to significant gains in visual acuity and improved quality of life as reported by participants.
Methodology: The study, named MADEOS, was a prospective, randomized, multicenter, double-blind, placebo-controlled pilot trial. It evaluated the effect of omega-3 supplementation on best corrected visual acuity, the blood omega-6/omega-3 ratio (arachidonic acid/EPA), and perceived vision and mood through a questionnaire. Patients with dry AMD or Stargardt disease were randomly assigned to receive either an active supplement containing 3660 mg of EPA and DHA (14 patients) or a placebo of sunflower oil (7 patients) daily for 24 weeks. Data were collected at baseline (Visit 1), 12 weeks (Visit 3), and 24 weeks (Visit 4), with comparisons made within and between groups.
Results: Participants in the active group experienced a statistically significant increase of 6 ETDRS letters on average from Visit 1 to Visit 4, comparing to the placebo group (p=0.002). The mean AA/EPA ratio significantly decreased in the active group from a baseline of 5.84 ± 1.05 to 1.47 ± 0.16 at Visit 4 (p=0.002). While questionnaire scores at Visit 3 were similar between groups, scores were higher for the active group versus the placebo at Visit 4 (9.38 ± 3.35 vs. 7.28 ± 2.36), indicating improvement in perceived vision and mood.
035Stargardt 3-disease knock-in mutation induces loss of very long-chain polyunsaturated fatty acids in zebrafish eyes
Uzoamaka Nwagbo, Corbin Luettinger, Paul Bernstein
University of Utah, Salt Lake City, USA
Research Highlights: Very-long-chain polyunsaturated fatty acids (VLC-PUFAs) make up <2% of the total fatty acids in the retina and are thought to play a structural role in photoreceptor outer segment disks. They are not easily obtained nutritionally through a Western diet but are biosynthesized in situ in a few tissues such as the retina, skin, and testes by the ELOVL4 enzyme. VLC-PUFAs are depleted in the retinas of patients with macular degeneration and diabetic retinopathy. Additionally, studying the function of VLC-PUFAs in vivo has been challenging due to the post-natal lethality through catastrophic dehydration observed in mice harboring a total Elovl4 gene knockout, and the mixed results obtained with conditional Elovl4 mutant mice.
In this project, we have generated three strains of Elovl4 mutant zebrafish to evaluate the effect of VLC-PUFAs on vision and ocular fatty acid profiles. The first strain has a deletion mutation in Elovl4b (Elovl4b KO); the second strain has a deletion mutation in its gene duplicate, Elovl4a (Elovl4a KO), and the third strain has a knock-in mutation of the Stargardt 3 disease-causing two 1-bp deletion mutations (STGD3 KI). Zebrafish present a unique model to study the role of VLC-PUFAs in vision because they do not catastrophically dry out, like the mouse models of Elovl4 -ablation, and have two gene copies of Elovl4, with divergent functions.
Methodology: We previously showed that homozygous Elovl4b KO fish had depleted C30 – C36 VLC-PUFA levels. For this study, we hypothesized that the two-1 bp deletion knock-in mutation induced in the zebrafish model would reduce ocular levels of VLC-PUFAs and recapitulate previous studies of STGD3-causing mutations in human and animal studies. To study this, we generated stable lines of zebrafish with the Stargardt 3 disease-causing two 1-bp deletion mutation in Elovl4b using CRISPR-Cas9 and outcrossing the founder fish to wild-type animals to ensure germline mutagenesis. We also used CRISPR-Cas9 to generate a stable line with a deletion mutation in Elovl4a. We analyzed ocular VLC-PUFAs using gas chromatography-mass spectrometry (GC-MS) on lipids extracted from adult zebrafish eyes. We also evaluated the lipid profile of the eyes through liquid chromatography-tandem mass spectrometry (LC-MS/MS). We evaluated gross retinal morphology using toluidine-blue stained retinal sections of adult zebrafish prepared and imaged by Histowiz. Moreover, we evaluated visual behavior using ViewPoint’s® ZebraBox and VisioBox platforms at the larval and adult stages, respectively.
Results: Our results confirmed our hypothesis because we observed a depletion of VLC-PUFAs longer than C30 in homozygous STGD3 KI mutants. We also observed diminished visual behavioral responses at the larval and adult stages. However, like the homozygous Elovl4b KO fish, we observed no obvious differences in gross retinal morphology. Interestingly, we observed increased rates of mortality, dwarfism, and infertility among homozygous Elovl4a KO fish compared to wild-type and heterozygous mutants. Elovl4a KO larvae also had reduced visual-motor response compared to wild-type controls.
036Therapeutic Potential of Coenzyme Q10 in Ocular Diseases: A Review of Clinical and Preclinical Evidence
Cemre Altas, Thomas Fuchsluger
Department of Ophthalmology, University Medical Center Rostock, Rostock, Germany
Research Highlights: Coenzyme Q10 (CoQ10) is a lipophilic molecule involved in mitochondrial energy production, antioxidative defense, and apoptosis regulation. Its therapeutic potential for ocular diseases, particularly glaucoma and corneal disorders, has been explored in various studies. This work aims to evaluate the effectiveness of CoQ10 based on existing evidence.
Methodology: We reviewed published studies investigating the use of CoQ10 in ophthalmology. Key clinical studies included the effects of CoQ10 in crosslinked hyaluronic acid (XLHA) formulations on patients with moderate dry eye disease (DEWS grade 2–3) and electrophysiological analyses examining CoQ10 combined with Vitamin E in glaucoma patients, focusing on retinal function and visual signal processing. Additionally, we analyzed preclinical studies on animal models to assess the neuroprotective effects of CoQ10 under ocular hypertension conditions.
Results: The reviewed studies reported:
Significant improvements in corneal regeneration, tear film stability, and symptom relief in patients treated with XLHA-CoQ10 compared to linear hyaluronic acid.
Enhanced retinal function (increased PERG amplitude) and accelerated visual signal processing (reduced VEP latency) in glaucoma patients receiving CoQ10 and Vitamin E therapy.
A marked reduction in retinal ganglion cell apoptosis in animal models of ocular hypertension treated with CoQ10.
These findings provide a robust foundation for further investigations into CoQ10 as a therapeutic agent for glaucoma and ocular surface diseases.
037Evaluating the Impact of Dietary Fibers on the Bioaccessibility of main Dietary Carotenoids
Anushka Shukla*1, Aziliz Rolland1, Thomas Schleeh2, Charles Desmarchelier3, Patrick Borel3, Torsten Bohn1
1Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg. 2ERIN Department, Luxembourg Institute of Science and Technology, Belvaux, Luxembourg. 3Center for CardioVascular and Nutrition Research (C2VN), Aix marseille University, Marseille, France
*Corresponding author, e-mail address: Anushka.shukla@lih.lu
Research highlights: Carotenoids are lipophilic phytochemicals associated with improved health outcomes, as supported by numerous epidemiological studies; however, their bioavailability can be low and variable [1].Bioavailability of carotenoids is influenced by several dietary factors, including lipids, fibers, minerals, other phytochemicals, and proteins [1–3]. Dietary fibers (DF) remain somewhat understudied factors that may affect carotenoid bioavailability by influencing their release from foods and solubilization into mixed micelles during digestion.This study aimed to investigate the interactions between dietary fibers and carotenoids during digestion. The findings reveal that dietary fibers influence carotenoid bioaccessibility in a neutral to negative way depending on the type of fiber and carotenoid, which was partly reflected by physico-chemical properties. The results of this study could be relevant for the formulation of nutritional supplements and dietary recommendations regarding optimal carotenoid sources.
Methodology: In this study, we investigated the dose-dependent effects of pectin, cellulose, guar gum, alginate, type 2 resistant starch, and fructo-oligosaccharides at amounts of 0, 30, and 90 mg, added at onset of gastro-intestinal (GI) digesta containing either β-carotene, lutein, or lycopene solubilized in oil. After simulating GI digestion using the INFOGEST static model, the bioaccessibility of individual carotenoids was determined spectrophotometrically from centrifuged and filtered digesta. Subsequently, their bioaccessibility was calculated using the Beer-Lambert law. The percentage of carotenoid micellization, serving as a measure of bioaccessibility, was calculated as the proportion of carotenoids present in the micellar phase of the filtered digesta after in vitro GI digestion, relative to the initial amount added to the sample. Additionally, other physio-chemical properties such as viscosity, surface tension, lipid hydrolysis, micelle size, and zeta potential were also measured.
Results: The addition of alginate significantly decreased the bioaccessibility of β-carotene from 29.1 ± 4.5% to 11.8 ± 3.8% (p<0.001), while pectin reduced it from 29.1 ± 2.6% to 17.9 ± 2.3% (p < 0.05). In contrast, other dietary fibers had no significant effect. For lutein, its bioaccessibility was only decreased by pectin, from 58.3±1.9% to 26±3.0% (p<0.001). For lycopene, the addition of pectin decreased its bioaccessibility from 7.2±0.5% to 5.4±0.2% (p<0.05), while alginate decreased it to 4.1±1.0% (p=0.001) and guar to 4.8±1.2% (p<0.05). Moreover, significant interactions between fiber type (pectin and alginate) and dose were observed for the bioaccessibility of lutein and β-carotene. However, viscosity and surface tension were only impacted to a small extent.
Desmarchelier C, Borel P. Overview of carotenoid bioavailability determinants: From dietary factors to host genetic variations. Trends Food Sci Technol. 2017; 69, Part B 270-80.
Iddir M, Vahid F, Merten D, Larondelle Y, Bohn T. Influence of Proteins on the Absorption of Lipophilic Vitamins, Carotenoids, and Curcumin—A Review. Molecular Nutrition and Food Research, 2022; in press.
Corte-Real J, Iddir M, Soukoulis C, Richling E, Hoffmann L, Bohn T. Effect of divalent minerals on the bioaccessibility of pure carotenoids and on physical properties of gastro-intestinal fluids. Food Chemistry. 2016; 197(Pt A): 546-53.
038Stronger Eyes, Sharper Minds: The LuTEEN Study
Brenda Fonseca
National University, San Diego, USA
Research Highlights: This study is the first of its kind to investigate the effects of lutein supplementation in a healthy preteen and teenage population. The findings suggest that lutein could play a role in supporting eye health, cognitive performance and reducing digital eye strain during critical developmental years, especially for children with high screentime exposure.
Methodology: A randomized, double-blind, placebo-controlled trial was conducted in 59 healthy children aged 8-16 with ≥4 hours of daily screen time (clinicaltrials.gov NCT05314647). Participants received 5 mg lutein (FloraGLO Lutein, Kemin Industries) or placebo gummies daily for 6 months. Macular pigment (MP) density was assessed using heterochromatic flicker photometry (HFP) (Quantifeye/MPS II, Electron Eye Technology) for peak macular optical density (MPOD) and using degree of polarization threshold based on Haidinger's Brushes phenomenon (MP-eye score) (MP-eye, Azul Optics Ltd.) for MP density. Cognitive performance was measured for executive function, attention, processing speed, and overall cognitive ability using the Flanker Inhibitory Control and the Pattern Comparison Processing Speed tasks (NIH Toolbox) and Verbal Fluency tasks. Digital eye strain was assessed via the Visual Fatigue Scale (VFS). Assessments were performed on days 0, 90, and 180, with a mixed model repeated measures (MMRM) analysis of changes from baseline.
Results: The average age of the participants was 12.3 years (SD=2.23) with 59% of the participants in the preteen/youth category (8-12 years) and 41% in the adolescent age range (13-16 years). Participants were evenly split between female (n=30) and male (n=29). Baseline MP values were similar for both groups with means and standard deviations for MPOD at 0.547 ± 0.144 and for MP-eye score at 5.136 ± 2.4563. Macular pigment density as measure by MP-eye score was significantly improved for the participants taking lutein compared to placebo, F(1,73.4)=6.86, p=.011. In addition, the treatment group showed a statistically significant reduction in digital eye strain compared to placebo, F(1,107)=6.798, p=0.010 as well as a significant improvement in the Flanker Ratio of congruent versus incongruent trials, F(1,57.9)=4.46,p=.039. Overall, healthy preteen and teenage participants receiving a daily lutein gummy exhibited a 14% increase in MP density levels in the eye, a 13% improvement in a cognitive assessment of attention and executive control, and a 6% reduction in digital eye strain compared to those in the placebo group.
039Skin carotenoid levels in pregnant and postpartum women measured by VEGGIE METER®
Akira Obana1, Yuko Gohto1, Takeshi Murakoshi2, Hiroko Konno2, Mieko Nakamura3, Ayako Miura4, Miho Nozue4, Ryo Asaoka1
1Eye Center, Seirei Hamamatsu General Hospital, Hamamatsu, Japan. 2Dept. of Obstetrics, Seirei Hamamatsu General Hospital, Hamamatsu, Japan. 3National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan. 4Faculty of Health Promotion Science, Tokoha University, Hamamatsu, Japan
Research Highlights: Carotenoid intake during pregnancy and postpartum affects not only maternal health but also child development. Previous studies have investigated the relationship between lutein and zeaxanthin intake during pregnancy and the incidence of retinopathy of prematurity, as well as the development of the infant’s brain and vision. Additionally, intervention trials have been conducted to examine the effects of supplement intake in pregnant women.
Japan’s Dietary Reference Intakes (2020) provide daily additional intake recommendations for energy, protein, vitamins such as folic acid, vitamin A and B1, and minerals such as iron and magnesium. However, there are no specific intake guidelines for pregnant and postpartum women with carotenoids other than vitamin A.
Therefore, as a first step in raising public awareness of the importance of carotenoid intake in pregnant and postpartum women, we measured the skin carotenoid (SC) levels in pregnant and postpartum women. Moving forward, we aim to achieve results that will attract even greater attention from society.
Methodology: This cross-sectional observational study involved 326 pregnant and postpartum women who visited the obstetrics department at Seirei Hamamatsu General Hospital. Participants underwent SC measurements using reflection spectroscopy (VEGGIE METER®, Longevity Link Co.) and completed dietary questionnaires. The study was approved by the hospital's ethics committee, and complied with the Declaration of Helsinki. All participants provided written informed consent.
Results: SC levels were measured in 324 individuals aged 16 to 44 years (mean, 32.6±4.5 years). Among them, 284 were prenatal (gestational weeks 6 to 40), and 40 were postpartum (12 to 93 days after delivery). The Veggie Score ranged from 99 to 677 (median, 322, mean, 335.2±104.9). No correlation was found between gestational age and Veggie Score before delivery; however, postpartum measurements showed a decrease in Veggie Scores over time. The Veggie Score exhibited a positive correlation with age and a negative correlation with body mass index (BMI). No significant difference in Veggie Scores was observed between singleton and twin pregnancies, but a significant difference was found between prenatal and postpartum periods (340.3±106.1, 299.2±89.4, p=0.020). Multivariate regression analysis identified age, BMI, and the prenatal or postpartum status as factors influencing Veggie Scores. We previously reported higher Veggie Scores in both elderly individuals and children. Although data for participants of similar age to this study are limited, the current results suggest a trend toward lower Veggie Scores, particularly in postpartum women. This decline during the puerperium is reflected in low carotenoid concentration in breast milk and potentially affects infant development.
040Lutein sports beverage and a Lutein cupcake: Product development and human bioavailability study
Alfonso Prado-Cabrero1, Roísín Flynn2, Tommy Power1, Marina Green-Gomez1, John M. Nolan1
1Nutrition Research Centre Ireland, South East Technological University, Waterford, Ireland. 2Cybercolors Ltd, Fermoy, Ireland
Research Highlights:
We developed Lutein-fortified isotonic sports beverages with 2, 11 or 22 mg of lutein per 500 mL of beverage.
We developed lutein-fortified cupcakes with 3, 11 and 22 mg of lutein per 50-g cupcake.
We prepared these novel lutein-fortified foods in accordance with food safety regulations and under the guidelines of HACCP.
The human bioavailability study that we conducted to assess the capability of these functional foods to deliver lutein to the bloodstream indicates that both lutein-fortified foods, containing 10 mg of lutein each of them, increased lutein levels in participant’s serum.
These lutein-fortified foods can enhance lutein consumption in the population, with a focus on sportswomen and men, children and elderlies with swallowing difficulties.
Methodology: In order to prepare our lutein-fortified isotonic sports beverage and cupcakes, we produced an emulsion of lutein esters (E 161b – natural derivative) in accordance with food safety regulations and under the guidelines of HACCP. HPLC analysis and colour analysis was carried out to quantify lutein in the foods produced. Then, we conducted a 96-hour bioavailability trial with human participants to evaluate the efficiency of these functional foods in increasing serum lutein levels. 19 subjects participated in the study. Lutein in serum was quantified by HPLC-DAD.
Results: Lutein remained stable in the cupcakes across their 7-day shelf life for the three concentrations of lutein used. The lutein-fortified isotonic sports beverages, prepared at three different lutein concentrations (2, 11 and 20 mg/500 mL) showed significant lutein degradation in light, oxygen, and temperature-exposed storage conditions. When stored in ambient light conditions, the lutein content of the isotonic sports beverages containing 2 mg of lutein degraded between 95% - 100% with oxygen presence and between 70 - 72% without oxygen, whereas in the beverages prepared with 11 and 20 mg/500 mL of lutein, this carotenoid degraded by 88% with oxygen and between 57 - 63% without oxygen. In ambient dark storage conditions, across all concentrations, degradation ranged from 77% to 95% in oxygenated conditions and 56% to 62% in non-oxygenated conditions. The most effective storage condition for this food matrix was non-oxygenated refrigeration, with 39%, 21%, and 24% degradation in the beverages prepared with the lowest, middle and highest lutein concentration, respectively.
Both lutein-fortified foods yielded a significant increase in serum lutein, whereas the lutein-fortified cupcake demonstrated a superior average increase compared to the isotonic sports beverage (ΔC, change of lutein concentration in serum over time) (μg/L): 36.83 ± 17.00 and 22.15 ± 14.99. The change in the Area Under the Curve of lutein concentration in serum over the 96 h trial (ΔAUC(0-96 h)) was also higher for the lutein-fortified cupcake, with 1257.55 ± 635.73 compared to 956.86 ± 440.04 h·μg/L in the lutein-fortified beverage.
041Neuropsychological performance and related nutritional and visual determinants in preadolescent children from Ghana
Isaiah Osei Duah Junior1,2, Nana Aba Senuwah Ashon1, Wendy Ofori-Asare1, Elizabeth J. Johnson3, Mary Amoako4, Dorcas Adu-Owusu4, Bernice Lebene Tettey 5, Josephine Ampomah Boateng1, Jessica Eyeson6, Gabriel Kwaku Agbeshie1, Kwadwo Owusu Akuffo1
1Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 2Department of Biological Science, College of Science, Purdue University, West Lafayette, USA. 3Friedman School of Nutrition Science and Policy, Tufts University, Boston, USA. 4Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 5Department of Chemistry, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 6School of Medical Sciences, College of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
Research Highlights: Suboptimal lutein (L) and zeaxanthin (Z) status, macular pigment (MP), and temporal visual acuity are associated with neuropsychological vulnerability in adults. However, the nutritional and visual determinants of neuropsychological performance in children remain elusive. Sex differences in neuropsychology are increasing, but the evidence in children remains puzzling. Here in, this study showed lower xanthophyll carotenoid intake and correspondingly lower macular carotenoids. There was a significantly reduced deficit in the neurological performance on the multi-domain task in the females as compared to the males. Macronutrients, total energy consumption, and xanthophyll carotenoids were related to executive function. Critical flicker frequency (CFF) and contrast sensitive function (CSF) were related to improved executive function. Collectively, CFF represents a robust ocular biomarker of cognition, while increased L+Z intakes and macronutrient modulation may improve neuropsychological performance in children.
Methodology: Herein, we hypothesized that biographical, nutritional, and visual factors predict neuropsychological performance. To test this hypothesis, a cohort of preadolescent children (N=290, aged 7 to 13 years) from Ghana were enrolled and biographical and health data were collected using a structured questionnaire. Body composition was evaluated using the Seca scale, and dietary intake was examined using a 24-hour 3-day dietary recall. Best corrected visual acuity and contrast sensitivity were measured using the LogMAR Early Diabetic Retinopathy Treatment Study (EDRTS) and Peli Robson charts, respectively. Refractive status was assessed with the Photorefractive Vision Screener and MP at one-degree retinal eccentricity was assayed with custom heterochromatic flicker photometry. Neuropsychological performance was assessed on 150 subjects using the Cambridge Neurophysiological Test Automated Battery (CANTAB) which assess memory (delayed matching to sample [DMS] and paired associates learning [PAL]), executive function (Stockings of Cambridge [SOC] and spatial working memory [SWM]), attention and psychomotor speed (reaction time [RTI]). Specifically, DMS assesses both simultaneous visual matching ability and short-term visual recognition memory for non-verbalizable patterns; PAL assesses visuospatial episodic memory and novel learning; SOC dissects spatial planning using a problem-solving strategy; RTI elicits motor and mental response speed, as well as measures of movement time, reaction time, response accuracy, and impulsivity; and SWM examines the retention and manipulation of visuospatial information.
Results: This study reports lower intakes of L, Z, L+Z, and MP scores. Sex differences persisted after adjustment for confounders, with females showing significant deficits (p<0.05) in short-term memory, visual recognition memory, visuospatial episodic memory, novel learning, attention, and psychomotor speed on the CANTAB. Intakes of Lutein, L+Z, egg consumption, and vitamin A was significantly related to improved executive function (p<0.05). Furthermore, macronutrients and total energy consumption was significantly related to enhanced spatial planning (p<0.05). Critical flicker frequency and CSF was significantly related to improved short-term and visual recognition memory (p<0.05).
042The LifeMeter Study: Irish consumers’ knowledge, understanding and insights on macular supplements
Kieran Cagney1, John M. Nolan2, Anne Graham Cagney2
1BKD Consulting Ireland, Greystones, Ireland. 2Nutrition Research Centre Ireland, South East Technological University, Waterford, Ireland
Research Highlights: Irish consumers’ knowledge, understanding and insights on macular supplements is limited. The majority expect the product content, active ingredients and their percentages stated on the label to be present in the product they purchase. Responsibility for label accuracy was attributed to brand/product/manufacturers and Government. ‘Worried well’ consumers are motivated to improve their carotenoid levels because they are concerned about maintaining their vision and brain function, and stage of life/getting older. This pilot study is the first of its kind in Ireland. It will inform the design and development of further national research.
Methodology: The consumer insights study sought to explore what consumers are buying, for whom and on whose recommendation; and to assess the general level of consumer product knowledge and reasons for using supplements. A randomized sample of consumers who were taking part in a nation-wide pharmacy non-invasive LifeMeter testing service presented a unique opportunity to conduct the research. Following ethical approval, an agreed schedule of locations and dates was organised with the LifeMeter Consultant and the designated pharmacies. Seven pharmacies and 113 participants took part over a four-week period; and an additional 12 participants completed the survey online.
The field researcher invited each consumer to take part in the survey while they waited for their LifeMeter test. All individuals with appointments agreed to participate. Other customers without appointments, who were present in the pharmacy on that day came forward and requested to participate. There were no inclusion or exclusion criteria, no inducement or payment offered, and adults (over age 18) were included. Following confirmation of consent, they answered 12 general questions on macular supplements. The time burden was 3-5 minutes. Many participants offered additional comments and viewpoints. All these were recorded in the researcher’s field notes.
Due to the small sample size, it is not possible to generalize to a larger population or reach broad conclusions. This survey is replicable and the methods allow for incorporation (with additions) into a larger study with the same population of interest; or to apply it to a national context with other populations (with appropriate design and scalability adjustments). Findings were drawn from the survey (quantitative data) and field researcher notes (qualitative data).
Results
The majority of participants (80%) stated they trusted the information on the label; 92% expected that: (1) the active ingredients listed on the label are present in the supplement they purchase; and (2) that they are present in the amounts claimed on the label.
Half of the participants (51%) believed manufacturers/brand/product owners had responsibility for ensuring the accuracy of the label; while a further 35% believed it was Government responsibility.
The strongest influence to use supplements and to choose one brand/product over another came from recommendations by GPs, pharmacists and their staff, and other medical/health consultants.
A ‘worried well’ population is motivated to use carotenoid supplements due to concerns regarding their: (1) stage of life/getting older; and (2) retention of cognitive and visual function as they age.
043Association of Dietary Fiber Intake and Fiber Supplement Use with Cognitive Impairment in Postmenopausal Women
Parker Polston1, Kaelyn Burns1, Heather Ochs-Balcom1, Jean Wactawski-Wende1, Kathleen Hovey1, Meghan Skiba2, Stephen Rapp3, Linda Van Horn4, Aladdin Shadyab5, Chrisa Arcan6, Amy Millen1
1Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA. 2Biobehavioral Health Science Division, College of Nursing, University of Arizona, Tucson, AZ, USA. 3Department of Psychiatry & Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA. 4Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. 5Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA. 6Department of Family, Population & Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
Research Highlights: Fiber supplement use, but not dietary fiber intake, was associated with higher risk of cognitive impairment. Higher risk in fiber supplement users may be due to gut microbiome disruptions caused by fiber supplementation used as a bulk laxative rather than to increase fiber intake.
Methodology: We evaluated the association between dietary fiber intake and fiber supplement use with risk of mild cognitive impairment (MCI), probable dementia, and any cognitive impairment (combined MCI or probable dementia) in a sample of postmenopausal women. Participants from the Women’s Health Initiative (WHI) Memory Study (WHIMS) (n=4,962), ancillary to the WHI hormone therapy (HT) trials, were included in the analyses. Cognitive outcomes were adjudicated by clinician experts. Annual cognitive evaluations took place in-person between 1996 and 2008, after which a centralized, validated neuropsychological battery was administered annually via telephone until 2021. At WHI enrollment (1993-1998), dietary fiber intake (total, soluble, and insoluble) was measured in g/day using a food frequency questionnaire. Fiber supplement use was self-reported on supplement and medication questionnaires. Cox proportional hazards regression was used to estimate hazards ratios (HRs) and 95% confidence intervals (CIs) for any cognitive impairment, MCI, and probable dementia, by quintiles (Qs) of energy-adjusted dietary fiber intake and by fiber supplement use (n=217) (versus non-use [n=4,745]). Models were adjusted for demographic (age, education) lifestyle (energy intake, alcohol intake, Healthy Eating Index score, recreational physical activity, pack years of smoking), and health variables (depressive symptom severity, cardiometabolic condition), baseline Modified Mini-Mental State Exam score, as well as WHI HT and calcium and vitamin D (CaD) trial arms. Exploratory analyses examined associations with total dietary fiber intake and fiber supplement use stratified by HT and CaD intervention versus control arms. An interaction term (exposure * intervention/control arm) was added to the multivariable models and considered statistically significant if p<0.05.
Results: WHIMS participants were aged 70.2 years at baseline. Between 1996 and 2021, there were 594 cases of MCI and 541 cases of probable dementia. In adjusted models, no statistically significant associations were observed between total, soluble, or insoluble dietary fiber intake and any cognitive outcome across quintiles of dietary fiber intake. Contrary to our hypothesis, fiber supplement use (versus non-use) was associated with a higher risk of any cognitive impairment and MCI (HR [95% CI] = 1.43 [1.09-1.88] and 1.60 [1.16-2.22]), respectively. There was no statistically significant effect modification of total dietary fiber intake or fiber supplement use by HT or CaD intervention versus control arms (p-for-interactions>0.05), although there was some suggestion of a lower risk of probable dementia with total dietary fiber intake in Q2-5 (compared to Q1) (HR [95% CI] = 0.48 [0.27-0.85], 0.75 [0.45-1.25], 0.52 [0.29-0.93], and 0.72 [0.42-1.23]), respectively, in the CaD intervention arm.
044Prevalence of Visual Impairment and Ocular Pathologies Among Elderly Residents of Irish Nursing Homes
Keshav Acharya1, Fraser Horn2, John M. Nolan1
1Nutrition Research Centre Ireland, South East Technological University, Waterford, Ireland. 2Pacific University Oregon, Oregon, USA
Research Highlights: Ocular conditions can lead to visual impairment and ultimately affect an individual’s life. The extent to which an individual’s life is affected largely depends on the nature and degree of ocular pathology. According to the World Health Organization, cataract and uncorrected refractive errors are the prevailing causes of avoidable blindness, with vast majority of individuals over fifty years of age. Technological advancements and improved living standards have yielded longer life expectancy, particularly in developed countries, like the Republic of Ireland. Last century, half the number of people in Ireland hardly lived beyond 65 years of age; while in the current time, older people live into their eighty and ninety years of age. Nursing homes in Ireland play a crucial role in providing care to this ageing population; however, reports suggest residents in nursing homes experience difficulties accessing specific medical services, in particular eye care. In fact, certain percentages of this population have no knowledge of their current eye and vision condition which could be potentially treated and improved. An understanding of prevalent ocular pathologies and vision impairment among elderly residents in Irish nursing homes will foster preventive and management strategies to improve quality of care.
Methodology: Cross-sectional mix-methods study will be conducted in 200 participants residing on Irish nursing homes situated in South-East region of Ireland. Participants above the age of 65 will be recruited for the study. A ‘Vision Van’ equipped with the portable eye equipment will be taken to individual nursing homes. Visual acuity, contrast sensitivity, anterior and posterior segment assessment of each participant will be conducted by a qualified optometrist. AI based fundus camera will be used to assess retinal pathologies. Participants will be presented with the visual function questionnaire to subjectively assess visual function and vision-related quality of life. Life Meter skin Carotenoid scan will be conducted in each participant to co-relate dietary Carotenoid intake and eye health.
Results: The study visit is scheduled to begin in June 2025. Very few studies have been done in Ireland to study the prevalence of ocular diseases, but no studies have reported the visual status of people residing on Irish nursing homes. This study will not only act as a foundation for further studies, but also help concerned authorities to incorporate better eye health services in nursing homes. Early diagnosis of the sight threatening conditions will allow immediate referral which helps to prevent possible sight loss and improve vision-related quality of life.
045Demonstrating the “Effect Size” of a micronutrient intervention in patients with vitreous floaters
Warren Roche, John M. Nolan
Nutrition Research Centre Ireland, South East Technological University, Waterford, Ireland
Research Highlights: Traditionally, statistical significance (assessed via the p-value) is used to represent the importance (significance) of a result in research. In particular, a p-value less than a priori determined alpha (α) level (e.g., 0.05) is used to declare the statistical significance of observations and is concluded to “prove” that, for instance, an intervention has the desired effect of interest. In other words, when p < α , a statistically significant effect is claimed. The reliance solely on the “p-value” to report findings of a research study is not optimal and, in many cases misrepresents the findings of a study. Reporting the duo of p-values and effect sizes is proposed to add greatly to the understanding of the research findings by providing a more comprehensive assessment of observed “effects”.
Here, by applying effect sizes to the Floater Intervention Study (FLIES) randomised controlled clinical trial dataset, we demonstrate the clinical importance of the study. In other words, within this work, we gain a more comprehensive understanding of the practical effect of a nutritional intervention on a patient’s vision.
Methodology: FLIES included 61 subjects with symptomatic vitreous floaters consuming either a formulation of selected micronutrients consisting of 125mg l-lysine, 40mg vitamin C, 25mg Vitis vinifera extract, 5mg zinc, and 100 mg of Citrus aurantium extract (active group; n=31) or placebo (placebo group; n=30) for 6 months [1]. The change in visual discomfort after 6 months of supplementation - assessed with the Floater Disturbance Questionnaire - represented the primary outcome measure. Secondary outcomes were change in quantitative vitreous opacity areas, best corrected visual acuity, letter contrast sensitivity, and functional contrast sensitivity. In this new analysis, effects sizes are calculated in order to quantify the magnitude of improvements experienced by patients suffering from floaters with targeted micronutrition.
Results: Statistically significant differences were observed between placebo and active groups over time for primary outcomes measures including visual discomfort with floaters, effect of floaters on daily life, and measure photopic functional contrast sensitivity with positive polarity, with p-values 0.028, 0.038, and 0.048 observed, respectively. The addition of effect size (assessed via value) to these variables exhibits a medium-to-large effect, with values of 0.086, 0.078, and 0.070 observed, respectively. Here, we demonstrate that the active intervention provides a medium-to-large effect in terms of the vision-related quality of life improvements experienced by the patients. This new analysis will support further doctors and patients on the benefits of enriching vitreous micronutrients for patients with longstanding symptomatic floaters.
References:
Ankamah E, Green-Gomez M, Roche W, Ng E, Welge-Lüßen U, Kaercher T, Nolan JM. Dietary Intervention With a Targeted Micronutrient Formulation Reduces the Visual Discomfort Associated With Vitreous Degeneration. Transl Vis Sci Technol. 2021 Oct 4;10(12):19. doi: 10.1167/tvst.10.12.19. PMID: 34647961; PMCID: PMC8525826.
046Analysis of Carotenoids and Omega-3 Fatty Acids in Dietary Supplements
Tommy Power, Alfonso Prado-Cabrero, John M. Nolan
Nutrition Research Centre Ireland, South East Technological University, Waterford, Ireland.
Research highlights: Here we confirm that from 147 carotenoid supplement products measured by Supplement Certified, only 64 products (44%) meet 100% of their label claim and 83 (56%) fail to meet label claim. For Omega-3 fatty acid supplements, 70 were measured by Supplement Certified, with 56 products (80%) meeting 100% of their label claim and 14 (20%) failing to meet label claim. This work highlights a major issue for these food supplements that fail to deliver on their label claim. We propose that regulatory standards for food supplement testing are improved and implemented to ensure that companies selling food supplements are required to provide label claim and product stability certification.
Methodology: Supplements were purchased mainly online on Amazon or in local shops in Ireland with either carotenoids on the label (Meso-zeaxanthin, Zeaxanthin and Lutein) or Omega-3 Fatty Acids (EPA and DHA) or both. The carotenoid supplements are analysed using High Performance Liquid Chromatography (HPLC) and the Omega-3 supplements are analysed using Gas Chromatography (GC). We analyse the macular carotenoids and omega-3 fatty acids following analytical methods developed in-house that are certified by the Irish National Accreditation Board (INAB) as part of our ISO/IEC 17025:2017 accreditation. This analysis has been conducted since 2019, and all the data/analysis has been gathered since then.
Results: We have tested 227 products from 105 companies declaring the macular carotenoids or omega-3. A total of 29 products declared both macular carotenoids and omega-3s. From 147 products declaring macular carotenoids, 83 failed to comply with 100% of their label claim (56%), which showed 75% failures corresponded to powder/tablets. From 70 products containing Omega-3 fatty acids, 14 failed to contain 100% of their label claim (20%).
047Understanding Policy Regarding Food Supplements for Human Health: The LABEL Study
Mariana Calheiros Lobo, Anne Graham Cagney, John M. Nolan
Nutrition Research Centre Ireland, South East Technological University, Waterford, Ireland.
Research Highlights: Food supplement regulations differ from country to country. For example, the European Food Safety Authority (EFSA) regulates food supplements in Europe, the Food and Drug Administration (FDA) in USA, and the Food and Drug Regulations (FDR) in Canada. Some of these regulatory bodies have published policies that set out the requirements for companies to confirm that their supplement products meet their label claim. However, quantitative analysis from the Supplement Certified laboratory suggests there are major disparities between label claim and the active ingredients measured. The laboratory has also identified issues with some products degrading during their shelf life. This research will examine Irish regulatory food supplement policies to understand what policy gaps lead to products failing their label claim. Specifically, we will study carotenoids and omega-3 fatty acid supplements. An expected highlight from this work is to provide data that will lead to positive changes in Irish food supplement policies, with a view to protecting the consumer.
Methodology: A full report will be prepared on the relevant Irish, European, Canadian and USA policies to provide background knowledge on the topic. This will be followed by a full critique of the extant research literature. An exploratory sequential mixed methods study design will be implemented that is comprised of (1) semi-structured interviews (qualitative data and analysis) with key stakeholders, followed by (2) a national Irish survey (quantitative data collection and analysis). The research design will provide data on Irish consumers’ perceptions of the benefits of supplements, and in particular their knowledge and understanding of carotenoid supplements. Results from the study will also identify the extent of consumer knowledge and understanding of the disparities between label claim, active ingredients and degeneration of products during their shelf life.
Expected Results: While the procurement of food supplements continues to increase, consumer knowledge and information about the active supplement ingredients and their stability over shelf-life is limited. Findings from the study will be drawn from both qualitative data that explore consumer meanings, experiences, behaviour and perspectives, and quantitative data that measure, analyse, and test relationships. Analysis of the collected mixed methods data will share knowledge on consumer influencing factors and motivators to purchase food supplements and in particular, carotenoid supplements. The study will identify the extent of the gaps in the current Irish food supplement policy and procedures; highlight what the consumer believes about the supplements they buy, and shed light on the failure of current policy to protect the consumer. The results will also support and inform the need for improvements in Irish Government food supplement policy and regulatory procedures. Finally, by informing consumers about the quality of the product they purchase, results from the study will influence an increase in consumer demand for high quality food supplements.
048Optimisation of ultrasound conditions to increase the bioaccessibility of macular carotenoids from the green seaweed Ulva lactuca
Carla M. Stinco1, Ana M. Benítez-González2, Antonio J. Meléndez Martínez2
1Food Colour and Quality Laboratory, Facultad de Farmacia, Universidad de Sevilla, 41012,, Sevilla, Spain. 2Food Colour and Quality Laboratory, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain
Research Highlights: To optimise ultrasound pre-treatment conditions to enhance the bioaccessible content of macular carotenoids from the green seaweed sea lettuce (Ulva lactuca). The use of ultrasounds to enhance the potential bioavailability of food components has been scarcely studied. The results indicate that it is feasible to increase carotenoid bioaccessibility markedly through the application of ultrasounds in sea lettuce. This is important in the context of health-promotion through the diet and has an important sustainability component as sonication is considered a green technology and algae offer many environmental benefits.
It was hypothesized that ultrasounds conditions can be modelled to increase the bioaccessibility of carotenoids from Ulva lactuca.
Methodology: Sea lettuce was obtained from Porto-Muíños S.L. (Spain), desalted with cold water, freeze-dried, ground, and sieved. A central composite design (CCD) with response surface methodology (RSM) was applied, considering ultrasound amplitudes in the range 20–50% and treatment times in the interval 1–5 min as independent variables. A 0.5 g sample was mixed with 20 mL of distilled water (S/L = 2.5%) and the sonications were performed using a Q500 ultrasound system (QSonica, USA) equipped with a QS-4220 probe. Samples were kept in an ice bath to prevent overheating. After sonication, samples were centrifuged (3220 g, 10 min), and the remaining solids were subjected to in vitro gastrointestinal digestion following the static model of Brodkorb et al. (2019), which simulates salivary, gastric, and duodenal phases. The bioaccessible fraction of macular carotenoids (lutein and zeaxanthin) was quantified using RRLC-DAD, following the validated method of Stinco et al. (2019). Results obtained under optimised UAE conditions were compared with an untreated control to evaluate improvements in carotenoid bioaccessibility.
Results: Confirms that amplitude and time parameters can influence significantly (p < 0.05) the bioaccessible content of macular carotenoids from Ulva lactuca. Optimisation modelling using response surface methodology (RSM) revealed that the optimal conditions for maximising bioaccessibility were the use of an amplitude of 45% for 1 minute. These conditions led to a 30% increase (1.3-fold increase) in bioaccessible macular carotenoid content compared to the untreated control.These results support the initial hypothesis and demonstrate that the optimisation of the ultrasound treatment can improve the bioaccessibility of macular carotenoids in the green alga.
049Ultrasound- and Microwave-Assisted Extraction of Carotenoids from the Macroalga Ulva lactuca: A Sustainable Green Chemistry Approach with Emerging Biosolvents
Dania E. Menchaca Martínez1, Ángeles Morón-Ortiz1, Paula Mapelli-Brahm1, Alberto Romero2, Antonio J. Meléndez Martínez1
1Food Colour and Quality Laboratory, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain. 2Chemical Engineering Department, Faculty of Chemistry, Universidad de Sevilla, Sevilla, Spain
Research Highlights: Carotenoids are considered to be beneficial in relation to ocular and neurological conditions. Specifically, lutein and zeaxanthin protect the eyes by absorbing harmful blue light, while the accumulation of carotenoids in the brain provides cognitive and neuroprotective benefits.
The aim of this study was to evaluate the efficacy of green technologies, such as microwave-assisted extraction (MAE) and ultrasound-assisted extraction (UAE), in combination with the biosolvents 2-methyltetrahydrofuran (MeTHF) and ethyl lactate for the extraction of carotenoids from sea lettuce (Ulva lactuca). Comparisons with a conventional extraction method (maceration with mechanical stirring) using traditional organic solvents (acetone, ethanol, ethyl acetate, and hexane) were made.
MAE outperformed UAE, significantly increasing the carotenoid content extracted with the tested biosolvents. MeTHF proved an effective and sustainable alternative to conventional solvents, exhibiting remarkable capability to extract carotenoids with diverse chemical structures and polarities.
Methodology: The hypothesis of this study was that MAE and/or UAE with emerging biosolvents can increase the extraction of carotenoids from Ulva lactuca Dehydrated U. lactuca was ground for 5 minutes at a frequency of 30 Hz, using a sample-to-solvent ratio of 1:20. The conditions for UAE and MAE were: 30% amplitude, 20 kHz frequency for 2 minutes, and 300 W power for 5 minutes, respectively. The extracts were centrifuged (4 °C, 4000 rpm, 5 minutes) and the supernatants were evaporated and saponified 30 minutes in darkness under constant stirring with 3 mL of dichloromethane and 3 mL of methanolic KOH (20% w/v). The saponified carotenoid extract was dried and analyzed by HPLC-DAD using a C30 column (YMC 150 × 4.6 mm, particle size 3 µm) and a mobile phase based on methanol, tert-butyl methyl ether, and water (Stinco et al., 2019).
Results: The main carotenoids detected were, in decreasing order of concentration: lutein, (9Z)-fucoxanthin, (9Z)-antheraxanthin, violaxanthin, α-carotene, and β-carotene. The efficiency of UAE varied depending on the type of carotenoid and the physicochemical properties of the extraction solvents. In contrast, the use of MAE led to significantly (P < 0.05) higher contents of individual carotenoids with all evaluated solvents, except for ethyl lactate and MeTHF, where no significant differences (P > 0.05) were observed in violaxanthin content. Regarding the total carotenoid content, a significant increase was observed compared to the control and the UAE treatment for all solvents.
Hexane and MeTHF were the most effective solvents for total carotenoid extraction, with no significant differences between them. MeTHF, with intermediate polarity, has the advantage of dissolving both polar and non-polar carotenoids, making it versatile for a broader range of carotenoids and a sustainable, environmentally friendly alternative compared to other conventional solvents. Thus, the hypothesis can be considered valid.
050Breeding Corn for Higher Lutein and Zeaxanthin for Direct Human Consumption and for Feeding Organic Laying Hen Poultry to Produce More Nutritious Egg Yolks
Torbert Rocheford1,2, Evan Rocheford2, Sarah Cloft1, Darrin Karcher1, Greg Fraley1.
1Purdue University, West Lafayette, USA. 2NutraMaize, West Lafayette, USA
Research Highlights: We present progress on breeding and related studies, which have shown higher levels of the macular carotenoids lutein and zeaxanthin in: corn grain (P<.001), yolks of eggs from hens fed the high carotenoid corn (P<.01), and higher total antioxidant capacity (TAC) in various organs of these same laying hens (P<.01). There is considerable interest in feeding organically produced high carotenoid orange corn grain to organic laying hens. The presence of higher levels of lutein and zeaxanthin in the grain initially enables the reduction or elimination of costly organic supplements extracted from paprika and marigolds grown in Israel and India. These supplements are used to color egg yolks to levels consumers desire. Yet orange corn results in higher levels of lutein and zeaxanthin in egg yolks than paprika.
Methods: We have used field studies at Purdue Agronomy Farm to assess carotenoids in corn grain, performed randomized feeding studies with different diets at Purdue Animal Sciences Farm to assess color scores in egg yolks, used HPLC to quantify carotenoids, and performed various lab assays to determine Total Antioxidant Capacity levels in organs of poultry.
Results: We have a growing body of results that collectively support feeding orange corn to poultry.We will present results from a series of studies involving breeding for higher macular carotenoids, feeding orange corn to poultry and assessing health and wellness indicators, as well as levels of carotenoids and color scores in egg yolks.
051Targeting Cx43 Gap Junctions, Oxidative Stress, and Aβ Aggregation: Carotenoids as Novel Therapeutics Against Aβ Neurotoxicity
Juanita Mathews / juanita.mathews@tufts.edu /
Tufts University, Medford, MA 02155, USA
Research Highlights: Alzheimer's disease (AD) is the most common neurodegenerative disorder and is characterized by the abnormal buildup of amyloid-beta (Aβ) plaques. Carotenoids demonstrate potential in mitigating Aβ-associated neurotoxicity by modulating gap junction communication, targeting oxidative stress pathways, and inhibiting Aβ aggregation. Pro-inflammatory activation of microglia releases glutamate via connexin 32 (Cx32) hemichannels as well as nitric oxide (NO), TNF-α, and IL-1β secretion. In addition, the TNF-α and IL-1β that is released stimulates astrocytes to produce NO which inhibits their gap junction intercellular communication (GJIC) and opens connexin 43 (Cx43) hemichannels to the extracellular environment, resulting in the release of intercellular glutamate, ATP, D-serine, and lactate. This release along with the release from the microglia triggers the overstimulation of NMDA receptors on neurons, resulting in calcium overload, which in turn promotes the endocytosis of the amyloid precursor protein (APP). APP, which is cleaved to produce Aβ, is then processed in endosomes, leading to an increase in Aβ production and release.
Carotenoids counteract Aβ-induced oxidative damage by scavenging free radicals, preserving mitochondrial function, and reducing pro-inflammatory cytokine release. These antioxidants mitigate nitric oxide (NO) overproduction, which disrupts electron transport chain activity, ATP synthesis, and gap junction coupling. Additionally, carotenoids can also upregulate Cx43 expression via a GC-box motif in the Cx43 promoter, which binds Sp1/Sp3 transcription factors. Retinoids require retinoic acid receptor (RAR) activation to illicit this response, but non-provitamin A carotenoids achieve this transcriptional upregulation via a peroxisome proliferator activated receptor (PPAR)- γ-dependent manner. Restoration of astrocytic network connectivity via GJIC supports neuronal energy demands and maintains ion balances necessary to prevent hyperexcitability and subsequent neurotoxicity.
As an additional way that carotenoids lower neurotoxicity, the aggregation of the Aβ peptide has been recently shown through computational analysis to be inhibited by the direct binding of lutein to the region essential for Aβ oligomerization. This makes lutein a very promising carotenoid to be used to reduce the severity of AD as the brain preferentially takes up lutein as compared to other carotenoids. Indeed, several recent clinical trials have shown that β-carotene, lutein, zeaxanthin, and meso-zeaxanthin reduce the severity of cognitive decline in Alzheimer's disease.
Methodology: In this review we go over the mechanisms involved in neurotoxicity resulting from inflammatory insult and the latest research on how carotenoids can modulate this neurotoxicity through their antioxidant and gap junction modulating properties as well as their ability to bind directly to the oligomerization domain of Aβ peptides.
Results: Through our search in the literature, we have found that carotenoids have great promise for the prevention and reduction of cognitive impairment caused by neurodegenerative disorders like Alzheimer's disease.
AUTHOR INDEX
A
Acharya, K. S27
Addo, E. K. S15
Adu-Owusu, D. S24
Agbeshie, G. K. S24
Akuffo, K. O. S24
Alexander, B. S4
Allen, J. S5
Altas, C. S21
AMD-Life Team S10
Amoako, M. S24
Arcan, C. S26
Asaoka, R. S23
Ashon, N. A. S. S24
B
Bandello, F. S20
Benítez-González, A. M. S29
Berlin, A. S9
Bernstein, P. S4, S15, S21
Boateng, J. A. S31
Bohn, T. S8, S22
Borel, P. S22
Brennan, L. S4
Brintz, B. S15
Burns, K. S26
Butler, J. S. S20
C
Cagney, A. G. S25, S28
Cagney, K. S25
Caro, D. S10
Ciszewska, K. S18
Clark, M. S9
Clark, M. E. S17
Cloft, S. S30
Crosson, J. S9
Cullinane, G. S17
Curcio, C. S9
Curcio, C. A. S17
D
Dadzie, E. E. S20
deGroot, L. S4
Desmarchelier, C. S22
E
Earley, T. S11
Eyeson, J. S24
F
Flynn, R. S24
Fogliano, V. S3
Fonseca, B. S23
Fraley, G. S30
Fromow-Guerra, J. J. S10
Fuchsluger, T. S21
G
Gębka, A. S18
Gao, L. S9, S17
Georgiou, T. S20
Goerdt, L. S9, S17
Gohto, Y. S23
Green-Gomez, M. S24
Gupta, A. S13
H
Hammer, M. S17
Harris, W. S5
Hartnett, M. E. S15
Holmes, C. S8
Horn, F. S2, S27
Hovey, K. S26
J
Jimenez-Martinez, M. C. S13
Johnson, E. J. S24
Jridi, A. S15
Junior, I. O. D. S24
K
Kaercher, T. S19
Karcher, D. S30
Keenan, T. S3
Kim, S. S9
Klaver, C. S10
Kolovos, P. S20
Koning-Backus, A. e. S10
Konno, H. S23
Kuchling, R. S18, S19
L
Lammoglia-Kirsch, A. S10
Linden, G. S8
Lobo, M. C. S28
Loughman, J. S20
Lucci, L. S15
Luettinger, C. S21
Lyons, C. S14
M
Mapelli-Brahm, P. S30
Meléndez-Martínez, A. J. S1
Martínez, A. J. M. S29, S30
Martínez, D. E. M. S30
Martínez-Leo, E. S7
Mastropasqua, L. S20
Mathews, J. S31
McEvoy, C. S4, S8
McGuinness, B. S8
McGwin, G. S9, S17
McKay, G. S8
Millen, A. S26
Miura, A. S23
Mohand-Said, S. S20
Morón-Ortiz, Á. S30
Moran, N. E. S4
Mulak, M. S18
Mulcahy, R. S14
Murakoshi, T. S23
N
Nakamura, M. S23
Nilson, J. S15
Nolan, J. M. S14, S16, S17, S19, S24, S25, S27, S28
Nozue, M. S23
Nwagbo, U. S21
O
O'Donoghue, A. S14
O'Gorman, M. S14
Obana, A. S23
Ochs-Balcom, H. S26
Ofori-Asare, W. S24
Ord, L. S15
Osęka, M. S18, S19
Owsley, C. S9, S17
P
Pasaye, M. S15
Passmore, P. S8
Patterson, C. S8
Peniche, F. S13
Polston, P. S26
Power, T. S24, S28
Prado-Cabrero, A. S17, S24, S28
Prinelli, F. S4
Prokopiou, E. S20
R
Raczyńska, K. S18
Rapp, S. S26
Reidy, C. S14
Roche, W. S16, S18, S19, S27
Rocheford, E. S30
Rocheford, T. S30
Rodriguez, A. N. C. S6
Rolland, A. S22
Romero, A. S30
Rosales-Díaz, R. S10
Rossetti, L. S20
S
Salcedo-Villanueva, G. S10, S11
Schleeh, T. S22
Seese, M. H. S6
Senkus, K. E. S6
Sergi, G. S4
Setti, A. S20
Shadyab, A. S26
Shukla, A. S22
Sivaperuman, P. S16
Skiba, M. S26
Sloan, K. S9
Sloan, K. R. S17
Smoor, M. S10
Sosa, M. S6
Spoth, E. S15
Srinivasan, V. S13
Stinco, C. M. S29
Stringham, J. S2
Stringham, J. M. S16
Sun, M. S6
Sutton, B. S6
Swiech, A. S18
Swinbourne, R. S15
Swinbourne, R. S16
T
Tettey, B. L. S24
Thomas, T. S17
Trevisan, C. S4
Tsangari, H. S20
V
Van Horn, L. S26
Volkert, D. S4
W
Wactawski-Wende, J. S26
Wade, J. M. S6
Wallace, T. C. S12
Ward, N. S4
Willett, W. S15
Wirth, F. S18, S19
Woodside, J. S8
