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Comparison of Serum Carotenoid Responses Between Women Consuming Vegetable Juice and Women Consuming Raw Or Cooked Vegetables1

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Comparison of Serum Carotenoid Responses Between Women Consuming Vegetable Juice and Women Consuming Raw Or Cooked Vegetables1 Vol. 8, 227–231, March 1999 Cancer Epidemiology, Biomarkers & Prevention 227 Comparison of Serum Carotenoid Responses between Women Consuming Vegetable Juice and Women Consuming Raw or Cooked Vegetables1 Archana J. McEligot, Cheryl L. Rock,2 Introduction Thomas G. Shanks, Shirley W. Flatt, Vicky Newman, The anticarcinogenic effects of various micronutrients and phy- Susan Faerber, and John P. Pierce tochemicals found in vegetables and fruits, such as carotenoids, Departments of Family and Preventive Medicine [A. J. M., C. L. R., S. W. F., have been demonstrated in laboratory studies (1). In addition to V. N., S. F., J. P. P.] and Medicine [T. G. S.], University of California at San their possible biological role in cancer prevention, plasma ca- Diego, La Jolla, California 92093 rotenoids reflect fruit and vegetable consumption and appear to be reasonable biomarkers of vegetable and fruit intake (2–4). In several feeding studies, an increase in dietary intake of fruits and vegetables has been correlated with an increase in circu- Abstract lating plasma carotenoid concentrations (5, 6), although large The objective of this study was to examine serum interindividual variability in response is typically observed. concentrations of a-carotene, b-carotene, lutein, lycopene, Plasma carotenoid response may be influenced by factors and b-cryptoxanthin due to consumption of vegetable that affect the bioavailability of these compounds from foods. juice versus raw or cooked vegetables. Subjects included Absorption of carotenoids is dependent on the matrix of the female breast cancer patients who had undergone food, presence of dietary fat, and various other factors (7–9). surgical resection and who were enrolled in a feasibility Consumption of tomato juice heated with oil was observed to study for a trial examining the influence of diet on breast increase serum lycopene concentration compared to unheated cancer recurrence. A high-vegetable, low-fat diet was the tomato juice (10). Mild heat treatment of carrots and pureeing focus of the intervention, and some of the subjects were or finely chopping vegetables also appears to enhance bioavail- specifically encouraged to consume vegetable juice. At 12 ability of b-carotene (11–13). Components of vegetables and months, blood samples were collected and analyzed for fruits, such as dietary fiber, may interfere with micelle forma- carotenoid concentrations via high-performance liquid tion and, therefore, reduce carotenoid response (14) and affect chromatography methodology. Matched analysis and plasma carotenoid concentrations. Thus, differences in plasma paired t test were conducted on two groups: those who carotenoid response to vegetable and fruit intake may be de- termined by the varying food forms in which the carotenoids consumed vegetable juice (the juice group) and those who are consumed (i.e., vegetable juice versus raw or cooked veg- consumed raw or cooked vegetables (no juice group). a etables). Serum concentrations of -carotene and lutein were The purpose of this study was to compare serum carote- significantly higher in the vegetable juice group than in noid response in a diet intervention study involving carotenoid- 5 the raw or cooked vegetable group (P < 0.05 and P rich vegetables, in which carotenoids were consumed from 0.05, respectively). Paired t test analysis did not vegetable juice and vegetables (raw or cooked). Identifying demonstrate a significant difference in serum values of whether or not consumption of various forms of carotenoid-rich b-carotene, lycopene, and b-cryptoxanthin between foods are associated with differing carotenoid response is rel- subjects consuming juice and those not consuming any evant to the interpretation of plasma carotenoid concentrations juice. These results suggest that a-carotene and lutein as indicators of vegetable and fruit intake. appear to be more bioavailable in the juice form than in raw or cooked vegetables. Therefore, the food form Materials and Methods consumed may contribute to the variability in serum Subjects. This study was part of a larger project examining the carotenoid response to vegetable and fruit interventions feasibility of an epidemiological diet intervention trial to reduce in clinical studies. the risk of breast cancer recurrence in women who had been diagnosed with primary breast cancer within the previous 4 years (the WHEL3 Study). Between May 1993 and October 1994, subjects were recruited from cancer registry lists and Received 9/9/98; revised 1/4/99; accepted 1/17/99. from community-based efforts. Inclusion criteria for the WHEL The costs of publication of this article were defrayed in part by the payment of feasibility study and trial were: 18–70 years of age at time of page charges. This article must therefore be hereby marked advertisement in diagnosis; a history of primary operable invasive breast carci- accordance with 18 U.S.C. Section 1734 solely to indicate this fact. 1 This research was supported in part by an award from the Walton Family noma categorized as Stage I, Stage II, or Stage IIIA within the Foundation. 2 To whom requests for reprints should be addressed, at Cancer Prevention and Control Program, University of California at San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0901. Phone: (619) 822-1126; Fax: (619) 822-1497; E-mail: 3 The abbreviations used are: WHEL, Women’s Healthy Eating and Living; BMI, [email protected]. body mass index; HPLC, high-performance liquid chromatography. Downloaded from cebp.aacrjournals.org on September 29, 2021. © 1999 American Association for Cancer Research. 228 Serum Carotenoid Response to Vegetable Juice previous 4 years; treatment with total mastectomy and axillary ysis of National Institute of Standards and Technology Refer- dissection or breast-sparing surgical removal of cancer with ence Material SRM 986: Fat-Soluble Vitamins, and both of the clear macroscopic margins and axillary dissection, followed by laboratories that provided the HPLC analyses for this study adjuvant breast radiation; completion of any prescribed adju- participated in the National Institute of Standards and Technol- vant chemotherapy; no evidence of recurrent disease or new ogy Micronutrients Measurement Quality Assurance Program. breast cancer since completion of initial local treatment; good Determination of serum cholesterol was performed with the general health; geographical and telephone accessibility for Kodak Ektachem Analyzer system (Johnson & Johnson, participation and follow-up; and ability to communicate dietary Rochester, NY; Ref. 20). data via 24-h food recall. WHEL Feasibility Study exclusion Statistical Analysis. Average daily dietary intakes of a-caro- criteria were: current enrollment in another dietary clinical trial; tene, b-carotene, lutein, lycopene, and b-cryptoxanthin were diagnosis of a comorbidity requiring a specific diet or medica- calculated from the dietary recall data. On the basis of food tion that contraindicated a high-fiber diet; estrogen replacement content analysis data, total raw or cooked vegetable and veg- therapy; other primary or recurrent invasive cancer within the etable juice intakes were calculated in servings in which one last 10 years; and inability to commit to the intervention sched- serving of raw or cooked vegetables was equivalent to 3 ounces ule. In this study, we included all women (n 5 63) for whom of vegetable juice for the purpose of this study. The subjects blood samples were available at the 12-month follow-up period. were divided into two groups: those consuming juice (vegetable The WHEL feasibility study involved an intervention in juice) and those replacing juice with vegetables (raw or cooked which one-half of the study participants were randomized to an vegetables). Of the 63 subjects, the 30 with no vegetable juice intensive telephone counseling group that emphasized con- intake comprised the “no juice” group. The 33 subjects with sumption of two 8-ounce portions of vegetable juice per day. vegetable juice intake (2.6 6 1.7 [Mean 6 SD] servings) made Further details have been described previously (15). However, up the “juice” group. not all participants complied with the recommendations to Initially, we conducted a regression analysis on the entire drink the juices, and some of the nonintervention group con- group to examine the association between serum carotenoid sumed juices of their own volition. Accordingly, for this study, concentrations and independent variables of interest (BMI, se- we ignored the study randomization and matched the partici- rum cholesterol concentration, vegetable, vegetable juice, and pants on their self-reported dietary intakes. Dietary supple- fruit intake). However, those consuming vegetable juice were ments were not a component of this trial, and participants were also consuming a high amount of vegetables and the significant particularly discouraged from using high-dose micronutrient intercorrelation between the independent variables made the formulations that could interfere with the interpretation of the interpretation of the results very difficult. Therefore, to remove diet intervention results. Subjects in the matched analysis (de- the joint effect of vegetable and vegetable juice consumption in scribed below) did not use b-carotene supplements or supple- the entire group, we separated the group on whether they ments of other carotenoids. consumed vegetable juice or vegetables only. To find compa- Participants provided fasting blood samples and other rel- rable subjects for each
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