Serum and macular responses to antioxidant supplementation verus a carotenoid-rich dietary intervention in the elderly.

The aim of this study was to observe responses of serum antioxidants, oxidative stress biomarkers, and macular carotenoid pigments to antioxidant supplements or dietary intervention in a single-masked, randomized, pilot clinical study of elderly subjects receiving antioxidant supplements or a dietary intervention. Methods: From a pool of ninety-eight community volunteers, forty-eight male and female subjects (age 65-85) with the lowest baseline serum lutein + zeaxanthin levels were selected and randomly assigned to receive for 12 weeks one of two different antioxidant supplements or a diet rich in fruits and vegetables containing approximately matched levels of four classes of carotenoids: carotenes, the xanthophylls lutein and zeaxanthin, and lycopene. Forty-six completed the study. Both supplements and diet also were rich in vitamins C and E. Outcome measures were changes from baseline: 1) in serum levels of antioxidant micronutrients (vitamins C and E, lutein, zeaxanthin, and carotene); 2) in levels of indicators of oxidative stress: serum lipid peroxides (LPO) and urinary 8-hydroxydeoxyguanosine (8-OHdG); and 3) macular pigment, measured by heterochromatic flicker photometry. Results: Interventions to promote eye health by either diet or supplementation showed consistent serum responses, with substantial improvements within twelve weeks. Serum lutein and vitamin C increased for all groups (p< 0.05), and lipid peroxides decreased for all subjects (p< 0.05); nonetheless, mean macular pigment did not increase significantly during the designated timeframe. Conclusion: Supplementation of elderly individuals potentially at risk for AMD with two different types of antioxidant formulations exhibited positive serum responses similar to a dietary intervention containing approximately comparable levels of carotenoids. This pilot study indicates that the ocular supplements tested in this study elicited responses in serum parameters similar to daily consumption of four servings of carotenoid-rich fruits and vegetables. The study also provides useful criteria for the design of larger-scale and longer-term studies of antioxidant supplementation in an elderly population potentially at risk for AMID.