The effects of lutein on cardiometabolic health across the life course: a systematic review and meta-analysis.

BACKGROUND: The antioxidant lutein is suggested as being beneficial to cardiometabolic health because of its protective effect against oxidative stress, but evidence has not systematically been evaluated. OBJECTIVE: We aimed to evaluate systematically the effects of lutein (intake or concentrations) on cardiometabolic outcomes in different life stages. DESIGN: This is a systematic review with meta-analysis of literature published in MEDLINE, Embase, Cochrane Central, Web of Science, PubMed, and Google Scholar up to August 2014. Included were trials and cohort, case-control, and cross-sectional studies in which the association between lutein concentrations, dietary intake, or supplements and cardiometabolic outcomes was reported. Two independent investigators reviewed the articles. RESULTS: Seventy-one relevant articles were identified that included a total of 387,569 participants. Only 1 article investigated the effects of lutein during pregnancy, and 3 studied lutein in children. Furthermore, 31 longitudinal, 33 cross-sectional, and 3 intervention studies were conducted in adults. Meta-analysis showed a lower risk of coronary heart disease (pooled RR: 0.88; 95% CI: 0.80, 0.98) and stroke (pooled RR: 0.82; 95% CI: 0.72, 0.93) for the highest compared with the lowest tertile of lutein blood concentration or intake. There was no significant association with type 2 diabetes mellitus (pooled RR: 0.97; 95% CI: 0.77, 1.22), but higher lutein was associated with a lower risk of metabolic syndrome (pooled RR: 0.75; 95% CI: 0.60, 0.92) for the highest compared with the lowest tertile. The literature on risk factors for cardiometabolic diseases showed that lutein might be beneficial for atherosclerosis and inflammatory markers, but there were inconsistent associations with blood pressure, adiposity, insulin resistance, and blood lipids. CONCLUSIONS: Our findings suggest that higher dietary intake and higher blood concentrations of lutein are generally associated with better cardiometabolic health. However, evidence mainly comes from observational studies in adults, whereas large-scale intervention studies and studies of lutein during pregnancy and childhood are scarce.

Maternal dietary patterns during pregnancy and body composition of the child at age 6 y: the Generation R Study.

BACKGROUND: Maternal diet during pregnancy may affect body composition of the offspring later in life, but evidence is still scarce. OBJECTIVE: We aimed to examine whether maternal dietary patterns during pregnancy are associated with body composition of the child at age 6 y. METHODS: This study was performed among 2695 Dutch mother-child pairs from a population-based prospective cohort study from fetal life onward. Maternal diet was assessed in early pregnancy by a 293-item semiquantitative food-frequency questionnaire. Vegetable, fish, and oil; nuts, soy, and high-fiber cereals; and margarine, snacks, and sugar dietary patterns were derived from principal component analysis. We measured weight and height of the child at age 6 y at the research center. Total body fat and regional fat mass percentages of the child were assessed with dual-energy X-ray absorptiometry. RESULTS: In the crude models, statistically significant associations were found for higher adherence to the vegetable, fish, and oil dietary pattern and the nuts, soy, and high-fiber cereals dietary pattern with lower body mass index, lower fat mass index, and lower risk of being overweight, but none of these associations remained significant after adjustment for sociodemographic and lifestyle factors. We found no associations between the margarine, snacks, and sugar dietary pattern and any of the outcomes. CONCLUSION: Our results suggest that the associations between maternal dietary patterns during pregnancy and body composition of the child at age 6 y are to a large extent explained by sociodemographic and lifestyle factors of mother and child.