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© 2005 The American Society for Nutritional Sciences J. Nutr. 135:2042S-2045S, August 2005


Supplement: Promises and Perils of Lycopene/Tomato Supplementation and Cancer Prevention

What Are Typical Lycopene Intakes?1

Marisa Porrini2 and Patrizia Riso

Department of Food Science and Microbiology, Division of Human Nutrition, University of Milan, Italy

2To whom correspondence should be addressed. E-mail: marisa.porrini{at}unimi.it.

KEY WORDS: • lycopene • tomatoes • human • intake


    EXPANDED ABSTRACT
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 EXPANDED ABSTRACT
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 LITERATURE CITED
 
Evidence from epidemiological studies suggests that high consumption of tomato products or lycopene is associated with a significantly lower risk of numerous cancers (1). However, dietary intake of tomato/lycopene is difficult to quantify precisely for several reasons, thus reducing the sensitivity of epidemiological studies to detect a relation with cancer risk. Data on lycopene intake, as reported in the literature, differ considerably among countries and among populations within the same country (Tables 1 and 2). Apart from different food habits, other factors that may contribute to these differences include inaccurate estimation of dietary intake (questionnaires used may be inadequate to estimate all relevant food items or portion sizes, study participants may have difficulties in interpreting questions), the quality of the food database used, and variation of lycopene concentration within a given food.


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TABLE 1 Dietary lycopene intake and plasma lycopene concentration in selected European countries1

 

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TABLE 2 Dietary lycopene intake and plasma lycopene concentration in North America, Canada, and Australia

 
FFQs generally used in epidemiological studies vary greatly in their usefulness in estimating the true variation in lycopene intake among individuals.

Mean dietary intakes of lycopene estimated by FFQs are generally higher than those obtained with diet records (11). The high intakes obtained using the FFQ method may result from a tendency of subjects to overestimate consumption of vegetables and fruits when presented with a long list of food items. FFQs have been reported to overestimate carotenoid intakes by 10–30% relative to estimated records and by 38–50% relative to weighed records (5,6).

Another important aspect to consider is that any given food source may vary greatly in lycopene content, because of differences in cultivar, technological processing, domestic cooking, etc. This variability also affects values reported in food databases. One of the most complete databases for carotenoids is the Carotenoids Dataset within the USDA National Nutrient Database for Standard Reference (12), but there are other published data on the carotenoid content of selected foods (Table 3). In this regard, it is interesting to underscore the large variability in the lycopene content of raw tomatoes and of tomato paste and puree reported by various authors.


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TABLE 3 Lycopene content according to different databases and authors1

 
Apart from the total lycopene intake, some data are reported in the literature on the intake of specific and/or total tomato products. An analysis of these data seems to suggest that the total tomato product daily intake in Italy ranges from 49 g to 175 g (Krogh and Sieri of the Italian EPIC group, Epidemiology Unit, National Cancer Institute, Milan; and La Vecchia and Bosetti, Istituto di Statistica Medica e Biometria, Università degli Studi di Milano & Laboratorio di Epidemiologia, Istituto di Ricerche Farmacologiche Marìo Negri, Milano, personal communications), in Spain it is ~65 g (15), and, in the United Kingdom, Scotland, and Wales, it is ~30 g (16). The contribution of individual tomato products to lycopene intake varies nationally and regionally (Table 4), but available studies indicate that only a few food products account for most of the lycopene intake. Raw tomatoes seem to be the major contributors to lycopene intake in France, United Kingdom, and Spain (3) and also in different regions of Italy (Krogh and Sieri of the Italian EPIC group, personal communication). The second most dominant source is generally cooked tomatoes, whereas pizza contributes more to lycopene intake in France, Ireland, United Kingdom, and The Netherlands than in Italy. In Spain, tomato puree used for the preparation of mixed dishes is the second leading source of lycopene, and, interestingly, the consumption of watermelon in summer contributes significantly to carotenoid intake. In the United States, the main lycopene source seems to be pasta sauce (17).


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TABLE 4 Percentage contribution of different tomato product to lycopene intake

 
The contribution of different tomato products to lycopene intake is important, because it is known that lycopene bioavailability depends on the food source. In fact, processed foods such as tomato sauce, paste, and puree are better sources of bioavailable lycopene than are raw tomatoes because of the release of lycopene during food processing (e.g., heating, homogenization). Food processing, the presence of fat, and individual variability in absorption capacity are crucial factors affecting lycopene absorption. Because so many factors affect bioavailability, measurement of lycopene concentration in blood may provide a useful link between dietary lycopene intake and risk assessment in epidemiological studies.

The relation between dietary intake of lycopene and plasma lycopene concentrations is weak (Tables 1, and 2). Plasma lycopene concentrations are never strongly correlated with estimated dietary intake (r = 0.0–0.46). Numerous potentially important determinants of blood-lycopene concentrations have been analyzed, including gender, smoking status, alcohol consumption, lycopene dietary intake, plasma cholesterol, BMI, race or ethnicity, seasonality, and marital status. Although up to 38% of the variance in plasma lycopene concentrations has been explained by these variables (18), a large proportion of the variance remains unexplained. The lack of correlation may also depend on other factors, such as the timing of blood col-lection in relation to dietary assessment, the impact of recent lycopene intake (which may significantly affect plasma lycopene concentration in the subsequent 12–24 h), the difference in absorption related to age and genetics (lycopene absorption seems impaired in the elderly), and the individual absorption capacity (it is suggested that some individuals are relatively poor absorbers).

The ideal intake of tomatoes is currently unknown, although there are suggestions from epidemiological and intervention studies that intakes of lycopene higher than 6 mg/d may produce plasma lycopene concentrations that provide protection. In our intervention studies (1922), the intake of different tomato products providing 6–8 mg lycopene/d significantly improved lymphocyte protection from DNA oxidative damage and decreased LDL susceptibility to oxidation (Table 5). Furthermore, a decrease in insulin-like growth factor 1 was reported in a group of healthy subjects who consumed 250 mL tomato drink for 26 d (unpublished data).


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TABLE 5 Effect of tomato/lycopene intake on selected biological markers

 
In our experience, routine consumption of 1 serving per d of a lycopene-bioavailable tomato product seems sufficient to significantly increase lycopene concentration in plasma and lymphocytes; conversely, lycopene concentration rapidly decreases after a tomato-free diet. It is also reported that the addition of processed tomato products to the diet increases lycopene concentration in buccal mucosal cells (23) and prostate tissue (24).

It remains to be demonstrated whether the protection ascribed to tomato consumption depends on the intake of lycopene alone. Recent studies support an effect of the whole tomato products instead of that of the single compound. For example, we found a significant increase in lymphocyte vitamin C concentration (~230%) after the intake of small amounts of various tomato products (20) and a significant increase in phytoene and phytofluene (~92% and 61% in plasma, respectively, and 159% and 84% in lymphocytes, respectively) after the intake of a tomato beverage (21). Lycopene may be one of the active substances that work in synergy to afford the protection observed. This suggests that the more relevant question is how many tomatoes and/or tomato products we should eat, instead of how much lycopene we need.


    CONCLUSIONS
 TOP
 EXPANDED ABSTRACT
 CONCLUSIONS
 LITERATURE CITED
 
Available data are not sufficient to define typical dietary lycopene intakes or to identify the precise amount needed to achieve a biological response. There is a need for improved methods for assessing dietary tomato/lycopene intakes, characterization of different populations for tomato intake and plasma lycopene levels, and validation of tomato/lycopene dietary needs with controlled intervention studies.


    FOOTNOTES
 
1 Presented as part of the conference "Promises and Perils of Lycopene/Tomato Supplementation and Cancer Prevention," February 17–18, 2005, Bethesda, MD. This conference was sponsored by the Division of Cancer Prevention, Division of Cancer Epidemiology and Genetics, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS); Office of Dietary Supplements (ODS), NIH, DHHS; and the Agricultural Research Services (ARS), USDA. Guest editors for the supplement publication were Cindy D. Davis, NCI, NIH; Johanna Dwyer, ODS, NIH; and Beverly A. Clevidence, ARS, USDA. Back


    LITERATURE CITED
 TOP
 EXPANDED ABSTRACT
 CONCLUSIONS
 LITERATURE CITED
 

1. Giovannucci, E. (1999) Tomatoes, tomato-based products, lycopene, and cancer: review of the epidemiologic literature. J. Natl. Cancer Inst. 91:317-331.[Abstract/Free Full Text]

2. Olmedilla, B., Granado, F., Southon, S., Wright, A. J., Blanco, I., Gil-Martinez, E., Berg, H., Corridan, B. & Roussel, A. M., et al (2001) Serum concentrations of carotenoids and vitamins A, E, and C in control subjects from five European countries. Br. J. Nutr. 85:227-238.[Medline]

3. O’Neill, M. E., Carroll, Y., Corridan, B., Olmedilla, B., Granado, F., Blanco, I., Van den Berg, H., Hininger, I. & Rousell, A. M., et al (2001) A European carotenoid database to assess carotenoid intakes and its use in a five-country comparative study. Br. J. Nutr. 85:499-507.[Medline]

4. Scott, K. J., Thurnham, D. I., Hart, D. J., Bingham, S. A. & Day, K. (1996) The correlation between the intake of lutein, lycopene and beta-carotene from vegetables and fruits, and blood plasma concentrations in a group of women aged 50–65 years in the UK. Br. J. Nutr. 75:409-418.[Medline]

5. Carroll, Y. L., Corridan, B. M. & Morrissey, P. A. (1999) Carotenoids in young and elderly healthy humans: dietary intakes, biochemical status and diet-plasma relationships. Eur. J. Clin. Nutr. 53:644-653.[Medline]

6. Yong, L. C., Forman, M. R., Beecher, G. R., Graubard, B. I., Campbell, W. S., Reichman, M. E., Taylor, P. R., Lanza, E., Holden, J. M. & Judd, J. T. (1994) Relationship between dietary intake and plasma concentrations of carotenoids in premenopausal women: application of the USDA-NCI carotenoid food composition database. Am. J. Clin. Nutr. 60:223-230.[Abstract/Free Full Text]

7. Michaud, D. S., Giovannucci, E. L., Ascherio, A., Rimm, E. B., Forman, M. R., Sampson, L. & Willett, W. C. (1998) Associations of plasma carotenoid concentrations and dietary intake of specific carotenoids in samples of two prospective cohort studies using a new carotenoid database. Cancer Epidemiol. Biomark. Prev. 7:283-290.[Abstract]

8. Slattery, M. L., Benson, J., Curtin, K., Ma, K. N., Schaeffer, D. & Potter, J. D. (2000) Carotenoids and colon cancer. Am. J. Clin. Nutr. 71:575-582.[Abstract/Free Full Text]

9. Johnson-Down, L., Saudny-Unterberger, H. & Gray-Donald, K. (2002) Food habits of Canadians: lutein and lycopene intake in the Canadian population. J. Am. Diet. Assoc. 102:988-991.[Medline]

10. McNaughton, S. A., Marks, G. C., Gaffney, P., Williams, G. & Green, A. (2005) Validation of a food-frequency questionnaire assessment of carotenoid and vitamin E intake using weighed food records and plasma biomarkers: the method of triads model. Eur. J. Clin. Nutr. 59:211-218.[Medline]

11. VandenLangenberg, G. M., Brady, W. E., Nebeling, L. C., Block, G., Forman, M., Bowen, P. E., Stacewicz-Sapuntzakis, M. & Mares-Perlman, J. A. (1996) Influence of using different sources of carotenoid data in epidemiologic studies. J. Am. Diet. Assoc. 96:1271-1275.[Medline]

12. U.S. Department of Agriculture, Agricultural Research Service (2004) Influence of using different sources of carotenoid data in epidemiologic studies. USDA National Nutrient Database for Standard Reference, Release 17 Nutrient Data Laboratory Home Page, http://www.nal.usda.gov/fnic/foodcomp.

13. Rao, A. V., Waseem, Z. & Agarwal, S. (1998) Lycopene content of tomatoes and tomato products and their contribution to dietary lycopene. Food Res. Int. 31:737-741.

14. Khachik, F., Carvalho, L., Bernstein, P. S., Muir, G. J., Zhao, D. Y. & Katz, N. B. (2002) Chemistry, distribution, and metabolism of tomato carotenoids and their impact on human health. Exp. Biol. Med. 227:845-851.[Abstract/Free Full Text]

15. Agudo, A., Esteve, M. G., Pallares, C., Martinez-Ballarin, I., Fabregat, X., Malats, N., Machengs, I., Badia, A. & Gonzalez, C. A. (1997) Vegetable and fruit intake and the risk of lung cancer in women in Barcelona, Spain. Eur. J. Cancer 33:1256-1261.

16. McNaughton, S. A., Mishra, A. D., Bramwell, G., Paul, A. A. & Wadsworth, M.E.J. (2005) Comparability of dietary patterns assessed by multiple dietary assessment methods: results from the 1946 British Birth Cohort. Eur. J. Clin. Nutr. 59:341-352.[Medline]

17. Mayne, S. T., Cartmel, B., Silva, F., Kim, C. S., Fallon, B. G., Briskin, K., Zheng, T., Baum, M. & Shor-Posner, G., et al (1999) Plasma lycopene concentrations in humans are determined by lycopene intake, plasma cholesterol concentrations and selected demographic factors. J. Nutr. 129:849-854.[Abstract/Free Full Text]

18. Ascherio, A., Stampfer, M. J., Colditz, G. A., Rimm, E. B., Litin, L. & Willett, W. C. (1992) Correlations of vitamin A and E intakes with the plasma concentrations of carotenoids and tocopherol among American men and women. J. Nutr. 122:1792-1801.

19. Porrini, M. & Riso, P. (2000) Lymphocyte lycopene concentration and DNA protection from oxidative damage is increased in women after a short period of tomato consumption. J. Nutr. 130:189-192.[Abstract/Free Full Text]

20. Visioli, F., Riso, P., Grande, S., Galli, C. & Porrini, M. (2003) Protective activity of tomato products on in vivo markers of lipid oxidation. Eur. J. Nutr. 42:201-206.[Medline]

21. Riso, P., Visioli, F., Erba, D., Testolin, G. & Porrini, M. (2004) Lycopene and vitamin C concentrations increase in plasma and lymphocytes after tomato intake. Effects on cellular antioxidant protection. Eur. J. Clin. Nutr. 58:1350-1358.[Medline]

22. Porrini, M., Riso, P., Brusamolino, A., Berti, C., Guarnieri, S. & Visioli, F. (2005) Daily intake of a formulated tomato drink affects carotenoid plasma and lymphocyte concentrations and improves cellular antioxidant protection. Br. J. Nutr. 93:93-99.[Medline]

23. Allen, C. M., Schwartz, S. J., Craft, N. E., Giovannucci, E. L., De Groff, V. L. & Clinton, S. K. (2003) Changes in plasma and oral mucosal lycopene isomer concentrations in healthy adults consuming standard servings of processed tomato products. Nutr. Cancer 47:48-56.[Medline]

24. Bowen, P., Chen, L., Stacewicz-Sapuntzakis, M., Duncan, C., Sharifi, R., Ghosh, L., Kim, H. S., Christov-Tzelkov, K. & van Breemen, R. (2002) Tomato sauce supplementation and prostate cancer: lycopene accumulation and modulation of biomarkers of carcinogenesis. Exp. Biol. Med. (Maywood) 227:886-893.[Abstract/Free Full Text]




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