Effects of vitamin E and carotenoid status on oxidative stress in health and disease. Evidence obtained from human intervention studies

Mol Aspects Med. 2003 Dec;24(6):391-402. doi: 10.1016/s0098-2997(03)00035-9.


Vitamin E and carotenoids are known to act as antioxidants both in vitro and in vivo. In this review we present a series of studies in healthy subjects and in patients who exhibit either acute or chronic oxidative stress. In the EU-Commission funded VITAGE project we investigated the status and effects of vitamin E and carotenoids on oxidative stress in 300 healthy volunteers. Depletion studies limiting dietary vitamin E or carotenoid intake to approximately 25% of the dietary reference intakes and subsequent repletion by supplementation with either large doses of vitamin E or intermediate doses of carotenoids showed significant changes in ex vivo LDL oxidizability, total plasma peroxide concentrations and urinary 8-oxo-7,8-dihydro-2(')-deoxyguanosine excretion. Patients on chronic hemodialysis present with oxidative stress in the presence of normal vitamin E but impaired vitamin C status and, due to anemia, need to be treated with parenteral iron. We studied the effects of a single oral dose of vitamin E taken 6 h prior to intravenous infusion of 100 mg iron, which exceeded the iron-binding capacity of transferrin. Vitamin E significantly reduced and in combination with a single dose of vitamin C completely abrogated acute oxidative stress induced by the iron load. Patients with cystic fibrosis are exposed to chronic oxidative stress due to an overproduction of reactive oxygen species as a result of neutrophil-dominated lung inflammation and impaired antioxidant status. Biochemical vitamin E and carotenoid deficiencies could be fully corrected even in the presence of fat malabsorption using intermediate doses of either RRR alpha-tocopherol or all-rac alpha-tocopheryl acetate and water-miscible all-trans beta-carotene. Long-term supplementation reduced ex vivo LDL oxidizability, in vivo lipid peroxidation and lung inflammation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aging
  • Carotenoids / administration & dosage
  • Carotenoids / blood
  • Carotenoids / metabolism*
  • Cystic Fibrosis / blood
  • Cystic Fibrosis / metabolism
  • Dietary Supplements
  • Health Status
  • Humans
  • Injections, Intravenous
  • Iron / administration & dosage
  • Iron / blood
  • Oxidative Stress / drug effects*
  • Renal Dialysis / adverse effects
  • Vitamin E / administration & dosage
  • Vitamin E / blood
  • Vitamin E / metabolism
  • Vitamin E / therapeutic use*
  • Vitamin E Deficiency / etiology
  • Vitamin E Deficiency / prevention & control*


  • Vitamin E
  • Carotenoids
  • Iron