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Nutritional factors and visual function in premature infants

Published online by Cambridge University Press:  28 February 2007

Victoria C. Jewell ,
Christine A. Northrop-Clewes ,
Richard Tubman  and
David I. Thurnham
Victoria C. Jewell*
Affiliation:
Northern Ireland Centre for Diet and Health, University of Ulster, Coleraine BT52 1SA, UK
Christine A. Northrop-Clewes
Affiliation:
Northern Ireland Centre for Diet and Health, University of Ulster, Coleraine BT52 1SA, UK
Richard Tubman
Affiliation:
Neonatal Intensive Care Unit, Royal Maternity Hospital, Belfast BT12 6BB, UK
David I. Thurnham
Affiliation:
Northern Ireland Centre for Diet and Health, University of Ulster, Coleraine BT52 1SA, UK
*
*Corresponding Author: Victoria Jewell, fax +44 28 70324965, email VC.Jewell@ulst.ac.uk
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Abstract

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Approximately 5–7 % of all infants are born prematurely, and birth before 37 weeks is the most common cause of neonatal mortality, morbidity and long-term disability. Premature infants are poorly equipped for life outside the womb, and oxidant stress has been implicated in the aetiology of visual impairment in these infants, who are often exposed to increased O2 concentrations and high light intensity in neonatal units. The carotenoids lutein and zeaxanthin, which give the macular area of the eye its yellow colour, are located in the retinal pigment epithelium of the eye, and are believed to play a role in protecting it against oxidative and light damage. The macular pigments are of dietary origin, and green leafy vegetables are the primary source of lutein and zeaxanthin. Lutein is one of the five most common carotenoids found in the diet. There is current interest in the macular pigment in relation to age-related macular degeneration, but these pigments may also have a protective role in the retinal pigment epithelium of the newborn infant. Little information is available on blood lutein and zeaxanthin levels in neonates. Levels of lutein in human milk are two to three times higher than those of β-carotene, whereas their concentrations in the mothers’ blood are approximately the same. Human milk is the main dietary source of lutein and zeaxanthin for infants until weaning occurs. The biochemical mechanisms which mediate the transport of the macular carotenoids into the eye are not known, but tubulin has been identified as the major carotenoid-binding protein, and may play a role in the physiology of the macula.

Keywords

PrematurityLuteinZeaxanthinMacula
Type
Postgraduate Symposium
Information
Proceedings of the Nutrition Society , Volume 60 , Issue 2 , May 2001 , pp. 171 - 178
Copyright
Copyright © The Nutrition Society 2001

References

Alberman, E & Botting, B (1991) Trends in prevalence and survival of very low birthweight infants, England and Wales: 1983–7. Archives of Disease in Childhood 66, 1304–1308.CrossRefGoogle ScholarPubMed
Audit Commission (1993) Children First: A Study of Hospital Services. London: H.M. Stationery Office.Google Scholar
Bernstein, PS, Balashov, NA, Tsong, ED & Rando, RR (1997) Retinal tubulin binds macular carotenoids. Investigative Ophthalmology and Visual Science 38, 167–175.Google Scholar
Blanche, D, Gesquiere, L, Loreau, N & Durard, P (1999) Oxidant stress: the role of nutrients in cell–lipoprotein interactions. Proceedings of the Nutrition Society 58, 559–563.Google Scholar
Bohin, S, Draper, ES & Field, DJ (1999) Health status of a population of infants born before 26 weeks gestation derived from routine data collected between 21 and 27 months post-delivery. Early Human Development 55, 9–18.Google Scholar
Bone, RA, Landrum, JT, Fernandez, L & Tarsis, SL (1988) Analysis of the macular pigment by HPLC: Retinal distribution and age study. Investigative Ophthalmology and Visual Science 34, 2033–2040.Google Scholar
Bone, RA, Landrum, JT, Friedes, LM, Gomez, CM, Kilburn, MD, Menendez, E, Vidal, I & Wang, W (1997) Distribution of lutein and zeaxanthin stereoisomers in the human retina. Experimental Eye Research 64, 211–218.CrossRefGoogle ScholarPubMed
Bone, RA, Landrum, JT & Tarsis, SL (1985) Preliminary identification of the human macular pigment. Vision Research 25, 1531–1535.Google Scholar
British Nutrition Foundation (1992). Unsaturated Fatty Acids: Nutritional and Physiological Significance. London: Chapman Hall.Google Scholar
Bonn, D (1998) Keeping the stork at bay until the time is right. Lancet 351, 576.Google Scholar
Carnielli, VP, Pederzini, F, Vittorangeli, R, Luijendijk, IHT, Boomaars, WEM, Pedrotti, D & Sauer, PJJ (1996) Plasma and red blood cell fatty acids of very low birth weight infants fed exclusively with expressed preterm human milk. Pediatric Research 39, 671–679.Google Scholar
Cartlidge, PHT, Jones, HP, Stewart, JH, Drayton, MR, Ferguson, DS, Matthes, JWA, Minchom, PE & Moorcraft, J (1999) Confidential enquiry into deaths due to prematurity. Acta Paediatrica 88, 220–223.CrossRefGoogle ScholarPubMed
Cooke, RW (1996) Improved outcome for infants at the limit of viability. European Journal of Pediatrics 155, 665–667.Google Scholar
Doyle, LW, Rogerson, S, Chuang, S, James, M, Bowman, ED & Davis, PG (1999) Why do preterm infants die in the 1990s? Medical Journal of Australia 170, 528–532.Google Scholar
Editorial (1988) Breast not necessarily best. Lancet i, 624–626.Google Scholar
Elder, DE, Hagan, R, Evans, SF, Benninger, HR & French, NP (1999) Hospital admissions in the first year of life in very preterm infants. Journal of Paediatrics and Child Health 35, 145–150.Google Scholar
Emenheiser, C, Simunovic, W, Sander, LC & Schwartz, SJ (1996) Separation of geometrical carotenoid isomers in biological extracts using a polymeric C30 column in reversed-phase liquid chromatography. Journal of Agricultural and Food Chemistry 44, 3887–3893.CrossRefGoogle Scholar
Ford, ES, Will, JC, Bowman, BA & Venkat Narayan, KM (1999) Diabetes mellitus and serum carotenoids: Findings from the Third National Health and Nutrition Examination Survey. American Journal of Epidemiology 149, 168–176.CrossRefGoogle ScholarPubMed
Gartner, C, Stahl, W & Sies, H (1996) Preferential increase in chylomicron levels of the xanthophylls lutein and zeaxanthin compared to β-carotene in the human. International Journal of Vitamin and Nutrition Research 66, 119–125.Google Scholar
Gibson, A (1982) Prematurity. In Fetal and Neonatal Pathology [Barson, A, editor\. London: Praeger Scientific.Google Scholar
Gorman, WA, Fallon, M, Kelly, M, Clarke, T, Griffin, E, Matthews, T, Murphy, J, O'Brien, N & Sheridan, M (1996) The Dublin outcome for low birth-weight infants. Irish Medical Journal 89, 186–187.Google ScholarPubMed
Halliwell, B & Aruoma, OI (1991) DNA damage by oxygen-derived species: Its mechanisms and measurement in mammalian systems FEBS Letters 281, 9–19.Google Scholar
Hammond, BR & Caruso-Avery, M (2000) Macular pigment optical density in a southwestern sample. Investigative Ophthalmology and Visual Science 41, 1492–1497.Google Scholar
Hammond, BR, Johnson, EJ, Russell, RM, Krinsky, NF, Yeum, KJ, Edwards, K & Snodderly, DM (1997) Dietary modification of human macular pigment density. Investigative Ophthalmology and Visual Science 38, 1795–1802.Google ScholarPubMed
Hughes, DA (1999) Effects of dietary antioxidants on the immune function of middle-aged adults. Proceedings of the Nutrition Society 58, 79–84.CrossRefGoogle ScholarPubMed
Jacques, PF, Taylor, A, Hankinson, SE, Willett, WC, Mahnken, B, Lee, Y, Vaid, K & Lahav, M (1997) Long-term vitamin C supplement use and prevalence of early age-related lens opacities. American Journal of Clinical Nutrition 66, 911–916.CrossRefGoogle ScholarPubMed
Jewell, VC, Sweet, D, Tubman, R, Northrop-Clewes, CA & Thurnham, DI (2000) Lutein and zeaxanthin levels in newborn infants and their mothers. Proceedings of the Nutrition Society 59, 47A.Google Scholar
Jones, L & Spencer, A (1999) Successful preterm breastfeeding. Practising Midwife 12, 54–57.Google Scholar
Khachik, F, Spangler, CJ & Cecil Smith, J (1997) Identification, quantitation, and relative concentrations of carotenoids and their metabolites in human milk and serum. Analytical Chemistry 69, 1873–1881.CrossRefGoogle Scholar
Landrum, JT, Bone, RA, Joa, H, Kilburn, MD, Moore, LL & Sprague, KE (1997) A one year study of the macular pigment: the effect of 140 days of a lutein supplement. Experimental Eye Research 65, 57–62.CrossRefGoogle ScholarPubMed
Landrum, JT, Bone, RA, Moore, LL & Gomez, CM (1999) Analysis of zeaxanthin distribution within individual human retinas. Methods in Enzymology 299, 457–467.Google Scholar
Le Blanc, MH, Graves, GR, Rawson, TW & Moffitt, JM (1999) Long-term outcome of infants at the margin of viability. Journal of the Mississippi State Medical Association 40, 111–114.Google Scholar
Lucas, A, Fentrell, MS & Davies, PW (1997) Breastfeeding and catch-up growth in infants born small for gestational age. Acta Paediatrica 86, 564–569.CrossRefGoogle ScholarPubMed
Main, DM & Hadley, CB (1988) The role of ultrasound in the management of preterm labor. Clinical Obstetrics and Gynecology 31, 53–60.Google Scholar
Malinow, MR, Feeney-Burns, L, Peterson, LH, Klein, ML & Neuringer, M (1980) Diet-related macular anomalies in monkeys. Investigative Ophthalmology and Visual Science 19, 857–863.Google ScholarPubMed
Micozzi, MS, Brown, ED, Edwards, BK, Bieri, JG, Taylor, PR, Khachik, F, Beecher, GR & Smith, JC (1992) Plasma carotenoid response to chronic intake of selected foods and β-carotene supplements in men. American Journal of Clinical Nutrition 55, 1120–1125.Google Scholar
Minicucci, G, Lepore, D & Molle, F (1999) Abnormal retinal vascularisation in preterm children. Lancet 353, 1099.CrossRefGoogle ScholarPubMed
Morris, BA, Miller-Loncar, CL, Landry, SH, Smith, KE, Swank, PR & Denson, SE (1999) Feeding, medical factors and developmental outcome in premature infants. Clinical Pediatrics 38, 451–457.CrossRefGoogle ScholarPubMed
National Perinatal Epidemiology Unit (1994) Disability and Perinatal Care: Measurement at 2 Years. A Report of 2 Working Groups Convened by the National Perinatal Epidemiology Unit and Oxford Regional Health Authority. Oxford: NPEU.Google Scholar
O'Neill, E & Thurnham, DI (1998) Intestinal absorption of β‐carotene, lycopene and lutein in men and women following a standard meal: response curves in the triacylglycerol-rich lipoprotein fraction. British Journal of Nutrition 79, 149–159.Google Scholar
Parker, RS, Swanson, JE, You, C, Edwards, AJ & Huang, T (1999) Bioavailability of carotenoids in human subjects. Proceedings of the Nutrition Society 58, 155–162.Google Scholar
Pennefather, PM, Clarke, MP, Strong, NP, Cottrell, DG, Dutton, J & Tin, W (1999) Risk factors for strabismus in children born before 32 weeks gestation. British Journal of Ophthalmology 83, 514–518.CrossRefGoogle ScholarPubMed
Sommerburg, O, Keunen, JEE, Bird, AC & Kuijk, FJGM (1998) Fruits and vegetables that are good sources for lutein and zeaxanthin: the macular pigment in human eyes. British Journal of Ophthalmology 82, 907–910.CrossRefGoogle Scholar
Sommerburg, O, Siems, WG, Hurst, JS, Lewis, JW, Klinger, DS & van Kuijk, FJGM (1999) Lutein and zeaxanthin are associated with photoreceptors in the human retina. Current Eye Research 19, 491–495.CrossRefGoogle ScholarPubMed
Thurnham, DI (1988) Vitamin C (ascorbic acid): antioxidant functions of vitamin C in disease in man and animals. Comparative Nutrition 34, 91–103.Google Scholar
Thurnham, DI (1994) Carotenoids: functions and fallacies. Proceedings of the Nutrition Society 53, 77–87.CrossRefGoogle ScholarPubMed
Thurnham, DI & Northrop-Clewes, CA (1999) Optimal nutrition: vitamin A and the carotenoids. Proceedings of the Nutrition Society 58, 449–457.Google Scholar
Thurnham, DI, Smith, E & Flora, PS (1988) Concurrent liquid-chromatographic assay of retinol, alpha-tocopherol, beta-carotene, alpha-carotene, lycopene, and beta-cryptoxanthin in plasma, with tocopherol acetate as internal standard. Clinical Chemistry 34, 377–381.CrossRefGoogle ScholarPubMed
Willett, WC, Stampfer, MJ, Underwood, BA, Taylor, JO & Hennekens, CH (1983) Vitamins A, E and carotene: effects of supplementation on their plasma levels. American Journal of Clinical Nutrition 38, 559–566.Google Scholar
World Health Organization (1961) Public Health Aspects of Low Birth Weight – Third Report of the Expert Committee on Maternal and Child Health. Technical Report Series no. 217. Geneva: WHO.Google Scholar
Van Vliet, J, Schreurs, WHP & van der Berg, H (1995) Intestinal β‐carotene absorption and cleavage in men: response of β‐carotene and retinyl esters in the triacylglycerol-rich lipoprotein fraction after a single dose of β-carotene. American Journal of Clinical Nutrition 62, 110–116.CrossRefGoogle Scholar
Veen, S, Ens Dokkum, MH, Schreuder, AM, Verloove Vanhorick, SP, Brand, R & Ruys, JH (1991) Impairments, disabilities, and handicaps of very preterm and very-low-birthweight infants at five years of age. The Collaborative Project on Preterm and Small for Gestational Age Infants (POPS) in The Netherlands. Lancet 338, 33–36.Google Scholar
Yu, VYH, Wong, PY, Bajuk, B, Orgill, AA & Astbury, J (1986) Outcome of extremely low birth weight infants. British Journal of Obstetrics and Gynaecology 93, 162–170.Google Scholar