Table Info

Table 1.

Study characteristics for selected studies

Author (publication year)	Aims of the study	Country	Study design/analysis	Descriptions	Outcomes	Findings
Canas et al. [32], 2017	To assess the effect of mixed carotenoids on central obesity and adipokines in children	Florida	A RCT	In this study, 20 children were included having a mean age of 10.5 years old ± 0.4 years old, BMI more than 90th percentile, and supplemented with MCS (contains 2,000 IU β-carotene, 10 mg lutein; 2 mg zeaxanthin, 500 µg of α-carotene, and 10 mg of γ-tocopherol). The primary results were found to change in β-carotene concentration, BMI z-score, and, abdominal fat whereas the secondary outcomes were found in insulin resistance markers and adipokines.	The result shows that there was an inverse correlation of β-carotene with BMI z-score, WHtR, visceral and subcutaneous adipose tissue.	The increased concentration of β-carotene reflects a decrease in BMI z-score, WHtR, and visceral and subcutaneous adipose tissue. MCS suggests an eminent role in obese children.
Coyne et al. [33], 2009	Association between serum carotenoid concentration and metabolic syndrome	Australia	A cross-sectional study	The information was collected from the international diabetes federation 2005, conducted over 1,523 adults with a mean age of 25 years and more from urban areas suffering from metabolic syndrome. The anthropometric data analysis, blood glucose, and lipid levels were determined along with serum carotene levels.	The persons with a metabolic syndrome found significantly lower (P < 0.05) concentrations of mean serum α-carotene, β-carotene, and the sum of all mentioned carotenoids.	The differences were noticed in former and non-smokers but not found in the present smokers. It concluded that the low level of serum α-carotene, β-carotene, and the sum of the included carotenoids was linked with metabolic syndrome.
Daniels et al. [34], 2014	To find out the association between excess consumption of fruits and vegetables increases serum carotenoid, and also activities of lecithin cholesterol acyltransferase (LCAT) and paraoxonase-1 (PON-1) in T2DM.	UK	A RCT	In this study, 8 obese T2DM subjects were randomized to a one or more than six portion per day fruits and vegetable diet were consumed for eight weeks. Fasting and postprandial blood glucose were noted. The serum carotenoids, HDL2 and HDL3 were measured by HPLC, the PON-1, HDL2, and HDL3 by a spectrophotometric and LCAT, HDL2 and HDL3 by fluorometric assay.	When comparing the group having more than six and one portions of fruit and vegetables, it was found that carotenoids increased in serum, along with HDL2 and HDL3 (α-carotene, β-cryptoxanthin, lutein, and lycopene having P values were 0.008, 0.042, 0.012, and 0.016), LCAT and PON-1 in HDL3 (P = 0.044 and 0.006, respectively).	It concluded that increased consumption of fruit and vegetables increased the carotenoid concentration and also influenced the enzyme intermingled with antioxidant properties of HDL, and these changes may help to increase the cardioprotective properties of this lipoprotein.
García et al. [35], 2012	To evaluate the concentration of vitamin A, ascorbic acid, and zinc linked with adiposity and leptin in women	Mexico	A cross-sectional study	In this study, 580 Mexican women (mean aged 37 years old ± 7.5 years old) from the rural area of the said region were evaluated. Anthropometric measurement [such as weight, height, waist circumference (WC), and HC], and fasting blood samples (such as glucose, zinc, leptin, lipid profile, and vitamin A, C, and E) was taken for analysis.	The prevalences of overweight and obesity were found at 36% and 44% (with BMI > 25 kg/m² and BMI > 30 kg/m²), whereas the prevalences of zinc, ascorbic acid, and tocopherol were alike in these patients but no vitamin A deficiency was found in them. It was noticed that vitamin C was inversely linked with BMI, WHR, and leptin (P < 0.05), whereas retinol was directly linked with leptin (P < 0.05). The leptin concentration was linked with lower vitamin C and zinc concentration in obese women (P < 0.05) and vitamin A concentration was higher in non-obese women (P ˂ 0.01). Whereas tocopherol was not linked with any obesity markers.	The concentration of zinc, retinol, and ascorbic acid were linked with adiposity, obesity, and leptin in women.
Harari et al. [36], 2020	To assess whether tissue carotenoid concentration has an inverse association among obese and insulin-resistant adults	Australia	Cohorts studied	In this study, 80 participants were included between 2008 and 2013 in Sydney with a mean age of 51.4 years old ± 1.1 years old. The retinol, lutein, lycopene, α-carotene, zeta-carotene, β-carotene, phytofluene, and phytoene were assessed by HPLC. Body composition was assessed by Dual-energy X-ray absorptiometry. Insulin resistance in 64 participants was measured by a two-step hyperinsulinemic-euglycemic clamp. In sixty patients MRI was used to measure the extra fat in the pancreas and liver. The carotenoid and retinol were measured by periumbilical subcutaneous fat biopsy in the tissue (n = 16).	Zeta-carotene was three times more in adipose tissue in contrast with serum while lycopene and lutein made up 21 percent and 20 percent of serum carotenoids. Liver (P ≤ 0.028) and adipose tissue (P = 0.023), but not muscle (P ≥ 0.16), insulin resistance was inversely associated with the serum carotenoids.	It concludes that there was a favorable relation between serum carotenoids and adipose tissues and metabolic health in humans.
Hekmat et al. [37], 2014	To assess the relationship between gestational women and fat-soluble antioxidants	Iran	A case-control study	In this study, 82 pregnant women were included for the study among which 41 were suffering from GDM and 41 were healthy women with a 32 weeks gestational age. Five ml venous blood was collected and sent for retinol and α-tocopherol analyzed by chromatography, and the data were calculated with chi-square (χ²) and t-test.	The serum retinol in the non-experimental group was 0.59 mg/dL which was quite higher than the GDM group (0.46 mg/dL; with P = 0.01). The mean α-tocopherol in gestational women was 6.21 mg/dL and in the non-experimental group was 6.92 mg/dL (P < 0.05).	It was concluded that the retinol was remarkably lower in diabetic pregnant women compared with the control group, and this is due to decreased antioxidant concentration in the GDM group.
Islam et al. [38], 2013	To evaluate whether serum zinc concentration linked to diabetes and prediabetes	Bangladesh	A cross-sectional study	In this study, 280 patients were included, among which 51 percent were normal, 13 percent had prediabetes and 36 percent had diabetes.	Mean serum zinc concentration was found low in prediabetic in contrast to normal (65 ppb/L) and diabetic participants (33 ppb/L). Multiple linear regression shows lower zinc levels in prediabetes than in those with normal blood glucose levels. Linear regression for HOMA parameters did not show any statistically significant relation between zinc concentration, insulin resistance (with P = 0.08), and β-cell function (with P = 0.07).	Low serum zinc is linked with insulin resistance along with an increase in BMI.
Larsen et al. [39], 2014	To determine whether ascorbic acid intake may cause a change in WC and body weight, among obese people linked with a genetic predisposition	Denmark	A prospective cohort study	In this study, 7,569 participants were included. They summarized 50 obesity-linked SNPs in four genetic scores and their score for BMI, WC, and WHR with which the SNPs connected. The linear regression evaluated the link between vitamin C consumption and annual change in body weight (ΔBW) or WCs (ΔWC).	The result indicates no remarkable connections between dietary vitamin C and ΔBW or ΔWC. The risk allele of the fourteen WHR-connected SNPs was connected with a ΔWC of 0.039 cm annually (with P = 0.02, at 95% confidence interval: 0.005 to 0.073) per 100 mg every day higher vitamin C intake.	The study does not assist any connection between vitamin C and body weight or WC, but a diet with a high ascorbic acid may be weakly connected with higher WC gain.
Manning et al. [40], 2004	To determine whether higher ingestion of tocopherol may be associated with insulin resistance among the overweight	New Zealand	Randomized clinical trial	Eighty overweight (BMI > 27 kg/m²) arbitrarily selected to obtain 800 IU per day of tocopherol and placebo for 3 months, and after that further 1,200 IU per day of tocopherol dose was increased for three months.	The result shows that plasma peroxidation decreased by 27% in the first three months and by 29% at 6 months. At three months it was noticed that the fasting glucose level and insulin concentration were significantly reduced but these things were not happening with six months of supplementation. Throughout the study, the alanine transaminase concentration was declining.	The author revealed that tocopherol supplementation helps to reduce OS, and the risk of insulin resistance and improves hepatocellular function.
Mansego et al. [41], 2015	To determine the nutrigenetic impact of tocopherol, catechol-O-methyltransferase (COMT), and TXN gene polymorphism on WC	Spain	A case-controlled trial	A total of 738 participants were included among which 246 were abdominally obese and 492 were non-abdominal obese. A valid procedure was used to assess anthropometric, biochemical, OS, and antioxidant intake. DNA was isolated from white blood cells and seven polymorphism genotypic genes taking part in OS were assessed by the SNPlex system. The consequences of c-793T were more than C polymorphism. The TXN was evaluated by reporter assay.	The AO group had increased 8-oxo-2-deoxyguanosine levels and took in less retinol and tocopherol compared to the non-AO group. Logistic regression analysis shows that TXN and COMT were linked with WC and AO. These polymorphisms were more firmly linked with variations in WC in subjects with low tocopherol ingestion.	WC is linked both with dietary tocopherol ingestion and genetic variants of COMT and TXN proposing the presence of a complex nutrigenetic pathway that regulates AO.
Mummidi et al. [42], 2021	To understand the impact of serum carotenoid on the pediatric metabolic index [such as insulin sensitivity (IS)]	Mexico	A cross-sectional study	Five hundred eighty children were involved in the study. Serum β-cryptoxanthin and lycopene concentrations were checked among them by using the UPLC-photodiode array method to check their heritability and association with cardiometabolic risk traits. They used response surface methodology to govern the 2-way interaction of carotenoids and pediatric metabolic index on the Matsuda IS index.	The concentration of β-cryptoxanthin and lycopene were [h² = 0.58, P = 1 × 10^–7 and h2 = 0.98, P = 7 × 10^–18]. The study found a negative phenotypic correlation (P ≤ 0.05) between β-cryptoxanthin and five cardiometabolic risk traits (such as BMI, WC, triglycerides, fat mass, fasting glucose of –0.22, –0.25, –0.18, –0.23, –0.09 and positive correlation with HDL (0.29), whereas the lycopene showed an inverse association with fasting glucose –0.08 and conclusive association with HDL (0.18).	Response surface methodology showed increased α and β-carotenoids had maximum effect on IS index compared with β-cryptoxanthin or lycopene.
Östh et al. [43], 2014	To evaluate the β-carotene concentration reduced in obesity and how it is linked with T2DM	Sweden	A cross-sectional study	In this study total, of 55 female patients were included among which 43 were non-diabetic and 12 were T2DM, and subcutaneous adipose tissues were obtained from these patients undergoing elective surgery. Subjects were split into 4 groups BMI < 23, 23 ≤ BMI < 28, to BMI ≥ 28, and T2DM.	The β-carotene concentration was found 50 percent less in adipocytes from the obese and diabetes group than in the other groups. The triacylglycerol was found in 92 ± 1 percent of adipocytes in the lean group whereas 99 ± 2 percent in the diabetic obese group (P < 0.05).	It concluded that β-carotene concentration was lowered in the obese subject and its lower concentration indicates adipocytes from T2DM subjects reflect obesity.
Sanchez-Lugo et al. [44], 1997	To determine any significant relationship between ingestion of tocopherol and ascorbic acid and IS, in Hispanic, non-Hispanic, and African Americans of both sexes	California, Colorado, Texas	A cross-sectional study	In this study, 1,151 participants were included from Hispanic, African American, and non-Hispanic. The tocopherol and ascorbic acid concentrations were evaluated with IS and insulin concentration. IS was assessed by insulin modification, minimal model analysis, and frequent intravenous glucose tolerance test, and nutrient consumption was measured by food frequency questionnaire methods.	The Pearson correlation coefficient for vitamins C and E in corresponds to IS were r = 0.07 (with P = 0.02) and r = 0.07 (with P = 0.01). After monitoring BMI and total energy intake, these associations were not statistically significant.	The findings did not produce any remarkable relation between improved IS and intake of vitamins E and C.
Takagi et al. [45], 2020	To assess the higher dietary ingestions of carotenoid-rich vegetables helps in lowering visceral adiposity among Japanese	Japan	Randomized clinical trial	In this study, 28 Japanese men aged (40 years old to 65 years old) with a BMI of more than 25 kg/m² were included in 8-week-long randomized clinical trials. Four dietary groups were made with variations in lycopene and lutein concentration.	The result shows that everyday beverage consumption may increase the carotenoids in plasma level and reduce the visceral fat in all groups significantly. The WC was significantly lowered in the group that had high lycopene with low lutein, and the CoQ10 oxidation rate was significantly reduced in each group. Only in low lycopene with low lutein group had to differ in their gene expression profile that indicates the effect of carotenoids on genetic profile.	It concluded that dietary intake of carotenoid-dense vegetables helps in the reduction of intra-abdominal visceral fat.
Toprak et al. [46], 2017	Determining the magnesium supplementation for the obese and pre-diabetes patients having mild to moderate CKD problems helps to improve their metabolic profile.	Turkey	A randomized control trial	In this study, 118 pre-diabetic and obese patients suffering from hypomagnesemia with a calculated GFR rate between 90 ml/min and 30 ml/min per 1.73 m² were taken in the study. Fifty-seven patients were taking 365 mg of magnesium orally and 61 groups were placebo once daily for 3 months.	The result shows that the group having magnesium compared with placebo had significantly decreased insulin resistance (–24.5 vs. –8.2 percent, with P = 0.007), insulin (–29.6 vs. –2.66 percent, P ˂ 0.001), HbA1c (–6.6 vs. –0.16 percent, P ˂ 0.001), WCs (–4.8 vs. 0.55 percent, P ˂ 0.001), whereas magnesium (0.21 mg/dL ± 0.18 mg/dL vs. –0.04 mg/dL ± 0.05 mg/dL, P ˂ 0.001) and albumin (0.91 vs. –2.91 percent, with P = 0.007) were remarkably increased. The metabolic syndrome also decreased pre-diabetes (–17.5 vs. –9.8 percent, P = 0.140) and obesity (–15.7 vs. –8.2 percent, with P = 0.131).	It concluded that magnesium supplementation in CKD patients suffering from hypomagnesemia along with obesity and diabetes helps to improve metabolic status.
Wilson et al. [47], 2017	To evaluate the vitamin C concentration (linked with obesity, glycemic control, and smoking) among prediabetes and diabetes.	New Zealand	A cross-sectional study	In the study, 89 participants were involved among those which NGT, pre-diabetes, and T2DM with managed diet and or with metformin.	The plasma ascorbic acid concentration was remarkably less in T2DM compared with NGT was 41.2 µmol/L and 57.4 µmol/L. In the prediabetes and T2DM groups, it was noticed that there was a high amount of vitamin C (˂ 11.0 µmol/L) was noted.	It concluded that the vitamin C requirement was greater in adults/patients with a history of prediabetes, T2DM, obesity, and smokers.

HDL2: high-density lipoprotein 2; HPLC: high-performance liquid chromatography; HC: hip circumference; GDM: gestational diabetes mellitus; HOMA: homeostatic model assessment; SNPs: single nucleotide polymorphisms; UPLC: ultra-performance liquid chromatography; CKD: chronic kidney disease; GFR: glomerular filtration rate; NGT: normal glucose tolerance; MCS: mixed carotenoid supplementation

Declarations

Author contributions

LS and DS: Conceptualization, Formal analysis, Writing—original draft, Writing—review & editing. LS: Supervision. Both authors wrote, read, approved the study for publication, and provided their critical feedback and approved the final manuscript.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

Not applicable.

Consent to participate

Not applicable.

Consent to publication

Not applicable.

Availability of data and materials

All datasets for this study are included in the manuscript.

Funding

Not applicable.

Copyright

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