2. The role of carotenoids, vitamin E and vitamin D in cardiovascular health
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Globally cardiovascular disease (CVD) is the leading cause of death. Nutrition plays a central role in the prevention of many non-communicable diseases such as CVD, diabetes and cancer. A diet abundant in micronutrients from fruit and vegetables has shown to be an important role player in the prevention of CVD because of their anti-inflammatory properties. Carotenoids are the yellow, red and orange colour pigments in fruit and vegetables and possess certain biochemical properties due to their chemical structure. The most well-known carotenoids in the human diet include α- and β-carotene, β-cryptoxanthin, lutein, lycopene and xeaxanthin. Vitamin E is the collective name for tocopherols and tocotrienols which are fat soluble vitamins displaying potent antioxidant activity through their lipoperoxyl radical-scavenging characteristics. Vitamin E consists of eight lipophillic molecules which include α-, β-, γ- and δ-tocopherols and tocotrienols. Vitamin D is a fat-soluble vitamin manufactured by the skin which functions as a steroid hormone. The liver derived precursor of vitamin D, 7-dehydrocholesterol is converted in the upper layer of the skin by UVB radiation to pre-vitamin D where it is spontaneously converted to cholecalciferol or vitamin D3 (25(OH)D). Observational studies have shown that carotenoids, vitamin E and vitamin D can reduce the risk for CVD through their various effects on blood lipids as well as their anti-oxidant and anti-inflammatory properties. Randomised controlled trials (RCTs) e.g. dietary intake and supplementation studies with carotenoids, vitamin E and vitamin D showed diverse results. This article aims to summarise results from observational studies and RCTs to create a more holistic picture of the role of carotenoids, vitamin E and vitamin D in the prevention of CVD.