title: Plasma levels of six carotenoids in nine European countries: report from the European Prospective Investigation into Cancer and Nutrition (EPIC).
abstract: BACKGROUND
  In addition to their possible direct biological effects, plasma carotenoids can be used as biochemical markers of fruit and vegetable consumption for identifying diet-disease associations in epidemiological studies. Few studies have compared levels of these carotenoids between countries in Europe.
  
  
  OBJECTIVE
  Our aim was to assess the variability of plasma carotenoid levels within the cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC).
  
  
  METHODS
  Plasma levels of six carotenoids--alpha-carotene, beta-carotene, beta-cryptoxanthin, lycopene, lutein and zeaxanthin--were measured cross-sectionally in 3043 study subjects from 16 regions in nine European countries. We investigated the relative influence of gender, season, age, body mass index (BMI), alcohol intake and smoking status on plasma levels of the carotenoids.
  
  
  RESULTS
  Mean plasma level of the sum of the six carotenoids varied twofold between regions (1.35 micromol l(-1) for men in Malmö, Sweden vs. 2.79 micromol l(-1) for men in Ragusa/Naples, Italy; 1.61 micromol l(-1) for women in The Netherlands vs. 3.52 micromol l(-1) in Ragusa/Naples, Italy). Mean levels of individual carotenoids varied up to fourfold (alpha-carotene: 0.06 micromol l(-1) for men in Murcia, Spain vs. 0.25 micromol l(-1) for vegetarian men living in the UK). In multivariate regression analyses, region was the most important predictor of total plasma carotenoid level (partial R(2)=27.3%), followed by BMI (partial R(2)=5.2%), gender (partial R(2)=2.7%) and smoking status (partial R(2)=2.8%). Females had higher total carotenoid levels than males across Europe.
  
  
  CONCLUSIONS
  Plasma levels of carotenoids vary substantially between 16 different regions in Italy, Greece, Spain, France, Germany, the UK, Sweden, Denmark and The Netherlands. Compared with region of residence, the other demographic and lifestyle factors and laboratory measurements have limited predictive value for plasma carotenoid levels in Europe.
authors.affiliation: Unit of Nutrition and Cancer, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France. Aldelaimy@iarc.fr
authors.forename: Wael K
authors.initials: WK
authors.lastname: Al-Delaimy
authors.forename: Anne Linda
authors.initials: AL
authors.lastname: van Kappel
authors.forename: Pietro
authors.initials: P
authors.lastname: Ferrari
authors.forename: Nadia
authors.initials: N
authors.lastname: Slimani
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Steghens
authors.forename: Sheila
authors.initials: S
authors.lastname: Bingham
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Johansson
authors.forename: Peter
authors.initials: P
authors.lastname: Wallström
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Tim J
authors.initials: TJ
authors.lastname: Key
authors.forename: Ailsa A
authors.initials: AA
authors.lastname: Welch
authors.forename: H Bas
authors.initials: HB
authors.lastname: Bueno-de-Mesquita
authors.forename: Petra H M
authors.initials: PH
authors.lastname: Peeters
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.forename: Jakob
authors.initials: J
authors.lastname: Linseisen
authors.forename: Françoise
authors.initials: F
authors.lastname: Clavel-Chapelon
authors.forename: Catherine
authors.initials: C
authors.lastname: Guibout
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro
authors.forename: Jose Ramón
authors.initials: JR
authors.lastname: Quirós
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Egidio
authors.initials: E
authors.lastname: Celentano
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Benetou
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kaaks
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
mesh_terms: D000428:Alcohol Drinking; D015992:Body Mass Index; D002338:Carotenoids / Q000097:blood*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009747:Nutritional Physiological Phenomena; D011446:Prospective Studies; D012016:Reference Values; D012621:Seasons; D012907:Smoking
chemical_list: D002338:Carotenoids