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Nutritional factors and visual function in premature infants
V C Jewell1, C A Northrop-Clewes, R Tubman
1Northern Ireland Centre for Diet and Health, University of Ulster, Coleraine, UK. VC.Jewell@ulst.ac.uk
Insights
Premature infants face risks of visual impairment due to oxidant stress. Lutein and zeaxanthin, found in breast milk, may protect the developing eyes of newborns.
Area of Science:
- Ophthalmology
- Neonatology
- Nutritional Science
Background:
- Premature birth (before 37 weeks) is a leading cause of infant mortality and long-term disability.
- Premature infants are susceptible to oxidant stress and visual impairment, exacerbated by neonatal unit environments (high O2, intense light).
- Lutein and zeaxanthin, macular carotenoids, protect the retina from oxidative and light damage and are dietary in origin.
Purpose of the Study:
- To investigate the role and levels of lutein and zeaxanthin in protecting newborn infants, particularly premature infants, from visual impairment.
- To explore the significance of macular pigments in neonatal retinal health.
- To assess the availability of these carotenoids through maternal blood and human milk.
Main Methods:
- Analysis of lutein and zeaxanthin levels in neonates (specific methods not detailed in abstract).
- Review of dietary sources and transfer mechanisms of macular carotenoids.
- Examination of potential protective roles in the neonatal retinal pigment epithelium.
Main Results:
- Little information is currently available on blood lutein and zeaxanthin levels in neonates.
- Lutein concentrations in human milk are significantly higher (2-3 times) than beta-carotene.
- Maternal blood concentrations of lutein and beta-carotene are similar, but lutein is more abundant in milk.
Conclusions:
- Lutein and zeaxanthin, primarily from human milk, are crucial dietary components for protecting the eyes of newborn infants.
- Further research is needed to understand carotenoid transport and their specific protective mechanisms in the neonatal macula.
- These macular pigments may play a vital role in preventing visual impairment in vulnerable premature infants.
Abstract:
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 beta-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.