Beta-carotene is a natural antioxidant that can also be converted into vitamin A in the body. It has multiple beneficial effects – it protects brain, eye, and skin health. It also helps prevent metabolic syndrome and diabetes. However, supplementing with beta-carotene may increase the risk of cancer and heart disease in smokers and those who drink alcohol. Keep reading to learn what it means to have high or low beta-carotene levels and how to increase or decrease them.
What is Beta-carotene?
Beta-carotene is a plant-derived pigment (carotenoid). It is a source of vitamin A and an important antioxidant [1].
It is found in many plant products, such as green leafy and yellow-colored vegetables, and orange-colored fruit [2].
Beta-carotene contributes about 30 – 35% of the dietary vitamin A intake in western countries, but in developing countries, it represents the most abundant, and in some instances, the sole source of vitamin A [3, 4].
Beta-carotene in Foods
Beta-carotene is found in [2, 5, 1, 6]:
- Fruits (apricots, peaches, persimmons, melons, citrus, tomatoes, etc.)
- Green vegetables (spinach, broccoli, parsley, collard greens)
- Orange tuber vegetables (carrots, sweet potatoes)
- Animal tissues and products (salmon, egg yolk, butterfat)
Studies suggest that the absorption of beta-carotene from plant sources ranges from 5% to 65% in humans [7]. This depends on many different factors, such as the fat and fiber content of the food. Fat has a positive, while fiber has a negative effect on beta-carotene bioavailability [8, 9, 10, 11].
Steaming increases the available of beta-carotene, but prolonged boiling has a negative effect [1].
Beta-carotene Supplements
Beta-carotene can also be obtained from supplements. However, whenever possible, you should aim to acquire your beta-carotene from your diet in foods such as fruits and vegetables. That’s because fruits and vegetables also contain multiple other healthy ingredients that have beneficial effects on the body.
When using supplements, bear in mind that they may contain different ingredients, and discrepancies are often found between labeled and actual ingredients or their amounts [12].
In addition, excess amounts of beta-carotene can have negative effects on health, especially in people who smoke or consume alcohol.
Always consult with your doctor before taking supplements.
SelfDecode has an AI-powered app that allows you to see how Beta-carotene benefits your personal genetic predispositions. These are all based on clinical trials. The red and sad faces denote an increased genetic risk of developing conditions that Beta-carotene counteracts. Beta-carotene may also help improve the sub-optimal homocysteine lab results that this user uploaded to SelfDecode’s Lab Test Analyzer.
Beta-carotene: The Good
1) It’s An Antioxidant
Similar to other carotenoids, beta-carotene has antioxidant properties. It helps protect against reactive oxygen species and prevents oxidative stress [13, 14].
When 12 healthy women were put on a low carotene diet, they experienced increased oxidative stress and decreased superoxide dismutase (SOD) antioxidant activity [15].
Similarly, in two studies with a total of 167 lead-exposed workers, beta-carotene supplements [16, 17]:
- Increased G6PD, catalase, and SOD activity – these are all enzymes that protect our body from oxidative stress
- Increased vitamin E levels
- Decreased malondialdehyde (MDA) levels – a marker of oxidative stress
- Decreased homocysteine levels – homocysteine is a metabolic byproduct that has been implicated as a marker of many chronic diseases
However, beta-carotene decreased glutathione peroxidase (GPx) and glutathione S-transferase (GST) activity. GPx and GST are important for neutralizing certain free radicals [16, 17, 18, 19].
Several studies suggest that beta-carotene is beneficial in patients with cystic fibrosis, where it decreases oxidative stress and improves the quality of life [20, 21, 22].
Apart from circulating in the blood, beta-carotene is also a normal component of human colostrum and mature milk, where it contributes to antioxidant defenses in newborns and infants [12].
2) It’s Good For The Skin
Many studies have shown that beta-carotene and other carotenoids help protect the skin against UV rays by exerting antioxidant effects [14, 23].
However, there are also studies that failed to find any beneficial effects [23, 24].
According to a meta-analysis of 7 studies (135 subjects), beta-carotene supplementation protects against sunburn. However, the protection becomes effective only after a minimum of 10 weeks of supplementation [25].
Another study looked at the effect of 2 different doses (30 and 90 mg/day) of beta-carotene on wrinkles, skin elasticity, collagen content, and UV-induced DNA damage in 30 healthy women. Interestingly, only the low dose (30 mg/day) improved facial wrinkles and elasticity and counteracted photoaging [26].
Dietary beta-carotene is more efficient than when it’s applied to the skin because it is more stable [27].
3) Improves Brain Health
Since oxidative stress contributes to the aging of the brain, antioxidants like beta-carotene can help protect brain function [28].
In a clinical trial of almost 6,000 people, those that received long term beta-carotene supplementation performed better on cognitive tasks. They had better memory and cognitive function in general. This was especially true for the people who took beta-carotene for more than 15 years. However, short-term supplementation was ineffective [28].
In a meta-analysis of 7 studies, dietary intake of beta-carotene was linked to a lower risk of Alzheimer’s [29].
4) Protects Eye Health
In a meta-analysis of 22 articles, higher blood levels of beta-carotene decreased the risk of cataracts, a clouding of the eye lens that impairs vision. A similar association was found for higher dietary beta-carotene intake [30].
In 29 patients with retinitis pigmentosa, an eye disease that can cause loss of vision, a supplement containing beta-carotene improved retinal function [31].
In a clinical trial of 3,640 adults, those who took antioxidant supplements (beta-carotene, vitamin E, and vitamin C) had a reduced risk of vision loss (including age-related macular degeneration) [32].
However, a study in 22,000 male physicians showed no overall benefit or harm of 12 years of beta-carotene supplementation when it comes to cataracts. But beta-carotene did seem to decrease the excess risk for smokers by about one fourth [33].
5) May Protects Against Diabetes
In over 37,000 healthy subjects, higher dietary intake of beta-carotene was linked with a decreased risk of diabetes [34].
However, when it comes to dietary studies, it’s hard to say if benefits are due to beta-carotene in particular or to higher fruit and vegetable intake in general.
In 108 obese non-diabetic people, higher blood levels of beta-carotene were linked to higher blood adiponectin levels. This means that beta-carotene in the blood may increase insulin sensitivity [35].
6) May Protect Against Metabolic Syndrome
Metabolic syndrome is a cluster of conditions that occur together and increase the risk of diabetes and heart disease. You have metabolic syndrome if you have at least three of the following:
- high blood pressure
- high blood sugar
- excess body fat around the waist
- high cholesterol
- high triglyceride levels
In an observational study of 910 people, those with high beta-carotene levels had a lower risk of developing metabolic syndrome over the next 10 years. In addition, they had a lower risk of having high cholesterol (dyslipidemia) [36].
Beta-carotene may protect against metabolic syndrome by decreasing cholesterol absorption in the gut and increasing cholesterol excretion in the feces [37].
A study in rats showed that supplementation with beta-carotene decreased total cholesterol, non-HDL cholesterol, and liver fat and cholesterol content. These were accompanied by an increase in the loss of fat and cholesterol through feces [37].
7) Is Associated with Lower Uric Acid Levels
High uric acid levels can lead to gout and kidney stones [38, 39].
In an observational study of over 14,000 people, low beta-carotene was linked to higher uric acid levels (hyperuricemia) [40].
8) May Protect Against Heart Disease
In over 1,000 men followed over 15 years, people with low blood levels of beta-carotene were over 2 times more likely to die of heart disease [41].
In mice fed a high-fat diet, a natural source of beta-carotene, alga Dunaliella, decreased the hardening of the arteries and prevented an increase in blood cholesterol levels [42].
9) May Protect Against Cancer
Studies support the role of dietary and circulating beta-carotene when it comes to cancer prevention. These levels correspond to a higher fruit and vegetable intake in general. But results are controversial when it comes to beta-carotene supplementation.
Circulating and Dietary Beta-Carotene
Higher blood levels of beta-carotene have been associated with a lower risk of cancer, including lung, leukemia, and bone cancer [43, 44].
A meta-analysis of 19 studies comprising over 500,000 people suggests that higher dietary beta-carotene intake decreases the risk of lung cancer [45].
Similarly, in another meta-analysis of 5 studies with over 3,700 subjects, high vs. low dietary intake of beta-carotene was associated with a 16% lower risk of getting ovarian cancer [46].
In 540 head and neck cancer patients treated by radiation, higher dietary and blood beta-carotene levels were associated with fewer adverse effects and a lower rate of cancer recurrence [47].
A study in 190 healthy individuals showed a U-shaped relationship between beta-carotene intake and genome stability. Both low and high intakes (< 4.1 and > 6.4 mg/day) increased DNA mutations, which can potentially lead to cancer [48].
Beta-carotene Supplements
Some studies show that supplementation with beta-carotene is linked to a modestly decreased risk of cancer, including prostate, neck, and colon cancer [49, 50].
Other studies (39,000 and 29,000 people) found no benefit or harm from beta-carotene supplementation regarding the incidence of cancer [51, 52].
However, a meta-analysis of 6 trials, including over 40,000 participants, found that beta-carotene supplements increased the risk of bladder cancer [53].
According to a meta-analysis of 9 trials, people who smoke and asbestos-exposed workers should avoid beta-carotene supplements because they may increase the risk of getting lung or stomach cancer [54].
10) May Protect Against Radiation
Beta-carotene supplements effectively decreased cell damage in 709 children exposed to different doses of radiation during and after the Chernobyl accident [55].
In rats, beta-carotene showed significant antimutagenic/radioprotective activity against radioactive iodine, which is used in diagnosing thyroid disorders [56].
11) May Promote Longevity
A meta-analysis of 41 observational studies (over 500,000 people) suggests that both higher blood levels and a higher dietary intake of beta-carotene are linked with decreased all-cause mortality [57].
According to another meta-analysis of over 25,000 people, higher blood levels of beta-carotene were linked to a reduced risk of death from all causes. Similarly, in 150,000 people, a higher intake of dietary beta-carotene was linked to a decreased risk of all-cause mortality [58].
In over 29,000 men, those with higher serum beta carotene had significantly lower overall, heart disease, stroke, and cancer mortality [59].
However, in a meta-analysis of 53 trials (over 240,000 participants), beta-carotene supplementation in a dose above the RDA (9.6 mg/day) was associated with slightly increased mortality [60].
Again, dietary and blood levels of beta-carotene mirror fruit and vegetable intake, which are beneficial for health in general.
Beta-carotene: The Bad
1) Increases Cancer and Heart Disease Risk in Smokers
In two large trials, supplementation with beta-carotene increased the risk of lung cancer. Subjects in these studies were predominantly cigarette smokers, and the adverse effects were more pronounced among those who also drank alcohol [61].
The first trial involved 18,000 participants at high risk for lung cancer because of a history of smoking or asbestos exposure. It was stopped ahead of schedule in 1996 when it became obvious that people randomly assigned to beta-carotene supplements had a 28% increase in the incidence of lung cancer, a 17% increase in death, and a 26% higher rate of heart disease mortality compared with the participants in the placebo group [62, 63].
In the second trial, beta-carotene increased the risk of getting a heart attack and lung cancer in 29,000 male smokers. The risk was not dependant on the tar or nicotine content of cigarettes smoked [64, 65].
In a study of 864 subjects with colon cancer who had the cancer removed, beta-carotene markedly decreased the risk of recurrent cancer in those who neither smoked cigarettes nor drank alcohol. There was a modest increase in the risk of recurrence among those who smoked. However, for those who smoked cigarettes and also drank more than one alcoholic drink per day, beta-carotene doubled the risk of colon cancer recurrence [61].
Beta-carotene supplements increased the risk of stroke (intracerebral hemorrhage) by 62% in a study with over 28,000 cigarette smokers [66].
Mechanisms
Benzyo[a]pyrene (BaP), present in tobacco smoke, has a well-known carcinogenic track record. It gets activated upon conversion into benzo[a]pyrene diol epoxide (BPDE), which is highly mutagenic. Protection against BPDE is provided by GSTs (glutathione S-transferases). However, beta-carotene blocks GTS function [18, 19].
In addition, carotenoid breakdown results in some very reactive products that increase oxidative stress. These are normally neutralized by other antioxidants, such as vitamins C and E, but smoking decreases their levels [67, 68].
2) Increases Cancer and Heart Disease Risk When Used With Alcohol
Alcohol (ethanol) interferes with the conversion of beta-carotene into vitamin A [69].
In smokers who also consume alcohol, beta-carotene supplementation promotes lung cancer and, possibly, heart disease [69].
3) Excess Supplementation May Increase Mortality
A meta-analysis of 53 trials with over 240,000 participants suggests that beta-carotene supplementation in a dose above 9.6 mg/day may slightly increase mortality [60].
Normal Range
Beta-carotene is not a routine test. But it is possible to test it using a simple blood test. Women will usually have slightly higher levels than men [5].
Normal levels for men are around 4 – 51 ug/dL (micrograms per deciliter) and for women 6 – 77 ug/dL. Levels may vary slightly between laboratories.
Low Beta-carotene Levels
Causes of Low Beta-carotene Levels
Causes shown here are commonly associated with low beta-carotene levels. Work with your doctor or another health care professional to get an accurate diagnosis.
1) Malnourishment
Beta-carotene levels are a good indicator of your fruit and vegetable intake, and your overall dietary habits [70].
Beta-carotene levels are low in inadequately nourished children and in those who it few vegetables and fruits [71].
A review of 7 articles including around 4500 European adolescents, showed that beta-carotene deficiency was quite prevalent, affecting 14 – 19% [72].
2) Obesity
Overweight and obese people tend to have lower beta-carotene levels than people with healthy weight [73, 74].
In a study with 92 healthy overweight subjects receiving beta-carotene supplements, those with higher BMI had lower circulating beta-carotene levels [75].
3) Smoking
Smoking decreases beta-carotene levels [70, 76].
4) Alcohol Consumption
Drinking alcohol also decreases beta-carotene levels [70].
5) Diseases that Impair Nutrient Absorption
Cholestatic liver disease can cause problems with the absorption of nutrients in the gut. In an observational study of 53 children with cholestatic liver disease, more than 80% had low beta-carotene levels [77].
Sometimes, and especially in developing countries, parasites can interfere with the absorption of nutrients in the gut. Studies show that in children, deworming (antihelminthic) therapy helps increase beta-carotene levels [78].
Beta-carotene deficiency is common in all stages of HIV/AIDS. This disease can cause diarrhea and prevents the small intestine from absorbing fats, which leads to decreased beta carotene levels in the blood [79].
However, clinical trials have not shown any beneficial effects of beta-carotene supplementation. Low beta-carotene levels tend to reflect a more active HIV-1 infection rather than a deficiency amenable to intervention [80, 81].
6) Hyperthyroidism
In various studies, patients with hyperthyroidism, or overactive thyroid, had decreased beta-carotene levels [82, 83].
7) Birth Control Pills
In an observational study of 150 women, the ones that took birth control pills (oral contraceptives) had lower beta-carotene levels than the ones that didn’t [76].
How to Increase Beta-carotene Levels
The most important thing is to work with your doctor to find out what’s causing your low beta-carotene levels and to treat any underlying conditions.
Discuss the lifestyle changes listed below with your doctor. None of these strategies should ever be done in place of what your doctor recommends or prescribes!
The best way to boost your beta-carotene levels is to increase the amount of beta-carotene-rich foods in your diet. Good sources, include [2, 5, 1, 6]:
- Fruits (apricots, peaches, persimmons, melon, watermelon, citrus, tomatoes)
- Green vegetables (spinach, broccoli, parsley, collard greens)
- Orange tuber vegetables (carrots, sweet potatoes)
- Animal tissues and products (salmon, egg yolk, butterfat)
Fiber can interfere with beta-carotene absorption. That is why fruit and vegetable juices are a better source of this nutrient than whole fruits/vegetables [8].
But what’s even better is adding fats to your beta-carotene rich meals. Dietary fats increase the bioavailability of carotenoids from meals. For example, studies show that avocado increases both beta-carotene absorption by 2.4 to 6.6-fold and also improves the conversion to vitamin A by 4.6 – 12.6-fold [9].
Similarly, mayonnaise can increase the absorption of beta-carotene. A study has found that mayonnaise-containing meal is a better source of beta-carotene than fruit/vegetable juice [10, 11].
Processed vegetables, such as carrots and spinach, are a better source of beta-carotene than their raw counterparts [84].
Consuming greater amounts of plant sterols that reduce cholesterol absorption reduces beta-carotene bioavailability [85]. Plant sterols are found in wheat germ, vegetable oils (corn, sesame, canola and olive oil), peanuts, almonds, and fortified foods. However, these foods are healthy for heart health because they also decrease cholesterol.
Lose weight if overweight. People who are obese/overweight have lower beta-carotene levels [73].
Avoid smoking and alcohol [70, 76].
Avoid lutein supplements, they decrease the absorption of beta-carotene [86, 87].
High Beta-carotene Levels
Causes of High Beta-carotene Levels
Causes shown here are commonly associated with high beta-carotene levels. Work with your doctor or another health care professional to get an accurate diagnosis.
1) Dietary Intake
Excessive dietary intake of beta-carotene rich foods will cause your beta-carotene levels to rise, as well as potentially cause vitamin A toxicity [88]. This, however, is extremely rare and happens only with highly specific diets.
Beta-carotene conversion to vitamin A decreases as the dietary dose increases, protecting us in most cases from vitamin A toxicity [89].
2) Hypothyroidism
People with hypothyroidism (underactive thyroid) have significantly higher beta-carotene levels [82, 83].
Symptoms of Excess Beta-carotene
Excess consumption of beta-carotene-rich foods can cause vitamin toxicity. Symptoms include [88, 90, 91]:
- Headache
- Nausea
- Vomiting
- Fatigue
- Dizziness
- Weight loss
- Hair loss
- Dry skin
- Diarrhea
- Muscle pain
How to Decrease Beta-carotene Levels
The most important thing is to work with your doctor to find out what’s causing your high beta-carotene levels and to treat any underlying conditions.
Discuss the lifestyle changes listed below with your doctor. None of these strategies should ever be done in place of what your doctor recommends or prescribes!
If you have vitamin toxicity, your doctor may recommend decreasing the amount of beta-carotene-rich foods in your diet for a while. You should avoid fruit and vegetable juices in favor of whole fruits and vegetables [8].
You can consume greater amounts of plant sterols that reduce cholesterol absorption and reduce beta-carotene bioavailability [85]. Plant sterols are found in wheat germ, vegetable oils (corn, sesame, canola and olive oil), peanuts, almonds, and fortified foods.
Genes Associated With Beta-carotene Levels
BCO1
The BCO1 (beta-carotene oxygenase 1) gene produces the enzyme responsible for converting beta-carotene into vitamin A (retinoid), thereby supporting vision, reproduction, and immune function [92]. 5 SNPs in this gene were linked to blood beta-carotene levels and the efficiency of beta-carotene conversion into vitamin A.
| SNP | High enzyme activity/Lower blood beta-carotene levels | Low enzyme activity/Higher blood beta-carotene levels | Reference |
| rs7501331 | CC | T (32% lower enzyme activity, 1.6 times higher beta-carotene levels) | 93 |
| rs7501331 & | CC & AA | T in both SNPs ( 69% lower enzyme activity, 2.4 times higher beta-carotene levels) | 93 |
| rs6564851 | TT | GG (48% lower enzyme activity); lower macular pigment optical density* | 94, 95, 96, 97 |
| rs11645428 | AA | GG (51% reduced activity); lower macular pigment optical density* | 94, 97 |
| rs6420424 | GG | AA (59% reduced activity); lower macular pigment optical density* | 94, 97 |
* The higher the macular pigment density, the better the visual performance. People with higher density have a lower risk for certain eye diseases [97, 98].
A missense mutation in this enzyme, T170M, leads to elevated beta-carotene levels and mild vitamin A deficiency [99].
BCO2
If carotenoids accumulate in mitochondria, they interfere with mitochondrial function and cause oxidative stress. In fact, this may help explain the adverse health effects of excess beta-carotene reported in clinical studies [100, 101].
BCO2 (beta-carotene oxygenase 2) is a key enzyme that prevents oxidative stress by breaking down beta-carotene in the mitochondria [101]. BCO2 breaks down beta-carotene in a different fashion from BCO1, without producing vitamin A.
The following SNPs in the BCO2 gene are related to increased inflammation, through the production of inflammatory cytokines (IL-18):
- rs2115763 – the minor variant T is linked to higher IL-18 levels [102]
- rs2250417 – the minor variant C increases IL-18 levels [103, 104]
