The Intake, Supplementation and Blood Concentrations of Carotenoids in the Prevention of Cardiovascular Diseases: Insights From an Umbrella Meta-Analysis

Background: Cardiovascular disease (CVD) remains a significant global health burden, while carotenoids are considered to have beneficial protective effects against CVD. Thus this study aimed to synthesize available relevant findings regarding the potential correlation between carotenoid consumption (including α/β-carotene, β-cryptoxanthin, lutein, lycopene, zeaxanthin, and astaxanthin) and CVD risk through an umbrella meta-analysis and systematic reviews. Methods: Literature searches were conducted in four online academic databases, including PubMed, Web of Science, Embase, and the Cochrane Library, as well as in the literature reference lists of existing meta-analyses and systematic reviews. The search was completed with a cutoff date of July 2023. Results: The association between carotenoids, including blood, carotenoid intake, and carotenoid supplements, and CVD risk was estimated as an odds ratio (OR) of 0.889 (95% confidence interval (95% CI): 0.857–0.922; p < 0.001), indicating a notable protective association. Furthermore, our analysis demonstrated that the protective impact of carotenoids on total CVD was the most significant for coronary heart disease (OR = 0.875; 95% CI: 0.822–0.932) and stroke (OR = 0.815; 95% CI: 0.734–0.906). Conclusions: By controlling for the confounding effects of heterogeneity, including clinical heterogeneity, methodological heterogeneity, and statistical heterogeneity, and publication bias, including positive result enrichment bias, duplicate publication bias, selective study inclusion bias, and selective bias in data extraction and analysis, etc., this study conducted a methodical assessment of the correlation between carotenoids and clinical outcomes of CVD, demonstrating significant inverse relationships between multiple carotenoids and both CVD incidence and mortality of CVD.