Wellness Foods + Supplements 1/2022

AMD and micronutrients
affects blue-sensitive photoreceptor cells.
With AMD, the perception of blue and
violet is therefore the first to fail. The colour
impression shifts towards grey to brown. It
could be shown that low carotenoid concentrations
in the macula are causally involved
in the development of AMD and can predict
corresponding eye damage with lead times
of around 20 years. (5) The macular pigment
lutein must be ingested with food because
the body cannot synthesize it from other
carotenoids such as β-carotene. The structurally
related carotenoid zeaxanthin, on the
other hand, can be synthesized from lutein
if required. A recent review that evaluated
data from more than 900 participants with
AMD showed significant improvements in
visual acuity and contrast sensitivity. Accordingly,
supplementation of lutein increases
the pigment content of the macula in a dosedependent
manner. (6)
Improving bioavailability through
phospholipids
Coenzyme Q10 and lutein are not soluble in
water and only have a limited solubility in fats.
The active ingredients tend to agglomerate
in the gastrointestinal tract when supplemented
in powder capsule or tablet form.
As a result, only molecules on the surface
of the agglomerates can be absorbed by the
enterocytes of the small intestine, while the
majority pass through the body unchanged.
However, a significant improvement in bioavailability
can be achieved by forming emulsions
with natural phospholipids (lecithin), in
which the active ingredients are present in
small droplets coated with lecithin (Fig. 5).
Lecithin is also a natural component of bile
that facilitates the absorption of dietary fats
and fat-soluble nutrients. A crossover study
was able to show that the bioavailability of
coenzyme Q10 can be improved by a factor
of five with an appropriate formulation. (7)
For more information, please contact
Philipp Gebhardt
65779 Kelkheim, Germany
p.gebhardt@mitotherapie.de
Conclusion
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Fig. 5: Improvement of the bioavailability of
coenzyme Q10 by formulation with lecithin: Coenzyme
Q10 is packaged in ultra-small droplets
with natural phospholipids [1]. The absorption
of the coenzyme begins in the mouth via the oral
mucosa [2]. The lecithin shell protects the active
ingredients from the harsh environment of the
stomach [3]. Lecithin is a natural component of
bile that facilitates the digestion of dietary fats
and fat-soluble nutrients [4]. The prepackaged
coenzyme Q10 can be absorbed much better
by the enterocytes of the small intestine [5]. In
the enterocytes, fat-soluble nutrients are packed
into chylomicrons or lipoproteins with the help
of phospholipids [6]. For systemic distribution,
the coenzyme Q10-containing chylomicrons are
released into the lymph and the coenzyme Q10-
containing lipoproteins into the blood [7].
The development of age-related macular
degeneration is promoted by a low carotenoid
content in the macula. The carotenoid lutein
can improve the eye’s natural sun protection
and thus reduce the harmful effects of light
and the light-induced formation of oxygen
radicals. Antioxidants such as coenzyme
Q10 can increase the neutralization capacity
for oxygen radicals and help to protect the
eyes. In addition to its antioxidant effect,
coenzyme Q10 is characterized by the fact
that it improves the function of the respiratory
chain and contributes to energy production.
In addition to a low intake of lutein with
food, smoking and high blood pressure are
considered risk factors for AMD. (8) In addition,
increased concentrations of the toxic
metabolic intermediate homocysteine and
reduced vitamin B12 levels have also been
identified as risk factors. (9)
3
Enterozyte
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5
4
References
(1) Brandl, C., Stark, K. J., Wintergerst, M., Heinemann,
M., Heid, I. M., & Finger, R. P. (2016). Epidemiologie der
altersbedingten Makuladegeneration. Der Ophthalmologe,
113(9), 735-745.
(2) Suter, M., Remé, C., Grimm, C., Wenzel, A., Jättela, M.,
Esser, P., ... & Richter, C. (2000). Age-related macular
degeneration the lipofuscin componentn-retinyl-n-retinylidene
ethanolamine detaches proapoptotic proteins
from mitochondria and induces apoptosis in mammalian
retinal pigment epithelial cells. Journal of Biological
Chemistry, 275(50), 39625-39630.
(3) Feher, J., Kovacs, B., Kovacs, I., Schveoller, M., Papale,
A., & Gabrieli, C. B. (2005). Improvement of visual functions
and fundus alterations in early age-related macular
degeneration treated with a combination of acetyl-L-carnitine,
n-3 fatty acids, and coenzyme Q10. Ophthalmologica,
219(3), 154-166.
(4) Arnold, C., Winter, L., Fröhlich, K., Jentsch, S.,
Daw czynski, J., Jahreis, G., & Böhm, V. (2013). Macular
xanthophylls and ω-3 long-chain polyunsaturated fatty
acids in age-related macular degeneration: a randomized
trial. JAMA ophthalmology, 131(5), 564-572.
(5) Arunkumar, R., Calvo, C. M., Conrady, C. D., & Bernstein,
P. S. (2018). What do we know about the macular
pigment in AMD: the past, the present, and the future.
Eye, 32(5), 992-1004.
(6) Feng, L., Nie, K., Jiang, H., & Fan, W. (2019). Effects of
lutein supplementation in age-related macular degeneration.
PloS one, 14(12).
(7) Wajda, R., Zirkel, J., & Schaffer, T. (2007). Increase of
bioavailability of coenzyme Q10 and vitamin E. Journal of
medicinal food, 10(4), 731-734.
(8) Hyman, L., & Neborsky, R. (2002). Risk factors for agerelated
macular degeneration: an update. Current opinion
in ophthalmology, 13(3), 171-175.
(9) Rochtchina, E., Wang, J. J., Flood, V. M., & Mitchell, P.
(2007). Elevated serum homocysteine, low serum vitamin
B12, folate, and age-related macular degeneration: the
Blue Mountains Eye Study. American journal of ophthalmology,
143(2), 344-346.
30 No. 1 April/May 2022