When 3.9 µmol/kg per day of L or Z for 24 to 101 weeks were supplemented, the rhesus monkeys showed significant increases in their corresponding serum, retinal, and adipose tissue concentrations. In their retina samples, L and meso-Z, but not Z, appeared in the L-supplemented group, while only Z was found in the group supplemented with Z. In humans, a study investigating the serum and macular responses of L, Z, and meso-Z from dietary supplements found that 13.13 mg/d for 12 weeks provided maximum MPOD improvement, whereas 7.44 mg/d was the amount that increased serum levels at the highest efficacy. These and other studies support the need for dietary recommendations for L and Z, particularly as conditionally essential nutrients due to their protective effects on eye health. Lutein and Z fulfill many criteria as essential nutrients, including high concentrations in select tissues, biological plausibility for eye health, depletion outcomes such as vision impairment in primates, and inverse associations with certain diseases. In addition to their role in eye health, L and Z are involved in cognitive function at all stages of life. A randomized controlled trial reported that L and Z supplementation improved neural efficiency and learning performance by increasing the interaction of numerous brain regions in older adults.
Other reports have demonstrated an association between L intake or circulating levels and preserving age-related cognitive decline, dutch bucket for tomatoes reducing the risks of certain cancers, coronary heart disease, stroke, metabolic syndrome, and achieving higher levels of physical activity. A systematic review of in vivo, ex vivo, and in vitro studies concluded that L may benefit vascular health by improving endothelial function, reducing inflammation, regulating favorable lipid profiles, and maintaining glucose homeostasis. Systematic reviews summarizing the amount of L needed for cognitive functions and enhancement of gray matter volume estimated that at least 10 mg/d for 12 months could be beneficial. Age must be considered when creating DRI values, since MPOD values are lower in older compared to younger individuals. Whether the proposed intake of L and Z should be based on the amount that can reduce AMD risk, benefit visual maturation in newborns, protect cognitive health, or reduce the risk of other diseases requires further consideration. Sex differences in AMD prevalence must also be considered, especially in relation to pregnancy and lactation, as discussed above. Nevertheless, L and Z are not included for DRI consideration due to inadequate details from food databases, limited large-scale dietary intake studies, and insufficient knowledge regarding their metabolism and biological functions.
Many continue to advocate for a DRI for L, since it satisfies all nine criteria for bio-active compounds. A rich dietary source of L and Z is goji berry, , also called wolfberry or Gou Qi Zi. The bright orange-red colored oval fruit, has been used for millennia in traditional Chinese medicine for its role in visual health, to provide immunoregulatory, neuro-protective, and anti-inflammatory benefits, and to help regulate liver and kidney meridians . Commercially-available goji berries and their products come primarily from the Ningxia and Xinjiang autonomous regions in western China. Goji berry is known for its high amount of carotenoids, with the Z content higher than any other known food.140,141 In addition to carotenoids, other bioactive compounds found in goji berries include Lycium barbarum polysaccharides , flavonoids, vitamins, minerals, betaine,cerebrosides, phenolic acids, and certain amino acids which may also support the overall health of the eye, particularly when working synergistically. Although the TCM use of goji berry also includes the leaves and bark of the plant, this review will discuss the potential benefits of the fruit on eye health. In addition to a robust amount of Z, goji berries contain modest amounts of β-cryptoxanthin, β- carotene, neoxanthin and L.
The Z and L content among different varieties of dried goji berries cultivated in Ningxia province ranged from 25 to 152 mg/100g, and 0.3 to 1.9 mg/100g, respectively.143 According to the United States Department of Agriculture food database, one serving of goji berries is 28 g, which would provide up to 42.6 mg of L + Z, depending on the cultivar. Moreover, the predominant form of Z in goji berries is a dipalmitate, found with a diester linkage. The ratio of Z dipalmitate to total carotenoids was up to 55% and 88%, in fresh and dried goji berry fruit, respectively. This esterified form of Z showed a significantly higher intestinal absorption than monoester and free Z due to the high efficacy of hydrolysis, mainly by carboxyl ester lipase. Plasma Z was significantly increased in individuals consuming 15g goji berries daily for 28 days in comparison to those on a habitual diet. Participants consuming 5 mg of Z dipalmitate extracted from goji berries showed a higher plasma Z concentration than when they consumed the same amount as unesterified Z over a nine to 24 hour period. The high Z content of goji berries has been proposed as a dietary source to reduce the risk of AMD, although studies are limited. In one study, circulating Z levels were significantly higher in healthy older individuals who consumed 10 mg of Z extract from goji berries daily for 90 days. No change in macular pigmentation or soft drusen was observed, but MPOD was not measured. In an uncontrolled trial, individuals with early stage AMD who consume a beverage containing 12 mg of L and 2 mg of Z derived from marigold flower and goji berry, respectively, daily for five months, showed higher circulating levels of L and Z, lower intraocular pressures, and better best-corrected visual acuity scores. Unfortunately, the study lacked a control group, did not test the effect of Z separately, and did not clarify whether the form of Z extracted from goji berry was the dipalmitate. Another study investigating the effects of an herbal formula among healthy adults with dry eyes noted that those chewing tablets containing L , Z , extracts from blackcurrant, chrysanthemum, and goji berry showed dose-dependent reductions in eye fatigue symptoms, improved tear secretion as well as MPOD, compared to placebo. The basis of this formula was derived from TCM, so the multi component formulation could not directly inform the role of any single ingredient. A study in patients with early AMD reported that the MPOD was significantly higher in those consuming 25 g/day of goji berries for 90 days, compared to their baseline levels and to a habitual diet control group. The BCVA was also significantly improved in the goji berry group compared to their baseline values.We recently reported that MPOD and skin carotenoid scores were increased in healthy middle-aged individuals consuming 28 g/day of goji berries five times a day for 90 days compared to a group taking a supplement with 6 mg of L and 4 mg of Z.These results illustrate that MPOD levels can increase in healthy individuals even without early signs of AMD. While these results are encouraging, longer intervention periods with a larger number of participants are necessary. In addition to AMD, goji berries have been studied as a therapy for retinitis pigmentosa, an inherited retinal disease. Patients who consume 0.35 g/d of LBP for 12 months showed a significant improvement in visual acuity and macular thickness, compared to control subjects who did not consume L or Z.156 Examples of human studies that evaluated the effects of supplements containing goji berries on retinal health are shown in Table 1. Based on preclinical evidence, potential benefits of goji berry intake on glaucoma and diabetic retinopathy may also exist. Goji berry extract ameliorated the high glucose-induced blood-retinal barrier disruption in human retinal pigment epithelial cells.Studies reported that LBP showed significant neuroprotective effects over retinal ganglion cells in male C57BL/6N mice and Sprague-Dawley rats with ocular hypertension.In db/db mice, goji berry extract restored the thickness of the retina, the ganglion cell number, blueberry grow pot and the integrity of RPE after daily intake over eight weeks.Although research on the upper limit of goji berry intake is scarce, goji berry allergy risk has been associated with the existence of cross-reactivity to nonspecific lipid transfer proteins from peaches, tomatoes, tobacco, tree nuts, and select pollens.In addition, bleeding symptoms after consuming goji berry juice, tea, or wine have been described in case reports among patients taking warfarin, an anticoagulant medicine.
Although the potential value of foods high in L and Z during pregnancy and lactation has been discussed above, the utilization of goji berry products during these unique periods in a woman’s life needs special caution. Clinical studies of goji berries on eye health have been conducted primarily in Asia, with emerging research reported from Italy, Lithuania, and Switzerland.Potential gene-nutrient interactions must be considered when comparing results from Asian with Caucasian populations.Macular xanthophylls cannot be synthesized de novo in primates. The oxidative defense and blue light filtering characters of L, Z, and meso-Z are important for visual function and potentially reducing the risk of AMD. Because L and Z storage in the maternal body during pregnancy and lactation may become depleted due to active transfer to the offspring, more attention to safe and robust intake of foods and dietary supplements containing these xanthophylls is warranted. Since many infant formula products are not fortified with L or Z, addition of these two xanthophylls should also be considered. The impact of foods and dietary supplements rich in L and Z on MPOD and visual function among AMD patients and in healthy individuals deserves further attention. Since Z may play a different role than L in terms of macular pigment development or protection, better analytical techniques are needed to reassess food composition databases to distinguish these compounds, with greater attention paid to Z as a stand-alone food component, rather than grouping it with other xanthophylls. Goji berries have the highest known content of Z of any commonly consumed food, which also comes in a unique dipalmitate form. Given the increasing rates of AMD worldwide, goji berries, along with L and Z supplements, may help reduce this escalation. As of 2010, safe and accessible drinking water has been explicitly recognized as a human right by the United Nations General Assembly and deemed essential for public health and economic prosperity. Despite this designation, 785 million people lack essential drinking water services globally, and at least two billion people use drinking water sources contaminated with feces. Diseases like cholera, diarrhea, dysentery, hepatitis, typhoid, and polio are linked to such sources of contamination . Despite the risks associated with a lack of essential water services, many drinking water utilities face challenges meeting regulations due to limited water supply, strict budgets, high demands due to population growth, aging infrastructure, and increasingly strict regulations for water quality. Analytical testing and water quality monitoring must be carried out regularly to ensure water is free from priority biological and chemical contamination. Unfortunately, these methods often take multiple days to conduct, in which case contaminated water may already have had negative impacts on public health. These challenges can contribute to public water utilities violating regulations established by the EPA, increasing interest in solutions such as point-of-use filtration, and real-time water quality monitoring. Even if violations are not observed from water utilities there is still potential for contamination between treatment and the tap. This contamination can source back to community water system’s distributional networks and property owner’s premise plumbing . Before reaching taps, consumers can install POU drinking water treatment systems in their water supply lines to provide on-site treatment to the water they consume. These systems encompass many treatment technologies such as membranes, filtration, UV disinfection, activated carbon, etc. The utility of implementing POU filtration shows in its ability to reduce contamination’s acute and chronic health effects. Still, there is little evidence of commercially available technologies to improve the “smartness” of point-of-use water systems in terms of their ability to perform tasks such as monitoring and reporting on water quality Possible ways to enhance the smartness of point-of-use filters include integrating Internet of Things enabled sensor technologies. Commercially available sensors measure parameters including pH, oxidation-reduction potential , and electrical conductivity , which can all be affected by chemical and biological contaminants—making these parameters effective indicators for the overall water quality as well as capable of detecting changes in water quality. When combined with the integrated circuit microcontrollers and micro processing technologies that have emerged in the last decade, there has become a platform for developing robust and customizable data loggers for relatively low costs.