Skin

Eight (8) publications meeting criteria for this review were available. Data suggest (6 of 8 reports) a beneficial effect of tomato/tomato-based foods intake and protection from UV light induced erythema. Of note however is that much of the work supporting this conclusion is from a single laboratory. Additional research from other laboratories is warranted. Research indicates that the protective effect of tomato intake may depend on increased carotenoid and lycopene concentrations in skin tissue.

Lycopene Supplementation and Disease Risk
Main findings

• Data suggest a beneficial effect of lycopene supplementation (> 8 weeks) in reducing UV light-induced erythema.
  
• Effect may depend on increased carotenoid and lycopene in skin.
  
• 1 RCT (n=80) suggests topical benefits for skin structure, firmness, and condition in postmenopausal women

Summary of studies and outcomes

Lycopene Supplementation and Disease Risk

This section critically evaluates the relationship between lycopene supplementation and skin protection measured by:

UV light-induced erythema
General skin condition

Category	Disease type	First Author	Study Title and Complete Citation	Date	Abstract	Study Type	G.Tom +, N,	P.Tom +, N,	F.Tom +, N, -	Lyco +, N,	Other +, N, -
Lycopene	Skin	Aust O	Supplementation with	+	Carotenoids are suitable photoprotectants, and beta-carotene supplements are used for protection against ultraviolet (UV)	RCT				(-)	(+)
Supplement			tomato-based products		light-induced erythema. Protective effects are also observed when carotenoids are provided with the diet. Here, we
and Disease			increases lycopene,		investigated the photoprotective effects of synthetic lycopene in comparison with a tomato extract (Lyc-o-Mato) and a drink					↓	↑ serum &
Risk			phytofluene, and phytoene levels in human serum and protects against UV-light-induced erythema. Aust O, Stahl W, Sies H, Tronnier H, Heinrich U. Int J Vitam Nutr Res. 2005 Jan;75(1):54-60.		containing solubilized Lyc-o-Mato (Lyc-o-Guard-Drink). With these different sources, the volunteers ingested similar amounts of lycopene (about 10 mg/day). After 12 weeks of supplementation, significant increases in lycopene serum levels and total skin carotenoids were observed in all groups. Significant increases in the serum levels of phytofluene and phytoene occurred in the Lyc-o-Mato and the Lyc-o-Guard-Drink group. At weeks 0, 4, and 12 an erythema was induced with a solar light simulator. Dorsal skin of each subject was irradiated with 1.25 minimal erythemal dose (MED). Reddening of the skin was evaluated before and 24 hours after irradiation by chromametry and expressed as positive a-values (red/green-axis). delta a-values (difference of a-value before irradiation and after 24 hours) were used as an index of erythema intensity. A decrease in the delta a-value from week 0 to week 12, indicating prevention of erythema formation, was observed in all groups. Compared to week 0, the delta a-value at week 12 was 25% lower in the synthetic lycopene group. The protective effect was more pronounced in the Lyc-o-Mato (38%) and Lyc-o-Guard-Drink (48%) groups. In the two latter groups, phytofluene and phytoene may have contributed to protection. Both of these carotenoids exhibit absorption maxima at wavelengths of UV light. Absorption of UV light protects skin from photodamage and might explain the differences observed between groups.					erythema	skin [lyco] with DS
Lycopene	Skin	Greul AK	Photoprotection of UV	2002	Endogenous antioxidants are decreased in skin and blood during UV exposure. Combined supplementation of beta-carotene,	RCT				N	Slight ↓ in
Supplement			irradiated human skin: an		alpha-tocopherol and ascorbic acid in addition to topical sunscreens may help to lower the risk of sunburning. Acute UV						MMP-1
and Disease			antioxidative combination		erythema with sunburn reaction are the most important factors in conjunction with the cumulative life-long UV dose for inducing						with
Risk			of vitamins E and C, carotenoids, selenium and proanthocyanidins. Greul AK, Grundmann JU, Heinrich F, Pfitzner I, Bernhardt J, Ambach A, Biesalski HK, Gollnick H. Skin Pharmacol Appl Skin Physiol. 2002 SepOct;15(5):307-15.		skin damage resulting in photoageing and precancerous and cancerous lesions. Therefore, a clinical, randomized, double-blind, parallel group, placebo-controlled study was conducted in healthy young female volunteers (skin type II) investigating the preventive, photoprotective effect of supplementation with Seresis, an antioxidative combination containing both lipid and water-soluble compounds: carotenoids (beta-carotene and lycopene), vitamins C and E, selenium and proanthocyanidins. In this study, the oral administration of Seresis appeared to be well tolerated. The preparation contains antioxidant compounds in quantities occurring at physiological levels and can therefore be used safely over a long period of time. Despite the fact that the assessment of the light sensitivity (minimal erythemal dose, chromametry) of the skin did not show any statistically significant differences between the Seresis and the placebo group, a clear statistical trend, however, could be demonstrated, i.e. Seresis was able to slow down the time of the development and grade of UVB-induced erythema. The primary efficacy parameter matrix metalloproteinases 1 (MMP-1) between treatment and placebo group following UV irradiation showed a significant difference (p < 0.05), which occurred due to the fact that after a 2-week UV irradiation, MMP-1 slightly increased (p < 0.03) in the placebo group and decreased (p < 0.044) in the treated group. The MMP-9 changes showed a clear tendency of decrease in the Seresis group (p < 1.393) and increase (p < 0.048) in the placebo group. These data emphasise that supplementation with Seresis decreases the UV-induced expression of MMP-1 and 9, which might be important in photoprotective processes. From our data, we thus finally draw the conclusion that by the combination of antioxidants, such as in the formulation of Seresis, a selective protection of the skin against irradiation can be achieved. This might be important for future recommendations for immediate suppression of the early phase of UV-induced erythema, that means pharmacological prevention of sunburn reaction as well as subsequent chronic skin damage.						supple

Tomato/Tomato-based foods and Disease Risk
Main findings

• Data suggest a beneficial effect of tomato intake (> 8 weeks) in reducing UV light-induced erythema; however, supporting data comes from a single lab and there are multiple overlaps in study design and subject population.
  
• Additional research is warranted in other laboratories.
  
• Effect may depend on increased carotenoid and lycopene in skin.

Summary of studies and outcomes

Tomato/Tomato-based foods and Disease Risk

This section critically evaluates the relationship between lycopene supplementation and skin protection measured by:

UV light-induced erythema

Category	Disease type	First Author	Study Title and Complete Citation	Date	Abstract	Study Type	G.Tom +, N,	P.Tom +, N,	F.Tom +, N, -	Lyco +, N,	Other +, N,
Tomato/tomato based Foods and Disease Risk	Skin	Naldi L	Dietary factors and the risk of psoriasis. Results of an Italian case-control study. Naldi L, Parazzini F, Peli L, Chatenoud L, Cainelli T. Br J Dermatol. 1996 Nov;135(5):858.	1996	We have conducted a case-control study to explore the relation between the consumption of selected foods and psoriasis. The out-patient services of nine teaching hospitals and five general hospitals in northern and southern Italy took part. Cases were newly diagnosed psoriatics with a history of skin problems of no more than 2 years. As controls, we selected subjects with newly diagnosed skin conditions, other than psoriasis, who were seen in the same out-patient clinics. Inclusion of cases and controls was limited to the age group 16-65 years. A total of 316 psoriatics and 366 controls were recruited. Anthropometric measures, including height and weight, were obtained. Diet was assessed by a semiquantitative food frequency questionnaire. Psoriasis appeared to be positively associated with body mass index (chi 2(1) trend 4.3, P < 0.05). Significant inverse relations with psoriasis were also observed for the intake of carrots (chi 2(1) trend 4.8, P < 0.05), tomatoes (chi 2(1) trend 26.3, P < 0.01), fresh fruit (chi 2(1) trend 11.7, P < 0.01) and index of beta-carotene intake (chi 2(1) trend 9.1, P < 0.01). Although largely explorative, these results provide some evidence for a potential role of diet in psoriasis.	CC	(-) ↓ risk psoriasis
Tomato/tomatobased Foods and Disease Risk	Skin	Sies H	Non-nutritive bioactive constituents of plants: lycopene, lutein and zeaxanthin. Sies H, Stahl W. Int J Vitam Nutr Res. 2003 Mar;73(2):95-100.	2003	Lycopene, lutein, and zeaxanthin are major carotenoids in human blood and tissues but unlike beta-carotene do not contribute to vitamin A supply. These carotenoids are efficient antioxidants quenching singlet molecular oxygen which is formed in photooxidative processes and thus may contribute to the prevention of light-exposed tissue, skin and eyes, from light-induced damage. Increasing lycopene intake by daily consumption of tomato paste over a period of ten weeks provides protection against erythema formation following UV-irradiation. Lycopene and other carotenoids may be used as oral sun protectants and contribute to the maintenance of skin health. The yellow color of the macula lutea is due to the presence of the carotenoid pigments lutein and zeaxanthin. These macula carotenoids are suggested to play a role in protection against light-dependent damage. Filtering of blue light and scavenging of reactive intermediates generated in photooxidation are considered to be the underlying protective mechanisms. Epidemiological studies provide evidence that an increased consumption of lutein is associated with a lowered risk for age-related macular degeneration, a disease with increasing incidence in the elderly.	Interv		(-) ↓ erythema

 

Category	Disease type	First Author	Study Title and Complete Citation	Date	Abstract	Study Type	G.Tom +, N,	P.Tom +, N,	F.Tom +, N, -	Lyco +, N,	Other +, N,
Tomato/tomato-	Skin	Skovgaard GR	Effect of a novel dietary	2006	OBJECTIVE: The aim of the present study was to quantify the effects on skin in post-menopausal women of a novel dietary	RCT				(-)
based Foods			supplement on skin aging		supplement (Imedeen Prime Renewal) that contained soy extract, fish protein polysaccharides, extracts from white tea, grape
and Disease			in post-menopausal		seed and tomato, vitamins C and E as well as zinc and chamomile extract.					↓
Risk			women. Skovgaard GR, Jensen AS, Sigler ML. Eur J Clin Nutr. 2006 Oct;60(10):1201-6. Epub 2006 May 3.		DESIGN: The study was a 6-month double blind, placebo controlled, randomized study on healthy post-menopausal females. SETTING: The study was performed at a commercial Contract Research Organisation (TJ Stephens & Associates Inc., TX, USA). INTERVENTIONS: Two tablets of Imedeen Prime Renewal or placebo were given twice daily for 6 months. SUBJECTS: Thirty-eight (active group) and 42 (placebo group) subjects completed the study out of 100. RESULTS: Clinical grading showed that the active group had a significantly greater improvement (P < 0.05) compared to placebo for the face after 6 months treatment for: forehead, periocular and perioral wrinkles, mottled pigmentation, laxity, sagging, under eye dark circles and overall apperance; skin on the decolletage after 2, 3 and 6 months treatment and skin on the hand after 3 and 6 months treatment. Photo evaluation showed that the active group had a significantly greater improvement (P < 0.05) on the face after 3 and 6 months for several parameters. Ultrasound measurements showed that the active group had a significantly greater improvement (P < 0.0001) for density measurements after 6 months treatment. CONCLUSION: In summary, this novel dietary supplement, Imedeen Prime Renewal, provides improved condition, structure and firmness of the skin in post-menopausal women after 6 months.					wrinkles, pigmentati oin, skin sagging ↑ skin firmness
Tomato/tomato-	Skin	Stahl W	Dietary tomato paste	2001	Carotenoids are efficient antioxidants capable of scavenging reactive oxygen species generated under conditions of	RCT		(-)			(+)
based Foods			protects against		photooxidative stress. It has been shown that supplementation with high doses of beta-carotene protects skin against
and Disease			ultraviolet light-induced		UV-induced erythema. This study was designed to investigate whether intervention with a natural dietary source rich in			↓			↑ serum
Risk			erythema in humans. Stahl W, Heinrich U, Wiseman S, Eichler O, Sies H, Tronnier H. J Nutr. 2001 May;131(5):1449-51.		lycopene protects against UV-induced erythema in humans. Tomato paste (40 g), providing approximately 16 mg/d of lycopene, was ingested with 10 g of olive oil over a period of 10 wk by 9 volunteers. Controls (n = 10) received olive oil only. Erythema was induced by illumination of dorsal skin (scapular region) with a solar simulator at the beginning of the study, after 4 wk and after 10 wk. Intensity of erythema was measured by chromatometry; the a-value was determined directly before and 24 h after irradiation. Serum carotenoid levels were measured by HPLC. At the beginning of the study, carotenoid levels did not differ between the two groups. Serum levels of lycopene increased in supplemented subjects; the other carotenoids did not change significantly, and no change in serum carotenoids was observed in the control group. At wk 10, dorsal erythema formation was 40% lower in the group that consumed tomato paste compared with controls (P = 0.02; Wilcoxon-Mann-Whitney test). No significant difference between groups was found at wk 4 of treatment. The data demonstrate that it is feasible to achieve protection against UV light-induced erythema by ingestion of a commonly consumed dietary source of lycopene.			erythema			[lyco] with DS

 

Category	Disease type	First Author	Study Title and Complete Citation	Date	Abstract	Study Type	G.Tom +, N,	P.Tom +, N,	F.Tom +, N, -	Lyco +, N,	Other +, N,
Tomato/tomato based Foods and Disease Risk	Skin	Stahl W	Carotenoids and protection against solar UV radiation. Stahl W, Sies H. Skin Pharmacol Appl Skin Physiol. 2002 SepOct;15(5):291-6.	2002	Upon exposure to UV light photooxidative reactions are initiated which are damaging to biomolecules and affect the integrity of cells and tissues. Photooxidative damage plays a role in pathological processes and is involved in the development of disorders affecting the skin. When skin is exposed to UV light, erythema is observed as an initial reaction. Carotenoids like beta-carotene or lycopene are efficient antioxidants scavenging singlet molecular oxygen and peroxyl radicals generated in during photooxidation. When beta-carotene was applied as such or in combination with alpha-tocopherol for 12 weeks, erythema formation induced with a solar light simulator was diminished from week 8 on. Similar effects were also achieved with a diet rich in lycopene. Ingestion of tomato paste corresponding to a dose of 16 mg lycopene/ day over 10 weeks led to increases in serum levels of lycopene and total carotenoids in skin. At week 10, erythema formation was significantly lower in the group that ingested the tomato paste as compared to the control group. No significant difference was found at week 4 of treatment. Thus, protection against UV light-induced erythema can be achieved by ingestion of a commonly consumed dietary source of lycopene. Such protective effects of carotenoids were also demonstrated in cell culture. The in-vitro data indicate that there is an optimal level of protection for each carotenoid. Copyright 2002 S. Karger AG, Basel	RCT		(-) ↓ erythema			(+) lyco in serum and skin
Tomato/tomato based Foods and Disease Risk	Skin	Stahl W	Lycopene-rich products and dietary photoprotection. Stahl W, Heinrich U, Aust O, Tronnier H, Sies H. Photochem Photobiol Sci. 2006 Feb;5(2):23842. Epub 2005 Aug 12.	2006	Plant constituents such as carotenoids and flavonoids are involved in the light-protecting system in plants and contribute to the prevention of UV damage in humans. As micronutrients they are ingested with the diet and are distributed into light-exposed tissues where they provide systemic photoprotection. beta-Carotene is an endogenous photoprotector, and its efficacy to prevent UV-induced erythema formation has been demonstrated in intervention studies. Lycopene is the major carotenoid of the tomato and is a very efficient singlet oxygen quencher in the group of carotenoids. Following ingestion of lycopene or tomato-derived products rich in lycopene, photoprotective effects have been demonstrated. After 10-12 weeks of intervention a decrease in the sensitivity towards UV-induced erythema was observed in volunteers. Dietary carotenoids may contribute to life-long protection against harmful UV radiation.	RCT	(-) ↓ erythema			(-) ↓ erythema