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Effects of carotenoid supplementation on glycemic control: a systematic review and meta-analysis of randomized clinical trials

European Journal of Clinical Nutrition volume 79, pages 113–125 (2025)Cite this article

Subjects

Abstract

Objectives

We conducted a systematic review and meta-analysis to assess the effects of carotenoid supplementation on glycemic indices, and the certainty of evidence.

Methods

A systematic literature search in PubMed, SCOPUS, ISI–Web of Science, and Cochrane Library was conducted from inception up to Jun 17, 2024. Randomized controlled trials (RCTs) investigating the effect of carotenoid supplementation on circulating glycemic parameters were included. Records were excluded when studies reported the effect of co-interventions with other nutrients, did not provide mean differences (MDs) and standard deviations (SD) for outcomes, or administered whole food rather than supplements of carotenoids. Summary mean differences (MDs) and 95% CI between intervention and control groups were estimated using a random-effects model. The risk of bias of the included studies was assessed using the Risk of Bias 2.0 (RoB 2.0) tool.

Results

Overall, 36 publications with 45 estimated effect sizes were included in the meta-analyses. The overall findings showed an improvement in fasting blood glucose (FBG) (MD = −4.54 mg/dl; 95% CI: −5.9, −3.2; n = 45), and hemoglobin A1C (HbA1C) (MD = −0.25% (95% CI: −0.4, −0.11; n = 22) in the intervention group in comparison with the control group. Moreover, in individuals with type 2 diabetes (T2D), interventions with astaxanthin and fucoxanthin led to a reduction in FBG by 4.36 mg/dl (95% CI: −6.13, −2.6; n = 10). The findings also showed that the intervention with crocin reduced FBG levels by 13.5 mg/dl (95% CI: −15.5, −7.8; n = 5), and HbA1C by 0.55% (95% CI: −0.77, −0.34; n = 5) in individuals with T2D. However, the certainty of evidence was very low.

Conclusion

Carotenoid’s supplementation improved glycemic parameters especially in people with T2D. However. the certainty of evidence was very low, mainly due to small sample size, and indirectness. Therefore, no specific recommendations can be provided at present and well-designed RCTs are required.

Registry URL

https://www.crd.york.ac.uk/PROSPERO/

Registry number

CRD42021285084

Registry and registry number for systematic reviews or meta-analyses

PROSPERO ID: CRD42021285084

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Data availability

Data described in the manuscript, code book, and analytic code will be made available upon request pending.

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Funding

The German Diabetes Center is funded by the German Federal Ministry of Health and the Ministry of Innovation, Science, Research, and Technology of the State North Rhine Westphalia. This study was also supported in part by a grant from the German Federal Ministry of Education and Research to the German Center for Diabetes Research. The funders had no role in the study design or in the collection, analysis, interpretation of data, writing of the report, or decision to submit the article for publication.

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Authors and Affiliations

  1. Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany

    Nafiseh Shokri-Mashhadi, Christina Baechle, Tim Schiemann, Edyta Schaefer, Janett Barbaresko & Sabrina Schlesinger

  2. German Center for Diabetes Research (DZD), Partner Düsseldorf, Muenchen-Neuherberg, Düsseldorf, Germany

    Nafiseh Shokri-Mashhadi, Christina Baechle, Edyta Schaefer & Sabrina Schlesinger

  3. Institute of Nutritional and Food Sciences, University of Bonn, Bonn, Germany

    Tim Schiemann

Authors
  1. Nafiseh Shokri-Mashhadi
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  2. Christina Baechle
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  3. Tim Schiemann
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  4. Edyta Schaefer
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  5. Janett Barbaresko
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  6. Sabrina Schlesinger
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Contributions

N.S-M, and S.S designed research; N.S-M, J.B, E.S and C.B conducted research; N.S-M and S.S analyzed data; and N.S-M, and S.S wrote the paper. N.S-M had primary responsibility for final content. All authors read and approved the final manuscript.

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Correspondence to Nafiseh Shokri-Mashhadi.

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Shokri-Mashhadi, N., Baechle, C., Schiemann, T. et al. Effects of carotenoid supplementation on glycemic control: a systematic review and meta-analysis of randomized clinical trials. Eur J Clin Nutr 79, 113–125 (2025). https://doi.org/10.1038/s41430-024-01511-y

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