Black Pepper and Dietary Lipids Synergistically Enhance Carotenoid Bioavailability: A Narrative Review.

Carotenoids are lipophilic micronutrients with significant health benefits, yet their poor bioaccessibility and bioavailability limit their physiological impact. Evidence suggests that co-ingestion of black pepper (piperine) and dietary lipids can synergistically enhance carotenoid utilization. This narrative review evaluates the scientific basis for this interaction. A randomized crossover human clinical trial clearly demonstrated that black pepper and a canola oil emulsion together markedly enhanced carotenoid absorption, and in vitro studies provide evidence for the ability of lipids and piperine to improve carotenoid uptake. Mechanistically, dietary lipids primarily act at the bioaccessibility level by promoting micellization, while piperine influences both bioaccessibility (eg, by altering micelle dynamics and intestinal permeability) and bioavailability (eg, by inhibiting efflux transporters and metabolic enzymes). These complementary actions produce a synergistic enhancement of carotenoid utilization. Despite promising findings, further studies are needed to clarify the mechanisms, establish dose-response relationships, and assess long-term efficacy and safety. Overall, combining black pepper and dietary lipids represents a practical, culturally relevant, and cost-effective dietary strategy for improving carotenoid bioavailability, with potential implications for preventing vitamin A deficiency and reducing chronic disease risk.