3/20/2014 Macular Society | Nutrition | Lutein and zeaxanthin

http://www.macularsociety.org/about-macular-conditions/Nutrition/Xanthophylls-Lutein-Zeaxanthin-Meso-zeaxanthin 1/3

Lutein and zeaxanthin

Since the first Age-Related Eye Disease Study (AREDS 1) in 1992, research hassuggested that the dietary xanthophyll’-s lutein and zeaxanthin may be effectivein reducing the risk of getting age-related macular degeneration (AMD) or itsprogression. This is due to their high concentrations in the macula, where theyare known as the macular pigment. The AREDS 2 trial investigated this linkfurther.

Introduction

The macular pigment has protective qualities which may be related to AMD. Xanthophyllsare only obtained from the diet; therefore a person’s macular pigment levels may bedependent on dietary habits.

A large amount of research suggests that lutein and zeaxanthin may be more effectivethan other nutrients in reducing the risk of getting AMD or it progressing. This is due totheir antioxidant and protective properties.

A high concentration of lutein, zeaxanthin, and a related compound meso-zeaxanthin, arefound in the macula, where they are known as the macular pigment.

The macular pigment protects the macula in several ways, it has the ability to interact withfree radicals and filter out damaging blue light. By acting as a blue light filter the macularpigment can protect the cells responsible for vision from light damage. Lutein in particularhas been shown to have the highest blue light filtering properties.

Free radicals are produced in the body when oxygen reacts with certain molecules. Theyare known to damage or destroy cells, altering their function and preventing them fromregenerating. They may be formed in the retina (light sensitive area at the back of the eyewhich contains the macula) due to its high demand for oxygen. Long term exposure maycause damage of the light sensing cells responsible for vision.

Dietary sources of lutein and zeaxanthin

Lutein and zeaxanthin can only be obtained by the human body from the diet, and meso-zeaxanthin is converted from lutein in the macula. An individual’s macular pigment levelscan therefore vary depending on their diet.

Around 78% of lutein and zeaxanthin is gained from eating vegetables particularly darkgreen leafy vegetables, such as kale and spinach. Corn and corn products are also a majorsource of zeaxanthin.

Eggs also contain high levels of both lutein and zeaxanthin, which is more easily absorbedby the body than from vegetables because of the fats they contain.

3/20/2014 Macular Society | Nutrition | Lutein and zeaxanthin

http://www.macularsociety.org/about-macular-conditions/Nutrition/Xanthophylls-Lutein-Zeaxanthin-Meso-zeaxanthin 2/3

Similarly, cooking, or eating these foods with fats or oil, or choosing a supplement thatcontains lutein and zeaxanthin bound in oil, can also help the body absorb them moreeffectively.

The list below shows which vegetables have the highest amount of lutein.

Lutein mg/100mg

Kale 21.9

Spinach 12.6

Celery 3.6

Broccoli 1.8

Peas 1.7

Sprouts 1.3

Macular pigment and lutein, zeaxanthin & meso-zeaxanthin

The level of macular pigment can be increased with dietary change, either by takingsupplements containing lutein and zeaxanthin or by eating foods rich in these nutrients.Doses of 10mg or higher per day of lutein have been found to have the most positiveeffects on macular pigment levels.

Other factors which may influence the levels of macular pigment in a person includesmoking habits (lower levels in smokers), genetics such as iris colour (lower levels withlighter iris colour), and gender (higher levels reported in men in some studies). Somestudies have also reported that an increased body fat is associated with decreased levelsof macular pigment.

One research group has looked at the relationship between supplements containing meso-zeaxanthin and macular pigment levels. They have found that supplements containinglutein, zeaxanthin and meso-zeaxanthin potentially offer advantages over supplementsthat do not contain meso-zeaxanthin. Further large scale trials may be needed to confirmthese findings.

What does this mean?

Research supports the theory that high macular pigment levels may reduce your risk ofAMD or its progression. Macular pigment can be increased by taking supplements withlutein or zeaxanthin or by changing your diet to include more of them.

Effects on visual performance

A number of small trials have shown AMD patients who use supplements containing luteinhave improved visual performance including their visual acuity, contrast sensitivity, glarerecovery and visual distortion.

The majority of these studies have found an improvement in the visual performance ofpatients given 10 mg or higher per day with lutein alone or combined with zeaxanthin andother antioxidants.

The large scale AREDS 2 trial found no effect of lutein 10mg and zeaxanthin 2mg together

3/20/2014 Macular Society | Nutrition | Lutein and zeaxanthin

http://www.macularsociety.org/about-macular-conditions/Nutrition/Xanthophylls-Lutein-Zeaxanthin-Meso-zeaxanthin 3/3

on visual acuity. The trial analysed the progression to moderate or worse vision loss,defined as a reduction of 15 or more letters.

The AREDS 2 results mean that findings from smaller trials which suggest improvementson visual performance should be treated with caution - more large scale studies areneeded.

AMD prevention or delay with lutein and zeaxanthin

Higher macular pigment levels due to taking supplements with lutein and zeaxanthin hasbeen shown to delay or prevent AMD in some studies, but research is still on-going in thisarea.

There are a number of trials which have investigated the protective role of lutein andzeaxanthin supplements in individuals with AMD, such as AREDS 2.

The AREDS 2 trial investigated the effect of lutein, zeaxanthin and omega-3 to delay theprogression of advanced AMD. It found that overall there was no additional benefit ofadding lutein and zeaxanthin to the original AREDS formula of antioxidants, however,participants who took the AREDS formulation with no beta-carotene but with lutein andzeaxanthin, had their risk of progressing to advanced AMD reduced by 18%. Participantswho had a low dietary intake of lutein and zeaxanthin at the start of the study who took aversion of the AREDS formula with lutein and zeaxanthin instead of beta-carotene werealso 25% less likely to develop advanced AMD.

Investigators have suggested that beta-carotene may have masked the effects of luteinand zeaxanthin in the overall analysis because it competes with lutein for absorption in thebody. It also is linked to an increased risk of lung cancer in smokers and former smokers.

The AREDS 2 investigators now suggest that 10mg of lutein and 2mg of zeaxanthin shouldreplace beta-carotene in the original AREDS formula. This is a safe and effective tool forthe treatment of AMD.

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