Lutein and Zeaxanthin:
Eye and Vision Benefits
Good nutrition is important to keep your eyes healthy and functioning their best throughout your lifetime. Two very important eye nutrients that may reduce your risk for macular degeneration and cataracts have names you may not be familiar with: lutein (LOO-teen) and zeaxanthin (zee-ah-ZAN-thin).
Lutein and zeaxanthin are compounds called xanthophylls (ZAN-thuh-fills), which are yellow pigments that occur naturally in many plants and vegetables. Xanthophylls belong to a class of organic compounds called carotenoids, which also includes orange and red plant pigments. Though lutein is considered a yellow pigment, in high concentrations it appears orange-red.
In nature, lutein and zeaxanthin appear to absorb excess light energy to prevent damage to plants from too much sunlight, especially from high-energy light rays called blue light.
Cooked spinach is one of the best natural food sources of lutein and zeaxanthin.
In addition to being found in many green leafy plants and colorful fruits and vegetables, lutein and zeaxanthin are found in high concentrations in the macula of the human eye, giving the macula its yellowish color. In fact, the macula also is called the "macula lutea" (from the Latin macula, meaning "spot," and lutea, meaning "yellow").
Recent research has discovered a third xanthophyll in the macula. Called meso-zeaxanthin, this carotenoid is not found in food sources and appears to be created in the retina from ingested lutein.
Lutein and zeaxanthin appear to have important antioxidant functions in the body. Along with other natural antioxidants, including vitamin C, beta carotene and vitamin E, these xanthophylls guard the body from damaging effects of free radicals, which are unstable molecules that can destroy cells and play a role in many diseases.
In addition to important eye and vision benefits, lutein may help protect against atherosclerosis (buildup of fatty deposits in arteries), the disease that leads to most heart attacks.
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Eye Benefits of Lutein and Zeaxanthin
It is believed that lutein, zeaxanthin and meso-zeaxanthin in the macula block blue light from reaching the underlying structures in the retina, thereby reducing the risk of light-induced oxidative damage that could lead to macular degeneration (AMD).
A number of studies have found that lutein and zeaxanthin either help prevent AMD or may slow progression of the disease:
- Research published in Nutrition & Metabolism found that a nutritional supplement containing meso-zeaxanthin, lutein and zeaxanthin effectively increased the optical density of the macular pigment in eyes of the majority of human subjects. The macular pigment is believed to offer protection against the development of macular degeneration.
- Studies published in American Journal of Epidemiology, Ophthalmology and Archives of Ophthalmology found higher levels of lutein and zeaxanthin in the diet are associated with a lower incidence of AMD.
- Two studies published in Investigative Ophthalmology and Visual Science found that eyes with greater levels of macular pigments were less likely to have or develop macular degeneration.
- In a research article published in Archives of Biochemistry and Biophysics in August 2010, the study authors conclude that lutein, zeaxanthin and meso-zeaxanthin filter short-wavelength light and prevent or reduce the generation of free radicals in the retinal pigment epithelium and choroid. They also suggest that a mixture of these carotenoids are more effective than any one of the individual xanthophylls at the same total concentration.
Despite the findings of these studies, some experts note that other research fails to show a relationship between the dietary intake or blood levels of lutein and zeaxanthin and a person's risk of developing AMD over time. Furthermore, they say it is premature to recommend lutein or zeaxanthin supplements until large, well-controlled studies support the benefits of these xanthophylls in preventing macular degeneration.
Such evidence may soon be available. The National Eye Institute (NEI) is sponsoring a second Age-Related Eye Disease Study (AREDS) to evaluate the effect of lutein and zeaxanthin and two omega-3 fatty acids (EPA and DHA) on the progression of advanced macular degeneration and/or moderate vision loss in people at moderate to high risk for AMD progression.
The study, called AREDS2, will evaluate the effect of a daily nutritional supplement containing 10 mg of lutein and 2 mg of zeaxanthin versus a placebo among subjects between the ages of 50 and 85 years. The study began in September 2006 and is estimated to be completed in December 2012.
The first NEI-sponsored AREDS, a 10-year study completed in 2006, found that a daily supplement containing high levels of several antioxidants and zinc reduced the risk of developing advanced AMD by about 25 percent.
The multivitamin supplement used in the first AREDS contained:
- Vitamin C - 500 mg
- Vitamin E - 400 IU
- Beta-carotene - 15 mg (equivalent of 25,000 IU of vitamin A)
- Zinc (as zinc oxide) - 80 mg
- Copper (as cupric oxide) - 2 mg
Also, some evidence suggests the protective benefit of lutein may extend beyond the macula to other areas of the retina as well. An animal study published in August 2012 shows lutein appears to protect the retina from damage due to temporary decreased blood flow and reduced oxygen supply (hypoxia).
In the study, the retinas of mice were deprived of blood flow for a period of two hours, after which blood flow was restored, with or without lutein supplementation. The lutein-treated retinas exhibited increased cell viability, less tissue damage and fewer inflammatory markers, suggesting lutein may exert both an antioxidant and an anti-inflammatory effect to protect retinal cells, according to the study authors.
In addition to protecting the retina, lutein and zeaxanthin also may reduce the risk of cataracts. Recent studies published in Archives of Ophthalmology have found that healthy diets with high levels of lutein, zeaxanthin and other carotenoids were associated with a lower risk and prevalence of cataracts in women.
Foods Containing Lutein and Zeaxanthin
The best natural food sources of lutein and zeaxanthin are green leafy vegetables and other green or yellow vegetables. Among these, cooked kale and cooked spinach top the list, according to the U.S. Department of Agriculture (USDA).
Non-vegetarian sources of lutein and zeaxanthin include egg yolks. But if you have high cholesterol, you're much better off getting most of these yellow nutrients from fruits and vegetables.
|Kale (cooked)||1 cup||23.7|
|Spinach (cooked)||1 cup||20.4|
|Collards (cooked)||1 cup||14.6|
|Turnip greens (cooked)||1 cup||12.2|
|Spinach (raw)||1 cup||3.7|
|Green Peas (canned)||1 cup||2.2|
|Corn (canned)||1 cup||2.2|
|Broccoli (cooked)||1 cup||1.7|
|Romaine lettuce (raw)||1 cup||1.3|
|Carrots (cooked)||1 cup||1.1|
|Green beans (cooked)||1 cup||0.8|
|Source: USDA National Nutrient Database for Standard Reference, Release 22 (2009)|
Lutein and Zeaxanthin Supplements
Because of the apparent eye and cardiovascular benefits of lutein and zeaxanthin, many nutritional companies have added these xanthophyll carotenoids to their multiple vitamin formulas. Others have introduced special eye vitamins that are predominantly lutein and zeaxanthin supplements.
There currently is no Recommended Dietary Allowance (RDA) or Recommended Daily Intake (RDI) for lutein or zeaxanthin, but some experts say you should ingest at least 6 milligrams (mg) of lutein per day for beneficial effects.
It remains unclear how much lutein and zeaxanthin is needed daily for adequate eye and vision protection. Also, it is unknown at this time whether supplements have the same effect as lutein and zeaxanthin obtained through food sources.
There are no known toxic side effects of taking too much lutein or zeaxanthin. In some cases, people who eat large amounts of carrots or yellow and green citrus fruits can develop a harmless yellowing of the skin called carotenemia. Though the appearance of the condition can be somewhat alarming and may be confused with jaundice, the yellow discoloration disappears by cutting back on consumption of these carotenoid-rich foods. (Carotenemia also can be associated with over-consumption of carotenoid-rich nutritional supplements.)
Popular lutein and zeaxanthin supplements include:
- EyePromise Zeaxanthin (Zeavision)
- ICaps Eye Vitamin Lutein & Zeaxanthin Formula (Alcon)
- Macula Complete (Biosyntrx)
- MacularProtect Complete (ScienceBased Health)
- MaxiVision Ocular Formula (MedOp)
- OcuGuard Plus (TwinLab)
- PreserVision (Bausch + Lomb)
The source of lutein in many lutein supplements is marigold flowers, while for zeaxanthin it is often red peppers. If you choose a lutein and zeaxanthin supplement, make sure it's a high quality product from a reputable dietary supplement company.
Remember that taking dietary supplements does not replace a healthy diet. Eating a well-balanced diet that includes plenty of fruits and vegetables usually is the best way to get the important eye nutrients you need.
Also, remember that individuals sometimes react differently to certain supplements, which can have unintended effects such as adverse reactions with medications. Consult with your physician or eye doctor before trying any vision supplements.
About the Author: Gary Heiting, OD, is senior editor of AllAboutVision.com. Dr. Heiting has more than 25 years of experience as an eye care provider, health educator and consultant to the eyewear industry. His special interests include contact lenses, nutrition and preventive vision care. Connect with Dr. Heiting via Google+.
Macular pigment response to a supplement containing meso-zeaxanthin, lutein and zeaxanthin. Nutrition & Metabolism. May 2007.
Lutein and zeaxanthin in the diet and serum and their relation to age-related maculopathy in the Third National Health and Nutrition Examination Survey. American Journal of Epidemiology. March 2001.
Dietary antioxidants and the long-term incidence of age-related macular degeneration: the Blue Mountains Eye Study. Ophthalmology. February 2008.
Associations between intermediate age-related macular degeneration and lutein and zeaxanthin in the Carotenoids in Age-Related Eye Disease Study (CAREDS). Archives of Ophthalmology. August 2006.
Macular pigment in donor eyes with and without AMD: a case-control study. Investigative Ophthalmology and Visual Science. January 2001.
Macular pigment and risk for age-related macular degeneration in subjects from a Northern European population. Investigative Ophthalmology and Visual Science. February 2001.
Studies on the singlet oxygen scavenging mechanism of human macular pigment. Archives of Biochemistry and Biophysics. August 2010.
Dietary carotenoids, vitamins C and E, and risk of cataract in women. Archives of Ophthalmology. January 2008.
Associations between age-related nuclear cataract and lutein and zeaxanthin in the diet and serum in the Carotenoids in the Age-Related Eye Disease Study (CAREDS), an ancillary study of the Women's Health Initiative. Archives of Ophthalmology. March 2008.
Healthy diets and the subsequent prevalence of nuclear cataract in women. Archives of Ophthalmology. June 2010.
Anti-inflammatory effects of lutein in retinal ischemic/hypoxic injury: in vivo and in vitro studies. Investigative Ophthalmology & Visual Science. Published online August 2012.
[Page updated October 2012]
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