Lutein Science
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Age Related Macular Degeneration
Since 2001, three double-blind, intervention studies have examined the effects of Lutein supplementation on vision
improvement in AMD patients. In a 12 month trial of 14 AMD patients, was demonstrated improvements of up to 92
percent in visual acuity tests after subjects consumed a diet consisting five ounces of spinach (approximately 14 mg
Lutein) 4-7 times weekly. In 2004, was published the results of a follow-up study – the Lutein Antioxidant
Supplementation Trial (LAST), a double blind, randomized, placebo-controlled study. Ninety males with atrophic
AMD were supplemented with either 10 mg Lutein; or 10 mg Lutein plus a broad spectrum formula containing
antioxidants/vitamins/minerals; or placebo for one year. The subjects were examined for MPD, photo-stress recovery,
contrast sensitivity, and visual acuity at baseline, and every four months until the end of the study. The most significant
finding was a 36 percent increase in MPD in the Lutein group and a 43 percent increase in MPD in the Lutein plus
antioxidant group, compared to a slight decrease in MPD in the placebo group. Lutein supplementation also resulted
in significant improvements in visual acuity, objective visual function parameters, photo-stress recovery, and contrast
sensitivity. The LAST confirms Lutein plays an important role in ocular health and that AMD appears to respond
favourably to Lutein supplementation. In an Italian study, 50 patients with AMD were given daily cocktails containing
antioxidants and 15 mg purified Lutein or placebo for 18 months. The researchers demonstrated a two-fold increase
in visual acuity in AMD patients compared to the placebo group.
Cataracts
Cataracts are the leading cause of impaired vision, with a large percentage of the geriatric population exhibiting
some signs of lesion. Cataracts are developmental or degenerative opacities of the lens that result in a gradual,
painless loss of vision. Oxidative insult appears to be a precipitating factor in cataracts, resulting in the development
of insoluble, oxidized lens proteins. Higher levels of hydrogen peroxide have been found in cataractous lenses
compared to normal lenses, indicating oxidative stress. Studies examining Lutein and Zeaxanthin levels in extracted
cataractous lenses have found up to three-fold higher levels in the newer epithelial tissue of the lens than in the
older inner cortex portion. The epithelial cortex layer comprises 50 percent of the tissue, yet it has been found to
contain 74 percent of the total lens Lutein and Zeaxanthin, supporting the hypothesis that these nutrients are
protective against the oxidative damage causing cataract formation.
The Nurses Health examined the effect of 12 years of carotenoid consumption on the risk of cataract formation in
77,466 female nurses, ages 45 and over. After controlling for other risk factors, nurses in the highest quintile for
Lutein and Zeaxanthin consumption had a 22-percent decreased risk for cataract extraction, compared with those in
the lowest quintile. Numerous other observational studies have found that increased consumption of foods high in
Lutein/Zeaxanthin is associated with a decreased risk for cataracts or cataract extraction in both men and women.
These studies provide strong evidence for a protective role for Lutein/Zeaxanthin against development of cataracts.
A randomized, double-blind trial on carotenoid supplementation and age-related cataracts measured visual acuity,
glare sensitivity, and serum carotenoid levels in 17 clinical diagnosed patients. Patients received 15 mg Lutein three
times weekly for two years and were compared to patients receiving 100 mg -tocopherol or placebo for the same
period. In patients receiving Lutein, statistically significant improvements in visual acuity and glare sensitivity and
increased serum concentration of Lutein were observed, compared to the -tocopherol and control patients.
Retinitis Pigmentosa
Retinitis pigmentosa (RP) is a rare, inherited, degenerative disease characterized by atrophy of the light-sensing
rods in the retina. The rods are responsible for vision in low-light situations; therefore, early RP (often in childhood) is
frequently characterized by poor night vision. A progressive loss of peripheral vision occurs over time, resulting in
tunnel vision in late stages of the disease. Although treatment is limited, high dose vitamin A supplementation has
been shown to slow the degeneration. In one study, it was found that 40 mg Lutein daily for nine weeks significantly
improved visual acuity
among 16 RP patients. Testing of visual acuity was via computer-simulated self-test by RP patients.
Skin Health and Ultraviolet Light Exposure
A study examined the effect of mixed carotenoids and straight beta-carotene supplementation on skin erythema after
exposure to UV light. Subjects were divided into two groups: Group 1 received a carotenoid supplement containing
24 mg beta-carotene, and Group 2 received 24 mg mixed carotenoids (8 mg each of beta-carotene, Lutein and
Lycopene) daily for 12 weeks. Group 2 patients demonstrated increased serum levels of all three nutrients and a
significant decrease in erythema was observed in both groups after UV exposure compared to pre-supplementation.
This study suggests carotenoids deposited in the skin may protect erythema and inflammation resulting from UV
rays. In support of this hypothesis, other researchers have demonstrated the presence of Lutein and its oxidative
metabolites in human skin. Although a direct association between skin levels of Lutein and Lutein consumption has
not been established, higher skin Lutein levels are observed in humans who take a regular Lutein-containing,
multivitamin supplement. Cardiovascular Disease and Stroke Epidemiological studies have long suggested an
association between carotenoid intake and decreased risk of cardiovascular disease. Research has shown oxidized
low density lipoprotein (LDL) to be a key factor in the initiation of atherosclerosis, one of the pathological processes
involved in cardiovascular and cerebrovascular disease. LDL expresses numerous adhesion molecules that appear
to enhance the binding of monocytes to aortic endothelium, where they may become transformed into foam cells and
initiate atherosclerosis. Consequently, antioxidants, including carotenoids, have been investigated for the ability to
scavenge free radicals and inhibit lipid peroxidation in cardiovascular and cerebrovascular disease. Case-control
studies utilizing carotid intimae-media thickness (IMT) to measure atherosclerotic progression in asymptomatic men
and women have found a moderate inverse association between Lutein and Zeaxanthin serum levels and carotid
IMT. In a three-year study, 231 asymptomatic ages-, sex, race, and field centre-matched case subjects from the
Atherosclerosis Risk in Communities (ARIC) study cohort demonstrated significantly lower serum Lutein/Zeaxanthin
levels and an average IMT two times larger(1.2 ± 0.3mm) than matched control subjects (0.6 ± 0.1 mm). More
recently, the Los Angeles Atherosclerosis Study examined the association between plasma Lutein/Zeaxanthin levels,
atherosclerotic progression, and carotid IMT. A total of 573 asymptomatic men and women were assessed via
plasma lipid levels and carotid artery ultrasound at baseline and after 18 months. After adjustment for age, sex, and
smoking status, changes in carotid IMT were significantly inversely
associated with Lutein/Zeaxanthin levels. The researchers concluded higher levels of these carotenoids may be
protective against atherosclerosis. Two studies have investigated the hypothesis that high Lutein/Zeaxanthin might
exert a protective effect against stroke in men. A prospective observational study of 43,738 men without
cardiovascular disease or diabetes found a slightly significant association between xanthophyll intake and ischemic
stroke. The relative risk for ischemic stroke for the top quintile of Lutein intake compared with the bottom quintile was
0.63. A
second cohort study of 26,593 male smokers in Finland investigated the association between carotenoid intake and
risk of stroke subtypes. An inverse association between Lutein intake and subarachnoid haemorrhage was
observed, and subjects of the highest quartile of Lutein intake had a risk ration of 0.47 for subarachnoid
haemorrhage compared to those in the lowest quartile (risk ratio of 1.0).
Cancer
In a 10-year study following 120,000 US men and women, a significant reduction in lung cancer was observed in
those with the highest intake of total carotenoids, including Lutein and Zeaxanthin. A second 14-year study assessed
the same relationship in 27,000 Finnish male smokers via a food-item questionnaire. Consumption of carotenoid
containing fruits and vegetables was associated with
decreased risk of lung cancer. A decreased risk was also observed in those in the highest quintiles of
Lutein/Zeaxanthin intake versus the lowest quintiles. A populationbased survey of 20 South Pacific Island populations
examined the association between Lutein and lung cancer and a markedly lower incidence rate for lung cancer
among Fijians, compared to other South Pacific populations. Fijians consume an average of 200 gr. dark greens
leafy vegetables (25 mg Lutein) daily; whereas, inhabitants of other South Pacific countries consume diets in which
colourful fruits and vegetables are less plentiful.
Since 2001, three double-blind, intervention studies have examined the effects of Lutein supplementation on vision
improvement in AMD patients. In a 12 month trial of 14 AMD patients, was demonstrated improvements of up to 92
percent in visual acuity tests after subjects consumed a diet consisting five ounces of spinach (approximately 14 mg
Lutein) 4-7 times weekly. In 2004, was published the results of a follow-up study – the Lutein Antioxidant
Supplementation Trial (LAST), a double blind, randomized, placebo-controlled study. Ninety males with atrophic
AMD were supplemented with either 10 mg Lutein; or 10 mg Lutein plus a broad spectrum formula containing
antioxidants/vitamins/minerals; or placebo for one year. The subjects were examined for MPD, photo-stress recovery,
contrast sensitivity, and visual acuity at baseline, and every four months until the end of the study. The most significant
finding was a 36 percent increase in MPD in the Lutein group and a 43 percent increase in MPD in the Lutein plus
antioxidant group, compared to a slight decrease in MPD in the placebo group. Lutein supplementation also resulted
in significant improvements in visual acuity, objective visual function parameters, photo-stress recovery, and contrast
sensitivity. The LAST confirms Lutein plays an important role in ocular health and that AMD appears to respond
favourably to Lutein supplementation. In an Italian study, 50 patients with AMD were given daily cocktails containing
antioxidants and 15 mg purified Lutein or placebo for 18 months. The researchers demonstrated a two-fold increase
in visual acuity in AMD patients compared to the placebo group.
Cataracts
Cataracts are the leading cause of impaired vision, with a large percentage of the geriatric population exhibiting
some signs of lesion. Cataracts are developmental or degenerative opacities of the lens that result in a gradual,
painless loss of vision. Oxidative insult appears to be a precipitating factor in cataracts, resulting in the development
of insoluble, oxidized lens proteins. Higher levels of hydrogen peroxide have been found in cataractous lenses
compared to normal lenses, indicating oxidative stress. Studies examining Lutein and Zeaxanthin levels in extracted
cataractous lenses have found up to three-fold higher levels in the newer epithelial tissue of the lens than in the
older inner cortex portion. The epithelial cortex layer comprises 50 percent of the tissue, yet it has been found to
contain 74 percent of the total lens Lutein and Zeaxanthin, supporting the hypothesis that these nutrients are
protective against the oxidative damage causing cataract formation.
The Nurses Health examined the effect of 12 years of carotenoid consumption on the risk of cataract formation in
77,466 female nurses, ages 45 and over. After controlling for other risk factors, nurses in the highest quintile for
Lutein and Zeaxanthin consumption had a 22-percent decreased risk for cataract extraction, compared with those in
the lowest quintile. Numerous other observational studies have found that increased consumption of foods high in
Lutein/Zeaxanthin is associated with a decreased risk for cataracts or cataract extraction in both men and women.
These studies provide strong evidence for a protective role for Lutein/Zeaxanthin against development of cataracts.
A randomized, double-blind trial on carotenoid supplementation and age-related cataracts measured visual acuity,
glare sensitivity, and serum carotenoid levels in 17 clinical diagnosed patients. Patients received 15 mg Lutein three
times weekly for two years and were compared to patients receiving 100 mg -tocopherol or placebo for the same
period. In patients receiving Lutein, statistically significant improvements in visual acuity and glare sensitivity and
increased serum concentration of Lutein were observed, compared to the -tocopherol and control patients.
Retinitis Pigmentosa
Retinitis pigmentosa (RP) is a rare, inherited, degenerative disease characterized by atrophy of the light-sensing
rods in the retina. The rods are responsible for vision in low-light situations; therefore, early RP (often in childhood) is
frequently characterized by poor night vision. A progressive loss of peripheral vision occurs over time, resulting in
tunnel vision in late stages of the disease. Although treatment is limited, high dose vitamin A supplementation has
been shown to slow the degeneration. In one study, it was found that 40 mg Lutein daily for nine weeks significantly
improved visual acuity
among 16 RP patients. Testing of visual acuity was via computer-simulated self-test by RP patients.
Skin Health and Ultraviolet Light Exposure
A study examined the effect of mixed carotenoids and straight beta-carotene supplementation on skin erythema after
exposure to UV light. Subjects were divided into two groups: Group 1 received a carotenoid supplement containing
24 mg beta-carotene, and Group 2 received 24 mg mixed carotenoids (8 mg each of beta-carotene, Lutein and
Lycopene) daily for 12 weeks. Group 2 patients demonstrated increased serum levels of all three nutrients and a
significant decrease in erythema was observed in both groups after UV exposure compared to pre-supplementation.
This study suggests carotenoids deposited in the skin may protect erythema and inflammation resulting from UV
rays. In support of this hypothesis, other researchers have demonstrated the presence of Lutein and its oxidative
metabolites in human skin. Although a direct association between skin levels of Lutein and Lutein consumption has
not been established, higher skin Lutein levels are observed in humans who take a regular Lutein-containing,
multivitamin supplement. Cardiovascular Disease and Stroke Epidemiological studies have long suggested an
association between carotenoid intake and decreased risk of cardiovascular disease. Research has shown oxidized
low density lipoprotein (LDL) to be a key factor in the initiation of atherosclerosis, one of the pathological processes
involved in cardiovascular and cerebrovascular disease. LDL expresses numerous adhesion molecules that appear
to enhance the binding of monocytes to aortic endothelium, where they may become transformed into foam cells and
initiate atherosclerosis. Consequently, antioxidants, including carotenoids, have been investigated for the ability to
scavenge free radicals and inhibit lipid peroxidation in cardiovascular and cerebrovascular disease. Case-control
studies utilizing carotid intimae-media thickness (IMT) to measure atherosclerotic progression in asymptomatic men
and women have found a moderate inverse association between Lutein and Zeaxanthin serum levels and carotid
IMT. In a three-year study, 231 asymptomatic ages-, sex, race, and field centre-matched case subjects from the
Atherosclerosis Risk in Communities (ARIC) study cohort demonstrated significantly lower serum Lutein/Zeaxanthin
levels and an average IMT two times larger(1.2 ± 0.3mm) than matched control subjects (0.6 ± 0.1 mm). More
recently, the Los Angeles Atherosclerosis Study examined the association between plasma Lutein/Zeaxanthin levels,
atherosclerotic progression, and carotid IMT. A total of 573 asymptomatic men and women were assessed via
plasma lipid levels and carotid artery ultrasound at baseline and after 18 months. After adjustment for age, sex, and
smoking status, changes in carotid IMT were significantly inversely
associated with Lutein/Zeaxanthin levels. The researchers concluded higher levels of these carotenoids may be
protective against atherosclerosis. Two studies have investigated the hypothesis that high Lutein/Zeaxanthin might
exert a protective effect against stroke in men. A prospective observational study of 43,738 men without
cardiovascular disease or diabetes found a slightly significant association between xanthophyll intake and ischemic
stroke. The relative risk for ischemic stroke for the top quintile of Lutein intake compared with the bottom quintile was
0.63. A
second cohort study of 26,593 male smokers in Finland investigated the association between carotenoid intake and
risk of stroke subtypes. An inverse association between Lutein intake and subarachnoid haemorrhage was
observed, and subjects of the highest quartile of Lutein intake had a risk ration of 0.47 for subarachnoid
haemorrhage compared to those in the lowest quartile (risk ratio of 1.0).
Cancer
In a 10-year study following 120,000 US men and women, a significant reduction in lung cancer was observed in
those with the highest intake of total carotenoids, including Lutein and Zeaxanthin. A second 14-year study assessed
the same relationship in 27,000 Finnish male smokers via a food-item questionnaire. Consumption of carotenoid
containing fruits and vegetables was associated with
decreased risk of lung cancer. A decreased risk was also observed in those in the highest quintiles of
Lutein/Zeaxanthin intake versus the lowest quintiles. A populationbased survey of 20 South Pacific Island populations
examined the association between Lutein and lung cancer and a markedly lower incidence rate for lung cancer
among Fijians, compared to other South Pacific populations. Fijians consume an average of 200 gr. dark greens
leafy vegetables (25 mg Lutein) daily; whereas, inhabitants of other South Pacific countries consume diets in which
colourful fruits and vegetables are less plentiful.
