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LE Magazine September 2005

Why Lutein and Zeaxanthin Are Becoming So Popular

By Heather S. Oliff, PhD

Macular Degeneration

As the name implies, macular degeneration occurs when the macula is damaged and breaks down. The macula produces central vision and color vision, and is vital for visual acuity. Thus, macular degeneration causes a gradual destruction of sharp, central vision, which is needed for reading, driving, watching television, and so forth. Macular degeneration causes permanent blindness and is the leading cause of blindness in people over the age of 50. Increased exposure to blue light or sunlight increases the risk of age-related macular degeneration (ARMD).23 While there is no cure for macular degeneration, lutein and zeaxanthin may slow the disease’s progression or even help prevent it.

A scientific review of the literature indicates that lutein and zea-xanthin could modulate the course of ARMD.23 Most risk-analysis studies evaluate the combination of lutein and zeaxanthin, and show that higher dietary intake of lutein and zeaxanthin is associated with reduced risk for ARMD.7,24,25 However, other conflicting data do not support this association.26,27 Among the explanations researchers provide for this disparity: consumption of lutein and zeaxanthin in some study populations may have been too low to have influenced the risk of ARMD; statistically, there may not have been enough patients who progressed from early to late macular degeneration to determine efficacy; and evaluating lutein and zeaxanthin together rather than separately may have obscured evidence that one xanthophyll is more effective than the other.26-28

Considering that they have different distribution patterns within the eye—zeaxanthin is the dominant macular pigment in the central macula and lutein is more prevalent in the peripheral retina—lutein and zeaxanthin may have different functions.28 Zeaxanthin may be more important for preventing macular degeneration. One study of 380 adults aged 66-75 found that those with the lowest plasma concentrations of zeaxanthin had twice the risk of ARMD compared to those with the highest zeaxanthin plasma concentrations.28 By contrast, plasma concentrations of lutein had no significant correlation with risk for macular degeneration.28

Importance of Macular Pigment Density

A low density of macular pigment permits greater blue light damage to the eye and increases the risk for ARMD. An autopsy study reported that ARMD patients had lower levels of macular pigments than patients without ARMD.29 Similarly, another study reported that eyes with ARMD had significantly less macular pigment than healthy eyes.30 The authors concluded that the low macular pigment caused the macular degeneration rather than the reverse (degeneration causing the low macular pigment).30

A sign of early ARMD is loss of visual sensitivity to blue and green light.31 Older adults aged 60-84 with lower macular pigment density reportedly have lower visual sensitivity. Older people with high macular pigment density reportedly have visual sensitivity comparable to younger people aged 24-36.32 Thus, high macular pigment density may help retain youthful visual sensitivity and retard age-related declines in visual function.32

Ways to Increase Macular Pigment Density

Macular pigment density can be increased by consuming foods and supplements that are rich in lutein and zeaxanthin.33-36 Ingested lutein and zeaxanthin may be transported from the blood into the retina in the same proportions found in the blood.37 Consuming lutein ester can increase macular pigment density in patients with early ARMD, so even people with diseased macula can accumulate lutein and possibly zeaxanthin.36

Obese men and women have a higher risk of ARMD and also have lower macular pigment density.1 Obese people may have lower macular pigment density than the non-obese because they typically have poor dietary habits and may not consume enough foods containing lutein and zeaxanthin.1 Also, body fat may compete with the retina for uptake of lutein and zeaxanthin. A larger quantity of body fat may draw more xanthophylls away from the serum and prevent their deposition in the retina.1 People with very low body fat have higher levels of serum carotenoids,38 which could translate to higher macular pigment density. This is yet another benefit of losing excess weight.


A cataract is a clouding of the eye lens, causing loss of vision. The lens is necessary to adjust the eye’s focus so that vision is sharp. Symptoms of a cataract include cloudy or blurry vision, problems with light (as when car headlights, glare from lamps, and sunlight seem too bright), and faded color vision. The most common cause of cataract is aging. Oxidative damaged caused by tobacco smoke, light exposure, and inadequate intake of dietary antioxidants is also thought to play a central role in cataract formation.32 The symptoms, along with the etiology, highlight the importance of xanthophylls in preventing cataract.

Eating foods rich in xanthophylls is associated with a decreased risk of cataract.39-41 Not only are xanthophylls important for preventing cataracts, but research shows that consuming xanthophylls can slow the progression of cataracts. Visual acuity and glare sensitivity significantly improve in patients with age-related cataracts who take lutein supplements.42 And patients with the highest intake of lutein and zea-xanthin have a lower risk of cataract extraction surgery compared to those with the lowest intake.39,40

Lutein and zeaxanthin protect lens cells from damaging ultraviolet light, a leading cause of cataract formation. When treated with xanthophylls, human lens epithelial cells exposed to ultraviolet B (UVB) light were protected from lipid peroxidation.43 Xanthophyll treatment also significantly decreased UVB-induced oxidative stress.43 These findings suggest that lutein and zeaxanthin protect against cataract by preventing sunlight-induced oxidative stress.


A wealth of scientific research demonstrates the benefits of a diet rich in fruits, vegetables, and eggs.

The antioxidants lutein and zea-xanthin have the power to protect eyes and vision, while helping prevent eye disorders. Xanthophylls provide optimal nutrition for ocular health by protecting the eyes from light-induced oxidative damage, which triggers macular degeneration and cataract. They can also protect against certain types of cancer, including skin cancer and breast cancer. Lutein and zeaxanthin likewise can help prevent atherosclerotic build-up by inhibiting fatty plaque formation and endothelial cell damage.

Tissue and plasma levels of xanthophylls can be increased by eating foods rich in lutein and zeaxanthin, taking dietary supplements, and maintaining a healthy weight.


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29. Bone RA, Landrum JT, Mayne ST, Gomez CM, Tibor SE, Twaroska EE. Macular pigment in donor eyes with and without AMD: a case-control study. Invest Ophthalmol Vis Sci. 2001 Jan;42(1):235-40.

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40. Brown L, Rimm EB, Seddon JM, et al. A prospective study of carotenoid intake and risk of cataract extraction in US men. Am J Clin Nutr. 1999 Oct;70(4):517-24.

41. Lyle BJ, Mares-Perlman JA, Klein BE, Klein R, Greger JL. Antioxidant intake and risk of incident age-related nuclear cataracts in the Beaver Dam Eye Study. Am J Epidemiol. 1999 May 1;149(9):801-9.

42. Olmedilla B, Granado F, Blanco I, Vaquero M. Lutein, but not alpha-tocopherol, supplementation improves visual function in patients with age-related cataracts: a 2-y double-blind, placebo-controlled pilot study. Nutrition. 2003 Jan ;19(1):21-4.

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