Key Ocular Nutrients: Lutein and Zeaxanthin

Lutein and zeaxanthin are key ocular nutrients found in foods such as leafy green vegetables, eggs and corn.  Humans cannot make these nutrients, so we must either consume them from food or supplements.

Lutein and zeaxanthin comprise the macular pigment, protecting photoreceptor cells and the retinal pigmented epithelium (RPE). Lutein and zeaxanthin act as antioxidants and filters of blue light. The average diet in many parts of the world only contains about 1 to 2 mg of lutein and zeaxanthin,1-5 so supplements can fill a gap for eye health.

Free Patient Brochures

Help educate your patients on the benefits lutein supplementation to protect their eye health. Order free patient brochures through Kemin.

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Retinal Cells

Protection from Blue Light

The topic of blue light is not new to eye care professionals, but attention to the subject has increased in recent years based on the prevalence of digital devices and LED lights. The blue wavelengths of light (400 to 500 nm) emit the highest energy of all visible light and pose the greatest potential for damage to the eye.6 In patients with hyperopia, astigmatism and presbyopia, blue light is focused directly on the macula.11 One recent study by Lin, et al. suggests that ocular damage can be elicited from the light output of a smartphone.12  

 

Cell cultures and animal models are used to evaluate the direct effects of blue light on ocular health.6-10 For obvious reasons, in humans only self-reported measures of eye strain and digital device use can quantify outcomes from blue light exposure.13 However, in making the case for benefits versus risk, the dietary forms of lutein and zeaxanthin (such as found in FloraGLO® Lutein) have extensive documented benefits for eye and brain health and a clear safety history.14 The case for lutein based on current scientific knowledge outweighs the unanswered questions on the extent of ocular damage from blue light.

One point not in dispute is the incidence of digital device eye strain in the US. In a recent study, 92% of American adults reported at least one symptom from digital devices overuse. The most common reported problem was tired eyes, reported by 81% of respondents.15  

Reduced risk for Age-Related Macular Degeneration (AMD)

The largest study to-date to examine the effects of nutritional supplementation on age-related macular degeneration (AMD) was the Age-Related Eye Disease Study 2 (AREDS2), which was conducted by the US National Eye Institute.

Researchers found that lutein and zeaxanthin (in place of beta-carotene) reduced the risk of progression to advanced AMD by 18 percent. In addition, results showed a 26 percent reduction in the risk of progression to AMD beyond the effects of the previous standard of care in individuals at the lowest versus highest quintile of dietary lutein and zeaxanthin intake.

Based on ARED2, the recommended supplement dose of lutein and zeaxanthin, respectively, is 10 mg and 2 mg. The AREDS2 formulation also included 500 mg vitamin C, 400 international units of vitamin E, 80 mg zinc and 2 mg copper.16

Improved Night Driving and contrast sensitivity

Lutein provides additional benefits of visual performance based on increased macular pigment optical density. Researchers Stringham and Hammond showed that daily supplementation with 10 mg FloraGLO Lutein and 2 mg OPTISHARP™ Zeaxanthin increased macular pigment optical density (MPOD), leading to increased tolerance to the intensity of glaring light and improved visual recovery time following bright light exposure.17 The study found that MPOD increased as early as two months after starting supplementation and continued to increase over six months. After six months of daily supplementation, MPOD increased an average of 39%. The response to supplementation occurred whether subjects had low or high MPODs at the start of the study.

Benefits of Lutein for Your Patients

·         Helps protect and maintain healthy eyes

·         Clinically proven to increase MPOD

·         Reduced risk of AMD progression

·         Improves glare recovery in night-time driving

·         Helps protect eyes from blue light exposure caused by sunlight, LED lights and digital devices

Is Lutein Ready to be Considered an Essential Nutrient?

While no Dietary Reference Intake (DRI) currently exists for lutein, the literature shows positive effects on eye health from 6 to 10 mg per day. In proposing criteria for considering a DRI for lutein, Randard, et al. outlined many of the milestones that lutein has met. For example, lutein has documented food sources, clinical trials for dose-response and efficacy, and safety data.18

Macular Pigment Optical Density Testing

Ideally all patient should be tested for macular pigment optical density (MPOD) with the gold standard method of heterochromic flicker photometry. For eye care professionals using MPOD devices, FloraGLO Lutein is developing a FREE database to allow prospective patients to locate your office. Click here to submit your practice.

The Lutein Source Matters

When looking at the Supplement Facts panels for eye vitamins, FloraGLO Lutein offers unique benefits. FloraGLO Lutein is the most studied lutein brand worldwide (with over 80 published human studies),19 the lutein brand chosen for the AREDS2 study,16 the number one doctor recommended brand in the US20 and the only brand clinically proven safe for use in infant nutrition.21 FloraGLO Lutein contains the same form of lutein as found in vegetables such as spinach and kale. Kemin, maker of FloraGLO Lutein, is also the inventor of a patent showing how lutein protects individuals with hyperopia, astigmatism and presbyopia from blue light.21 Tell your patients to look for lutein supplements with FloraGLO Lutein on the label.

References

1. Granado F, et al. (2007). Public Health Nutr. 10: 1018-1023.

2. O’Neil M, et al. (2001). Br J Nutr. 85: 499-507.

3. Lucarini M, et al. (2006). Int J Vitam Nutr Res. 76: 103-109.

4. Amanio R, et al. (2012). Seguranca Alimentar e Nutriciional 19: 130-140.

5. Hosatani K, et al. (2012). Ophthalmol. 115: 147-157.

6. Tosini G, Ferguson I, and Tsubota K (2016). Effects of blue light on the circadian system and eye physiology. Mol Vis. 24: 22: 61-2272.       

7. Yu M, Yan W, and Beight C (2018).  Lutein and Zeaxanthin Isomers Protect against Light-Induced Retinopathy via Decreasing Oxidative and Endoplasmic Reticulum Stress in BALB/cJ Mice.  Nutrients. 10: pii: E842.

8. Vicente-Tejedor J, Marchena M, Ramírez L, García-Ayuso D, Gómez-Vicente V, Sánchez-Ramos C, de la Villa P, and Germain F (2018).  Removal of the blue component of light significantly decreases retinal damage after high intensity exposure.  PLoS One. 13: e0194218.

9. Wu J, Seregard S, and Algvere P (2006). Photochemical damage of the retina. Surv Ophthalmol. 51: 461-481.

10. Algvere P, Marshall J, and Seregard S (2006). Age-related maculopathy and the impact of blue light hazard. Acta Ophthalmol Scand. 84: 4-15.

11. US Patent 9,226,940 B2, Method of Treating Ocular Disorders, Issued Jan. 5, 2016 to Kemin Industries.                                                                       

12. Lin C, Wu M, Li C, Cheng H, Huang S, Tsai C, Lin F, Ho J, Kang J, Hsiao G, and Cheng Y (2017).  Periodic Exposure to Smartphone-Mimic Low-Luminance Blue Light Induces Retina Damage Through Bcl-2/BAX-Dependent Apoptosis.  Toxicol Sci. 157: 196-210.        

13. Stringham et al. Macular Carotenoid Supplementation Improves Visual Performance, Sleep Quality, and Adverse Physical Symptoms in Those with High Screen Time Exposure. Foods 2017. 6, 47.  

14. Joint FAO/WHO Expert Committee on Food Additives. June 2018. http://www.who.int/foodsafety/areas_work/chemical-risks/JECFA86-Summary.pdf.

15. Kemin/DSM Consumer Research, 2018. 

16. Age-Related Eye Disease Study 2 (AREDS2) Research Group (2014). JAMA Ophthalmol. 132: 142-149.

17. Stringham JM, and BR Hammond. Macular pigment and visual performance under glare conditions. Optometry and Vision Science 85: 82-88, 2008.

18. Ranard KM et al. Dietary guidance for lutein: consideration for intake recommendations is scientifically supported. European Journal of Nutrition (2017) 56 (Suppl 3):S37–S42.

19. PubMed, 2018.

20. Based on the results of the US Quintiles IMS National Disease and Therapeutic (NDTI) syndicated report among US physicians who recommend a dietary supplement with lutein for eye health between June 1, 2017 to March 31, 2018.

21. U.S. Food & Drug Administration, 2004. GRAS Notice Inventory, GRN No. 140, 221 and 390.

 

FloraGLO is a trademark of Kemin Industries, Inc. and its group of companies 2017. All rights reserved. OPTISHARP and OPTISHARP Natural are trademarks of DSM Nutritional Products. OPTISHARP Natural is made with patented ZeaONE from Kemin. ZeaONE is a trademark of Kemin Industries, Inc. and licensed under U.S. Patents Nos. 6,748,351, 7.575,766 and 7,033,622.