Free Shipping on All Orders $75 Or More!

Your Trusted Brand for Over 35 Years

Life Extension Magazine

<< Back to September 2005

Why Lutein and Zeaxanthin Are Becoming So Popular

September 2005

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.


1. Hammond BR, Jr., Ciulla TA, Snodderly DM. Macular pigment density is reduced in obese subjects. Invest Ophthalmol Vis Sci. 2002 Jan;43(1):47-50.

2. Sommerburg O, Keunen JE, Bird AC, van Kuijk FJ. Fruits and vegetables that are sources for lutein and zeaxanthin: the macular pigment in human eyes. Br J Ophthalmol. 1998 Aug;82(8):907-10.

3. Micozzi MS, Beecher GR, Taylor PR, Khachik F. Carotenoid analyses of selected raw and cooked foods associated with a lower risk for cancer. J Natl Cancer Inst. 1990 Feb 21;82(4):282-5.

4. Faulks RM, Hart DJ, Brett GM, Dainty JR, Southon S. Kinetics of gastro-intestinal transit and carotenoid absorption and disposal in ileostomy volunteers fed spinach meals. Eur J Nutr. 2004 Feb;43(1):15-22.

5. McEligot AJ, Rock CL, Shanks TG, et al. Comparison of serum carotenoid responses between women consuming vegetable juice and women consuming raw or cooked vegetables. Cancer Epidemiol Biomarkers Prev. 1999 Mar;8(3):227-31.

6. Jones ST, Aryana KJ, Losso JN. Storage stability of lutein during ripening of cheddar cheese. J Dairy Sci. 2005 May;88(5):1661-70.

7. Antioxidant status and neovascular age-related macular degeneration. Eye Disease Case-Control Study Group. Arch Ophthalmol. 1993 Jan;111(1):104-9.

8. Gruber M, Chappell R, Millen A, et al. Correlates of serum lutein + zeaxanthin: findings from the Third National Health and Nutrition Examination Survey. J Nutr. 2004 Sep;134(9):2387-94.

9. Krinsky NI. Possible biologic mechanisms for a protective role of xanthophylls. J Nutr. 2002 Mar;132(3):540S-2S.

10. Molnar J, Gyemant N, Mucsi I, et al. Modulation of multidrug resistance and apoptosis of cancer cells by selected carotenoids. In Vivo. 2004 Mar-Apr;18(2):237-44.

11. Millen AE, Tucker MA, Hartge P, et al. Diet and melanoma in a case-control study. Cancer Epidemiol Biomarkers Prev. 2004 Jun;13(6):1042-51.

12. Zhang S, Hunter DJ, Forman MR, et al. Dietary carotenoids and vitamins A, C, and E and risk of breast cancer. J Natl Cancer Inst. 1999 Mar 17;91(6):547-56.

13. Toniolo P, Van Kappel AL, Akhmedkhanov A, et al. Serum carotenoids and breast cancer. Am J Epidemiol. 2001 Jun 15; 153(12):1142-7.

14. Alexander RW. Theodore Cooper Memorial Lecture. Hypertension and the pathogenesis of atherosclerosis. Oxidative stress and the mediation of arterial inflammatory response: a new perspective. Hypertension. 1995 Feb;25(2):155-61.

15. Martin KR, Wu D, Meydani M. The effect of carotenoids on the expression of cell surface adhesion molecules and binding of monocytes to human aortic endothelial cells. Atherosclerosis. 2000 Jun;150(2):265-74.

16. Dwyer JH, Navab M, Dwyer KM, et al. Oxygenated carotenoid lutein and progression of early atherosclerosis: the Los Angeles atherosclerosis study. Circulation. 2001 Jun 19;103(24):2922-7.

17. Handelman GJ, Nightingale ZD, Lichtenstein AH, Schaefer EJ, Blumberg JB. Lutein and zeaxanthin concentrations in plasma after dietary supplementation with egg yolk. Am J Clin Nutr. 1999 Aug;70(2):247-51.

18. Chung HY, Rasmussen HM, Johnson EJ. Lutein bioavailability is higher from lutein-enriched eggs than from supplements and spinach in men. J Nutr. 2004 Aug; 134(8):1887-93.

19. Herron KL, Fernandez ML. Are the current dietary guidelines regarding egg consumption appropriate? J Nutr. 2004 Jan; 134(1):187-90.

20. Yeum KJ, Taylor A, Tang G, Russell RM. Measurement of carotenoids, retinoids, and tocopherols in human lenses. Invest Ophthalmol Vis Sci. 1995 Dec;36(13):2756-61.

21. Moeller SM, Jacques PF, Blumberg JB. The potential role of dietary xanthophylls in cataract and age-related macular degeneration. J Am Coll Nutr. 2000 Oct;19(5 Suppl):522S-7S.

22. Kirschfeld K. Carotenoid pigments: their possible role in protecting against photooxidation in eyes and photoreceptor cells. Proc R Soc Lond B Biol Sci. 1982 Aug 23; 216(1202):71-85.

23. Mozaffarieh M, Sacu S, Wedrich A. The role of the carotenoids, lutein and zeaxanthin, in protecting against age-related macular degeneration: A review based on controversial evidence. Nutr J. 2003 Dec 11;2(1):20.

24. Seddon JM, Ajani UA, Sperduto RD, et al. Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group. JAMA. 1994 Nov 9;272(18):1413-20.

25. Mares-Perlman JA, Fisher AI, Klein R, et al. Lutein and zeaxanthin in the diet and serum and their relation to age-related maculopathy in the third national health and nutrition examination survey. Am J Epidemiol. 2001 Mar 1;153(5):424-32.

26. Mares-Perlman JA, Klein R, Klein BE, et al. Association of zinc and antioxidant nutrients with age-related maculopathy. Arch Ophthalmol. 1996 Aug;114(8):991-7.

27. VandenLangenberg GM, Mares-Perlman JA, Klein R, Klein BE, Brady WE, Palta M. Associations between antioxidant and zinc intake and the 5-year incidence of early age-related maculopathy in the Beaver Dam Eye Study. Am J Epidemiol. 1998 Jul 15; 148(2):204-14.

28. Gale CR, Hall NF, Phillips DI, Martyn CN. Lutein and zeaxanthin status and risk of age-related macular degeneration. Invest Ophthalmol Vis Sci. 2003 Jun;44(6):2461-5.

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.

30. Landrum JT, Bone RA, Kilburn MD. The macular pigment: a possible role in protection from age-related macular degeneration. Adv Pharmacol. 1997;38:537-56.

31. Beatty S, Boulton M, Henson D, Koh HH, Murray IJ. Macular pigment and age related macular degeneration. Br J Ophthalmol. 1999 Jul;83(7):867-77.

32. Hammond BR, Jr., Wooten BR, Snodderly DM. Preservation of visual sensitivity of older subjects: association with macular pigment density. Invest Ophthalmol Vis Sci. 1998 Feb;39(2):397-406.

33. Hammond BR, Jr., Johnson EJ, Russell RM, et al. Dietary modification of human macular pigment density. Invest Ophthalmol Vis Sci. 1997 Aug;38(9):1795-801.

34. Landrum JT, Bone RA, Joa H, Kilburn MD, Moore LL, Sprague KE. A one year study of the macular pigment: the effect of 140 days of a lutein supplement. Exp Eye Res. 1997 Jul;65(1):57-62.

35. Berendschot TT, Goldbohm RA, Klopping WA, van de Kraats J, van Norel J, van Norren D. Influence of lutein supplementation on macular pigment, assessed with two objective techniques. Invest Ophthalmol Vis Sci. 2000 Oct;41(11):3322-6.

36. Koh HH, Murray IJ, Nolan D, Carden D, Feather J, Beatty S. Plasma and macular responses to lutein supplement in subjects with and without age-related maculopathy: a pilot study. Exp Eye Res. 2004 Jul;79(1):21-7.

37. Bone RA, Landrum JT, Friedes LM, et al. Distribution of lutein and zeaxanthin stereoisomers in the human retina. Exp Eye Res. 1997 Feb;64(2):211-8.

38. Curran-Celentano J, Erdman JW, Jr., Nelson RA, Grater SJ. Alterations in vitamin A and thyroid hormone status in anorexia nervosa and associated disorders. Am J Clin Nutr. 1985 Dec;42(6):1183-91.

39. Chasan-Taber L, Willett WC, Seddon JM, et al. A prospective study of carotenoid and vitamin A intakes and risk of cataract extraction in US women. Am J Clin Nutr. 1999 Oct;70(4):509-16.

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.

43. Chitchumroonchokchai C, Bomser JA, Glamm JE, Failla ML. Xanthophylls and alpha-tocopherol decrease UVB-induced lipid peroxidation and stress signaling in human lens epithelial cells. J Nutr. 2004 Dec;134(12):3225-32.

44. Kopsell D, Kopsell D, Curran-Celentano J. Carotenoid variability among kale and spinach cultivars. Hortscience. 2004;39(2):34.