Lutein, zeaxanthin for AMD protection: more science

By Stephen Daniells

- Last updated on GMT

Higher intakes of the carotenoids lutein and zeaxanthin in the diet
may slash the risk of age-related macular degeneration by 65 per
cent, suggests a new study from Down Under.

Protective effects from an increased intake of zinc-rich foods was also observed, report the researchers in the journal Ophthalmology​, which supports finding from the Age-Related Eye Disease Study (AREDS) On the flip side, the Australian researchers reported that an increased intake of beta-carotene may increase the risk of AMD - a degenerative retinal disease that causes central vision loss and leaves only peripheral vision, and the leading cause of legal blindness for people over 55 years of age in the Western world, according to AMD Alliance International. "In this population-based cohort study, the authors found that higher dietary intake of lutein and zeaxanthin may confer protection against long-term incident neovascular AMD or indistinct soft or reticular drusen and that zinc intake from diet and supplements combined may protect against early or any AMD. A high intake of vegetables also was protective for any AMD,"​ states the article. Lead author Jennifer Tan details that, of the 3654 participants signed up at the start of the Blue Mountains Eye Study​, 2454 participants were re-examined after five and/or 10 years. The researchers, from the University of Sydney and the University of Newcastle, report that people with the highest average intakes of dietary lutein and zeaxanthin had a 65 per cent reduced risk of neo-vascular AMD than those with the lowest average intakes. Moreover, high zinc intake was associated with a 44 per cent reduction in any type of AMD, and a 46 per cent reduction in early AMD. On the other hand, the highest versus lowest intakes of total beta-carotene from dietary and supplemental sources was associated with a 168 per cent increase in the risk of neo-vascular AMD, while beta-carotene from diet was associated with a 140 per cent increase in the same type of AMD. "In this population-based cohort study, higher dietary lutein and zeaxanthin intake reduced the risk of long-term incident AMD. This study confirmed the Age-Related Eye Disease Study finding of protective influences from zinc against AMD,"​ wrote the researchers. "Higher beta-carotene intake was associated with an increased risk of AMD." ​ Tan and co-workers stated that the link between higher beta-carotene intakes and an increased risk of AMD was inconsistent with other reports. "The authors are not aware of other studies reporting a higher risk of AMD with increasing dietary intake of beta-carotene, and they have no biological explanation for this finding,"​ states the article. "Thus, these findings need to be taken with caution."Inconsistencies ​ Despite protective effects from lutein, zeaxanthin and zinc, Tan and co-workers report that high intakes of beta-carotene, and vitamins C and E were not associated with reduced risks of AMD, despite earlier findings by studies such as AREDS. "Given the inconsistency of dietary findings to date, and the potentially important therapeutic implications, further longitudinal studies and randomised clinical trials, such as AREDS II, are needed to clarify these associations,"​ they wrote. The results of the follow-up study, AREDS2, are eagerly awaited by many in the field. Earlier this week, English researchers stated that more definitive answers concerning lutein and eye health would be provided by the trial. The AREDS formula, the patent for which is held by Bausch and Lomb, comprises vitamins C and E, beta carotene, zinc and copper. AREDS2 will include the antioxidant carotenoids lutein and zeaxanthin, and the omega-3 fatty acids DHA and EPA. "The AREDS2 also is examining the effect of eliminatingbeta-carotene from the current AREDS formulation in patients with moderate to high AMD risk,"​ wrote Tan and co-workers. "This may provide further insights into the association between ß-carotene and AMD."Zeaxanthin and eye health ​ In this month's American Journal of Clinical Nutrition​, researchers from the Macular Pigment Research Group at the Waterford Institute of Technology in Ireland investigated the role of dietary antioxidants in protection against age-related maculopathy (ARM). The study, which included 828 healthy Irish subjects aged between 20 and 60, found that a dietary zeaxanthin intake decreased with age, which was associated with an increased risk of ARM. "Our finding that age, the most important and universal risk factor for ARM, is associated with a relative lack of dietary zeaxanthin, is an important finding that warrants further investigation,"​ wrote the authors. Speaking to NutraIngredients.com, lead researcher Stephen Beatty explained that his group did not test lutein or zeaxanthin with respect to ARM, but "simply observed that dietary intake of zeaxanthin decreases with increasing age (which is, obviously, the most important risk-factor for ARM).""In other words, perhaps people should take zeaxanthin supplements as they get older (with or without lutein and meso-zeaxanthin),"​ he added. Source: Ophthalmology​ (Elsevier) February 2008, Volume 115, Issue 2, Pages 334-341 "Dietary Antioxidants and the Long-term Incidence of Age-Related Macular Degeneration: The Blue Mountains Eye Study" ​Authors: J.S.L. Tan, J.J. Wang, V. Flood, E. Rochtchina, W. Smith, P. Mitchell Source: American Journal of Clinical Nutrition​ March 2008, Volume 87, Number 3, Pages 712-722 "Diet and risk factors for age-related maculopathy"​ Authors: E.D. O'Connell, J.M. Nolan, J. Stack, D. Greenberg, J. Kyle, L. Maddock, S. Beatty

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