Key points to remember
- A dietary supplement containing lutein and zeaxanthin, along with vitamin C, vitamin E, zinc and copper, may slow the progression of age-related macular degeneration better than similar supplements containing beta carotene.
- The lutein/zeaxanthin formula does not increase the risk of developing lung cancer in current or former smokers like beta-carotene does.
Preventing vision loss just got a whole lot safer. According to new research, a dietary supplement containing lutein and zeaxanthin is both more effective at slowing the progression of age-related macular degeneration and safer than a supplement containing beta-carotene.
Both supplement formulations also contained vitamin C, vitamin E, copper and zinc.
Beta-carotene, lutein, and zeaxanthin are all types of carotenoids or pigments that give plants like pumpkins, corn, and tomatoes their orange, yellow, or red colors. Previous studies have shown that although beta-carotene is able to slow the progression of macular degeneration, it increases the risk of lung cancer in people who are or were smokers. Lutein and zeaxanthin slow progression more than beta-carotene and do not increase the risk of lung cancer.
These results are based on 10 years of follow-up data from a large study called AREDS2, the Studies on age-related eye diseaseswho evaluated the new formulation. The original AREDS study, launched in 1992, tested a supplement containing 15 milligrams of beta-carotene and found a significant slowing in the progression of macular degeneration.
What is macular degeneration?
Age-related macular degeneration is one of the leading causes of vision loss and blindness. According to national eye instituteeleven million people in the United States suffer from the disease, which involves damage to the macula, the central part of the eye’s retina.
Change in wording
When AREDS started in the 1990s, researchers didn’t know much about carotenoids. But they knew that carotenoids were probably important for protecting vision since they concentrate in the retina.
According to the AREDS investigator Paul S. Bernstein, MD, PhDbeta-carotene was studied in the 90s because it was marketed as a supplement at a time when lutein and zeaxanthin were not widely available.
“The [new] the study was reassuring to me as a carotenoid researcher [because it shows] that carotenoids are not created equal,” Bernstein, who is currently a professor of ophthalmology and visual sciences at the University of Utah School of Medicine, told Verywell. “Beta-carotene is a bad actor when given in very high doses. Lutein and zeaxanthin behave very differently even though they only differ by two oxygens from beta-carotene.
Beta-carotene in food is not a problem for smokers or former smokers. And eating a diet rich in carotenoids is not dangerous.
“It’s supplementation on top of being a veteran or a cigarette smoker that makes this disastrous lung cancer equation,” Emily Chew, MD, principal investigator of AREDS2, told Verywell. Chew is the director of the Division of Epidemiology and Clinical Applications at the National Eye Institute.
“Our goal with AREDS2 was to create an equally effective supplement formula that could be used by anyone, whether they smoke or not,” Chew said.
His team’s research followed 3,882 of the original 4,203 AREDS2 participants for an additional five years from 2012. Of the study participants who received a supplement formulation with beta-carotene, 6 of the 637 non-smokers (0.94%) and 32 of 711 former smokers (4.5%) developed lung cancer.
In comparison, among those who received lutein and zeaxanthin supplements, 4 of 606 (0.66%) non-smokers and 17 of 735 (2.3%) former smokers developed lung cancer.
The lutein/zeaxanthin formulation reduced the risk of macular degeneration progression by 26%.
According to American Academy of Ophthalmology (AAO), risk factors for macular degeneration include smoking, high blood pressure, high cholesterol, and a diet high in saturated fat.
Should you take lutein and zeaxanthin?
Should everyone take a dietary supplement with lutein and zeaxanthin?
“Go to your doctor first,” Chew said. “If you don’t have middle-age related macular degeneration (AMD), it won’t help you and it’s just an added cost.”
Chew suggests following a healthy diet, like the Mediterranean diet, and incorporating monounsaturated oils like olive oil and fish twice a week.
What this means for you
A dietary supplement containing 10 milligrams of lutein and 2 milligrams of zeaxanthin is more effective at preventing the worsening of age-related macular degeneration than supplements containing beta-carotene. Beta-carotene was associated with a doubling of the risk of developing lung cancer, a risk that was not seen with lutein and zeaxanthin.