Lutein · The Ingredient Files

①

Evidence by effect

Evidence strength (A–D, color) and effect size (dots, fill) are shown separately. The two axes are independent.

Claimed effect

Evidence strength

Effect size

One-line summary · key source

Slowing progression of intermediate or worse macular degenerationAn age-related eye disease in which the central retina (macula) is damaged, blurring central vision (AMD). (AMD)Evidence type: RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.

B Moderate

Moderate

Lutein's firmest evidence, but with a complex texture. In the AREDS2 randomized trial of 4,203 people at risk of advanced AMD, adding lutein 10 mg + zeaxanthin 2 mg to the existing AREDS formula did not significantly further reduce progression in the primary analysis (hazard ratio 0.90, p=0.12). However, over 10-year follow-up (Report 28), the lutein/zeaxanthin group had lower late-AMD progression (hazard ratio 0.91, p=0.02), and compared directly with beta carotene it was better at 0.85 (p=0.02). Moreover, beta carotene increased lung cancer (odds ratio 1.82) while lutein/zeaxanthin did not. So the revised AREDS formula now uses lutein/zeaxanthin instead of beta carotene. It is meaningful as the safer carotenoidA family of yellow, orange, and green plant pigments; lutein, zeaxanthin, and beta carotene belong to it. in a specific formula for an at-risk group. PMID: 23644932 · 35653117

Preventing AMD or helping early stages in the general populationEvidence type: RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.

D Insufficient

None

The belief that 'it is good for the eyes, so taking it ahead of time prevents macular degenerationAn age-related eye disease in which the central retina (macula) is damaged, blurring central vision (AMD).' has no support. AREDS2 studied people already at risk of progression (bilateral large drusenYellow deposits that build up under the retina; many or large ones signal a higher risk of AMD progression., etc.), not prevention in healthy people. Even in that at-risk group, adding lutein/zeaxanthin to the existing formula did not significantly reduce progression in the primary analysis (hazard ratio 0.90, p=0.12). There is no confirmed evidence that people in early stages, at low risk, or with healthy eyes benefit from taking it for prevention. Any AMD benefit is confined to those already at intermediate or worse risk. PMID: 23644932

Preventing cataractAn age-related eye disease in which the lens becomes cloudy, reducing vision.Evidence type: Observational

C Weak

Minimal

Observational studies show an association, but causation is not established. In a meta-analysisA statistical synthesis combining results of multiple studies into one conclusion. of blood lutein/zeaxanthin and cataractAn age-related eye disease in which the lens becomes cloudy, reducing vision., higher levels were linked to lower nuclear-cataract risk (relative risk 0.63 for zeaxanthin, 0.73 for lutein). Another meta-analysis of dietary intake likewise found that in cohort studies, higher lutein/zeaxanthin intake was linked to lower cataract risk with a dose-response (26% lower per 10 mg/day). But these are all observational, and people who eat more vegetables may differ in other healthy habits. Indeed, in the same meta-analysis, randomized trials of antioxidant vitamins (vitamin E, beta carotene) did not reduce cataract risk. So there is an association, but not yet proof that a supplement prevents it. PMID: 24451312 · 30624584

Blocking blue light, easing eye strain, improving general vision (the belief)Evidence type: Observational

D Insufficient

Minimal

The most common selling point in the smartphone and monitor era, but weakly supported. It is true that the macular pigmentThe layer of lutein and zeaxanthin accumulated in the central retina (macula) that filters blue light and resists oxidation. formed by lutein/zeaxanthin filters blue light, but that does not translate into 'taking a supplement makes eyes less tired and vision better.' A meta-analysisA statistical synthesis combining results of multiple studies into one conclusion. of macular pigment density and visual function in healthy eyes found correlations with some measures (contrast sensitivity, photostress recovery, glare disability), but these are only correlations - 'people with denser pigment tend to score better' - not proof that supplementing improves them. No robust evidence confirms that a supplement prevents blue-light eye damage or relieves digital eye strain. PMID: 32792595

Evidence strength A Strong · B Moderate · C Weak · D Insufficient/refuted

Effect size Large → None

②

Who benefits / who should be cautious

The statements in this section are translated directly from institutional sources (NIH-ODS, etc.), not our own interpretation. Consult a professional before use.

Benefit

For people already at intermediate or worse AMD risk, lutein/zeaxanthin is used as the carotenoidA family of yellow, orange, and green plant pigments; lutein, zeaxanthin, and beta carotene belong to it. replacing beta carotene in AREDS-type eye supplements. This substitution matters especially for current or former smokers, who should avoid beta carotene because it raises lung-cancer risk. source↗

Original text

because of potential increased incidence of lung cancer in former smokers, lutein + zeaxanthin could be an appropriate carotenoid substitute in the AREDS formulation.
Caution

Adding lutein/zeaxanthin to an existing eye supplement did not further reduce AMD progression in the primary analysis. It is one ingredient in a formula for an at-risk group, not something that by itself guarantees dramatic prevention or improvement. source↗

Original text

Addition of lutein + zeaxanthin, DHA + EPA, or both to the AREDS formulation in primary analyses did not further reduce risk of progression to advanced AMD.
Caution

Benefits for cataractAn age-related eye disease in which the lens becomes cloudy, reducing vision. and general eye health are mostly an 'association' from observational studies. In fact, randomized trials of antioxidant vitamins did not reduce cataract risk. A varied diet of vegetables and fruit comes before a single supplement. source↗

Original text

In RCTs, vitamin E (RR: 0.97; 95% CI: 0.91, 1.03; P = 0.262) or beta-carotene (RR: 0.99; 95% CI: 0.92, 1.07; P = 0.820) intervention did not reduce the risk of ARC significantly compared with the placebo group.

③

Form & dosage evidence

Trial doses by effect

AMD (AREDS2 trial dose): Lutein 10 mg + zeaxanthin 2 mg/day (as part of the AREDS formula) [23644932]

④

Balanced conclusion

Lutein is not a catch-all eye supplement; what matters is who uses it and why. Its firm evidence is in people already at intermediate or worse AMD risk, where in AREDS2-type formulas lutein/zeaxanthin lowers progression risk (long-term hazard ratios 0.85 to 0.91) while safely replacing beta carotene, which raises lung cancer. That is why revised eye supplements now use lutein/zeaxanthin instead of beta carotene. But there is no evidence for preventing AMD or helping early stages in healthy people; cataractAn age-related eye disease in which the lens becomes cloudy, reducing vision. benefit is only an observational association not confirmed by supplement trials; and 'blocking blue light, easing eye strain, and improving vision' rests on a correlation between macular pigmentThe layer of lutein and zeaxanthin accumulated in the central retina (macula) that filters blue light and resists oxidation. and some visual measures, weakly supporting that supplementing helps. Smokers should avoid eye supplements containing beta carotene and choose lutein/zeaxanthin formulas. In short, it is meaningful as the safe ingredient of a specific formula for at-risk people, but weakly grounded for prevention or eye-strain relief in healthy eyes, and getting it from dark-green vegetables and eggs comes first.

Apply - Get it from food

Examples of foods rich in Lutein. Amounts are shown for reference against the doses used in the trials.

Note: eating these foods does not guarantee immediate treatment or prevention of any disease.

There is no official recommendation for lutein/zeaxanthin. The AREDS2 trial used lutein 10 mg + zeaxanthin 2 mg a day, while ordinary dietary intake is roughly 1 to 2 mg. It is abundant in dark-green vegetables and egg yolk as below, and being fat-soluble it is absorbed better with some oil. Egg lutein, though smaller in amount, tends to be well absorbed.

Spinach, boiled100 g ~11.3 mg [source]
Kale, boiled100 g ~5.0 mg [source]
Green peas, boiled100 g ~2.6 mg [source]
Romaine lettuce, raw100 g ~2.3 mg [source]
Broccoli, boiled100 g ~1.1 mg [source]
Egg, hard-boiled100 g ~0.35 mg [source]

⑤

Sources

Each source shows its one-line summary and key summary up front. Expand the collapsed section to read the original abstract. Every citation is verified by re-resolving through the API.

PMID 23644932 Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial Randomized controlled trial (AREDS2) · JAMA, 2013 4,203 people - adding lutein/zeaxanthin to the AREDS formula did not further reduce progression in the primary analysis (HR 0.90, p=0.12), but is a safe replacement for lung-cancer-raising beta carotene.

Key summary

A multicenter randomized double-masked phase 3 trial in 4,203 people at risk of advanced AMD (aged 50-85, with bilateral large drusenYellow deposits that build up under the retina; many or large ones signal a higher risk of AMD progression., etc.). On top of the existing AREDS formula, participants added lutein 10 mg + zeaxanthin 2 mg, DHAAn omega-3 fatty acid (docosahexaenoic acid). + EPAAn omega-3 fatty acid (eicosapentaenoic acid)., both, or placeboAn inert dummy treatment used as the comparison baseline., over 5 years. In the primary analysis, no combination further reduced advanced-AMD risk significantly (lutein/zeaxanthin hazard ratio 0.90, 98.7% CI 0.76-1.07, p=0.12). Removing beta carotene or lowering zinc had no effect on progression. However, more lung cancers occurred in the beta-carotene group (2.0% vs 0.9%, mostly former smokers). The authors concluded that although there was no added benefit, because of the lung-cancer risk lutein/zeaxanthin could be an appropriate carotenoidA family of yellow, orange, and green plant pigments; lutein, zeaxanthin, and beta carotene belong to it. substitute for beta carotene.

Show original abstract

IMPORTANCE: Oral supplementation with the Age-Related Eye Disease Study (AREDS) formulation (antioxidant vitamins C and E, beta carotene, and zinc) has been shown to reduce the risk of progression to advanced age-related macular degeneration (AMD). OBJECTIVES: To determine whether adding lutein + zeaxanthin, DHA + EPA, or both to the AREDS formulation decreases the risk of developing advanced AMD and to evaluate the effect of eliminating beta carotene, lowering zinc doses, or both in the AREDS formulation. DESIGN, SETTING, AND PARTICIPANTS: The Age-Related Eye Disease Study 2 (AREDS2), a multicenter, randomized, double-masked, placebo-controlled phase 3 study with a 2 x 2 factorial design, enrolling 4203 participants aged 50 to 85 years at risk for progression to advanced AMD. INTERVENTIONS: Participants were randomized to receive lutein (10 mg) + zeaxanthin (2 mg), DHA (350 mg) + EPA (650 mg), lutein + zeaxanthin and DHA + EPA, or placebo. RESULTS: Comparison with placebo in the primary analyses demonstrated no statistically significant reduction in progression to advanced AMD (hazard ratio [HR], 0.90 [98.7% CI, 0.76-1.07]; P = .12 for lutein + zeaxanthin). There was no apparent effect of beta carotene elimination or lower-dose zinc on progression to advanced AMD. More lung cancers were noted in the beta carotene vs no beta carotene group (23 [2.0%] vs 11 [0.9%], nominal P = .04), mostly in former smokers. CONCLUSIONS AND RELEVANCE: Addition of lutein + zeaxanthin, DHA + EPA, or both to the AREDS formulation in primary analyses did not further reduce risk of progression to advanced AMD. However, because of potential increased incidence of lung cancer in former smokers, lutein + zeaxanthin could be an appropriate carotenoid substitute in the AREDS formulation. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.

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PMID 35653117 Long-term Outcomes of Adding Lutein/Zeaxanthin and Omega-3 Fatty Acids to the AREDS Supplements on Age-Related Macular Degeneration Progression: AREDS2 Report 28 Epidemiologic follow-up (AREDS2 Report 28) · JAMA Ophthalmol, 2022 10-year follow-up, 3,882 people - lutein/zeaxanthin lowered late-AMD progression (HR 0.91) and 0.85 vs beta carotene; beta carotene raised lung cancer (OR 1.82), lutein did not.

Key summary

An epidemiologic study following AREDS2 participants for 5 more years after the trial (3,882 people, 6,351 eyes, at 10 years). Late-AMD progression was lower in those assigned lutein/zeaxanthin than not (hazard ratio 0.91, 95% CI 0.84-0.99, p=0.02); restricted to those also on beta carotene it was 0.80 (p=0.002), and lutein/zeaxanthin versus beta carotene directly was 0.85 (p=0.02). Lung-cancer risk was higher in the beta-carotene group (odds ratio 1.82, p=0.02) and not significant for lutein/zeaxanthin (1.15). Long-term follow-up supports lutein/zeaxanthin reducing AMD progression while being safer than beta carotene, the basis for the revised AREDS formula replacing beta carotene with lutein/zeaxanthin.

Show original abstract

IMPORTANCE: After the Age-Related Eye Disease Study 2 (AREDS2) study, the beta carotene component was replaced by lutein/zeaxanthin for the development of the revised AREDS supplement. OBJECTIVE: To assess 10-year risk of developing lung cancer and late age-related macular degeneration (AMD). DESIGN, SETTING, AND PARTICIPANTS: A multicenter epidemiologic follow-up study of the AREDS2 clinical trial. RESULTS: This study included 3882 participants and 6351 eyes. At 10 years, the odds ratio (OR) of having lung cancer was 1.82 (95% CI, 1.06-3.12; P = .02) for those randomly assigned to beta carotene and 1.15 (95% CI, 0.79-1.66; P = .46) for lutein/zeaxanthin. The hazard ratio (HR) for progression to late AMD comparing lutein/zeaxanthin with no lutein/zeaxanthin was 0.91 (95% CI, 0.84-0.99; P = .02) and comparing omega-3 fatty acids with no omega-3 fatty acids was 1.01 (95% CI, 0.93-1.09; P = .91). When the lutein/zeaxanthin main effects analysis was restricted to those randomly assigned to beta carotene, the HR was 0.80 (95% CI, 0.68-0.92; P = .002). A direct analysis of lutein/zeaxanthin vs beta carotene showed the HR for late AMD was 0.85 (95% CI, 0.73-0.98; P = .02). ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.

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PMID 24451312 Association between lutein and zeaxanthin status and the risk of cataract: a meta-analysis Meta-analysis (observational) · Nutrients, 2014 1 cohort, 7 cross-sectional - higher blood lutein/zeaxanthin linked to lower nuclear-cataractAn age-related eye disease in which the lens becomes cloudy, reducing vision. risk (RR 0.63 zeaxanthin, 0.73 lutein); other cataract types not significant. Observational limits.

Key summary

A meta-analysisA statistical synthesis combining results of multiple studies into one conclusion. of blood lutein/zeaxanthin and age-related cataractAn age-related eye disease in which the lens becomes cloudy, reducing vision. (1 cohort, 7 cross-sectional studies). The highest-concentration group had significantly lower nuclear-cataract risk than the lowest (relative risk 0.63 for zeaxanthin, 0.73 for lutein). For cortical and subcapsular cataract the associations were mostly non-significant (only a marginal lutein-subcapsular link). The authors concluded that high blood lutein/zeaxanthin is significantly associated with lower nuclear-cataract risk. But most were cross-sectional, so causation cannot be inferred, and results differed by lens region.

Show original abstract

The purpose of this meta-analysis was to evaluate the relationship between blood lutein and zeaxanthin concentration and the risk of age-related cataract (ARC). MEDLINE, EMBASE, ISI and Cochrane Library were searched to identify relevant studies up to April 2013. Meta-analysis was conducted to obtain pooled relative risks (RRs) for the highest-versus-lowest categories of blood lutein and zeaxanthin concentrations. One cohort study and seven cross-sectional studies were included in the meta-analysis. There were significant inverse associations between nuclear cataract and blood lutein and zeaxanthin concentrations, with the pooled RRs ranging from 0.63 (95% confidence interval (CI): 0.49, 0.77) for zeaxanthin to 0.73 (95% CI: 0.59, 0.87) for lutein. Blood lutein and zeaxanthin were also noted to lead towards a decrease in the risk of cortical cataract and subcapsular cataract; however, these pooled RRs were not statistically significant, with the exception of a marginal association between lutein and subcapsular cataract. Our results suggest that high blood lutein and zeaxanthin are significantly associated with a decrease in the risk of nuclear cataract. However, no significant associations were found for ARC in other regions of the lens. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.

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PMID 30624584 Dietary vitamin and carotenoid intake and risk of age-related cataract Meta-analysis · Am J Clin Nutr, 2019 8 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s, 12 cohorts - in cohorts, higher lutein/zeaxanthin intake linked to lower cataractAn age-related eye disease in which the lens becomes cloudy, reducing vision. (RR 0.81, 26% per 10 mg/day), but antioxidant-vitamin RCTs (vitamin E, beta carotene) did not reduce cataract. Observational-vs-RCT gap.

Key summary

A meta-analysisA statistical synthesis combining results of multiple studies into one conclusion. of dietary vitamin and carotenoidA family of yellow, orange, and green plant pigments; lutein, zeaxanthin, and beta carotene belong to it. intake and age-related cataractAn age-related eye disease in which the lens becomes cloudy, reducing vision. (8 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s, 12 cohorts). In cohort studies, higher intake of vitamins A, C, E, beta carotene, and lutein/zeaxanthin was linked to lower cataract risk, with lutein/zeaxanthin showing a dose-response of 26% lower per 10 mg/day (relative risk 0.81). But in randomized trials, vitamin E or beta-carotene supplementation did not significantly reduce cataract risk versus placeboAn inert dummy treatment used as the comparison baseline. (RR 0.97 and 0.99). It is a classic case of an observational association not reproduced in intervention trials, suggesting other traits of people who eat more fruit and vegetables may be involved.

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BACKGROUND: Existing studies suggest that dietary vitamins and carotenoids might be associated with a reduced risk of age-related cataract (ARC). OBJECTIVES: The aim of this study was to conduct a meta-analysis of randomized controlled trials (RCTs) and cohort studies of dietary vitamin and carotenoid intake and ARC risk. RESULTS: We included 8 RCTs and 12 cohort studies in the meta-analysis. Most vitamins and carotenoids were significantly associated with reduced risk of ARC in the cohort studies, including vitamin A (RR: 0.81; 95% CI: 0.71, 0.92), vitamin C (RR: 0.80; 95% CI: 0.72, 0.88), vitamin E (RR: 0.90; 95% CI: 0.80, 1.00), beta-carotene (RR: 0.90; 95% CI: 0.83, 0.99), and lutein or zeaxanthin (RR: 0.81; 95% CI: 0.75, 0.89). In RCTs, vitamin E (RR: 0.97; 95% CI: 0.91, 1.03) or beta-carotene (RR: 0.99; 95% CI: 0.92, 1.07) intervention did not reduce the risk of ARC significantly compared with the placebo group. Further dose-response analysis indicated that in cohort studies the risk of ARC significantly decreased by 26% for every 10-mg/d increase in lutein or zeaxanthin intake (RR: 0.74; 95% CI: 0.67, 0.80). ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.

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PMID 32792595 The association between macular pigment optical density and visual function outcomes: a systematic review and meta-analysis Systematic review (correlational) · Eye (Lond), 2021 22 studies in healthy eyes - macular pigmentThe layer of lutein and zeaxanthin accumulated in the central retina (macula) that filters blue light and resists oxidation. density correlated with contrast sensitivity, photostress recovery, and glare disability. But only correlation, not proof supplements improve them.

Key summary

A systematic review and meta-analysisA statistical synthesis combining results of multiple studies into one conclusion. of macular pigmentThe layer of lutein and zeaxanthin accumulated in the central retina (macula) that filters blue light and resists oxidation. optical density (MPOD) and visual function in healthy eyes (22 studies). Macular pigment density showed significant correlations with some contrast sensitivity measures (summary r 0.37, 0.31), photostress recovery (r -0.17 to -0.57), and glare disability (r 0.47). Other visual functions had insufficient data to pool. The authors concluded there is a link between macular pigment and visual function. But this is a correlation - people with denser pigment score better - not intervention evidence that lutein supplementation improves these measures.

Show original abstract

OBJECTIVES: To conduct a systematic review and meta-analysis on data related to macular pigment optical density (MPOD) and visual function in adults with healthy eyes. METHODS: Included studies examined correlation of MPOD and visual function in adults with healthy eyes. Visual function outcomes of interest included photostress recovery, contrast sensitivity, visual acuity, glare sensitivity/disability, and dark adaptation. Random effects model meta-analyses combined study-level correlation (r). RESULTS: Twenty-two publications were included. In meta-analysis MPOD was found to be significantly correlated with contrast sensitivity at 30' (two studies, summary r: 0.37; 95% CI 0.15, 0.56), and at 1 degree eccentricity with a spatial frequency of 7, 11, and 21 cpd (three studies, summary r: 0.31; 95% CI 0.06, 0.52), with photostress recovery at a 1 degree eccentricity (four studies, summary r: -0.57; 95% CI -0.78, -0.24), and with glare disability at 30' eccentricity (three studies, summary r = 0.47; 95% CI 0.32, 0.59). There were insufficient data for meta-analysis for other visual functions. CONCLUSIONS: Our review identifies a link between MPOD and visual function with significant correlations with photostress recovery, glare disability, and contrast sensitivity. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.

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USDA FoodData Central Spinach, cooked, boiled, drained, without salt (FDC 170531)