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Lutein, Zeaxanthin, Meso-Zeaxanthin – An Update

Your Eyes Benefit from Lutein, Zeaxanthin, and Meso-zeaxanthin

food high in Lutein, Zeaxanthin, Meso-zeaxanthinLutein, zeaxanthin, and meso-zeaxanthin are potent antioxidants found in green leafy vegetables, eggs, corn and even chocolate. They have a profound effect on preserving healthy vision, brain function, the immune and cardiovascular systems.

New research is focusing less on the well-established understanding of local benefit from nutrients, e.g. lutein for macular degeneration or cataract, and more on its systemic benefits affecting the immune system, the brain and cognitive function, the eye, cancer, and cardiovascular health.1 In addition, new research is focused on the “why” of the benefit of these carotenoids.

Macular Degeneration

Macular degeneration (AMD) is one of the leading causes of vision loss and blindness. Our retina is abundantly supplied with oxygen but repeated or prolonged exposure to light, especially UV and blue light, decreases long-chain polyunsaturated fatty acids (such as omega-3s) in the retina, increases certain molecular bonds (lipid conjugated dienes), and degrades the photoreceptors and retina.2

Accumulated exposure to UV and blue light can cause accumulation of free radicals, oxidative stress, accelerate vision loss, and hasten breakdown of photoreceptor cells which are essential for vision.

Lutein: Systemic Anti-inflammation

Researchers have been unravelling the biological properties of lutein. They have identified a protein in the retina that binds to lutein (SR-B1), and find that this same SR-B1 receptor affects uptake in the gut.  In the blood, lutein is transported by HDL lipoproteins and the genes related to both SR-B1 and HDL levels are related to macular degeneration risk.

Furthermore, recent findings show that lutein affects the immune system and inflammation response, lessening various types of ocular inflammation including inflammation induced by toxins.3

Because AMD exhibits some properties of chronic low-grade, wide-spread, inflammatory response “attention to the exact role of lutein in this disease has shifted from a local effect in the eye towards a possible systemic anti-inflammatory function”4 through the entire body.

Zeaxanthin & Meso-zeaxanthin: Light Filters

Studies have shown that AMD retinas are deficient in not only in lutein and but in zeaxanthin and in meso-zeaxanthin (produced from lutein).  These three antioxidants filter out harmful wavelengths of light and are potent antioxidants and anti-inflammatories.5 6

For quenching free radicals and protecting the retina from AMD, scientists have uncovered exactly how deposits of macular xanthophylls like zeaxanthin are located within oily layers of the retinal membrane, and from that position are able to block blue light exposure.7 

Research shows that people with higher macular pigment levels tolerate light better.8

Glaucoma

Glaucoma is a leading cause of irreversible blindness. A 2021 review points out that research identifies key risk factors as sustained oxidative stress and compromised antioxidant defenses. Oxidative stress and the accumulation of free radicals is attributed to increasing mitochondrial dysfunction as we age.9

Lutein: Cell Neuroprotection

Lutein is especially linked to reduced risk of glaucoma. It provides retinal ganglion cell neuroprotection and protects synapse activity.  Generally, there is a protective trend against glaucoma in diets high in carotenoids, but even in cases of glaucoma the carotenoids were helpful in protecting visual acuity – serving synergistic neuroprotective effects.10

Such protection may go beyond simple synergistic neuroprotection.  In the case of glaucoma caused by two drugs commonly prescribed for tuberculosis in lab animals, lutein is effective in preventing toxic optic neuropathy from these drugs.11

Zeaxanthin & Meso-zeaxanthin: Improved Acuity

Like lutein, when patients have glaucoma, the zeaxanthin and meso-zeaxanthin are helpful in protecting visual acuity of the narrowed visual field. They do so by augmenting the macular pigment thickness.12

Cataract

About 30 million Americans aged 40 years and older have cataract in one or both eyes.  Some doctors suggest that 90% of the population will eventually develop cataracts.

Lutein: Reduces Toxin Effect

The human lens contains lutein, and it is recognized as beneficial to lens health. It is well established that oxidative stress from reactive oxygen and nitrogen species are significant risk factors for cataracts. It is clear that lutein consumption has a close correlation with cataract incidence.13  Research with lab animals indicates that lutein reduces toxin-induced cataract.  It’s not the same as ‘natural’ cataracts developing in humans, nonetheless, both animal and human cataracts are caused by inflammation.14

Zeaxanthin & Meso-zeaxanthin

The lens also contains zeaxanthin.  Meso-zeaxanthin is a by-product of lutein. Most research is focused on benefits of antioxidants generally.  Both are powerful carotenoid antioxidants that directly impact eye health and more.

Diabetic Retinopathy

Lutein, Zeaxanthin & Meso-zeaxanthin: Neuroprotection

Diabetic retinopathy is a complication of diabetes in working-age people, caused by damage to the tiny microvascular structure of the eye.  The exact pathology is somewhat elusive despite much research, but oxidative damage as an underlying cause is well recognized.15 Lutein, zeaxanthin, and meso-zeaxanthin accumulate in the macular pigment of the retina and neutralize free radicals preventing oxidative damage.16

As mentioned above, researchers are now finding evidence that these carotenoids also show neuroprotective and anti-inflammatory protection in the retina.17

Dry Eyes/Inflammation

Dry eye syndrome is the most commonly reported condition to eye doctors.  Long hours at computers or electronic devices are the main contributors, although poor diet and not enough exercise are also key factors.

Lutein, Zeaxanthin & Meso-zeaxanthin: Anti-inflammation

Lutein has long been recognized as helpful for dry eye.18 19 Since lutein is not produced by the body it must be taken in through diet (think lots and lots of leafy greens and colored vegetables) and supplemental lutein.

What is new is that researchers are now considering using lutein in eye drops to deliver it directly to the lens of the eye.  In lab animals, lutein-containing eye drops reduced inflammation in corneal epithelial cells, and inhibited inflammatory cytokines in the cornea.20

In addition to lutein, zeaxanthin is often added to formulations for dry eye, eye fatigue, eye soreness, etc.  Like lutein, it has anti-inflammation action which is useful and can be helpful in protecting the tear film covering the surface of the cornea.21 22

Blue Light/Computer & Other Devices

The long-term use and/or long hours of daily use of digital screens including computer, iphones, tablets, etc. increases exposure to blue light which contributes to eye disease and potential vision loss.23

As discussed above lutein, zeaxanthin, and meso-zeaxanthin all thicken the macular pigment which acts as an internal filter to UV and blue light damage.  Furthermore, as antioxidant they exert a neuroprotective and anti-inflammatory effect for the retina.24 25

Light Sensitivity

Light sensitivity takes many forms, from photophobia, an abnormal intolerance to light, to the ways that individual sensitivities can affect sleep patterns and circadian rhythm depending on light exposure.

Lutein, Zeaxanthin & Meso-zeaxanthin: Molecular Blinds

Nutrient deficiencies such as a deficiency of beta-carotene, lutein, or zeaxanthin may contribute to light sensitivity. We know that these carotenoids support thicker macular pigment and research shows that people with higher macular pigment levels tolerate light better.26 27

New research uncovers some of the reasons that macular pigment is protective. The carotenoids located in the retina “act as “molecular blinds,” opening and closing on a submillisecond timescale to dynamically control the intensity of light reaching the photoreceptors, thus enabling vision at a very low light intensity and protecting the retina from photodegradation when suddenly exposed to strong light.”28  So it is not just that macular pigment acts as a filter, but mechanical action is part of the picture.

Note. In one study, researchers found that a moderate dose of 13.3mg combined carotenoids, comprised of 83% lutin (11mg), 10% zeaxanthin (1.33mg), 7% meso-zeaxanthin (.93mg), was more effective than higher doses in enhancing macular pigment, even though higher doses were reflected in serum blood levels.29

Alzheimer’s & Brain Health

Essential nutrients, such as lutein and zeaxanthin30 which are needed to keep the brain healthy have been found in research studies to be deficient in the brains of Alzheimer’s patients.31

Lutein: Slows Cognitive Decline

Placebo-controlled studies show that increased lutein consumption improves cognitive function32 but a 2021 meta-analysis (a review of many studies) reported that although there is not enough data to say that lutein significantly improves cognitive function, that the evidence from many studies suggests that “lutein may nonetheless prevent cognitive decline, especially executive function.”33

Zeaxanthin: Protect Learning & Memory

A 2022 study reports that pre-treatment of zeaxanthin protects learning and memory in lab animals.34 Earlier studies had reported that zeaxanthin reduced amyloid beta clumping,35 reduced Alzheimer’s mortality,36 and improved cognitive function.37

Top Foods for the Eye & Brain

Top brain foods include avocado, blueberries (and other dark berries) dark chocolate, eggs, fish, fruits and vegetables, goji berry, green and black teas, mulberry, nuts. mushrooms (reiki, shitake, and lion’s mane for example), pomegranate juice, prunes, pumpkin seeds, yogurt (organic plain), and walnuts.

Top vision foods include dark leafy greens, broccoli and Brussels sprouts, fatty fish such as wild salmon or sardines, red peppers, sweet potatoes, seeds and nuts, beans and legumes, and eggs.

Supplement Recommendations

Advanced Eye and Vision Support Formula, our whole food, organic, GMO free formula with lutein and zeaxanthin.

Dr. Grossman’s Whole Food Organic Superfood Multi-Vitamin 120 Vcaps, our organic, whole food, GMO free multivitamin.

Dr. Grossman’s Meso Plus Retinal Support and Computer Eye Strain Formula with lutein, zeaxanthin, meso-zeaxanthin, and astaxanthin.

Blue Light Protecting/Night Vision Package

Brain and Memory Support Package 1

Footnotes

  1. Buscemi S, Corleo D, Di Pace F, Petroni ML, Satriano A, Marchesini G. The Effect of Lutein on Eye and Extra-Eye Health. Nutrients. 2018 Sep 18;10(9):1321. ↩
  2. Johra FT, Bepari AK, Bristy AT, Reza HM. (2020). A Mechanistic Review of β-Carotene, Lutein, and Zeaxanthin in Eye Health and Disease. Antioxidants (Basel). Oct 26;9(11):1046. ↩
  3. Chae SY, Shin MC, Jeon S, Kang MS, Han DW, et al. (2021). A Simple Route to the Complexation of Lutein with Reduced Graphene Oxide Nanocarriers and Antioxidant Protection Against Blue Light. Int J Nanomedicine.  Oct 7;16:6843-6860. ↩
  4. Ibid. Chae. 2021. ↩
  5. Kijlstra A, Tian Y, Kelly ER, et al. Lutein: more than just a filter for blue light. Prog Retin Eye Res. 2012 Jul;31(4):303-15. ↩
  6. Bian Q, Gao S, Zhou J, et al. (2012). Lutein and zeaxanthin supplementation reduces photooxidative damage and modulates the expression of inflammation-related genes in retinal pigment epithelial cells. Free Radic Biol Med. Sep 15;53(6):1298-307. ↩
  7. Johra FT, Bepari AK, Bristy AT, Reza HM. A Mechanistic Review of β-Carotene, Lutein, and Zeaxanthin in Eye Health and Disease. Antioxidants (Basel). 2020 Oct 26;9(11):1046. ↩
  8. Wenzel A J, Fuld K, Stringham JM, Curran-Celentano J. (2006). Macular pigment optical density and photophobia light threshold. Vis Res. 46(28):4615–4622. ↩
  9. Lem DW, Gierhart DL, Davey PG. Carotenoids in the Management of Glaucoma: A Systematic Review of the Evidence. Nutrients. 2021 Jun 6;13(6):1949. ↩
  10. Ibid. Lem. (2021). ↩
  11. Karakurt Y, Süleyman H, Keskin Cimen F, Tasli G, Ucak T, et al. (2019). The effects of lutein on optic nerve injury induced by ethambutol and isoniazid: an experimental study. Cutan Ocul Toxicol. Jun;38(2):136-140. ↩
  12. Loughman J, Loskutova E, Butler JS, Siah WF, O’Brien C. (2021). Macular Pigment Response to Lutein, Zeaxanthin, and Meso-zeaxanthin Supplementation in Open-Angle Glaucoma: A Randomized Controlled Trial. Ophthalmol Sci. Jul 11;1(3):100039. ↩
  13. Manayi A, Abdollahi M, Raman T, Nabavi SF, Habtemariam S, et al. (2016). Lutein and cataract: from bench to bedside. Crit Rev Biotechnol. Oct;36(5):829-39. ↩
  14. Bodoki E, Vostinaru O, Samoila O, Dinte E, Bodoki AE, et al. (2019). Topical nanodelivery system of lutein for the prevention of selenite-induced cataract. Nanomedicine. Jan;15(1):188-197. ↩
  15. Hu BJ, Hu YN, Lin S, et al. (2011). Application of Lutein and Zeaxanthin in nonproliferative diabetic retinopathy. Int J Ophthalmol. 2011;4(3):303-6. ↩
  16. Ibid. Lem. (2021). ↩
  17. Neelam K, Goenadi CJ, Lun K, Yip CC, Au Eong KG. (2017). Putative protective role of lutein and zeaxanthin in diabetic retinopathy. Br J Ophthalmol. May;101(5):551-558. ↩
  18. Chao SC, Vagaggini T, Nien CW, Huang SC, Lin HY. (2015). Effects of Lutein and Zeaxanthin on LPS(25) induced Secretion of IL-8 by Uveal Melanocytes and Relevant Signal Pathways. J Ophthalmol. 152854. ↩
  19. Chao SC, Nien, CW, Iacob C, Hu DN, Huang SC, et al. (2016). Effects of Lutein on Hyperosmoticity(26)Induced Upregulation of IL-6 in Cultured Corneal Epithelial Cells and Its Relevant Signal Pathways. J Ophthalmol. 2016:8341439. ↩
  20. Chen YZ, Chen ZY, Tang YJ, Tsai CH, Chuang YL, Hsieh EH, Tucker L, Lin IC, Tseng CL. Development of Lutein-Containing Eye Drops for the Treatment of Dry Eye Syndrome. Pharmaceutics. 2021 Oct 27;13(11):1801. ↩
  21. Kan J, Wang M, Liu Y, Liu H, Chen L, et al. (2020). A novel botanical formula improves eye fatigue and dry eye: a randomized, double-blind, placebo-controlled study. Am J Clin Nutr. Aug 1;112(2):334-342. ↩
  22. Radkar P, Lakshmanan PS, Mary JJ, Chaudhary S, Durairaj SK. (2021). A Novel Multi-Ingredient Supplement Reduces Inflammation of the Eye and Improves Production and Quality of Tears in Humans. Ophthalmol Ther. Sep;10(3):581-599. ↩
  23. Alaimo A, Linares GG, Bujjamer JM, et al. (2019). Toxicity of blue led light and A2E is associated to mitochondrial dynamics impairment in ARPE-19 cells: implications for age-related macular degeneration. Arch Toxicol. May;93(5):1401-15. ↩
  24. Ibid. Kijlstra. (2012). ↩
  25. Ibid. Chae. (2021). ↩
  26. Stringham JM, Fuld K, Wenzel AJ. (2004). Spatial properties of photophobia. Invest Ophthalmol Vis Sci. Oct;45(10):3838-48. ↩
  27. Wenzel A J, Fuld K, Stringham J M, Curran-Celentano J. (2006). Macular pigment optical density and photophobia light threshold. Vis Res, 46(28):4615–4622. ↩
  28. Luchowski R, Grudzinski W, Welc R, Mendes Pinto MM, Sek A, et al. (2021). Light-Modulated Sunscreen Mechanism in the Retina of the Human Eye. J Phys Chem B.  Jun 17;125(23):6090-6102. ↩
  29. Stringham JM, Stringham NT. (2016). Serum and retinal response to three different doses of macular carotenoids over 12 weeks of supplementation. Exp Eye Res. Oct;151:1-8. ↩
  30. Qu M, Shi H, Wang K, et al. (2021). The Associations of Plasma/Serum Carotenoids with Alzheimer’s Disease: A Systematic Review and Meta-Analysis. J Alzheimers Dis. 2021;82(3):1055-66. ↩
  31. Davinelli S, Ali S, Solfrizzi V, et al. (2021). Carotenoids and Cognitive Outcomes: A Meta-Analysis of Randomized Intervention Trials. Antioxidants (Basel). Feb 2;10(2). ↩
  32. Hammond BR, Jr., Miller LS, Bello MO, et al. (2017). Effects of Lutein/Zeaxanthin Supplementation on the Cognitive Function of Community Dwelling Older Adults: A Randomized, Double-Masked, Placebo-Controlled Trial. Front Aging Neurosci. 2017;9:254. ↩
  33. Li J, Abdel-Aal EM. Dietary Lutein and Cognitive Function in Adults: A Meta-Analysis of Randomized Controlled Trials. Molecules. 2021 Sep 24;26(19):5794. ↩
  34. Li X, Zhang P, Li H, Yu H, Xi Y. (2022). The Protective Effects of Zeaxanthin on Amyloid-β Peptide 1-42-Induced Impairment of Learning and Memory Ability in Rats. Front Behav Neurosci. Jun 23;16:912896. ↩
  35. Lakey-Beitia J, Doens D, Jagadeesh Kumar D, Murillo E, Fernandez PL, et al. (2017). Anti-amyloid aggregation activity of novel carotenoids: implications for Alzheimer’s drug discovery. Clin Interv Aging. May 15;12:815-822. ↩
  36. Min JY, Min KB. (2014). Serum lycopene, lutein and zeaxanthin, and the risk of Alzheimer’s disease mortality in older adults. Dement Geriatr Cogn Disord. 2014;37(3-4):246-56. ↩
  37. Hammond BR Jr, Miller LS, Bello MO, Lindbergh CA, Mewborn C, et al. (2017). Effects of Lutein/Zeaxanthin Supplementation on the Cognitive Function of Community Dwelling Older Adults: A Randomized, Double-Masked, Placebo-Controlled Trial. Front Aging Neurosci. 2017; 9: 254. ↩