Dr. Grossman’s Blog

Oral supplementation with lutein and zeaxanthin with coantioxidants may improve vision at 36 months for those at high risk for progression to late age-related macular degeneration (AMD).

In the Carotenoids and Co-Antioxidants in Age-Related Maculopathy (CARMA) study, presented at the Association for Research in Vision and Ophthalmology (ARVO) 2009 Annual Meeting, researchers examined the effects of supplementation with serum lutein and zeaxanthin plus coantioxidants (vitamins C and E and zinc) on visual function and the progression from early to late stages of AMD.

A total of 433 participants in the United Kingdom with early AMD in at least one eye, or any level of AMD in the study eye and late-stage AMD in the fellow eye, received either carotenoids plus coantioxidants or a placebo.

Study participants were examined at 12, 18, 24, 30, and 36 months. Although no statistically significant difference was seen in best corrected distance visual acuity (BC DVA) at 12 months, at the 36 month follow-up researchers did note an improved BC DVA.

Investigative team member Usha Chakravarthy, MD, PhD, from Queens University of Belfast in Northern Ireland concluded that supplementation with lutein and zeaxanthin results in better macular function in patients with early AMD. He also noted that the eyes of people who had high serum (lutein) demonstrated a less severe early AMD change over time, and suggested that supplementation may prove beneficial in preventing progression to late AMD.

Learn about self-help for macular degeneration, including recommended diet and supplements containing lutein and zeaxanthin at the Natural Eye Care website

SOURCE: ARVO 2009: Lutein, Zeaxanthin Supplements May Result in Better Macular Function in Early AMD, Chakravarthy, et al, The Association for Research in Vision and Ophthalmology (ARVO), May 4, 2009.

Researchers from Tufts University have found that a diet rich in omega-3 fatty acids and low in starchy carbohydrates can significantly reduce the risk of age-related macular degeneration (AMD).

The study, published in the journal Ophthalmology, is the first to calculate the combined effect of specific dietary nutrients and eating habits on a person’s risk for age-related macular degeneration.

During the study of 4003 participants in the ongoing Age-Related Eye Disease Study (AREDS), each dietary factor was assigned a percentile score; these scores were accumulated to find each participant’s compound score. The compound score was then evaluated for its association with the risk of AMD.

Researchers showed that vitamins C and E, zinc, lutein, zeaxanthin and the omega-3 fatty acids known as D.H.A. and E.P.A. were linked to lower risk for AMD.

The lowest risk of AMD was found in participants who regularly consumed a combination of these nutrients as part of a low-glycemic index diet.

The glycemic index (GI) is a measure of the effects of carbohydrates on blood glucose levels. Carbohydrates that break down rapidly during digestion, such as white bread and pastries, have a higher GI, as they release glucose into the bloodstream rapidly. Foods that break down more slowly, such as vegetables and proteins, have a lower GI value.

Read more about AMD on the Natural Eye Care website

Learn more about food sources for nutrients important for good eye health, including omega-3 fatty acids

SOURCE: “Dietary Compound Score and Risk of Age-Related Macular Degeneration in the Age-Related Eye Disease Study”, Chiu, et al, Ophthalmology, Volume 116, Issue 5, Pages 939-946.

Evidence continues to show that oxidative stress contributes to age-related maculopathy (ARM) and that consuming appropriate antioxidants such as zeaxanthin may protect against this condition. 

The term maculopathy is associated with diseases of the macula, an area at the center of the retina that is associated with highly sensitive, accurate vision.  Age-related macular degeneration (AMD) is an example of maculopathy.

A study published in the American Journal of Clinical Nutrition investigated the link between lower intakes of antioxidants and ARM.   828 healthy Irish participants between the ages of 20 and 60 years were analyzed for risk factors for ARM and dietary intake of relevant nutrients.

Researchers showed that several variables related to risk for ARM are associated with a relative lack of key nutrients in the diet.  They determined that the most important and universal risk factor for ARM is a lack of dietary zeaxanthin.

Zeaxanthin is one of the two carotenoids contained within the retina of the eye.  Ultraviolet radiation is absorbed by the lens, but visible or “blue” light penetrates to the retina, enabling us to see.  Along with lutein, zeaxanthin absorbs the potentially harmful effects of blue light.

How can you ensure you are consuming zeaxanthin?  Good dietary sources include green vegetables such as spinach, kale, turnip greens, collard greens, romaine lettuce, broccoli, zucchini, corn, garden peas and Brussels sprouts.

Read more about antioxidants and nutrient food sources for good eye health

Learn about natural zeaxanthin products

SOURCE:  O’Connell, et al, Diet and risk factors for age-related maculopathy, American Journal of Clinical Nutrition, Vol. 87, No. 3, 712-722, March 2008.

A new European study suggests that the combination of low levels of antioxidants and blue light exposure from the sun is associated with certain forms of age-related macular degeneration (AMD).

The EUREYE study, led by Astrid Fletcher, Professor of Epidemiology of Ageing at the London School of Hygiene & Tropical Medicine, is the first to report an adverse association between sunlight exposure and AMD in people with low levels of antioxidants.

It is known that the eye is vulnerable to the damaging effects of sunlight. Ultraviolet radiation is absorbed by the lens, but visible or “blue” light penetrates to the retina, enabling us to see. Protection against the harmful effects of blue light is provided by antioxidant enzymes—including vitamins C and E, the carotenoids (lutein and zeaxanthin) and zinc.

Researchers measured levels of these nutrients in the blood of 4,753 older adults (average age 73.2) who were part of the European Eye Study. Participants were interviewed about their lifetime sunlight exposure and had photographs taken of their retinas to detect AMD.

Participants with the lowest concentrations of antioxidants in the blood were found to be most at risk of AMD due to blue light exposure. In fact, participants with the combination of blue light exposure and low levels of zeaxanthin, alpha tocopherol and Vitamin C were nearly four times more likely to develop AMD. Researchers also noted that blue light exposure in middle age might be more damaging than at younger ages.

Professor Fletcher comments: ‘In the absence of cost-effective screening methods to identify people in the population with early AMD, we suggest that recommendations on protecting the eyes, ensuring that diets contain the right nutrients and antioxidants, are targeted at the general population, and especially middle-aged people’.

Study authors don’t advise people to stay out of the sun altogether — sunlight is important for its role in vitamin D synthesis. However, they do recommend avoiding exposing eyes to too much sunlight by wearing a wide-brimmed hat and sunglasses when outdoors.

In addition, study authors advise consumption of key antioxidants, which can be accomplished by consuming recommended dietary intake levels of vitamin C and zinc and increasing consumption of carotenoid-rich fruits and vegetables.

Learn more about macular degeneration

Read more about antioxidants and nutrient food sources for good eye health

SOURCE: Fletcher AE et al. Sunlight exposure, antioxidants, and age-related macular degeneration. Archives Ophthalmology 2008; 126:1396-1403.

At the American Glaucoma Society meeting, Dr. JoAnn A. Giaconi reported that women who reported eating greater amounts of fruits and vegetables appeared to have a lower likelihood of developing glaucoma.

The foods that seemed especially protective included fresh oranges, peaches, spinach, collard greens, and kale.

Dr. Giaconi presented results from a review of data from the Study of Osteoporotic Fractures.  In this study involving a subset of 584 black women, glaucoma was diagnosed in at least one eye in 77 participants.  Disc photos and suprathreshold visual fields were evaluated in conjunction with Block Food Frequency Questionnaires on the participants’daily food consumption.

The results?

• Eating three or more servings of fruit or fruit juices daily decreased the odds of black women developing glaucoma by 79%
• Eating one serving of collard greens or kale decreased the odds of glaucoma by 57%
• Eating more than two servings per week of fresh oranges and peaches also significantly decreased the chance of developing glaucoma.

Researchers believe that the antioxidants in fruits and vegetables (vitamin A, alpha- and beta-carotene, folate, lutein, zeaxanthin) can potentially block oxidation stress that can lead to cell damage in glaucoma.

Read other studies about the benefits of consuming antioxidants

SOURCE:  Giaconi JA, et al. Nutritional associations with glaucoma among older black women. Paper presented at: The 18th Annual AGS Meeting; March 8, 2008; Washington, DC.

A new study indicates that the carotenoids lutein and zeaxanthin may help improve vision under glare conditions such as bright sunlight or the beams of car headlights.

Scientists at the Vision Science Laboratory at the University of Georgia recently studied the relationship of lutein and zeaxanthin on macular pigment (MP), glare disability, and photostress recovery.

The macula helps filter damaging light rays. When the concentration of lutein and zeaxanthin in the macula is higher, the higher density of macular pigment enables the macula to absorb the light rays more efficiently.

Researchers studied forty healthy subjects (average age of 23.9) for six months, giving assessments at baseline, 1, 2, 4, and 6 months. Subjects were given 12mg daily of lutein and zeaxanthin supplements.

After 6 months, the lutein and zeaxanthin supplementation was shown to significantly reduce the negative effects of glare for both the visual performance tasks assessed for most of the subjects.

Read other studies about lutein and zeaxanthin, including their role in preventing macular degeneration and cataracts.

Learn more about natural leutein and zeaxanthin supplements

SOURCE: “Macular pigment and visual performance under glare conditions”, Stringham and Hammond, Optom Vis Sci., 2008 Feb;85(2):82-8

A study conducted in North India found that people with low levels of antioxidants had higher levels of cataracts.

Several recent studies have shown antioxidants are important in fighting macular degeneration. We are now learning how important these same antioxidants may be for preventing cataracts as well.

How can you boost your antioxidant levels? Eat more fruits and vegetables, especially those high in yellow, orange and dark green pigments.

In this new study 1,112 participants aged 50 or older were interviewed for risk factors (tobacco, alcohol, biomass fuel use, sunlight exposure and socioeconomic status) and underwent lens photography and blood sampling to measure antioxidant levels.

Researchers found significant inverse associations between cataracts and the antioxidants vitamin C, zeaxanthin, lutein, lycopene, alpha- and beta-carotene and beta-cryptoxanthin; people with lower levels of these antioxidants had higher rates of cataracts.

Read more about antioxidants

Learn more about cataracts

Learn more about food sources for nutrients crucial for good eye health

Read more research on antioxidants and their importance for vision

SOURCE: Dherani M, Murthy GV, Gupta SK, et al. Blood levels of vitamin C, carotenoids and retinol are inversely associated with cataract in a North Indian population. Invest Ophthalmol Vis Sci 2008;49(8):3328-35.

Women who eat plenty of green vegetables may decrease their risk of nuclear cataracts. Nuclear cataract is the most common type of cataract among older Americans.

Authors of the Carotenoids in Age-Related Disease Study (CAREDS) report that women with diets high in lutein and zeaxanthin have a lower prevalence of nuclear cataract. Lutein and zeaxanthin are nutrients found in green vegetables such as spinach, kale, turnip greens and broccoli. Learn more about good sources of lutein and zeaxanthin.

Participants in this study were 1082 women with intakes of lutein and zeaxanthin above the 78th (high) or below the 28th (low) percentile. These women (from Iowa, Wisconsin and Oregon) ranged in age from 50 to 79.

Researchers evaluated associations between nuclear cataracts and lutein and zeaxanthin in the diet and serum of patients. Nuclear cataract was determined from slitlamp photographs. Lutein and zeaxanthin the diet were estimated from a validated, semi-quantitative food frequency questionnaire. Serum levels of lutein, zeaxanthin and tocopherols were determined at Tufts University by a reverse-phase HPLC analysis.

Women in the group with high dietary levels of lutein and zeaxanthin had a 23% lower prevalence of nuclear cataract compared with the low level group.

In 2006 the authors of CAREDS found that a stable intake of lutein and zeaxanthin over time could also reduce the risk of AMD in healthy women. Read more about the results of this study.

Read more about cataracts

Review other studies on cataracts

Learn about natural products for cataracts

SOURCE: Associations Between Age-Related Nuclear Cataract and Lutein and Zeaxanthin in the Diet and Serum in the Carotenoids in the Age-Related Eye Disease Study (CAREDS), an Ancillary Study of the Women’s Health Initiative, Moeller et al, Arch Ophthalmol. 2008; 126(3): 354-364.

Cataracts can not only be prevented, but can even be reversed through nutrition, supplementation and lifestyle changes. Read what folks who’ve tried these methods say about products that help cataracts.

Cataracts – once considered an inevitability for the elderly and sometimes not-so-elderly, redeemable only by surgery. There’s been quite a bit of interesting new research in the last several years pointing to the alternatives and effects of different modes of living that have an impact.

1. 2008 – An observational 10-year study of more than 35,000 middle-aged U.S. women observed the women’s use of dietary supplements and occurrence of cataracts – further verifying that lutein, zeaxanthin and vitamin E were significantly helpful. more …

2. 2006 – Two studies show significant reductions in cataracts for those in the highest percentage of vitamin C & bioflavanoids intake. more …

3. 2007 – Dietary linolenic acid (think flaxseed oil, fish oil) intake is positively associated with five-year change in eye lens nuclear density (think cataracts!). more …

Causes?

• Free radicals are responsible for most cataracts. They are natural byproducts of metabolism. These highly reactive chemicals cause oxidation, which in turn causes aging. As the lens of the eye ages, it hardens and loses its ability to focus. This process is similar to hardening of the arteries, and is often associated with changes in the joints.
• Chronic physical stress such as dental problems, physical injury to the vertebrae or neck, or any stress that reduces eye movement and increases muscle tension.
• Food Allergies or sensitivities, particularly involving dairy products, wheat and/or soy can congest the sinuses, impairing lymphatic and veinous drainage, resulting in decreased nutrition to the eyes.
• Toxins, pharmaceutical drug side effects, such as steroid drugs, or photosensitizing drugs such as gout medications, cholesterol lowering drugs, antibiotics and diuretics.
• Smoking – the risk in ex-smokers is 50 percent higher compared to non smokers. Each cigarette also robs the body of 25 mg of vitamin C. Smokers have an increase in lipids (both fat and cholesterol) which increase the risk of severe cardiovascular disease. These factors produce narrowing of the retina blood vessels that carry valuable nutrients to the eye.
• Diabetes and other diseases that affect multiple areas of the body such as hypertension, arthritis, heart disease, and diabetes. Diabetics develop cataracts at an earlier age than non- diabetics. An accumulation of sorbitol and fructose in the lens can induce osmotic swelling of the lens, which will lead to the development of a cataract.
• Poor nutrition and digestion. Nutritional deficiencies, such as in poor areas of Third World countries, can cause cataracts to develop early and progress faster. In every part of the world, people with poor digestion and chronic bowel problems have a fourfold higher incidence of cataracts.
• Heredity
• Aging of the Eyes – hardening of the lens occurs as we age.
• Sunlight – invisible ultraviolet light (UV light) which is one of the light frequencies of sunlight promotes free-radical damage to the lens. The effects of UV light are cumulative over time.
• Alcoholic Consumption - High intake of alcohol more than doubles the risk of developing cataracts. More than 7 drinks per week will increase the risk, while moderate use does not seem to increase the risk.
• Too much Vitamin B2 aggrevates – Those with Cataracts should not use supplemental Vitamin B2. Vitamin B2 is a photosensitizing substance – experimental studies have shown that when Vitamin B2 is exposed to Visible Light, Cataracts can occur (or be exacerbated) as a result of the generation of Free Radicals from the interaction of Visible Light, Oxygen and Vitamin B2. This indicates that in persons afflicted with Cataracts, excessive Vitamin B2 is more harmful than beneficial.

See our comprehesive discussion of cataracts solutions.

Solutions
These are the four most important supplements for cataracts.