Lutein

Overview

Lutein is a member of the carotenoid family, which are naturally occurring fat-soluble pigments found in plants. Lutein occurs in numerous foods but the highest concentrations occur in marigolds, which are the source of most of the lutein that is used commercially. Lutein specifically concentrates in the macula, which is a small area in the center of the retina in the eye. The macula lies directly behind the lens and is the area of the eye that receives the most light. Lutein protects the macula by filtering out potentially damaging forms of light. Thus, lutein is associated with protection from various diseases of the eyes, especially age-related macular degeneration, which is a leading cause of blindness in older adults. Lutein supplementation resulted in increased macular pigment density. (1) , (2)

A growing body of evidence suggests that lutein may provide protective effects against the development of breast, colon, lung, skin, cervical and ovarian cancers. (3) , (4) Recent research also indicates that lutein may help prevent cardiovascular disease. For example, mice supplemented with lutein have significantly less atherosclerosis than controls and in humans, serum lutein levels have been found to be inversely related to arterial wall thickness. (5) Also, two epidemologic studies have reported an inverse relationship between levels of lutein and the incidence of stroke. (6) , (7) And finally, recent animal studies suggest that lutein may enhance immune function. In both dogs and cats, lutein supplementation increased lymphocyte and antibody production after vaccinations compared to animals on control diets. (8) , (9)

Depletion-repletion studies are the accepted standard for determining whether or not a substance should be classified as a vitamin. Studies in monkeys on lutein-free (depletion) diets results in eventual loss of macular pigment. (10) Subsequently, lutein supplementation resulted in restoration of macular pigment. (11)

Dosage Info

Dosage Range

2-40mg daily

Most Common Dosage

6mg daily

Dosage Forms

Tablets, capsules, and soft gel capsules.

Adult RDI

None established

Adult ODA

None established

RDA

  • : None established

Interactions and Depletions

Interactions

Active Forms

Lutein.

Absorption

Lutein is a fat-soluble compound that is readily absorbed from the gastrointestinal tract.

Toxicities & Precautions

General

No side effects or toxicity have been reported with lutein.

Functions in the Body

Antioxidant:

Protects the eyes by neutralizing oxygen free-radicals and singlet oxygen, which are generated in the retina as a consequence of the simultaneous presence of light and oxygen.

Conversion to zeaxanthin:

It has been reported that small amounts of lutein are converted into zeaxanthin in the macula of the eye in humans. (12)

Prevention of Photodamage:

Lutein filters out blue light, which can cause photodamage and contribute to the progression of macular degeneration if it is excessive.

Clinical Applications

Cataracts

Lutein is the primary carotenoid found in the eye. (13) Individuals found to be in the highest quintile (20 percent) of dietary lutein intake were only half as likely to develop cataracts as those in the lowest quintile of lutein intake. (14)

Retinitis Pigmentosa

In one study, supplementation resulted in increased serum lutein levels in all patients, but only half the patients registered increases in macular pigment density. (15) Another study noted that patients with retinitis pigmentosa who took 40 mg/day of lutein for 9 weeks exhibited significant improvement in visual acuity. (16) This needs to be followed up with double-blind, placebo-controlled trials.

Macular Degeneration

Lutein has been called our "natural sun glasses" due to its ability to protect the eyes against radiation damage by acting as an optic filter and an antioxidant. (17) , (18) , (19) . In a 4-week study, participants consuming diets high in lutein-containing foods showed increases in their macular density. (20) In another study, two subjects were given 30mg of lutein daily for 140 days. They registered a 10-fold increase in their serum lutein concentration, and increased their macular pigment and optical density by 39 percent and 21 percent respectively, which they maintained for 40 to 50 days after discontinuing the supplement. This resulted in a 30 percent to 40 percent reduction in the amount of blue light reaching the eye, and represents a substantial protection against the type of damage that leads to macular degeneration. (21)

Recently the third National Health and Nutrition Examination Survey (NHANES) evaluated the relationship between dietary lutein and zeaxanthin and the presence of age-related maculopathy. No overall observations could be made regarding inverse relations between these carotenoids and age-related maculopathy. Pigment abnormalities are generally early signs of age-related maculopathy. An interesting find was that higher levels of lutein and zeaxanthin in the diet were associated with lower rates of pigmentary abnormalities. (22)

Symptoms and Causes of Deficiency

Since lutein is not an essential nutrient, no deficiency condition has been identified.

Dietary Sources

Foods that contain high concentrations of lutein are corn, egg yolks, spinach, kale, romaine lettuce, peas, leeks, and collard greens.

References

  1. View Abstract: Berendschot TT, Goldbohm RA, Klopping WA, van de Kraats J, van Norel J, van Norren D. Influence of lutein supplementation on macular pigment, assessed with two objective techniques. Invest Ophthalmol Vis Sci. Oct2000;41(11):3322-6.
  2. View Abstract: Richer S, Stiles W, Statkute L, et al. Double-masked, placebo-controlled, randomized trial of lutein and antioxidant supplementation in the intervention of atrophic age-related macular degeneration: the Veterans LAST study (Lutein Antioxidant Supplementation Trial). Optometry. Apr2004;75(4):216-30.
  3. View Abstract: Toniolo P, Van Kappel AL, Akhmedkhanov A, Ferrari P, Kato I, Shore RE, et al. Serum carotenoids and breast cancer. Am J Epidemiol. Jun2001;153(12):1142-7.
  4. View Abstract: Cooper DA, Eldridge AL, Peters JC. Dietary carotenoids and certain cancers, heart disease, and age-related macular degeneration: a review of recent research. Nutr Rev. Jul1999;57(7):201-14.
  5. View Abstract: Dwyer JH, Navab M, Dwyer KM, et al. Oxygenated carotenoid lutein and progression of early atherosclerosis: the Los Angeles atherosclerosis study. Circulation. Jun2001;19:103(24):2922-7.
  6. View Abstract: Ascherio A, Rimm EB, Hernan MA, et al. Relation of consumption of vitamin E, vitamin C, and carotenoids to risk for stroke among men in the United States. Ann Intern Med. Jun1999;130(12):963-70.
  7. View Abstract: Hirvonen T, Virtamo J, Korhonen P, et al. Intake of flavonoids, carotenoids, vitamins C and E, and risk of stroke in male smokers. Stroke. Oct2000;31(10):2301-6.
  8. View Abstract: Kim HW, Chew BP, Wong TS, et al. Dietary lutein stimulates immune response in the canine. Vet Immunol Immunopathol. May2000;74(3-4):315-27.
  9. View Abstract: Kim HW, Chew BP, Wong TS, et al. Modulation of humoral and cell-mediated immune responses by dietary lutein in cats. Vet Immunol Immunopathol. Mar2000;73(3-4):331-41.
  10. View Abstract: Malinow MR, Feeney-Burns L, Peterson LH, et al. Diet-related macular anomalies in monkeys. Invest Ophthalmol Vis Sci. Aug1980;19(8):857-63.
  11. Neuringer M, Johnson EJ, Snodderly DM, et al. Supplementation of carotenoid-depleted rhesus monkeys with lutein or zeaxanthin: Effects on serum and adipose tissue carotenoids and macular pigment. ARVO. 2001;42:S224.
  12. View Abstract: Bone RA, Landrum JT, Friedes LM, et al. Distribution of lutein and zeaxanthin stereoisomers in the human retina. Exp Eye Res. Feb1997;64(2):211-8.
  13. View Abstract: Yeum KJ, et al. Measurement of Carotenoids, Retinoids, and Tocopherols in Human Lenses. Invest Ophthalmol Vis Sci. Dec1995;36(13):2756-61.
  14. View Abstract: Lyle BJ, et al. Antioxidant Intake and Risk of Incident Age-related Nuclear Cataracts in the Beaver Dam Eye Study. Am J Epidemiol. May1999;149(9):801-09.
  15. View Abstract: Aleman TS, Duncan JL, Bieber ML, de Castro E, Marks DA, Gardner LM, et al. Macular pigment and lutein supplementation in retinitis pigmentosa and Usher syndrome. Invest Ophthalmol Vis Sci. Jul2001;42(8):1873-81.
  16. View Abstract: Dagnelie G, Zorge IS, McDonald TM. Lutein improves visual function in some patients with retinal degeneration: a pilot study via the Internet. Optometry. Mar2000;71(3):147-64.
  17. View Abstract: Pauleikhoff D, van Kuijk FJ, Bird AC. Macular pigment and age-related macular degeneration. Ophthalmologe. Jun2001;98(6):511-9.
  18. View Abstract: Nussbaum JJ, et al. Historic Perspectives. Macular Yellow Pigment. The First 200 Years. Retina. 1981;1(4):296-310.
  19. View Abstract: Landrum JT, et al. A One Year Study of the Macular Pigment: The Effect of 140 Days of a Lutein Supplement. Exp Eye Res. Jul1997;65(1):57-62.
  20. View Abstract: Hammond BR Jr, et al. Dietary Modification of Human Macular Pigment Density. Invest Ophthalmol Vis Sci. Aug1997;38(9):1795-801.
  21. View Abstract: Landrum JT, et al. A One Year Study of the Macular Pigment: The Effect of 140 Days of a Lutein Supplement. Exp Eye Res. Jul1997;65(1):57-62.
  22. View Abstract: Mares-Perlman JA, Fisher AI, Klein R, Palta M, Block G, Millen AE, Wright JD. Lutein and zeaxanthin in the diet and serum and their relation to age-related maculopathy in the third national health and nutrition examination survey. Am J Epidemiol. Mar2001;153(5):424-32.