Luz9.0

Lutein + Zeaxanthin Research

39 peer-reviewed studies · Evidence score: 9/10

Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration

Evans JR et al. • The Cochrane database of systematic reviews (2023)

Moderate-certainty evidence suggests that antioxidant vitamin and mineral supplementation (AREDS: vitamin C, E, beta-carotene, and zinc) probably slows down progression to late AMD.

These studies enroled 11,952 people aged 65 to 75 years and included slightly more women (on average 56% women).
People taking antioxidant vitamins were less likely to progress to late AMD (odds ratio (OR) 0.72, 95% confidence interval (CI) 0.58 to 0.90; 3 studies, 2445 participants; moderate-certainty evidence).
Low-certainty evidence from one study of 110 people suggested higher quality of life scores (measured with the Visual Function Questionnaire) in treated compared with non-treated people after 24 months (mean difference (MD) 12.30, 95% CI 4.24 to 20.36).

Systematic Reviewn=2,445

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Efficacy of different nutrients in age-related macular degeneration: A systematic review and network meta-analysis

Li SS et al. • Seminars in ophthalmology (2022)

Taking multivitamin supplementation may not prevent the development of late AMD.

In the network meta-analysis, we found that there was more risk of progression to late AMD in the multivitamin group than carotenoids and vitamin E groups (RR 0.45, 95% CI 0.32 to 0.65; RR 0.56, 95% CI 0.40 to 0.79; RR 0.42, 95% CI 0.26 to 0.67).
Taking multivitamin supplementation may not prevent the development of late AMD.
The nutrient of zinc and carotenoids (lutein/zeaxanthin) supplementation were associated with better improvement in VA.

Meta-Analysisn=85,321

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The Effect of Lutein/Zeaxanthin Intake on Human Macular Pigment Optical Density: A Systematic Review and Meta-Analysis

Wilson LM et al. • Advances in nutrition (Bethesda, Md.) (2021)

Our objective was to determine a minimum concentration of lutein/zeaxanthin intake that is associated with a statistically significant and/or clinically important change in macular pigment optical ...

Our objective was to determine a minimum concentration of lutein/zeaxanthin intake that is associated with a statistically significant and/or clinically important change in macular pigment optical density (MPOD) among adults with healthy eyes.
We included 46 studies (N = 3189 participants; mean age = 43 y; 42% male).
There was no statistically significant change in MPOD among studies evaluating <5 mg/d of total lutein/zeaxanthin intake which primarily assessed dietary interventions for 3-6 mo (pooled mean difference, 0.02; 95% CI: -0.01 to 0.05).

Meta-Analysisn=3,189

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Role of Lutein Supplements in the Management of Dry Eye Syndrome: A Systematic Review

Chu YC et al. • International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition (2024)

Lutein supplementation may benefit DED patients by improving symptoms and tear film stability.

Improvements were observed in subjective symptoms, with significant reductions in Ocular Surface Disease Index (OSDI) scores in some studies.
Schirmer's test and corneal-conjunctival staining results varied, with some showing significant improvements and others not.
Lutein supplementation may benefit DED patients by improving symptoms and tear film stability.

Systematic Reviewn=584

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What did we learn in 35 years of research on nutrition and supplements for age-related macular degeneration: a systematic review

Pameijer EM et al. • Acta ophthalmologica (2022)

Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.

A high consumption of alcohol was associated with a higher risk of developing AMD (moderate certainty of evidence).
Supplementary vitamin C, vitamin E, or β-carotene were not associated with the development of AMD, and supplementary omega-3 fatty acids were not associated with progression to late AMD (high certainty of evidence).
Research in the last 35 years included in our overview supports that a high intake of specific nutrients, the use of antioxidant supplements and adherence to a Mediterranean diet decrease the risk of progression of early to late AMD.

Systematic Reviewn=2,021

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The effects of lutein on cardiometabolic health across the life course: a systematic review and meta-analysis

Leermakers ET et al. • The American journal of clinical nutrition (2016)

Our findings suggest that higher dietary intake and higher blood concentrations of lutein are generally associated with better cardiometabolic health.

Meta-analysis showed a lower risk of coronary heart disease (pooled RR: 0.88; 95% CI: 0.80, 0.98) and stroke (pooled RR: 0.82; 95% CI: 0.72, 0.93) for the highest compared with the lowest tertile of lutein blood concentration or intake.
There was no significant association with type 2 diabetes mellitus (pooled RR: 0.97; 95% CI: 0.77, 1.22), but higher lutein was associated with a lower risk of metabolic syndrome (pooled RR: 0.75; 95% CI: 0.60, 0.92) for the highest compared with the lowest tertile.
Our findings suggest that higher dietary intake and higher blood concentrations of lutein are generally associated with better cardiometabolic health.

Meta-Analysisn=387,569

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Lutein and zeaxanthin and macular pigment optical density

Ma L et al. • British Journal of Nutrition (2012)

Lutein and zeaxanthin supplementation significantly increased macular pigment optical density.

Increased macular pigment density
Dose-dependent response
Benefits seen in healthy adults

Meta-Analysisn=1,176

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Lutein and zeaxanthin for reducing morbidity and mortality in preterm infants

Choo YM et al. • The Cochrane database of systematic reviews (2025)

While supplementation with lutein and zeaxanthin from day one of life in preterm infants until discharge probably reduces the incidence of ROP stage 3 and above, it may have little or no effect on the incidence of ROP at any stage, IVH or NEC, or mortality assessed throughout the NICU stay.

Lutein and zeaxanthin supplementation probably reduces the incidence of ROP stage 3 and above (RR 0.49, 95% CI 0.29 to 0.81; P = 0.005; I2 = 0%; 4 studies, 532 infants; moderate-certainty evidence).
While supplementation with lutein and zeaxanthin from day one of life in preterm infants until discharge probably reduces the incidence of ROP stage 3 and above, it may have little or no effect on the incidence of ROP at any stage, IVH or NEC, or mortality assessed throughout the NICU stay.
However, the pooled estimates for these outcomes may change with further rigorously conducted trials.

Meta-Analysis

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A positive effect of egg consumption on macular pigment and healthy vision: a systematic review and meta-analysis of clinical trials

Khalighi Sikaroudi M et al. • Journal of the science of food and agriculture (2021)

Subgroup analyses showed that egg consumption: (a) had a larger effect on MPOD in studies with a parallel design; and (b) increased serum lutein to a greater extent in a healthy population.
We did not detect any heterogeneity between studies.
Daily egg consumption has beneficial effects on MPOD and serum lutein is inversely associated with reduced AMD progression.

Meta-Analysisn=296

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Oral Supplements and Photoprotection: A Systematic Review

Natarelli N et al. • Journal of medicinal food (2025)

Future research is necessary to determine optimal dosing and supplementation duration for intended photoprotective outcomes.

The weakest evidence exists for photoprotective effects of isolated vitamin or coenzyme Q supplementation.
Dietary supplements may promote enhanced photoprotection, although current evidence is limited by small sample size and short duration.
Supplementation with photoprotective active ingredients may be especially favorable for individuals with predisposed ultraviolet sensitivity, such as those with polymorphic light eruption.

Systematic Reviewn=47

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Effect of Antioxidant Supplementation on Macular Pigment Optical Density and Visual Functions: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

Hu W et al. • Advances in nutrition (Bethesda, Md.) (2024)

Especially, the L + zeaxanthin + fatty acid combination was ranked best for macular pigment optical density (surface under the cumulative ranking: 99.3%) and second best for contrast sensitivity at...

Especially, the L + zeaxanthin + fatty acid combination was ranked best for macular pigment optical density (surface under the cumulative ranking: 99.3%) and second best for contrast sensitivity at low spatial frequency (67.7%).
Overall, antioxidant supplementation was estimated to improve eye health parameters, whereas different combinations of antioxidants may also have varying effects on improving visual health from multiple perspectives.
This study was registered at PROSPERO as CRD42022369250.

Meta-Analysisn=38

DOI

A systematic review of dietary and circulating carotenoids and liver disease

Hu B et al. • Food & function (2024)

However, for malignant diseases such as liver cancer, it did not show the significant effects of carotenoid supplementation.

Two reviewers independently scored the literature quality and extracted data, and the results were represented by the standard mean difference (SMD) with a 95% confidence interval.
Cochran Q statistics and I2 statistics were used to evaluate statistical heterogeneity (defined as significant when P < 0.05 or I2 > 50%).
However, no significant difference was observed between serum β-cryptoxanthin (SMD = 0.02, 95% CI (-0.41, 0.45), P = 0.92) and lutein/zeaxanthin (SMD = 0.62, 95% CI (-1.20, 2.45), P = 0.502).

Systematic Reviewn=30

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Lutein supplementation and retinopathy of prematurity: a meta-analysis

Cota F et al. • The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (2022)

It may reduce the number of transfusions but this result has to be assessed in a separate ad hoc trial.

Meta-analysis examining Lutein + Zeaxanthin efficacy
Further research warranted to confirm findings

Meta-Analysisn=406

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"Analysis of Macular Pigment Optical Density in Childhood: A Systematic Review"

Ponce-García V et al. • Seminars in ophthalmology (2024)

Lutein and zeaxanthin accumulation plays an important role during the maturational stage and childhood development.

Lutein and zeaxanthin accumulation plays an important role during the maturational stage and childhood development.
Although cognitive function is more strongly correlated with MPOD values, the relationship with visual function remains unclear, and further studies are required to support this relationship.
Further research warranted to confirm findings

Systematic Review

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Smoking, dietary factors and major age-related eye disorders: an umbrella review of systematic reviews and meta-analyses

Kai JY et al. • The British journal of ophthalmology (2023)

Smoking as a risk factor for cataract was the most robust association we identified.

Smoking as a risk factor for cataract was the most robust association we identified.
We also identified several dietary elements associated with AREDs.
Large prospective studies are warranted to further examine the associations discussed in this review.

Meta-Analysis

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Effect of xanthophyll-rich food and supplement intake on visual outcomes in healthy adults and those with eye disease: a systematic review, meta-analysis, and meta-regression of randomized controlled trials

Hu W et al. • Nutrition reviews (2023)

Intake of xanthophyll-rich food or supplements can improve eye health.

Intake of xanthophyll-rich food or supplements can improve eye health.
Additional improvement in visual acuity was observed in patients with eye disease.
A positive association between MPOD and serum lutein level, while absent with dietary xanthophyll intake, suggests the importance of bioavailability when examining the effect of xanthophyll on eye health.

Meta-Analysis

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The effect of lutein and Zeaxanthine on dyslipidemia: A meta-analysis study

Ghasemi F et al. • Prostaglandins & other lipid mediators (2023)

L/Z administration could be an effective treatment for improving circulating HDL-C concentration in elderly adults.

L/Z supplementation has null effect on circulating levels of TC (WMD: -3.82 95% CI: -13.83, 6.18; I-square: 85.2%), and LDL-C (WMD: -4.54; 95% CI: -11.5, 2.48; I-square: 83.9%).
In contrast, L/Z treatment could significantly increase HDL-C levels in older adults (WMD: 4.06; 95% CI: 0.64, 7.48; I-square: 50.7%).
L/Z administration could be an effective treatment for improving circulating HDL-C concentration in elderly adults.

Meta-Analysis

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Carotenoids supplementation and inflammation: a systematic review and meta-analysis of randomized clinical trials

Hajizadeh-Sharafabad F et al. • Critical reviews in food science and nutrition (2022)

The overall results supported possible protective effects of carotenoids on inflammatory biomarkers.

The random-effect model was used to analyze data and the overall effect size was computed as weighted mean difference (WMD) and corresponding 95% of confidence interval (CI).
A total of 26 trials with 35 effect sizes were included in this meta-analysis.
Also, only lycopene (WMD: ‒1.08 pg/ml, 95%CI: ‒2.03, ‒0.12, P = 0.027) led to a significant decrease in IL-6.

Meta-Analysisn=26

DOI

Carotenoids in the Management of Glaucoma: A Systematic Review of the Evidence

Lem DW et al. • Nutrients (2021)

The data suggest that carotenoid vitamin therapy exerts synergic neuroprotective benefits and has the capacity to serve adjunctive therapy in the management of glaucoma.

A comprehensive literature search was conducted in three databases (PubMed, Cochrane Library, and Web of Science) and 20 records were identified for screening.
Lutein demonstrated enhanced neuroprotection on retinal ganglion cell survival and preserved synaptic activity.
In clinical studies, a protective trend was seen with greater dietary consumption of carotenoids and risk of glaucoma, while greater carotenoid levels in macular pigment were largely associated with improved visual performance in glaucomatous eyes.

Systematic Review

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A Systematic Review of Carotenoids in the Management of Diabetic Retinopathy

Lem DW et al. • Nutrients (2021)

These findings provide a strong molecular basis and a line of evidence that suggests carotenoid vitamin therapy may offer enhanced neuroprotective effects with therapeutic potential to function as an adjunct nutraceutical strategy for management of diabetic retinopathy.

Lutein and zeaxanthin demonstrated significant protection against capillary cell degeneration and hyperglycemia-induced changes in retinal vasculature.
Observational studies indicate that depletion of xanthophyll carotenoids in the macula may represent a novel feature of DR, specifically in patients with type 2 or poorly managed type 1 diabetes.
Meanwhile, early interventional trials with dietary carotenoid supplementation show promise in improving their levels in serum and macular pigments concomitant with benefits in visual performance.

Systematic Review

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