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The beneficial role of lutein and zeaxanthin in cataracts

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Nutrafoods

Abstract

Cataracts remain the leading cause of visual loss and blindness worldwide. Cataract surgery is the most common surgical procedure in several countries and its occurrence is expected to increase substantially due to the ageing of the population and the reduced visual acuity threshold required for considering it. Cataracts are characterised by lens opacity and are caused by the precipitation of proteins induced by oxidative damage. The fact that oxidation of the lens is a contributing cause for cataracts suggests that antioxidants may play a positive role in cataract prevention. Lutein and zeaxanthin, two dietary xanthophylls exclusively deposited in the macula lutea and known for their beneficial role in age-related macular degeneration, are the only carotenoids deposited in the lens and may have an important role in reducing the ROSinduced damage of the lens contributing to cataract development. This paper will review the current science derived from epidemiological and intervention studies addressing the association between lutein and zeaxanthin intake, their serum level, and the possible benefits for primary prevention of age-related cataract. Additional insights into the potential health cost savings from the increased intake of these dietary ingredients originating from a U.S. study are also provided.

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References

  1. WHO. Prevention of blindness and visual impairment. World Health Organization. http://www.who.int/blindness/causes/priority/en/index1.html. Accessed January 2015

    Google Scholar 

  2. Abdel-Aal EM, Akhtar H, Zaheer K, Ali R (2013) Dietary sources of lutein and zeaxanthin carotenoids and their role in eye health. Nutrients 5:1169–1185

    Article  CAS  Google Scholar 

  3. Fernandez MM, Afshari NA (2011) Cataracts: we have perfected the surgery, but is it time for prevention? Curr Opin Ophthalmol 22:2–3

    Google Scholar 

  4. Chitchumroonchokchai C, Bomser JA, Glamm JE, Failla ML (2004) Xanthophylls and a-tocopherol decrease UVBinduced lipid peroxidation and stress signaling in human lens epithelial cells. J Nutr 134:3225–3232

    CAS  Google Scholar 

  5. Seddon JM (2007) Multivitamin-multimineral supplements and eye disease: age-related macular degeneration and cataract. Am J Clin Nutr 85:304S–307S

    CAS  Google Scholar 

  6. Mares JA, Voland R, Adler R, Tinker L, Millen AE, Moeller SM, Blodi B, Gehrs KM, Wallace RB, Chappell RJ et al (2010) Healthy diets and the subsequent prevalence of nuclear cataract in women. Arch Ophthalmol 128:738–749

    Article  CAS  Google Scholar 

  7. Yeum KJ, Shang FM, Schalch WM, Russell RM, Taylor A (1999) Fat-soluble nutrient concentrations in different layers of human cataractous lens. Curr Eye Res 19:502–505

    Article  CAS  Google Scholar 

  8. Krinsky NI, Landrum, JT, Bone RA (2003) Biologic mechanisms of the protective role of lutein and zeaxanthin in the eye. Annu Rev Nutr 23:171–201

    Article  CAS  Google Scholar 

  9. Berendschot TT, Broekmans WM, Klopping-Ketelaars IA, Kardinaal AF, Van Poppel G, Van Norren D (2002) Lens aging in relation to nutritional determinants and possible risk factors for age-related cataract. Arch Ophthalmol 120:1732–1737

    Article  Google Scholar 

  10. Hammond BR, Wooten BR, Snodderly DM (1997) Density of the human crystalline lens is related to the macular pigment carotenoids, lutein and zeaxanthin. Optom Vis Sci 74:499–504

    Article  Google Scholar 

  11. Gao S, Qin T, Liu Z, Caceres MA, Ronchi CF, Chen CO, Yeum K, Taylor A, Blumberg JB, Liu Y, Shang F (2011) Lutein and zeaxanthin supplementation reduces H2O2-induced oxidative damage in human lens epithelial cells. Mol Vis 17:3180–3190

    CAS  Google Scholar 

  12. Dorey CK, Granata L, Nichols CR, Cheng KM, Craft NE (2005) Dietary modulation of lens zeaxanthin in quail. Exp Eye Res 81:464–477

    Article  CAS  Google Scholar 

  13. Arnal E, Miranda M, Almansa I, Muriach M, Barcia JM, Romero FJ, Diaz-Llopis M, Bosch-Morell F (2009) Lutein prevents cataract development and progression in diabetic rats. Graefes Arch Clin Exp Ophthalmol 247:115–120

    Article  Google Scholar 

  14. Gale CR, Hall NF, Phillips DI, Martyn CN (2001) Plasma antioxidant vitamins and carotenoids and age-related cataract. Ophthalmology 108:1992–1998

    Article  CAS  Google Scholar 

  15. Brown L, Rimm, EB, Seddon JM et al (1999) A prospective study of carotenoid intake and risk of cataract extraction in US men. Am J Clin Nutr 70:517–524

    CAS  Google Scholar 

  16. Chasan-Taber L, Willett WC, Seddon JM et al (1999) A prospective study of carotenoid and vitamin A intakes and risk of cataract extraction in US women. Am J Clin Nutr 70:509–516

    CAS  Google Scholar 

  17. Lyle BJ, Mares-Perlman JA, Klein BE, Klein R, Palta M, Bowen PE, Greger JL (1999) Serum carotenoids and tocopherols and incidence of age-related nuclear cataract. Am J Clin Nutr 69:272–277

    CAS  Google Scholar 

  18. Jacques PF, Chylack LT Jr, Hankinson SE, Khu PM, Rogers G, Friend J, Tung W, Wolfe JK, Padhye N, Willett WC et al (2001) Long-term nutrient intake and early age-related nuclear lens opacities. Arch Ophthalmol 119:1009–1019

    Article  CAS  Google Scholar 

  19. Rodriguez-Rodrigues E, Ortega RM, Lopez-Sobaler AM, Aparicio A, Bermejo LM, Marin-Arias LI (2006) The relationship between antioxidant nutrient intake and cataracts in older people. Int J Vit Nutr Res 76:359–366

    Article  Google Scholar 

  20. Vu HT, Robman L, Hodge A, McCarty CA, Taylor H (2006) Lutein and zeaxanthin and the risk of cataract: the Melbourne visual impairment project. Invest Ophthalmol Vis Sci 47:3783–3786

    Article  Google Scholar 

  21. Christen WG, Liu S, Glynn RJ et al (2008) Dietary carotenoids, vitamin C and E, and risk of cataract in women. Arch Ophthalmol 126:102–109

    Article  Google Scholar 

  22. Moeller SM, Voland R, Tinker L, Blodi BA, Klein ML, Gehrs KM, Johnson EJ, Snodderly DM, Wallace RB, Chappell RJ et al (2008) 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, an Ancillary Study of the Women’s Health Initiative. Arch Ophthalmol 126:354–364

    Article  Google Scholar 

  23. Lyle BJ, Mares-Perlman JA, Klein BE, Klein R, Greger JL (1999) Antioxidant intake and risk of incident age-related nuclear cataracts in the Beaver Dam Eye Study. Am J Epidemiol 149:801–809

    Article  CAS  Google Scholar 

  24. Delcourt C, Carrière I, Delage M, Barberger-Gateau P, Schalch W (2006) Plasma lutein and zeaxanthin and othercarotenoids as modifiable risk factors for age-related maculopathy and cataract: the POLA Study. Invest Ophthalmol Vis Sci 47:2329–2335

    Article  Google Scholar 

  25. Dherani M, Murthy GV, Gupta SK, Young IS, Maraini G, Camparini M, Price GM, John N, Chakravarthy U, Fletcher AE (2008) Blood levels of vitamin C, carotenoids and retinol are inversely associated with cataract in a North Indian population. Invest Ophthalmol Vis Sci 49:3328–3335

    Article  Google Scholar 

  26. Karppi J, Laukkanen JA, Kurl S (2012) Plasma lutein and zeaxanthin and the risk of age-related nuclear cataract among the elderly Finnish population. Br J Nutr 14:148–154

    Article  Google Scholar 

  27. Ravindran RD, Vashist P, Gupta SK, Young IS, Maraini G, Camparini M, Jayanthi R, John N, Fitzpatrick KE, Chakravarthy U et al (2011) Inverse association of vitamin C with cataract in older people in India. Opthalmology 118:1958–1965

    Article  Google Scholar 

  28. Chiu CJ, Taylor A (2007) Nutritional antioxidants and agerelated cataract and maculopathy. Exp Eye Res 84:229–245

    Article  CAS  Google Scholar 

  29. Weikel KA, Garber C, Baburins A, Taylor A (2014) Nutritional modulation of cataract. Nutr Rev 72:30–47

    Article  Google Scholar 

  30. Vitale S, West SK, Halfrisch J, Allston C, Wang F, Moorman C, Muller D, Singh V, Taylor H (1993) Plasma antioxidants and risk of cortical and nuclear cataract. Epidemiology 4:195–203

    Article  CAS  Google Scholar 

  31. Mares-Perlman JA, Brady WE, Klein BE, Klein R, Palta M, Bowen P, Stacewicz-Sapuntzakis M (1995) Serum carotenoids and tocopherols and severity of nuclear and cortical opacities. Invest Ophthalmol Vis Sci 36:276–288

    CAS  Google Scholar 

  32. Cui YH, Jing CX, Pan HW (2013) Association of blood antioxidants and vitamins with risk of age-related cataract: a meta-analysis of observational studies. Am J Clin Nutr 98:778–786

    Article  CAS  Google Scholar 

  33. Ma L, Hao ZX, Liu RR, Yu RB, Shi Q, Pan JP (2014) A doseresponse meta-analysis of dietary lutein and zeaxanthin intake in relation to risk of age-related cataract. Graefes Arch Clin Exp Ophthalmol 252:63–70

    Article  CAS  Google Scholar 

  34. Liu XH, Yu RB, Liu R, Hao ZX, Han CC, Zhu ZH, Ma L (2014) Association between lutein and zeaxanthin status and the risk of cataract: a meta-analysis. Nutrients 6:452–465

    Article  Google Scholar 

  35. Olmedilla B, Granado F, Blanco I et al (2003) Lutein, but notalpha-tocopherol, supplementation improves visual function in patients with age-related cataracts: a 2-y double-blind, placebo-controlled pilot study. Nutrition 19:21–24

    Article  CAS  Google Scholar 

  36. Age-related Eye Disease Study 2 (AREDS2) Research Group (2013) Lutein/zeaxanthin for the treatment of age-related cataract: AREDS2 randomized trial report no. 4. JAMA Ophthalmol 131:843–850

    Article  Google Scholar 

  37. Age-related Eye Disease Study 2 Research Group (2013) Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. JAMA 309:2005–2015

    Article  Google Scholar 

  38. Age-related Eye Disease Study 2 (AREDS2) Research Group (2014) Secondary analyses of the effects of lutein/zeaxanthin on age-related macular degeneration progression. AREDS2 Report No. 3. JAMA Ophthalmol 132:142–149

    Article  Google Scholar 

  39. Shanahan C, de Lorimier R; Frost and Sullivan (2013) Smart prevention: health care cost savings resulting from the targeted use of dietary supplements. http://www.crnusa.org/ CRNfoundation/HCCS/chapters/CRNFrostSullivan-fullreport0913. pdf

    Google Scholar 

  40. Granado F, Blázquez S, Olmedilla B (2007) Changes in carotenoid intake from fruit and vegetables in the Spanish population over the period 1964–2004. Public Health Nutr 10:1018–1023

    Article  CAS  Google Scholar 

  41. Giuliano AR, Siegel EM, Roe DJ, Ferreira S, Baggio ML, Galan L, Duarte-Franco E, Villa LL, Rohan TE, Marshall JR et al (2003) Dietary intake and risk of persistent human papillomavirus (HPV) infection: the Ludwig-McGill HPV Natural History Study. J Infect Dis 188:1508–1516

    Article  Google Scholar 

  42. O’Neill ME, Carroll Y, Corridan B, Olmedilla B, Granado F, Blanco I, Van Den Berg H, Hininger I, Rousell AM, Chopra M, Southon S, Thurnham DI (2001) A European carotenoid database to assess carotenoid intakes and its use in a fivecountry comparative study. Br J Nutr 85:499–507

    Article  Google Scholar 

  43. Johnson EJ, Maras JE, Rasmussen HM, Tucker KL (2010) Intake of lutein and zeaxanthin differ with age, sex, and ethnicity. J Am Diet Assoc 110:1357–1362

    Article  CAS  Google Scholar 

  44. Christen WG, Liu S, Glynn RJ, Gaziano JM, Buring JE (2008) Dietary carotenoids, vitamins C and E, and risk of cataract in women: a prospective study. Arch Ophthalmol 126:102–109

    Article  Google Scholar 

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Authors and Affiliations

  1. Kemin Human Nutrition and Health a division of Kemin Foods L.C., Campo Grande 35-8°D, 1700-087, Lisbon, Portugal

    Samanta Maci

  2. Kemin Human Nutrition and Health a division of Kemin Foods L.C., Rua Ettore Soliane, 471, 13347-394, Indaiatuba, SP, Brazil

    Rafaela Santos

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Correspondence to Samanta Maci.

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Maci, S., Santos, R. The beneficial role of lutein and zeaxanthin in cataracts. Nutrafoods 14, 63–69 (2015). https://doi.org/10.1007/s13749-015-0014-0

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  • DOI: https://doi.org/10.1007/s13749-015-0014-0

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