Lutein and zeaxanthin, two plant pigments found in foods and in our eyes, may help protect us from age-related eye diseases and more, discovers Patsy Westcott.
🕒 12 min read
What are lutein and zeaxanthin?
Lutein and zeaxanthin are fat-soluble antioxidants belonging to the carotenoid family of plant chemicals, which provide the colour of green leafy and orange and yellow vegetables and fruit, as well as flowers like marigolds. Known as macular pigments, they are also found in the retina. Lutein and zeaxanthin are closely related, but zeaxanthin is especially concentrated in the central macula.1
The retina is the light-sensitive layer of tissues at the back of the eyeball which converts light into electrical signals that travel along the optic nerve to the brain, helping us form the images we see. Lutein and zeaxanthin are densest in the macula, the part of the retina responsible for the sharp central vision we need to recognise faces, read and drive.2, 3, 4
In the eyes lutein and zeaxanthin help filter light and are studied for their ability to protect eye tissues from photochemical damage. Specifically they act as antioxidants, helping to protect against oxidative stress by limiting the formation of reactive oxygen species (ROS) and mopping up rogue molecules called free radicals. This nutritional role does not replace UV-protective sunglasses.5, 6, 7
- Carotenoids are also responsible for giving birds their bright plumage and fish, shrimps, sea sponges and other sea creatures their colour.8
- There are around 700 carotenoids in nature, 40 found in fruit and vegetables and 20 to 30 in blood and tissues. Lutein, zeaxanthin and the related pigment meso-zeaxanthin make up the macular pigment in our eyes.1
- In traditional Chinese medicine carotenoid-rich bright orange goji berries are recommended for healthy eyes.3
Lutein, zeaxanthin and AMD
As we get older, protecting our eye health becomes increasingly important. Much research into lutein and zeaxanthin focuses on eye diseases that strike in later life, such as age-related macular degeneration (AMD), a major cause of sight loss, and age-related cataracts (ARC).
One job of 'good' HDL cholesterol is to transport lutein and zeaxanthin into the retina, and low blood levels of HDL cholesterol have been linked with low levels of the two nutrients in the body, especially in the retina.9
Unlike plants our bodies can't synthesise lutein and zeaxanthin. Boosting our intake of fruits and vegetables rich in lutein and zeaxanthin supports nutritional intake. For people with certain stages of AMD, a specific combination of nutrients in an AREDS2 supplement can help slow progression; this does not mean every lutein supplement prevents eye disease.10
In the past it was thought that the benefits of lutein and zeaxanthin were largely due to the blue light-filtering effect of lutein, but over the last decade evidence has begun to emerge of an immune and inflammation-modifying effect. Inflammaging, the increase in inflammation that happens as we get older, is thought to be the underlying driver of a host of age-related diseases.11
- AMD is a major cause of irreversible sight loss in older adults.12
- Risk factors include older age, family history, smoking, high blood pressure, obesity, female sex, light-coloured irises, AMD in the other eye, and a poor diet low in nutrients and high in fat.13
- There are different stages: early, intermediate and late. In the earlier stages there may be no symptoms and no vision loss.14
- If symptoms develop you are likely to notice them when looking straight at something; e.g. reading, looking at your mobile phone or watching TV.
- There are two types of late (advanced) AMD: dry and wet.
- Dry AMD develops slowly over years, during which time central vision may become distorted or blurred. You may develop a dark or missing area in your central vision.
- Wet AMD is caused by new blood vessels growing, and may develop quickly over a period of days or weeks. Dry AMD can transform into wet AMD.
- Management depends on the stage and type of AMD. An eye specialist may recommend an AREDS2 supplement for intermediate AMD, while wet AMD can be treated with injectable medications called anti-vascular endothelial growth factor (anti-VEGF) drugs. New distortion or a change in central vision needs prompt assessment.10
Retinex Max Eye Support
Lutein, zeaxanthin and vitamin B2 for daily nutritional support
- 20 mg lutein and 2,000 µg zeaxanthin per tablet
- Vitamin B2 contributes to normal vision
- Vegan-friendly, one-a-day tablets
The AREDS studies
Most interest in lutein and zeaxanthin has focused on their role in formulations studied to help delay the progression of AMD and help maintain vision. The seminal AREDS2 (Age-related Eye Disease Study 2) is one of the most exciting findings to come out of research into the two nutrients.7
In a previous study, AREDS 1, scientists found that a supplement containing vitamins C (500 mg) and E (400 IU), beta-carotene (15 mg), zinc (80 mg) and copper (2 mg) lowered the risk of progression to a more advanced AMD in people with intermediate AMD by about a quarter (25%).15
In AREDS2 researchers tested lutein (10 mg) and zeaxanthin (2 mg), alongside changes to the original formulation. Adding lutein and zeaxanthin did not produce a statistically significant extra benefit in the main analysis. Further analyses supported their use in place of beta-carotene, especially for people with low dietary intake. Beta-carotene is not advised for smokers or former smokers because of an increased risk of lung cancer.16
In a further follow-up study published in 2022, researchers concluded that not only was the AREDS2 formulation safer, but that after 10 years the group who received lutein and zeaxanthin had a lower risk of progression to late AMD. The findings supported lutein and zeaxanthin as a safer replacement for beta-carotene in the AREDS formulation.
This follow-up study included 3,882 participants who took AREDS2 supplements containing lutein/zeaxanthin, vitamins C and E, and zinc plus copper (as above).17
OptiVision
A combination of carotenoids, vitamins, minerals and algal omega 3
- 20 mg lutein and 2,000 µg zeaxanthin per daily serving
- 250 mg DHA from a vegan algal source
- Vitamin B2 and zinc contribute to normal vision
How much lutein and zeaxanthin should you take?
The amounts used in a study are not automatically the right daily dose for everyone. Follow the label on your chosen supplement; if you have AMD, ask your eye specialist which formulation suits your stage of the condition.
| Example | Lutein / zeaxanthin | What to know |
|---|---|---|
| AREDS2 research | 10 mg / 2 mg | Part of a specific vitamin-and-mineral formula studied in people at risk of advanced AMD; not a universal daily target.10 |
| Retinex Max | 20 mg / 2 mg | Amounts in one tablet. Follow the current product directions. |
| OptiVision | 20 mg / 2 mg | Amounts per daily tablet-and-capsule serving. Check the full ingredient list before combining supplements. |
These Healthspan products provide nutritional options with different ingredient combinations. They are not identical to the complete AREDS2 research formula. Compare the full formulation, rather than lutein strength alone.
Lutein and blue light
In recent years scientists have become interested in lutein’s role in filtering blue light and supporting visual performance. This should not be confused with evidence that ordinary screen use damages the retina: the American Academy of Ophthalmology says there is no scientific evidence that blue light from digital devices causes eye damage.18
In a 2020 Japanese study researchers found that taking a dietary supplement containing 12 mg of lutein over a period of 16 weeks increased the density of macular pigment in the retina, made the outlines of visible objects clearer and prevented a downturn in visual function caused by glare from light – all of which are thought to be linked to the ability of lutein to filter blue light.19
Lutein, zeaxanthin and cataracts
Although not as far advanced as research into AMD, there are suggestions that lutein and zeaxanthin could reduce the risk of cataracts and improve vision in those with them. A 2014 Chinese meta-analysis (a study of studies) found that higher blood levels of lutein and zeaxanthin were associated with a lower risk of nuclear cataracts. Because these were observational studies, the findings do not establish that taking a supplement prevents cataracts.20
An earlier study, meanwhile, a small pilot trial comparing lutein, vitamin E (alpha-tocopherol) and placebo in separate groups, concluded that 'Visual function in patients with age-related cataracts who received the lutein supplements improved, suggesting that a higher intake of lutein, through lutein-rich fruit and vegetables or supplements, may have beneficial effects on the visual performance of people with age-related cataracts.'21
Lutein, zeaxanthin and cognitive function
It may not just be our eyes that could benefit from a greater intake of lutein and zeaxanthin. Emerging research suggests that they may also help keep our brains sharper as we get older, according to a Spanish review that examined the links between cognitive function, macular pigmentation and the intake of lutein and zeaxanthin.22
To compare nutritional options, explore our eye health supplements.
Diet matters
So how should you eat, and what are the best foods to put on the menu for the health of your eyes? According to a recent systematic review a Mediterranean or Oriental pattern of eating is the way to go. The study found that a Mediterranean diet was associated with slower progression of AMD. Meanwhile an Oriental diet was linked with a lower prevalence.23
By contrast a Western dietary pattern and high-GI (glycaemic index) diets were linked with increased prevalence. Interestingly, the consumption of more than two units of alcohol a day was also linked with greater prevalence of AMD, so it's a good idea to moderate alcohol intake.
Research links Mediterranean and Asian dietary patterns with favourable eye-health outcomes.
The authors recommended a high intake of carotenoid-rich veg and oily fish containing omega 3 fatty acids, alongside limiting red and processed meat. These dietary findings describe associations rather than proving that a particular diet prevents AMD.
To maximise your intake of lutein and zeaxanthin, pile your plate with a rainbow of different-coloured foods. Kale and spinach pack the biggest punch when it comes to lutein, and you'll find both lutein and zeaxanthin in lettuce, broccoli, Brussels sprouts, courgettes, parsley, peppers and egg yolk.
The ancient grain freekeh, available now in many supermarkets, and egg noodles are other sources. When it comes to fruit, nectarines, blackberries, avocados, raspberries, gooseberries, kiwi fruits, and blackcurrants have the highest content.24, 25
Lutein and zeaxanthin food sources at a glance
A varied diet makes it easier to include these pigments regularly. Amounts vary by variety, preparation and portion size, so this table focuses on useful food choices and practical ways to eat them.26
| Food sources | Nutritional focus | Easy ways to include them |
|---|---|---|
| Kale and spinach | Leafy greens are rich sources of lutein. | Stir into soups, omelettes or pasta. |
| Broccoli, peas and romaine lettuce | Useful green-vegetable sources of macular carotenoids. | Add to salads, stir-fries or vegetable sides. |
| Sweetcorn and orange peppers | Colourful choices that contribute lutein and zeaxanthin. | Add to soups, salads or traybakes. |
| Egg yolks | A source of lutein and zeaxanthin. | Serve eggs with vegetables for a varied meal. |
Top tip
Like other carotenoids, lutein and zeaxanthin are fat-soluble. To optimise absorption, eat foods containing these nutrients with a source of fat or oil to maximise their benefits – think a drizzle of olive oil on salads and vegetables or a dollop of full-fat Greek yogurt with fruit.
Other eye helpers – the studies
Research suggests that several other nutrients may have benefits for eye health. These include:
- A 2022 systematic review of the role of lutein and zeaxanthin in AMD noted that trace minerals such as zinc and copper may also exert antioxidant properties in the retina.25
- The same review suggested that omega 3 fatty acids may also have protective effects against AMD, with antioxidant and anti-inflammatory properties, and help block the formation of new blood vessels (neovascularization), which is a feature of so-called wet AMD (see above). These mechanisms do not establish that omega-3 supplements treat AMD.
- A 2016 review explored omega 3 fatty acids in eye health. This is an area of research, rather than evidence that a supplement can reverse AMD; AREDS2 did not find an additional benefit from adding omega 3 for AMD progression.27, 10
- A 2022 French study found a strong link between normal blood levels of folate, and a high dietary intake of vitamin B5 and vitamin B6, and a lower risk of developing AMD, leading the authors to conclude that 'adopting a healthy diet rich in B vitamins may help reduce vision loss due to AMD.'28
- A 2023 pilot study reported that taking a supplement of bilberry extract combined with fish oil for three months helped to improve the signs and symptoms of severe dry eyes, in a group of young and middle-aged participants. Read our guide to bilberry and eye health for more on this ingredient.29
- A small randomised controlled trial published in 2023 found that eight weeks of probiotic supplementation in people with AMD significantly increased 'good' HDL cholesterol, antioxidant capacity (the ability to scavenge free radicals), and decreased malondialdehyde (MDA) levels (a sign of lipid peroxidization or rancidity). More research is needed.30
- A review examined the role of macular pigments throughout life, from the cradle to the grave. Researchers observed that macular pigments 'can promote enhanced ocular and cognitive function in normal individuals.' Watch this space.3
Lutein and zeaxanthin FAQs
What is lutein good for?
Lutein is a carotenoid found in food and concentrated in the macula. It helps filter light and has antioxidant properties. Its best-established clinical role is as one ingredient in AREDS2 formulations for selected people with AMD, alongside other nutrients.10
What is zeaxanthin, and how is it different from lutein?
Zeaxanthin is a closely related carotenoid and macular pigment. Both occur in foods and eye supplements, but their distribution in the retina differs: zeaxanthin is especially concentrated in the central macula.
Which foods contain lutein and zeaxanthin?
Try leafy greens such as kale and spinach, along with broccoli, peas, sweetcorn, peppers and egg yolks. Vary your choices across the week rather than relying on a single food.26
How much lutein and zeaxanthin should I take daily?
Follow the directions on your supplement. AREDS2 used 10 mg lutein and 2 mg zeaxanthin within a specific combination formula, but this is not a general prescription for everyone. If you have AMD, ask your eye specialist about the complete formula.10
When should I take lutein and zeaxanthin?
They are fat-soluble, so taking them with a meal containing some fat is a practical choice. Follow the product label and pick a time that fits your routine.
Can lutein and zeaxanthin improve eyesight?
The answer depends on what is causing the vision problem. Research includes visual performance and AMD progression, but supplements do not correct a glasses prescription. Regular eye tests help identify which care, if any, your eyes need. AREDS2 benefits apply to specific stages of AMD.10
