How we rate
“Strong” = several concordant meta-analyses or systematic reviews. “Moderate” = one synthesis, or several controlled trials. “Limited” = early trials only. The rating is about the quality of the studies, not about how useful the supplement is.
Lutein
One of the rare pigments present in the macula of the eye. As a supplement, it thickens this pigment and slightly improves vision in AMD, but it slowed neither progression to the advanced form nor cataracts in the largest trial.
Benefits
- Thickens the macula pigment: +27.9% in 6 months in 126 patients with AMD; in healthy-eyed adults (46 studies), the effect is clearest starting from 20 mg per day
- Slightly improves visual acuity and contrast sensitivity in AMD, all the more so as the dose is high (8 trials, 1,176 patients)
- In early AMD, 10 mg per day for one year prevented the drop in visual acuity observed with placebo (72 patients)
- Slows down mid-peripheral visual field loss in retinitis pigmentosa, at 12 mg per day in addition to vitamin A (225 patients)
- Better contrast vision in low light after 6 months, in 34 adults
- Two small positive trials on cognition: spatial memory, reasoning and attention in 51 young adults in one year; attention and flexibility in 62 elderly people
Precautions
If you have smoked, look at the composition of an eye formula: in AREDS2, beta-carotene was followed by more lung cancers (2.0% vs 0.9%), especially in former smokers, and the authors suggest lutein and zeaxanthin to replace it. In 175 healthy men, 15 mg per day for three months had no effect, neither beneficial nor adverse, on the biological markers studied (LDL oxidation, antioxidant status). Also good to know: in AREDS2, progression to advanced AMD in 5 years was 29% with lutein vs 31% with placebo, a non-significant difference; cataract surgery, vision loss, cognition (3,741 people) and cardiovascular diseases (4,203 people) did not budge. In observational studies, eating more lutein is not associated with less early AMD. Several positive trials are small (8, 17, 34 participants).
Recommended dosage
10 to 20 mg per day in trials (10 mg with 2 mg of zeaxanthin in AREDS2); at least 20 mg per day for the clearest effect on macular pigment.
How to take it
- For whom: most trials involve people with AMD, cataracts or retinitis pigmentosa; only a portion involve adults with healthy eyes.
- Dose: 10 mg per day in most trials, up to 20 mg; across 46 studies in adults with healthy eyes, less than 5 mg per day changes nothing clear to the macular pigment, and 20 mg or more makes it rise the most.
- Dose effect: at 5, 10 or 20 mg per day for 140 days, blood lutein rises with the dose then plateaus, and the macular pigment rises all the faster as the dose is strong.
- Duration: at 10 mg per day, macular pigment rose by about 4 to 5% every four weeks in a small trial; trials last from 3 to 12 months.
- With zeaxanthin: the large AMD trial combines 10 mg of lutein with 2 mg of zeaxanthin; a trial in early AMD also tests 10 mg of each.
- What does not work: in AREDS2 (over 4,000 elderly people with AMD), it reduced neither progression to advanced AMD, nor cataract surgery, nor cognitive decline, nor cardiovascular diseases.
- Timing and meals: no study in this sheet compares the timing of intake nor intake during a meal.
Did you know?
In AREDS2, lutein did not reduce cataract surgery overall (over 3,000 participants) — except in those who ate the least of it initially, whose risk dropped by 32%.
What the studies say
This systematic review and meta-analysis synthesized 46 studies, including 3,189 adult participants with healthy eyes, to evaluate the effect of lutein/zeaxanthin intake on macular pigment optical density (MPOD). MPOD increased with lutein/zeaxanthin intake, particularly at higher doses (≥20 mg/day) over periods of 3 to 12 months. The effects of intakes below 5 mg/day or dietary sources were less clear. The study concludes that increased lutein/zeaxanthin intake may help maintain eye health.
Wilson LM, Tharmarajah S, Jia Y, Semba RD, Schaumberg DA, Robinson KA. — Advances in nutrition (Bethesda, Md.) (2021) — View the source study
For information only: not a substitute for medical advice. Dietary supplements are not a replacement for a varied, balanced diet. Learn more