As reported by NutraIngredients-USA on Monday, results of the much anticipated AREDS2 study were published in the Journal of the American Medical Association and presented Sunday at the Association for Research in Vision and Ophthalmology annual meeting.
While no overall additional benefits were observed for adding lutein, zeaxanthin and/or omega-3 fatty acids to the original AREDS eye health formula in terms of age-related macular degeneration (AMD) risk, significant benefits were associated with lutein and zeaxanthin in people with the lowest intake of the carotenoids in their diet.
Abhijit Bhattacharya, COO of lutein/zeaxanthin supplier OmniActive, told us: “Low dietary intakes of lutein are representative of the general population, and these people experienced a 26% reduction in progression to advanced AMD.”
“This is an important message. There is a substantial portion of the population with intakes of lutein below one milligram per day.
“There is clear evidence in the secondary analysis between lutein/zeaxanthin plus AREDS minus beta-carotene vs AREDS with beta-carotene (old formula) that the presence of lutein and zeaxanthin shows an 18% reduction in the risk of progression to AAMD and 22% reduction in the risk of progression to neovascular AMD,” he added.
‘Supplements are important’
Taylor Wallace, PhD, senior director, scientific & regulatory affairs, at the Council for Responsible Nutrition (CRN), added: “We know that optimal nutrition is good for the eyes, and certainly lutein/zeaxanthin and omega-3s are important components of a good diet. If you’re not getting enough lutein/zeaxanthin from your diet through foods such as spinach and eggs, or enough EPA/DHA omega-3s through fatty fish, then supplements still remain an important option to help fill those gaps.”
“Age-related eye disease has a long incubation period, and prevention through good nutrition habits should start early and continue throughout a lifespan,” added Dr Wallace.
“Maintaining good nutrition and lifestyle habits most likely have a better chance at preventing chronic disease onset than in halting or correcting a disease progression.”
The first results from AREDS2 reported on a five year follow-up in an elderly population where the average age was 74-75, with already impaired eye function, and therefore might not be generalizable to younger individuals and/or those with normal eye function.
Cataracts
Bhattacharya also commented on the results published in JAMA Ophthalmology concerning the AREDS2 formula and the incidence of age-related cataracts.
The general conclusion had been there was no “effect of supplementation with lutein/ zeaxanthin on cataract surgery, cortical or PSC lens opacity progression, or vision loss”.
“However, when dietary intake data is taken into account there is a different story: Subjects in the quintiles with the lowest Lutein/zeaxanthin saw significant benefit from lutein and zeaxanthin supplementation,” said Bhattacharya.
“The lowest quintiles saw reductions of 36% in cataract surgery, a 30% reduction in any cataract and a 31% reduction in severe cataracts when taking zeaxanthin / lutein.
“This is especially worth noting when you consider that the population in this study was very well nourished and the beneficial effects may be much more evident in groups more representative of the general population.”
Beta-carotene
The AREDS2 research group also raised concerns about beta-carotene, with more lung cancers observed in the beta carotene group, compared with the no-beta-carotene group, mostly in former smokers.
“Based on apparent risks of beta carotene and possible benefits that are only evident within exploratory subgroup analyses, lutein + zeaxanthin requires further investigation for potential inclusion in the AREDS supplements,” wrote the authors from the AREDS2 research group.
Bhattacharya noted that beta-carotene in the AREDS formulation decreased the serum levels of zeaxanthin and lutein for those who were taking them.
“Therefore in effect, the AREDS formula was not just a pseudo control , it also actively interfered with the performance of the lutein and zeaxanthin supplementation.”
Source: JAMA
2013, Volume 309, Number 19, Pages 1-11, doi:10.1001/jama.2013.4997
“Lutein + Zeaxanthin and Omega-3 Fatty Acids for Age-Related Macular Degeneration: The Age-Related Eye Disease Study 2 (AREDS2) Randomized Clinical Trial”
Authors: The Age-Related Eye Disease Study 2 (AREDS2) Research Group
JAMA Ophthalmology
2013, Volume 131, Number 4, Pages 1-7, doi:10.1001/jamaophthalmol.2013.4412
“Lutein/Zeaxanthin for the Treatment of Age-Related Cataract: AREDS2 Randomized Trial Report No. 4”
Authors: The Age-Related Eye Disease Study 2 (AREDS2) Research Group