Skip to main content

Advertisement

SpringerLink
Log in

A dose–response meta-analysis of dietary lutein and zeaxanthin intake in relation to risk of age-related cataract

  • Cataract
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

Lutein and zeaxanthin are thought to have beneficial effects on protecting the lens against cataract formation, but findings from epidemiologic studies have been inconsistent. We aimed to conduct a meta-analysis of prospective cohort studies to examine the association between dietary lutein and zeaxanthin intake and risk of age-related cataract (ARC).

Methods

We systematically searched MEDLINE, EMBASE, Web of Science, and Cochrane Library databases up to March 2013. Reference lists from retrieved articles were also reviewed. The adjusted relative risks (RRs) from each study were extracted to calculate a pooled estimate with its 95 % confidence interval (CI). The dose–response relationships were assessed by using generalized least-squares trend estimation.

Results

Six prospective cohort studies were identified involving 4,416 cases and 41,999 participants. For the comparison between the highest and the lowest categories of dietary lutein and zeaxanthin intake, significant inverse association were found for nuclear cataract (RR: 0.75; 95 % CI: 0.65, 0.85), but not for cortical cataract (RR: 0.85; 95 % CI: 0.53, 1.17) and for posterior subcapsular cataract (RR: 0.77; 95 % CI: 0.40, 1.13). Dose–response analysis showed that every 300 μg/d increment in dietary lutein and zeaxanthin intake was associated with a 3 %, 1 %, or 3 % reduction in the risk of nuclear cataract (RR: 0.97; 95 % CI: 0.94, 0.99), cortical cataract (RR: 0.99; 95 % CI: 0.95, 1.02), or posterior subcapsular cataract (RR: 0.97; 95 % CI: 0.93, 1.01) respectively.

Conclusions

Dietary lutein and zeaxanthin intake is associated with a reduced risk of ARC, especially nuclear cataract in a dose–response manner, indicating a beneficial effect of lutein and zeaxanthin in ARC prevention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Pascolini D, Mariotti SP (2012) Global estimates of visual impairment: 2010. Br J Ophthalmol 96:614–618

    Article  PubMed  Google Scholar 

  2. Congdon N, Vingerling JR, Klein BE, West S, Friedman DS, Kempen J, O’Colmain B, Wu SY, Taylor HR (2004) Prevalence of cataract and pseudophakia/aphakia among adults in the United States. Arch Ophthalmol 122:487–494

    Article  PubMed  Google Scholar 

  3. Hatch WV, Campbell Ede L, Bell CM, El-Defrawy SR, Campbell RJ (2012) Projecting the growth of cataract surgery during the next 25 years. Arch Ophthalmol 130:1479–1481

    Article  PubMed  Google Scholar 

  4. Salm M, Belsky D, Sloan FA (2006) Trends in cost of major eye diseases to Medicare, 1991 to 2000. Am J Ophthalmol 142:976–982

    Article  PubMed  Google Scholar 

  5. Fan X, Zhang J, Theves M, Strauch C, Nemet I, Liu X, Qian J, Giblin FJ, Monnier VM (2009) Mechanism of lysine oxidation in human lens crystallins during aging and in diabetes. J Biol Chem 284:34618–34627

    Article  CAS  PubMed  Google Scholar 

  6. Zhang J, Yan H, Löfgren S, Tian X, Lou MF (2012) Ultraviolet radiation-induced cataract in mice: the effect of age and the potential biochemical mechanism. Invest Ophthalmol Vis Sci 53:7276–7285

    Article  CAS  PubMed  Google Scholar 

  7. Tan AG, Mitchell P, Flood VM, Burlutsky G, Rochtchina E, Cumming RG, Wang JJ (2008) Antioxidant nutrient intake and the long-term incidence of age-related cataract: the Blue Mountains Eye Study. Am J Clin Nutr 87:1899–1905

    CAS  PubMed  Google Scholar 

  8. Barker FM 2nd, Snodderly DM, Johnson EJ, Schalch W, Koepcke W, Gerss J, Neuringer M (2011) Nutritional manipulation of primate retinas, V: effects of lutein, zeaxanthin, and n-3 fatty acids on retinal sensitivity to blue-light-induced damage. Invest Ophthalmol Vis Sci 52:3934–3942

    Article  CAS  PubMed  Google Scholar 

  9. Bian Q, Gao S, Zhou J, Qin J, Taylor A, Johnson EJ, Tang G, Sparrow JR, Gierhart D, Shang F (2012) Lutein and zeaxanthin supplementation reduces photooxidative damage and modulates the expression of inflammation-related genes in retinal pigment epithelial cells. Free Radic Biol Med 53:1298–1307

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. 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  PubMed Central  PubMed  Google Scholar 

  11. 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  PubMed  Google Scholar 

  12. Maralani HG, Tai BC, Wong TY, Tai ES, Li J, Wang JJ, Mitchell P (2013) Metabolic syndrome and risk of age-related cataract over time: an analysis of interval-censored data using a random-effects model. Invest Ophthalmol Vis Sci 54:641–646

    Article  Google Scholar 

  13. Millett GA, Flores SA, Marks G, Reed JB, Herbst JH (2008) Circumcision status and risk of HIV and sexually transmitted infections among men who have sex with men: a meta-analysis. JAMA 300:1674–1684

    Article  CAS  PubMed  Google Scholar 

  14. Borenstein M, Hedges LV, Higgins JPT, Rothstein HR (2009) Introduction to meta-analysis. Wiley, Chichester

    Book  Google Scholar 

  15. Greenland S, Longnecker MP (1992) Methods for trend estimation from summarized dose–response data, with applications to meta-analysis. Am J Epidemiol 135:1301–1309

    CAS  PubMed  Google Scholar 

  16. Deeks JJ, Macaskill P, Irwig L (2005) The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J Clin Epidemiol 58:882–893

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  19. Moeller SM, Voland R, Tinker L, Blodi BA, Klein ML, Gehrs KM, Johnson EJ, Snodderly DM, Wallace RB, Chappell RJ, Parekh N, Ritenbaugh C, Mares JA (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  PubMed Central  PubMed  Google Scholar 

  20. Taylor A, Jacques PF, Chylack LT Jr, Hankinson SE, Khu PM, Rogers G, Friend J, Tung W, Wolfe JK, Padhye N, Willett WC (2002) Long-term intake of vitamins and carotenoids and odds of early age-related cortical and posterior subcapsular lens opacities. Am J Clin Nutr 75:540–549

    CAS  PubMed  Google Scholar 

  21. Zheng Selin J, Rautiainen S, Lindblad BE, Morgenstern R, Wolk A (2013) High-dose supplements of vitamins C and E, low-dose multivitamins, and the risk of age-related cataract: a population-based prospective cohort study of men. Am J Epidemiol 177:548–555

    Article  PubMed  Google Scholar 

  22. Ma L, Lin XM (2010) Effects of lutein and zeaxanthin on aspects of eye health. J Sci Food Agric 90:2–12

    Article  CAS  PubMed  Google Scholar 

  23. Subczynski WK, Wisniewska A, Widomska J (2010) Location of macular xanthophylls in the most vulnerable regions of photoreceptor outer-segment membranes. Arch Biochem Biophys 504:61–66

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  24. Bhosale P, Bernstein PS (2005) Synergistic effects of zeaxanthin and its binding protein in the prevention of lipid membrane oxidation. Biochim Biophys Acta 1740:116–121

    Article  CAS  PubMed  Google Scholar 

  25. 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  PubMed  Google Scholar 

  26. Gao S, Qin T, Liu Z, Caceres MA, Ronchi CF, Chen CY, Yeum KJ, 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  PubMed  Google Scholar 

  27. Kijlstra A, Tian Y, Kelly ER, Berendschot TT (2012) Lutein: more than just a filter for blue light. Prog Retin Eye Res 31:303–315

    Article  CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  29. van Leeuwen R, Boekhoorn S, Vingerling JR, Witteman JC, Klaver CC, Hofman A, de Jong PT (2005) Dietary intake of antioxidants and risk of age-related macular degeneration. JAMA 294:3101–3107

    Article  PubMed  Google Scholar 

  30. 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 five-country comparative study. Br J Nutr 85:499–507

    Article  PubMed  Google Scholar 

  31. Khanna R, Pujari S, Sangwan V (2011) Cataract surgery in developing countries. Curr Opin Ophthalmol 22:10–14

    Article  PubMed  Google Scholar 

  32. Chang JR, Koo E, Agrón E, Hallak J, Clemons T, Azar D, Sperduto RD, Ferris FL 3rd, Chew EY (2011) Risk factors associated with incident cataracts and cataract surgery in the Age-related Eye Disease Study (AREDS): AREDS report number 32. Ophthalmology 118:2113–2119

    Article  PubMed Central  PubMed  Google Scholar 

  33. Michael R, Bron AJ (2011) The ageing lens and cataract: a model of normal and pathological ageing. Philos Trans R Soc Lond B Biol Sci 366:1278–1292

    Article  CAS  PubMed  Google Scholar 

  34. Sireesha R, Laxmi SG, Mamata M, Reddy PY, Goud PU, Rao PV, Reddy GB, Vishnupriya S, Padma T (2012) Total activity of glutathione-S-transferase (GST) and polymorphisms of GSTM1 and GSTT1 genes conferring risk for the development of age related cataracts. Exp Eye Res 98:67–74

    Article  CAS  PubMed  Google Scholar 

  35. Beebe DC, Holekamp NM, Siegfried C, Shui YB (2011) Vitreoretinal influences on lens function and cataract. Philos Trans R Soc Lond B Biol Sci 366:1293–1300

    Article  CAS  PubMed  Google Scholar 

  36. Yoshida M, Takashima Y, Inoue M, Iwasaki M, Otani T, Sasaki S, Tsugane S (2007) Prospective study showing that dietary vitamin C reduced the risk of age-related cataracts in a middle-aged Japanese population. Eur J Nutr 46:118–124

    Article  CAS  PubMed  Google Scholar 

  37. Chew EY, SanGiovanni JP, Ferris FL, Wong WT, Agron E, Clemons TE, Sperduto R, Danis R, Chandra SR, Blodi BA, Domalpally A, Elman MJ, Antoszyk AN, Ruby AJ, Orth D, Bressler SB, Fish GE, Hubbard GB, Klein ML, Friberg TR, Rosenfeld PJ, Toth CA, Bernstein P (2013) Lutein/zeaxanthin for the treatment of age-related cataract: AREDS2 Randomized Trial Report No. 4. JAMA Ophthalmol 131:843–850

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Served as scientific advisors (LM, JPP); critically reviewed the study proposal (LM, RRL, QS, JPP); collected data (LM, ZXH, RBY); management, analysis and interpretation of the data (LM, ZXH, RRL, RBY, JPP); and preparation of the manuscript (LM, RRL, JPP).

Financial Support

This study was supported in part by grants from the National Natural Science Foundation of China (81202198), the Natural Science Foundation of Shaanxi Province of China (2013JQ4008) and the Fundamental Research Funds for the Central Universities of China (xjj2012052).

Conflict of Interest

None of the authors have any conflicts of interest associated with the work presented in this manuscript.

Author information

Authors and Affiliations

  1. School of Public Health, Xi’an Jiaotong University College of medicine, 76 Yanta West Road, Xi’an, Shaanxi, 710061, China

    Le Ma, Zhen-xuan Hao, Rong-bin Yu & Jian-ping Pan

  2. Xi’an center for disease control and prevention, 599 Xiying Road, Xi’an, Shaanxi, 710054, China

    Ru-ru Liu

  3. The First Affiliated Hospital, Xi’an Jiaotong University College of medicine, 277 Yanta West Road, Xi’an, Shaanxi, 710061, China

    Qiang Shi

Authors
  1. Le Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhen-xuan Hao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ru-ru Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rong-bin Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Qiang Shi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jian-ping Pan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jian-ping Pan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ma, L., Hao, Zx., Liu, Rr. et al. A dose–response meta-analysis of dietary lutein and zeaxanthin intake in relation to risk of age-related cataract. Graefes Arch Clin Exp Ophthalmol 252, 63–70 (2014). https://doi.org/10.1007/s00417-013-2492-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-013-2492-3

Keywords

Search

Navigation