Macular Health Formula™
AREDS is a Landmark Research Project that Evaluated
the Ability of Nutrients to Support Macular Health
It featured a controlled, randomized clinical trial that evaluated the effect of large doses of nutritional supplements on macular health over several years.1 The researchers evaluated the helpful effects of zinc and/or a formulation that consisted of nutrients with antioxidant properties, including vitamin C, vitamin E, and beta-carotene. The researchers concluded that a combination of these antioxidants with zinc promoted superior macular health.
However, like many other groundbreaking studies, the original AREDS researchers generated numerous unanswered questions and suggestions for areas of further study. Many of these items have already been or will be addressed by AREDS2. The enrollment for AREDS2 concluded in June 2008, and participants will be followed for five to six years. The first official reports from AREDS2 are anticipated in 2013.2
The primary objective of AREDS2 is to evaluate the effect of dietary carotenoids—including lutein and zeaxanthin—and/or omega-3 fatty acids—including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA)—on macular health over time.3
In an ideal world of healthy living, these dietary compounds would be best obtained through a balanced diet. In reality, however, our food intake is severely deficient of these important nutrients.
The average western diets contain 1.3mg to 3mg of lutein and zeaxanthin, with a ratio of lutein to zeaxanthin of 7:1.4,5 The highest natural concentrations of lutein are found in dark green leafy vegetables, such as spinach, kale and collard greens, whereas zeaxanthin is the major carotenoid found in corn, orange peppers and oranges.
Additionally, both lutein and zeaxanthin are found at relatively high percentages in egg yolk.6 It is important to note that approximately 78% of dietary lutein and zeaxanthin is sourced from vegetables.6
Of the numerous carotenoids found in nature, just lutein, zeaxanthin and meso-zeaxanthin are present in human macular pigment.8 Because these carotenoids are likely to play a part in the maintenance of normal cell physiology, their bioavailability remains important for maintenance of healthy macular structure.
Both lutein and zeaxanthin were considered for study in AREDS; however, neither carotenoid was commercially available for manufacturing in a research formulation.3 By Contrast, AREDS2 researchers are studying their potential utility in maintaining macular health over time.
Age, along with personal characteristics and habits such as smoking are known to influence macular health.11-14 The free radical theory of aging proposes that oxidative stress occurs in the retina because levels of reactive oxidative intermediates (ROIs) increase to a level that exceeds the detoxifying capacity of antioxidants.
We have now learned that diets rich in lutein and zeaxanthin have been shown to support macular health maintenance.21-24 Oral supplementation of lutein or lutein/zeaxanthin combinations increased mean serum levels of the carotenoid metabolites that constitute the macular pigment. These effects are not always uniform in all individuals.25-29
Omega-3 Long Chain Polyunsaturated Fatty Acids
One important question being addressed by AREDS2 is whether high supplemental doses of omega-3 fatty acids will support the maintenance of macular health. Researchers have previously determined that DHA and EPA may serve as agents that protect the integrity of ocular cells.30 DHA is a major component of retinal photoreceptor outer segment membranes, and sufficient intake of this essential fatty acid is important for continued normal retinal function.31-35
Overall, epidemiological studies have shown superior macular health in individuals with diets high in total fat intake (exempting diets that are specifically high in omega-3 fatty acids).36-43
Another important supplement investigated in AREDS was zinc. The tolerable upper level of daily zinc intake is 40mg; however, AREDS researchers supplemented patients with 80mg of zinc per day.44,45 AREDS2 investigators are examining the effects of both 80mg and 40mg dosages of zinc per day to determine whether a lower dose is as effective in macular maintenance.
AREDS2 will also investigate the effect of eliminating beta-carotene from the original AREDS formulation. This is of particular interest because high doses of beta carotene alone, or in combination with vitamin E, are associated with a statistically significant risk of developing lung cancer in smokers.48,49 Therefore, it is not recommended to place any patients who smoke or recently quit smoking on beta carotene supplementation.
The Million-dollar Question
Have we now officially determined that dietary and lifestyle changes at an early age can support maintenance of macular health in the long-term?
The answer is quite clear: Yes.
Results from AREDS and other nutritional studies strongly indicated that the earlier an individual begins to make lifestyle alterations and take nutritional supplements, the better eye health he or she will experience. And, for older patients, it is better late than never when it comes to the use of nutraceuticals.
In the very near future, the results from AREDS2 will shed more light on the most effective means on maintaining macular health, including specific nutritional supplements.
EyeScience Macular Health Formula was designed to take the best of both AREDSand AREDS 2. Together with additional clinically proven nutrients, our formula is the most complete ocular supplement designed for promoting macular health.
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