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      Consumption of Lutein and Zeaxanthin and Its Relation to the Level of Macular Pigment Optical Density in Thai Subjects


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          The aim of the study is to determine dietary lutein and zeaxanthin ( L/ Z) consumption and to evaluate its association with macular pigment optical density (MPOD) in Thai subjects. Methods. This study was a cross-sectional study. A total of 120 ophthalmologically healthy subjects aged between 40 and 72 years were recruited from Bangkok and the vicinity area. Demographic data were collected using a questionnaire, while a semiquantitative food frequency questionnaire assessed the L/ Z intake. MPOD was determined using the reflectometry method (VISUCAM 500®, Carl Zeiss Meditec AG). Pearson's correlation coefficient analyzed the relationship between L/ Z consumption and MPOD. Results. The mean age of the participants was 50.7 ± 7.5 years. The mean consumption of L/ Z was 3.03 ± 2.65 mg per day. The mean MPOD was 0.102 ± 0.023 density units. Consumption of foods rich in L/ Z, including ivy gourd ( r = 0.217, p < 0.05), Chinese flowering cabbage ( r = 0.194, p < 0.05), balsam pear ( r = 0.193, p < 0.05), lettuce ( r = 0.182, p < 0.05), sweet corn ( r = 0.181, p < 0.05), and pumpkin ( r = 0.181, p < 0.05), was positively associated with the mean optical density (mean MPOD). Consumption of green onion ( r = 0.212, p < 0.05) was positively associated with the sum of optical densities (MPOD volume). In contrast, chilli pepper consumption showed a negative association with mean MPOD ( r = −0.220, p < 0.05) and amaranth showed a negative association with MPOD volume ( r = −0.283, p < 0.05). No association was found between total L/ Z consumption and MPOD. Conclusion. L/ Z consumption is low among Thais living in Bangkok and the vicinity area, which may not be sufficient to ensure eye health, and total L/ Z consumption is not associated with MPOD.

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          Age-related macular degeneration.

          Age-related macular degeneration is a major cause of blindness worldwide. With ageing populations in many countries, more than 20% might have the disorder. Advanced age-related macular degeneration, including neovascular age-related macular degeneration (wet) and geographic atrophy (late dry), is associated with substantial, progressive visual impairment. Major risk factors include cigarette smoking, nutritional factors, cardiovascular diseases, and genetic markers, including genes regulating complement, lipid, angiogenic, and extracellular matrix pathways. Some studies have suggested a declining prevalence of age-related macular degeneration, perhaps due to reduced exposure to modifiable risk factors. Accurate diagnosis combines clinical examination and investigations, including retinal photography, angiography, and optical coherence tomography. Dietary anti-oxidant supplementation slows progression of the disease. Treatment for neovascular age-related macular degeneration incorporates intraocular injections of anti-VEGF agents, occasionally combined with other modalities. Evidence suggests that two commonly used anti-VEGF therapies, ranibizumab and bevacizumab, have similar efficacy, but possible differences in systemic safety are difficult to assess. Future treatments include inhibition of other angiogenic factors, and regenerative and topical therapies. Copyright © 2012 Elsevier Ltd. All rights reserved.
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            Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group.

            OBJECTIVE--To evaluate the relationships between dietary intake of carotenoids and vitamins A, C, and E and the risk of neovascular age-related macular degeneration (AMD), the leading cause of irreversible blindness among adults. DESIGN--The multicenter Eye Disease Case-Control Study. SETTING--Five ophthalmology centers in the United States. PATIENTS--A total of 356 case subjects who were diagnosed with the advanced stage of AMD within 1 year prior to their enrollment, aged 55 to 80 years, and residing near a participating clinical center. The 520 control subjects were from the same geographic areas as case subjects, had other ocular diseases, and were frequency-matched to cases according to age and sex. MAIN OUTCOME MEASURES--The relative risk for AMD was estimated according to dietary indicators of antioxidant status, controlling for smoking and other risk factors, by using multiple logistic-regression analyses. RESULTS--A higher dietary intake of carotenoids was associated with a lower risk for AMD. Adjusting for other risk factors for AMD, we found that those in the highest quintile of carotenoid intake had a 43% lower risk for AMD compared with those in the lowest quintile (odds ratio, 0.57; 95% confidence interval, 0.35 to 0.92; P for trend = .02). Among the specific carotenoids, lutein and zeaxanthin, which are primarily obtained from dark green, leafy vegetables, were most strongly associated with a reduced risk for AMD (P for trend = .001). Several food items rich in carotenoids were inversely associated with AMD. In particular, a higher frequency of intake of spinach or collard greens was associated with a substantially lower risk for AMD (P for trend < .001). The intake of preformed vitamin A (retinol) was not appreciably related to AMD. Neither vitamin E nor total vitamin C consumption was associated with a statistically significant reduced risk for AMD, although a possibly lower risk for AMD was suggested among those with higher intake of vitamin C, particularly from foods. CONCLUSION--Increasing the consumption of foods rich in certain carotenoids, in particular dark green, leafy vegetables, may decrease the risk of developing advanced or exudative AMD, the most visually disabling form of macular degeneration among older people. These findings support the need for further studies of this relationship.
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              Lutein and Zeaxanthin—Food Sources, Bioavailability and Dietary Variety in Age-Related Macular Degeneration Protection

              Lutein and zeaxanthin (L/Z) are the predominant carotenoids which accumulate in the retina of the eye. The impact of L/Z intake on the risk and progression of age-related macular degeneration (AMD), a leading cause of blindness in the developed world, has been investigated in cohort studies and clinical trials. The aims of this review were to critically examine the literature and evaluate the current evidence relating to L/Z intake and AMD, and describe important food sources and factors that increase the bioavailability of L/Z, to inform dietary models. Cohort studies generally assessed L/Z from dietary sources, while clinical trials focused on providing L/Z as a supplement. Important considerations to take into account in relation to dietary L/Z include: nutrient-rich sources of L/Z, cooking methods, diet variety and the use of healthy fats. Dietary models include examples of how suggested effective levels of L/Z can be achieved through diet alone, with values of 5 mg and 10 mg per day described. These diet models depict a variety of food sources, not only from dark green leafy vegetables, but also include pistachio nuts and other highly bioavailable sources of L/Z such as eggs. This review and the diet models outlined provide information about the importance of diet variety among people at high risk of AMD or with early signs and symptoms of AMD.

                Author and article information

                J Nutr Metab
                J Nutr Metab
                Journal of Nutrition and Metabolism
                15 April 2022
                : 2022
                : 6321778
                1Faculty of Agriculture, Kasetsart University, Bangkok 10900, Thailand
                2Institute of Nutrition, Mahidol University, Nakhon Pathom 73170, Thailand
                Author notes

                Academic Editor: Rajesh Kamath

                Author information
                Copyright © 2022 Wipada Sae-Lao et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                : 16 December 2021
                : 27 February 2022
                : 9 March 2022
                Research Article

                Nutrition & Dietetics
                Nutrition & Dietetics


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