Diet and nutrition are essential for optimal health, and our eyes are no exception. Lutein and zeaxanthin are essential nutrients for optimal eye health. Lutein and zeaxanthin (pronounced “lew-teen” and “zee-uh-zan'-thin”, and sometimes abbreviated as “LZ”) are powerful xanthophyll carotenoids, a class of phytonutrients (plant chemicals or nutrients derived from plants) that exist in the cells of some plants, algae and bacteria.

 

Lutein and zeaxanthin are what gives some common foods, like cantaloupe, pasta, corn, carrots, orange/yellow peppers, and eggs their yellow or orange color.  Carotenoids help plants absorb light energy from the sun, specifically the blue-green spectrum of light that they use for photosynthesis. Approximately 700 different carotenoids have been identified in nature and between 20 and 30 in the human body, but lutein and zeaxanthin are the only carotenoids found in the eye. They are also important antioxidants, playing a key role in deactivating harmful free-radicals, which are atoms of oxygen that can damage cells within the body. [1]

In our bodies, lutein and zeaxanthin are found throughout the central nervous system (brain, spinal cord, nerves) but are at their highest concentration in the macular region of the retina. The macula is the yellowish spot near the center of the retina, which is responsible for clear, fine central vision. The accumulation of lutein and zeaxanthin within the macula are often referred to as macular pigment and give the macula its dark yellow appearance. As they do in plants, lutein and zeaxanthin, help act as a filter for damaging light rays (such as blue light) from damaging the macula.  

Lutein and zeaxanthin, and their benefit to eye health, have been the focus of numerous studies and clinical trials, particularly relating to their use to improve visual function, and reduce the risk and slow the progression of age-related macular degeneration (AMD) and cataracts. There have also been encouraging results in the use of lutein and zeaxanthin in diabetic retinopathy (a disease of the retina caused by diabetes), and retinopathy of prematurity (an eye disease which can develop in premature babies). [6] 

The levels of lutein and zeaxanthin in our eyes is solely dependent on dietary intake. Unfortunately, the body cannot make these carotenoids and they must be consumed from diet. Some foods and the way they are prepared are better sources of lutein and zeaxanthin than others. The amount of a nutrient that can be actively used by the body once it has been ingested is referred to as its bioavailability. With some foods, how they are prepared and what they are eaten with can all have an influence on its bioavailability, meaning how well the body can take up and use the nutrient.   

 

How much lutein and zeaxanthin is recommended for maintaining eye health?

The average American adult diet typically contains 1–3 mg/day of lutein and zeaxanthin, while studies have shown that 5-10mg/day are beneficial to eye health, with approximately 6 mg/day being related specifically to decreased risk of AMD. [3, 7] There is currently no Recommended Daily Intake (RDI) or Recommended Dietary Allowance (RDA) cited for lutein and zeaxanthin.

 

What are the 5 best dietary sources of lutein and zeaxanthin?

We can increase our daily intake of lutein and zeaxanthin by eating a diet rich in these nutrients. Excellent sources of lutein and zeaxanthin tend to come from dark green or yellow/orange fruits and vegetables, so eat colorfully! Some examples include parsley, spinach, kale, corn, pistachios and egg yolk. Many reports will lump the nutrient sources together, however many of the vegetables contain high levels of lutein, while foods like corn and eggs contain both lutein and zeaxanthin. [3] 

Lutein and zeaxanthin are fat-soluble, which means that including a healthy fat, such as extra virgin olive oil as a salad dressing or cooking oil with these nutrients can improve their absorption. Even though fruits and vegetables have higher levels of lutein and zeaxanthin, egg yolk is a better overall source because of its fat content, making it more readily absorbable (increased bioavailability) by the body.

1. Spinach.  The "emperor" of green leafy vegetables, spinach has 12mg of lutein/zeaxanthin in 100g of spinach (about 3 cups raw, or 1 cup chopped). Cooked spinach has been shown to have almost as much lutein as raw spinach.  

2. Kale.  Kale is an excellent source of lutein. 100g of kale provides approximately 18mg of lutein/zeaxanthin.  

3.  Corn - Corn contains both lutein and zeaxanthin. Of the different types and colors of corn (white, yellow, blue and red), yellow corn was found to have the highest lutein content (406 μg/100 g) and blue corn had the lowest (5.2 μg/100 g). [2] Corn is being studied as a staple food, a good source of lutein and zeaxanthin that can be used to support eye health in lower income regions where leafy greens or supplements may not be available.  

4.  Pistachios – Pistachios are the only nut containing significant amounts of lutein.  Its colorful green and purple kernel color is a result of its lutein and anthocyanin content. Pistachios also contain mono and polyunsaturated fats, which help to improve nutrient absorption.  

5.  Egg yolks -  Even though the concentrations of lutein and zeaxanthin in egg yolk are less than levels in vegetables and fruits, they are still considered a better source because they can be absorbed more easily in the body because of the natural fat content in eggs. An average chicken egg yolk (~18grams) contains approximately 292 μg of lutein and 213 μg of zeaxanthin. Some studies have shown that the nutrient levels can depend on the chicken’s diet. Additionally, cooking the eye yolk reduces the amounts of available lutein and zeaxanthin by approximately 10%. [3]  

Worried about cholesterol? A study was conducted of adults that ate one egg daily for 5 weeks and found that their lutein levels increased by 26% and zeaxanthin by 38% while their total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides were not affected. [4]

Another source of egg yolk based nutrients are egg noodles, which contain nearly six times more carotenoids than regular pasta noodles. [5]

Freekeh - Freekeh, an ancient grain that is green harvested when it’s young, retaining more nutrients than maturely harvested wheat, contains substantially higher amounts of lutein and zeaxanthin.

Dietary supplements – Sometimes getting everything we need from our diets can be challenging, so to ensure that you are receiving the desired amount of lutein and zeaxanthin, taking a daily supplement can be the best choice. The Age-Related Eye Disease Studies (AREDS and AREDS2) were conducted by the National Eye Institute and found that taking certain nutritional supplements every day reduced the risk of developing advanced age-related macular degeneration (AMD). An excellent, validated source of lutein and zeaxanthin used in supplements is marigold flower. It is important to carefully read product labels to confirm that the supplement is of the highest quality, from a reputable company, and contains appropriate nutrient amounts and no unwanted ingredients such as dyes or fillers.

 

Super Lutein and Zeaxanthin Salad

An example of a lutein and zeaxanthin nutrient packed salad could include roasted butternut squash, a variety of leafy greens (kale, spinach, lettuces), yellow/orange peppers and chopped pistachios, topped with a hard boiled egg and dressed with an olive oil based dressing.

The United States Department of Agriculture, Nutrient Data Laboratory reports the following lutein and zeaxanthin content of 100 grams of common foods. As an example, 1 cup of chopped kale is approximately 67 grams and one medium orange is approximately 130 grams.   

Crunchy Kale Chips Recipe

Kale chips are a healthy and easy to make snack that has plenty of lutein and zeaxanthin. They also have canola oil, which is a source of omega-3 fatty acids. This recipe takes about 15 minutes to prepare, and 35 minutes to cook. To make enough crunchy kale chips to feed 2 people, you’ll need: A bunch of kale, 1 tablespoon of canola oil, 1 tablespoon of sherry vinegar, a pinch of sea salt. Cooking and preparations go as follows: preheating your oven to 300° F. Cut away the inner ribs of the kale leaves, tear them into uniform pieces, wash and completely dry them. Put the kale pieces into a resealable bag along with half a tablespoon of canola oil, and squeeze the bag so that the oil is distributed evenly across all the kale pieces.Add the rest of the canola oil to the bag and continue to squeeze until each piece is evenly coated. Sprinkle in the vinegar and reseal the bag, shake to spread the vinegar evenly over the leaves. Spread the leaves evenly onto a baking tray and roast in the preheated oven for about 35 minutes or until the kale chips are mostly crisp. Season with salt and serve them immediately.

5mg Lutein and Zeaxanthin Meal Plan

A meal plan is an easy way to make sure you get the recommended amount of lutein and zeaxanthin throughout the day. Here is a meal plan for your day that includes snacks. 

Breakfast: For breakfast have a porridge (rolled oats, milk, water) topped with 30g of pistachio nuts and ½ tsp of honey, and one medium sized orange. This will provide 589 µg of lutein and zeaxanthin.

Lunch: Your lunch should be a curried egg sandwich consisting of a boiled egg mixed with mayonnaise and curry powder, two slices of wholegrain bread, and salad vegetables including baby spinach. This meal contains 4026 µg of lutein and zeaxanthin.

Dinner: Dinner will be an oven-baked salmon fillet, corn on the cob, and steamed vegetables including asparagus and broccoli. This course will provide 1729 µg of lutein and zeaxanthin.

Snacks: Throughoutthe day as a snack, you can enjoy a cup of blueberries or some cheese and crackers. This can provide around 118 µg of lutein and zeaxanthin to your daily intake. 

Based on this meal plan, you should have consumed 6462 µg of lutein and zeaxanthin. If you maintain a regular intake of 5-10mg of lutein and zeaxanthin, your eye health will improve. [3]
 

Individual Lutein and Zeaxanthin Values of Common Foods
Food	Lutein Trans (µg per 100 g)		Zeaxanthin Trans (µg per 100 g)
Spinach, Cooked	12,640		0
Kale, Cooked	8,884		0
Spinach, Raw	6,603		0
Parsley, Raw	4,326		0
Lettuce, Romaine, Raw	3,824		0
Pistachio Nuts, Raw	1,405		0
Asparagus, Cooked	991		0
Egg Yolk, Raw	787		762
Broccoli, Cooked	772		0
Egg Yolk, Cooked	645		587
Green Beans, Cooked	306		0
Egg Whole, Raw	288		279
Egg Whole, Cooked	237		216
Orange Pepper, Raw	208		1,665
Corn, Cooked	202		202

References:

[1] Abdel-Aal el-SM, Akhtar H, Zaheer K, Ali R. Dietary sources of lutein and zeaxanthin carotenoids and their role in eye health. Nutrients. 2013 Apr 9;5(4):1169-85. https://www.ncbi.nlm.nih.gov/pubmed/23571649

[2] De Oliveira G.P.R, Rodriguez-Amaya D.B. Processed and prepared corn products as sources of lutein and zeaxanthin: Compositional variation in the food chain. J. Food Sci. 2007, 72, S79–S85. https://www.ncbi.nlm.nih.gov/pubmed/17995903

[3] Eisenhauer B, Natoli S, Liew G, Flood VM. Lutein and Zeaxanthin-Food Sources, Bioavailability  and Dietary Variety in Age-Related Macular Degeneration Protection. Nutrients. 2017 Feb 9;9(2). https://www.ncbi.nlm.nih.gov/pubmed/28208784

[4] Goodrow EF, Wilson TA, Houde SC, Vishwanathan R, Scollin PA, Handelman G, Nicolosi RJ.  Consumption of one egg per day increases serum lutein and zeaxanthin concentrations in older adults without altering serum lipid and lipoprotein cholesterol concentrations. J Nutr. 2006 Oct;136(10):2519-24. https://www.ncbi.nlm.nih.gov/pubmed/16988120

[5] Humphries J.M, Khachik F. Distribution of lutein, zeaxanthin, and related geometrical isomers in fruits, vegetable, wheat, and pasta products. J. Agric. Food Chem. 2003, 51, 1322–1327. https://www.ncbi.nlm.nih.gov/pubmed/12590476

[6] Scripsema NK, Hu DN, Rosen RB. Lutein, Zeaxanthin, and meso-Zeaxanthin in the Clinical Management of Eye Disease. J Ophthalmol. 2015;2015:865179. https://www.ncbi.nlm.nih.gov/pubmed/26819755

[7] Seddon J.M, Ajani U.A, Sperduto R.D, Hiller R, Blair N, Burton T.C, Farber M.D, Gragoudas E.S, Haller J, Mille D.T. et al. Dietary carotenoids, vitamin A,C and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group. JAMA 1994, 272, 1413–1420. https://www.ncbi.nlm.nih.gov/pubmed/7933422