Eat Well and Protect Your Eyes
from Age-Related Diseases
By Wendy Priesnitz
Turns out mother was right when she told you to eat
your carrots. There is growing evidence that the intake of certain foods and
nutrients may help maintain eye health, a key quality-of-life concern for older
In addition to vitamin A, for which a role in
eyesight is well established, evidence suggests that vitamins C and E and
the carotenoids lutein and zeaxanthin may be linked to a reduced risk for
age-related eye diseases, in particular, age-related macular degeneration
(AMD) and cataracts.
Cataract extractions are one the most common
surgical procedures. Epidemiologists at the National Eye Institute in the
United States have estimated that if the progression of cataracts could be
delayed by ten years, the number of cataract extraction surgeries per year
would be reduced by forty-five percent.
AMD is the leading cause of acquired blindness
among the elderly. The exact cause of the breakdown of cells in the macula
is not yet known; however, as with cataracts, the risk of AMD increases with
age. Dry AMD can develop into the more severe wet AMD if blood vessels from
the choroid begin to grow pathologically into the macula. Wet AMD can
rapidly cause blindness due to the leakage of blood into the subretinal
space. Laser treatments may retard or halt the process, but rarely can
recover lost or damaged vision.
There are logical reasons to suspect that
vitamin C may play a role in eye health. First, the antioxidant properties
of vitamin C may be particularly useful in protecting the lens. The lens and
aqueous humor are isolated from the blood supply and contain few cells to
provide repair mechanisms when oxidative damage occurs. Vitamin C is a
small, water-soluble molecule that can penetrate the layers of the lens,
providing the body with a means of delivering chemical protection into this
Secondly, the active accumulation of vitamin C
in the lens and aqueous humor is striking: Vitamin C concentrations are 20
times higher here than those found in plasma. Interestingly, vitamin C
concentration correlates poorly with normal dietary intake. Only very high
or very low vitamin C intakes appear to notably change the concentration in
Research has found consistent associations
between higher dietary or plasma vitamin C levels and a reduced risk for
cataracts, espeically among long-term smokers and people with hypertension.
This implies that vitamin C may mitigate the impact of other cataract risk
factors, rather than independently reducing cataract risk.
Length of usage also seems important. In one
study, the need for cataract surgery was lower among women who used vitamin
C supplements for ten years or longer, while a similar association between
dietary intake alone and cataract risk was not found. In contrast, an
association between vitamin C supplement use and cataracts has not been
found in studies of shorter duration.
Vitamin E is an essential nutrient for nervous
system and reproductive function, as well as for antioxidant protection of
all cell membranes. Unlike vitamin C, vitamin is not specifically
concentrated in the eye as compared to other tissues.
Epidemiological studies have found a fairly
consistent correlation between plasma vitamin E concentrations and cataract
risk, whether reduced risk at high plasma concentrations, increased risk at
low concentrations, or consistent risk associations across different
One study found that vitamin E, along with other
nutrients, helped some people who had moderate age-related macular degeneration, reducingd the risk of developing advanced age-related
macular degeneration by 25 percent.
Lutein & Zeaxanthin
Carotenoids, the yellow to red pigments found
in plants – including those carrots your mother encouraged you to eat for
eye health – have long been of interest to the nutrition community because
of the body’s ability to convert a few of these compounds into vitamin A.
Most of them have recently become more
interesting to researchers due to their function as antioxidants, protecting
cells from oxidative damage or potentially regulating cellular processes
that monitor oxidation.
Two such compounds are lutein and zeaxanthin.
They often occur together in the same food sources, and in many studies are
reported together. Both lutein and zeaxanthin are associated with a reduced
risk of both AMD and cataracts.
The eye concentrates these carotenoids in a
layer of retinal tissue that comprises the macula region. Their biological
function in the eye is not fully understood, but two potential functions
have been proposed. One is based on the fact that lutein and zeaxanthin
absorb near-to-UV blue light, the most damaging wavelength of light that
actually reaches the retina. Secondly, lutein and zeaxanthin provide
antioxidant defense against free radicals, and conditions in the macula are
highly favourable for free radical formation.
In research studies where eyes were examined
post-mortem from people who had AMD, it was found that these individuals’
eyes had significantly less lutein and zeaxanthin than those without AMD.
Increased macular pigment density has been
demonstrated using spinach as a lutein-rich food and corn as a
zeaxanthin-rich food, lutein dietary supplements, and bilberry extract as a
low-dosage lutein supplement.
The link between lutein, zeaxanthin and AMD
risk has been examined in two major studies. One study, which examined
associations between nutrition and neovascular or “wet” AMD among people
aged 55 to 80 found that AMD risk was significantly lower with increasing
serum concentrations of lutein and zeaxanthin. Dietary intake of spinach or
collard greens (which are particularly rich sources of lutein and
zeaxanthin), was associated with lower AMD risk.
Recent research also indicates that
easy-to-obtain levels of lutein and zeaxanthin intake can significantly
lower risk of developing cataracts.
Vitamin C: Whereas virtually everyone obtains the
scant amount needed to prevent scurvy (10 to 15 mg), not as many people obtain
the 200 mg needed to maximize levels in plasma and tissues, and thus provide
optimum eye protection. Many researchers feel you should consume
significantly more vitamin C. For example, 500 mg was the daily dose of
vitamin C used in studies that showed a reduced risk of cataracts. One cup of fresh squeezed orange juice yields
between 75 and 124 mg of vitamin C. Sweet red peppers will provide 283 mg
per one cup serving, and a cup of broccoli yields 82 mg.
Vitamin E: Most people average 13 IU per day
from their diet. A quarter cup of almonds will add just over that to your
diet, while a bowl of cereal with wheat germ yields around 27 IU. The RDA for Vitamin E is 22.5
IU. Intakes as low as 100 to 200
IU have shown benefits to eye health. The American Optometric Association
recommends 400 IU/day.
Lutein & Zeaxanthin: Epidemiological evidence
indicates that approximately 6 mg per day are associated with reduced risk
for AMD and cataracts. The American Optometric Association recommends 10 mg
of lutein and 2 mg for zeaxanthin. A cup of raw kale yields 40 mg of lutein
and zeaxanthin, while the same quantity of cooked spinach will add 7 mg. to
your diet. Many of the same fruits and vegetables that are good sources of
vitamin C are also good sources of lutein and/or zeaxanthin, such as
spinach, orange peppers, tangerines, Brussels sprouts, and squash. Peas and
corn are other good sources.
Wendy Priesnitz is Natural Life
Magazine's editor, and the author of twelve books.