Eye Spy Supplements

The eyes are our window to the world, and the last thing we’d want to do is to see this key sense suffer due to factors within our control, like diet. While eating carrots may not provide us with 20-20 vision, there is certainly a link between good nutrition and eye health.
Diet in Sight
For optimal eye health, experts recommend a diet consisting of many fruits and dark green leafy vegetables such as spinach, kale or collard greens (1). According to the National Eye Institute (NEI), research has also shown eating fish high in omega-3 fatty acids, such as salmon, tuna and halibut, benefits eye health. Maintaining a healthy weight may also be linked to eye health. According to the NEI, being obese or overweight increases risk of developing diseases such as type-2 diabetes, which can lead to glaucoma or even vision loss.
Another eye condition that may get some support from a good diet is age-related macular degeneration (AMD). Eye Care America, the Foundation of the American Academy of Ophthalmology, says approximately 10 million Americans suffer from AMD (2). AMD symptoms include blurred vision and a dark and empty area in the center of the visual field, most often in those 65 years or older. American Macular Degeneration Foundation expert George Torrey, Ph.D., states consumption of foods containing two carotenoid pigments (lutein and zeaxanthin) can possibly be responsible for reducing the risk of age-related macular degeneration (3). 
What Are Carotenoids?
Cartonenoids including lutein and zeaxanthin are found in squash; corn; dark green, leafy vegetables and other plants. Lutein and zeaxanthin naturally exist in the body, with the biggest amounts being in the eyes where they contribute to macula health and visual acuity.
The macula supports concise, central vision required for activities like sewing, reading and driving. Torrey explains, “Lutein and zeaxanthin protect the macular pigment in two ways: by absorbing harmful blue light from the sun’s rays and by acting as antioxidants that neutralize free radicals.”
John Landrum, Ph.D., a leading researcher of the macular pigments of the eye, compared how much lutein and zeaxanthin were present in the eyes of AMD patients versus healthy individuals. He stated, “Those with the lowest levels of carotenoid accumulation in the outer retina were significantly more likely to suffer from age-related macular degeneration than those with higher pigment levels. The difference in risk between those having the highest and lowest levels was 75%” (3).
Supplements Savvy
One of the strongest cases for eye health supplements comes from the Age-Related Eye Disease Study (AREDS), first conducted in the 1990s. Researchers from the National Institutes of Health investigated the history and risk factors of AMD and found that a combination of high levels of antioxidant vitamins A, C and E “significantly reduce the risk of AMD” (4). Data showed that high daily doses of vitamins C and E, beta-carotene, zinc and copper (the so-called the AREDS formulation) can help slow the progression to advanced AMD. 
Certified nutrition specialist, Shereen Jegtvig, writes about several supplements that can aid in the reduction or slowing of chronic eye problems. Jegtvig recommends vitamin D be taken in supplement form because it is associated with a lower risk of AMD. Lutein and zeaxanthin, phytochemical antioxidants and omega-3 essential fatty acids are also on the list of recommended supplements. 
In spring 2013, the second round of data (collected 2006–2011) from this monumental study, AREDS 2, was released. “Millions of older Americans take nutritional supplements to protect their sight without clear guidance regarding benefit and risk,” said National Eye Institute director Paul A. Sieving, M.D., Ph.D., in an official statement. “This study clarifies the role of supplements in helping prevent advanced AMD.”
The study delved into how adding or removing certain nutrients from the AREDS formulation affected patient outcome. Those who took the formulation with lutein and zeaxanthin, but not beta-carotene, had an 18% lower risk of developing advanced AMD than those that took the same combination with beta-carotene. It’s possible, say the researchers, that carotenoids may compete with each other for absorption and beta-carotene may mask the effects of lutein and zeaxanthin. 
Participants with low dietary intake of lutein and zeaxanthin at the beginning of the study who took an AREDS formulation with lutein and zeaxanthin during the study were 25% less likely to develop advanced AMD than those with similar dietary intake who did not take lutein and zeaxanthin. And, omega-3 fatty acids are said to promote retinal development and repair. Thus, the new AREDS formulation (with a doctor’s approval) is 10 mg of lutein, 2 mg of zeaxanthin, 1,000 mg of omega-3s (350 mg DHA and 650 mg EPA), no beta-carotene and 25 mg of zinc.
Defeating Dry Eyes
Other eye-related issues such as dry eyes can also benefit from supplements. Doctor of Optometry, Gary Heiting, suggests flaxseed oil or fish oil as supplements to relieve dry eyes due to the important fatty acids they contain (5).  These two supplements can help reduce dry eye symptoms such as stinging, redness and burning. “For this reason, many eye doctors now are recommending flaxseed oil and fish oil supplements for their patients who suffer from dry eyes,” states Heiting. WF 
1. “Eye Health Tips” National Eye Institute, www.nei.nih.gov/healthyeyes/eyehealthtips.asp, accessed April 26, 2013.
2. “Healthy Eating Habits May Delay Age-Related Macular Degeneration,” Nation Institute of Health, www.nei.nih.gov/nehep/newsletter/2008/1008.asp#4, accessed April 25, 2013.
3. G. Torrey, “Improved Nutrition May Reduce the Risk of Macular Degeneration,” American Macular Degeneration Foundation, www.macular.org/nutrition/index.html, accessed April 25, 2013.
4. S. Jegtvig, “Guide to Choosing Nutritional Supplements for Vision,” All About Vision, May 2012, www.allaboutvision.com/nutrition/supplements.htm, accessed April 25, 2013.
5. “NIH Study Provides Clarity On Supplements for Protection against Blinding Eye Disease,” press release distributed May 6, 2013.
6. G. Heiting, “Using Flaxseed Oil and Fish Oil To Relieve Dry Eye,” All About Vision, April 2011, www.allaboutvision.com/nutrition/flaxseed-oil.htm, accessed April 25, 2013.
Published in WholeFoods Magazine, August 2013