Research Article ISSN 2641-4295

Food Science & Nutrition Research

Effects of Supplementation with Lutein Oral Complex on Eye Dryness,

Visual Function and serum lutein level in Healthy Subjects
Evelyn Jou Chen Huang1,2, Ling-Wen Hsu3, and Yi-Wen Chien3,4,5,6*

Department of Ophthalmology, Taipei Medical University

1

Hospital, Taiwan, Japan.

Department of Ophthalmology, School of Medicine, College of

2

Medicine, Taipei Medical University, Taiwan, Japan.

*
Correspondence:
Department of Nutrition and Health Science, Taipei Medical
3
Yi-Wen Chien, Department of Nutrition and Health Science,
University, Taiwan, Japan.
Taipei Medical University, Taipei 11031, Taiwan, Japan, Tel:
Research Center of Geriatric Nutrition, College of Nutrition, Taipei
4 +886-2-2736-1661 (ext. 6556); Fax: +886-2-2737-3112.
Medical University, Taiwan, Japan.
Received: 01 Nov 2024; Accepted: 17 Dec 2024; Published: 24 Dec 2024
Graduate Institute of Metabolism and Obesity Sciences, Taipei
5

Medical University, Taiwan, Japan.

TMU Research Center for Digestive Medicine, Taipei Medical

6

University, Taiwan, Japan.

Citation: Evelyn Jou Chen Huang, Ling-Wen Hsu, Yi-Wen Chien. Effects of Supplementation with Lutein Oral Complex on Eye Dryness,
Visual Function and serum lutein level in Healthy Subjects. Food Sci Nutr Res. 2024; 7(2): 1-7.

ABSTRACT
Dry eye syndrome (DES) has become increasingly prevalent due to the prolonged use of digital devices in modern
society. Individual supplementation with lutein, anthocyanins or astaxanthin demonstrated potential benefits for
eye health. This study aimed to investigate the effects of lutein complex supplementation on DES, visual function,
and serum lutein level in healthy individuals. Twenty-four participants, aged 20~60 years, received lutein complex
supplements (containing 10 mg lutein, 2 mg zeaxanthin, 10 mg anthocyanins, 75 mg proanthocyanins, and 1 mg
astaxanthin) for 12 weeks. Ophthalmological examinations and blood test were carried out, and a questionnaire
was administered at weeks 0, 6, and 12 of the study. After 12 weeks of the intervention, the serum lutein level had
significantly increased, and intraocular pressure (IOP) had significantly decreased. It also improved symptoms of
eye strain, heavy eyelids, dry eyes, eyes itching, photophobia, blurred vision, sore eyes, blurred vision at night.
This suggests that lutein complex supplementation may increase the serum lutein level, reduce the IOP, and offer
potential benefits for DES.

Keywords is inadequate or evaporation is too rapid, the protective film on

Lutein, Dry eye syndrome, Visual function, Serum lutein level. the surface of the eye cannot form properly, leading to DES [1,2].
The symptoms of DES are varied and may include eye strain,
Introduction heavy eyelids, itching eyes, thick eye discharges, a foreign-matter
Dry eye syndrome (DES) is a common ophthalmological sensation in the eyes. If left untreated, DES can cause damage to
syndrome characterized by dryness and discomfort in the eyes the cornea and conjunctiva, further affecting vision. In modern
due to insufficient tear production or poor tear quality. Tears society, people stare for long periods at digital devices, such as
play a crucial role in eye health by lubricating the eyeball and mobile phones, computers, and tablets, and stay in air-conditioned
providing essential nutrients and protection. When tear production environments, which have led to an increase in the risk of DES

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[3,4]. A previous study reported that the global prevalence of DES were conducted at the professional ophthalmology clinic at the
was 29.5% [5]. In Taiwan, a population-based cross-sectional baseline, week 6, and week 12. Participants also completed
survey showed that 33.7% of elderly were symptomatic, defined subjective symptom questionnaires to evaluate eye comfort.
as frequently or always reporting one or more dry eye symptoms Additionally, fasting blood samples and blood samples taken two
[6]. The incidence rate of DES in 2015 in Taiwan was 4.26%, and hours after lutein complex supplementation intake were collected
the incidence rates of DES generally increase with age [7]. to measure serum lutein levels. Compliance with lutein complex
supplementation was assessed at the study visits by counting the
Lutein is a carotenoid naturally found in green leafy vegetables soft gel supplements that were returned.
and certain fruits, known for its powerful antioxidant properties.
It is primarily concentrated in the macula of the eye, where it Test Supplement and Dosage
helps protect the eyes from harmful light and free radical damage. The lutein complex supplementation (VITABOX® Free Form
Since lutein cannot be synthesized by the human body, it must be Lutein Pro) was a product produced and supplied by VITABOX®
obtained through diet or supplements [8]. Lutein is crucial for eye Devotion International Co., Ltd. (Taipei, Taiwan). Table 1 shows
health, particularly in protecting the retina and maintaining vision. the composition of the lutein complex supplementation, which
Research has shown that lutein can help prevent eye conditions included free-form lutein, free-form zeaxanthin, black soybean
such as age-related macular degeneration (AMD) [9] and cataracts seed coat extract, grape seed extract and red algae extract
[8]. While lutein is not a direct treatment for dry eye syndrome, (astaxanthin).
it may provide supportive benefits in alleviating symptoms.
Anthocyanins are natural pigments found in various dark-colored Table 1: Ingredient list of the lutein complex supplementation.
fruits and vegetables, such as blueberries, purple grapes, and black Ingredient Active ingredients Daily intake
soybean seed coat [10,11]. Their strong antioxidant properties help Free-form lutein 10 mg
Marigold extract
neutralize free radicals, protecting cells from oxidative damage. Free-form zeaxanthin 2 mg
Previous study suggested that anthocyanins can support the healthy Black soybean seed coat extract Anthocyanins 10 mg
functioning of the lacrimal glands, enhancing tear production and and grape seed extract proanthocyanins 75 mg
improving eye lubrication, thus alleviating DES [12]. Red algae extract Astaxanthin 1 mg
Zinc yeast Zinc 2.5 mg
Considering the evidence that lutein supplementation can protect Selenium yeast Selenium 100 μg
the eyes and anthocyanins can improve DES to the best of our
knowledge, the effects of lutein complex supplementation on Dry Eye Syndrome (DES)
DES, visual function in healthy subjects are still unclear. Thus, in Several methods were used to assess DES, including the tear break-
this study, we aimed to explore effects of the combination of lutein up time (TBUT) and a strip meniscometry test. The TBUT was
and anthocyanins on dry eye-related indicators and symptoms, used to assess the stability of the tears, and the strip meniscometry
visual function in healthy individuals. test was used to measure tear secretions. To determine whether
lutein complex supplementation could attenuate DES, the TBUT
Materials and Methods and strip meniscometry test were conducted. All data associated
Study Participants with the eyes are presented as the average of both eyes.
This clinical trial employed a single-arm design with the
following inclusion criteria: male and female volunteers aged Tear Break-up Time (TBUT)
40 to 60, healthy, who either experienced dry eye symptoms The TBUT was mainly used to observe the stability of the tear
or engaged in frequent eye use. The exclusion criteria included film. After fluorescein dye was instilled into the eyes of a subject,
individuals who were pregnant, breastfeeding, receiving treatment the subject was asked to blink a few times to ensure adequate
or currently taking medications, or had any infections, high blood mixing of the fluorescein dye and then to stop blinking. The time
pressure, diabetes, cerebrovascular, cardiovascular, liver, kidney, between the last blink and the appearance of the first black spot
or gastrointestinal diseases, specific eye conditions, or allergies to was measured with a slit lamp. A value of the TBUT below 10
any components involved in the study. seconds indicated tear instability.

Trail Design Strip Meniscometry Test

This experiment was approved by the Joint Institutional Review The strip meniscometry test (Echo Electricity, Fukushima, Japan)
Board of Taipei Medical University (N202308022). The 12- was used to evaluate tear secretions. After topical anesthesia was
week study was conducted at Taipei Medical University Hospital applied, calibrated filter paper strips were placed in the lower
(Taipei, Taiwan), recruiting 24 healthy participants, with an equal eyelid for 5 seconds, and readings were measured in millimeters
number of males and females. All participants were required to (mm) of the wet strip after 5 seconds. Values of less than 5 mm
take one lutein complex supplement (capsule) daily after breakfast indicated insufficient tear secretion.
and maintain their habitual diet, exercise routines, while avoiding
excessive intake of foods high in lutein or zeaxanthin, as well Visual Function
as other lutein supplements. Assessments of visual functions At each visit, subjects underwent a complete ophthalmologic

Food Sci Nutr Res, 2024 Volume 7 | Issue 2 | 2 of 7

examination to assess the visual function, including corrected Five milliliters of the supernatant (n-hexane layer) was placed in a
visual acuity, contrast sensitivity, IOP, and central macular brown centrifuge tube, vacuumed, and dried to remove the solvent;
thickness. 200 µL methanol was added and mixed for even dissolution. A
sample (10 µL) and 10 µL of a standard solution were applied
Corrected visual acuity and IOP were measured using an Auto Ref/ to the HPLC system (Hitachi L-7100 intelligent pump, L-7200
Kerato/Tono/Pachymeter TONOREF™ III (Nidek, Gamagori, autosampler, and L-7455 diode array detector; Tokyo, Japan). The
Japan). Contrast sensitivity (%) indicates an individual’s ability analytical conditions were as follows: reverse-phase C18 HPLC
to distinguish an object’s lightness or darkness compared to the column (4.6 mm × 250 mm × 10 μm); detection wavelength, 450
background in a picture with different levels of contrast changes nm; mobile phase flow rate, 1.0 mL/min; and mobile phase A was
(Figure 1). The central macular thickness was measured using methanol, mobile phase B was methanol/acetonitrile (15:85). The
optical coherence tomography (OCT) (Heidelberg Engineering, concentration of the lutein standard solution was 1000 μg/mL.
Heidelberg, Germany). OCT is a noninvasive imaging technique During analysis, it was diluted with methanol to different lutein
and was established to measure and assess structural parameters concentrations of 6.3, 12.5, 25, 50, and 100 μg/mL to construct
within the eye bulbus, such as the macular thickness. a standard concentration curve, which was used to calculate
concentrations of test samples.

Statisical Analysis
Data are presented as the mean ± standard deviation (SD) and
were analyzed by GraphPad Prism vers. 8.0 software (GraphPad
Software, San Diego, CA, USA). During the intervention period,
differences among weeks 0, 4, and 8 were compared using a
repeated-measures one-way analysis of variance (ANOVA),
followed by Tukey's test. Statistical significance was accepted at
p < 0.05.

Results
Subject Characteristics and Participation
Baseline characteristics of participants in this study are shown in
Figure 1: Contrast sensitivity test picture. Table 2. In total, 24 participants were initially enrolled in the study
at the baseline, including 12 males and 12 females, aged between
Questionnaire of Subjective Symptoms Associated with Eye 20 and 60 years old, with an average age of 24.13 ± 3.86 years. At
Comfort the 12th-week follow-up, the remaining number of lutein complex
Items of the subjective symptom questionnaire included eye strain, supplementation was calculated to assess compliance, with a
heavy eyelids, eye dryness, itching eyes, thick eye discharges, compliance rate of 94 ± 6% for the participants.
swollen eyes, sore eyes, foreign-matter sensation in the eyes,
photophobia, blurred vision, blurred vision at night, and the eyes Table 2: Characteristics of enrolled subjects.
tearing involuntarily. The questionnaire consisted of 12 questions. All subjects (N=24)
Possible answers to the questions as to the frequency of symptoms Male 12
within a 1-week recall period were “never", "rarely", "sometimes", Female 12
"often", and "everyday”. Each frequency was assigned a score Age (years)
from 4 to 0. Possible answers to the questions as to the severity 21~30 21
of symptoms within a 1-week recall period were “never", "mild", 31~40 3
"moderate", and "severe”. Each severity level was assigned a Average age of subjects (years) 24.13 ± 3.86
score from 3 to 0. Scores for the frequency and severity of each Average age is presented as the mean ± standard deviation (N = 24).
symptom were summed to give a total score for that symptom. In
addition, the total score of each subjective symptom represented Effects of Lutein Complex Supplementation on DES in Healthy
the score of eye fatigue and dry eye-related symptoms. A higher Subjects
summary score indicated less eye fatigue and fewer dry eye- As shown in Table 3, after 6 and 12 weeks of the lutein
related symptoms. complex supplementation intervention, there were no significant
differences in the strip meniscometry test for the OD, OS, or OU
Serum Lutein Level in healthy subjects. However, there was a trend of increased strip
Absolute alcohol (0.5 mL; containing 10 mg/mL pyrogallol) meniscometry test in the OD and the OU. As shown in Table
was added to 0.5 mL of serum, and the solution was mixed in a 4, after 6 and 12 weeks of the lutein complex supplementation
tube mixer for 30 s. n-Hexane (5 mL; high-performance liquid intervention, there were no significant differences in the TBUT for
chromatographic (HPLC) grade) was added, mixed in a tube the OD, OS, or OU in healthy subjects.
mixer for 2 min, and centrifuged at 4 °C and 1000 ×g for 5 min.

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Table 3: Effect of lutein supplementation on strip meniscometry test. Effects of Lutein Complex Supplementation on Contrast
OD OS OU Sensitivity in Healthy Subjects
Week 0 2.75 ± 1.11 2.88 ± 1.42 2.81 ± 0.87 As shown in Table 7, after 12 weeks of intervention with lutein
Week 6 2.88 ± 1.12 2.33 ± 0.70 2.60 ± 0.69 complex supplementation, there was no significant change in
Week 12 3.29 ± 1.80 2.50 ± 0.78 2.90 ± 0.97 contrast sensitivity, whether in the OD, OS or the OU.
All values are mean ± SD (n=24). OD: Oculus dexter; OS: Oculus sinister;
OU: Oculus uterque. Differences between time points were determined by Table 7: Effect of lutein complex supplementation on contrast sensitivity.
a one-way ANOVA with Tukey's test. Contrast sensitivity (%) OD OS OU
Week 0 2.92 ± 1.59 3.13 ± 2.12 3.02 ± 1.80
Table 4: Effect of lutein supplementation on tear break-up time (TBUT).
Week 6 2.81 ± 1.53 2.81 ± 1.53 2.81 ± 1.53
TBUT (sec) OD OS OU
Week 0 4.83 ± 1.63 5.38 ± 1.56 5.10 ± 1.53 Week 12 2.60 ± 0.51 2.60 ± 0.51 2.60 ± 0.51
Week 6 5.29 ± 1.33 5.42 ± 1.25 5.35 ± 1.26 All values are mean ± SD (n=24). OD: Oculus dexter; OS: Oculus sinister;
Week 12 5.29 ± 1.27 5.75 ± 1.42 5.52 ± 1.24 OU: Oculus Uterque. Differences between time points were determined
by a one-way ANOVA with Tukey's test.
All values are mean ± SD (n=24). OD: Oculus dexter; OS: Oculus sinister;
OU: Oculus Uterque. Differences between time points were determined
by a one-way ANOVA with Tukey's test. Effects of Lutein Complex Supplementation on Central
Macular Thickness in Healthy Subjects
Effects of Lutein Complex Supplementation on Corrected As shown in Table 8, after 12 weeks of intervention with lutein
Visual Acuity in Healthy Subjects complex supplementation, there was no significant change in
As shown in Table 5, after 12 weeks of intervention with lutein central macular thickness, whether in the OD, OS or the OU.
complex supplementation, there was no significant change in
corrected visual acuity, whether in the OD, OS or the OU." Table 8: Effect of lutein complex supplementation on central macular
thickness.
Table 5: Effect of lutein supplementation on corrected visual acuity. Central macular
OD OS OU
thickness (μm)
Corrected
visual acuity OD OS OU Week 0 267.71 ± 17.01 266.21 ± 18.23 266.96 ± 16.71
(-LogMAR) Week 6 266.17 ± 18.49 266.88 ± 17.39 266.52 ± 17.33
Week 0 0.019 ± 0.049 0.024 ± 0.058 0.021 ± 0.053 Week 12 264.67 ± 18.26 269.42 ± 17.97 267.04 ± 17.41
Week 6 0.019 ± 0.047 0.024 ± 0.058 0.021 ± 0.047 All values are mean ± SD (n=24). OD: Oculus dexter; OS: Oculus sinister;
Week 12 0.014 ± 0.035 0.023 ± 0.049 0.019 ± 0.047 OU: Oculus Uterque. Differences between time points were determined
All values are mean ± SD (n=24). OD: Oculus dexter; OS: Oculus sinister; by a one-way ANOVA with Tukey's test.
OU: Oculus Uterque. Differences between time points were determined
by a one-way ANOVA with Tukey's test. Effects of Lutein Complex Supplementation on Questionnaire
of Subjective Symptoms Associated with Eye Comfort in
Effects of Lutein Complex Supplementation on Intraocular Healthy Subjects
Pressure in Healthy Subjects As shown in Table 8, compared to week 0, the subjective symptoms
As shown in Table 6, compared to week 0, there was no significant associated with eye comfort significantly increased after 6 and 12
change in the IOP of the OD at week 6, but the IOP of the OD weeks of lutein complex supplementation. However, there was
significantly decreased when comparing week 0 to week 12 and no statistically significant difference between week 6 and week
week 6 to week 12. In contrast, the IOP of the OS showed no 12, though there was still a trend of improvement. Significant
significant change at any time point. The average IOP of both eyes improvements were particularly noted in symptoms such as eye
showed no change when comparing week 0 to week 6 and week 6 strain, heavy eyelids, dry eyes, eyes itching, photophobia, blurred
to week 12, but significantly decreased when comparing week 0 to vision, sore eyes, blurred vision at night, and eyes strain.
week 12. The results indicate that after 12 weeks of intervention
with the lutein complex supplementation, IOP can be reduced. Effects of Lutein Complex Supplementation on Serum Lutein
Level in Healthy Subjects
Table 6: Effect of lutein complex supplementation on intraocular pressure. The serum lutein level is considered one of the methods to assess
Intraocular lutein nutritional status. Participants took one lutein complex
OD OS OU
pressure (mmHg) supplementation daily, and the serum lutein level was measured at
Week 0 16.01 ± 2.76a
15.54 ± 3.30 15.78 ± 2.81a weeks 0, 6, and 12. The results are shown in Table 10. After 6 and
Week 6 15.73 ± 2.42a
15.10 ±2.42 15.42 ± 2.24ab 12 weeks of lutein complex supplementation, compared to week
Week 12 14.34 ± 3.06b
14.82 ±2.95 14.58 ± 2.85b 0, there was a significant increase in serum lutein level.
All values are mean ± SD (n=24). OD: Oculus dexter; OS: Oculus sinister;
OU: Oculus Uterque. Different letters indicate a significant difference
between different time points at p < 0.05 by a one-way ANOVA with
Tukey's test.

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Table 9: Effects of lutein complex supplementation on questionnaire of (ETDRS) chart (Test Chart 2000 PRO), demonstrated a significant
subjective symptoms associated with eye comfort. improvement in contrast sensitivity compared to the placebo
Subjective symptoms group [14]. However, since the intervention period in this study
associated with eye comfort Week 0 Week 6 Week 12 was 3 months (12 weeks), it is hypothesized that a longer duration
(score) of lutein compound supplementation may improve contrast
Eyes strain 4.08 ± 1.25c 5.25 ± 1.26b 5.79 ± 1.41a sensitivity in the future.
Heavy eyelids 5.25 ± 1.39b 6.04 ± 1.33a 6.04 ± 1.40a
Dry eyes 4.54 ± 1.89b 5.79 ± 1.44a 5.75 ± 1.54a
The results of this experiment indicate that supplementation
Eyes itching 5.21 ± 1.35b 6.04 ± 1.27a 6.13 ± 1.08a
with a lutein complex (10 mg lutein and 2 mg zeaxanthin) for 12
Thicker eyes discharge 6.00 ± 1.50b 6.42 ± 1.06ab 6.71 ± 0.81a
weeks significantly reduced the average intraocular pressure (IOP)
Foreign matter sensation in the
6.04 ± 1.40 6.38 ± 1.17 6.59 ± 0.83 in both eyes of healthy young individuals who are prone to eye
eyes
Photophobia 5.63 ± 1.50b 6.29 ± 1.37ab 6.46 ± 0.93a
strain, temporary blurred vision, dry eyes, and prolonged eye use.
Blurred vision 5.83 ± 1.63b 6.33 ± 1.13ab 6.67 ± 0.76a Currently, research on the effects of lutein supplementation alone
Swollen eyes 6.29 ± 1.08 6.58 ± 0.97 6.63 ± 0.88 on IOP remains limited and generally shows minimal efficacy.
Sore eyes 5.21 ± 1.53b 5.83 ± 1.13b 6.42 ± 1.06a However, previous studies have suggested that astaxanthin
Eyes tears involuntarily 6.25 ± 1.45 6.54 ± 0.93 6.75 ± 0.90 may be related to improving elevated IOP. Astaxanthin is a
Blurred vision at night 5.96 ± 1.37b 6.42 ± 1.10ab 6.71 ± 0.69a natural carotenoid found in salmon and crustaceans, with strong
Eyes strain 4.08 ± 1.25c 5.25 ± 1.26b 5.79 ± 1.41a antioxidant properties. It is known to offer various health benefits,
All values are mean ± SD (n=24). Different letters indicate a significant including cardiovascular disease prevention and immune system
difference between different time points at p < 0.05 by a one-way ANOVA enhancement [15]. Moreover, increasing evidence points to
with Tukey's test. astaxanthin's efficacy in treating retinal diseases, ocular surface
diseases, cataracts, and visual fatigue [16]. Some studies also
Table 10: Effect of lutein complex supplementation on serum lutein level. suggest that astaxanthin has the potential to reduce IOP. In rats
Serum lutein level (ug/dL) with induced elevated IOP, astaxanthin supplementation restored
Week 0 0.10 ± 0.03c IOP to control levels, and its strong antioxidant properties reduced
Week 6 0.21 ± 0.08a protein oxidation, lipid peroxidation, and apoptosis caused by
Week 12 0.16 ± 0.06b high intraocular pressure [17]. Therefore, the reduction in IOP
All values are mean ± SD (n=24). Different letters indicate a significant observed in this 12-week supplementation study may be related to
difference between different time points at p < 0.05 by a one-way ANOVA the inclusion of astaxanthin in the lutein complex supplementation.
with Tukey's test.
Tear volume plays a protective role on the surface of the eye. When
Discussion tear secretion is insufficient or tear evaporation is rapid, it leads to
This prospective, one-group, pretest-posttest clinical study aimed reduced moisture on the eye’s surface. Over time, this can cause
to investigate the effects of daily supplementation with a lutein epithelial cells on the cornea or conjunctiva to shed, potentially
complex supplementation, taken for 12 weeks, on subjective leading to inflammation and increasing the risk of DES. In this
symptoms of eye fatigue, such as eye strain, temporary blurred experiment, the strip meniscometry test is related to the amount
vision, and dry eyes, as well as objective clinical indicators in of tear production, while TBUT is associated with the rate of tear
healthy individuals who engage in prolonged eye-intensive work. evaporation. The larger the values for strip meniscometry test and
The results showed that, the participants' serum lutein levels TBUT, the lower the risk of developing DES [18]. The results of
increased significantly by 2.1 times after 6 weeks, and after this study indicate that supplementation with a lutein complex
continued supplementation for 12 weeks, lutein levels remained for 12 weeks did not affect strip meniscometry test, but there
1.6 times higher than baseline. After 12 weeks of supplementation, was a trend of increasing TBUT. Additionally, the self-reported
the trial indicated that taking a lutein complex supplementation questionnaire results showed a significant increase in scores of
(10 mg lutein and 2 mg zeaxanthin) for 12 weeks did not affect dry eyes after supplementation. A previous study by Kizawa et
the corrected visual acuity or contrast sensitivity in the healthy al. also found similar results. After continuous supplementation
population. According to a previous clinical trial by Nolan et al., with a lutein compound containing anthocyanins (60 mg/day),
healthy adults who were given daily supplementation of 12 mg astaxanthin (6 mg/day), and lutein (10 mg/day) for six weeks, the
lutein and 1 mg zeaxanthin for 12 months showed no changes in strip meniscometry test, TBUT, and scores on an eye comfort-
visual acuity compared to the placebo group, which is similar to related questionnaire all significantly improved [19]. This study
the results of this study [13]. Additionally, another randomized, by Kizawa et al. discussed how anthocyanins could increase
double-blind, placebo-controlled clinical trial showed that nitric oxide (NO) production, which relaxed blood vessels, and
healthy adults without any retinal diseases who were given daily astaxanthin was thought to inhibit lipid peroxidation on cell
supplementation of 10 mg lutein, 2 mg zeaxanthin, and 10 mg membranes, reducing oxidative damage to red blood cells and
meso-zeaxanthin for 12 months, and were tested for contrast maintaining blood flow, thus improving ocular blood circulation.
sensitivity using the Early Treatment Diabetic Retinopathy Study These findings support the idea that while lutein supplementation

Food Sci Nutr Res, 2024 Volume 7 | Issue 2 | 5 of 7

may not increase tear secretion, it can improve tear film stability, Acknowledgments
reduce tear evaporation, and maintain eye hydration. These effects We thank VITABOX® Devotion International Co., Ltd. (New
may be related to the inclusion of anthocyanins and astaxanthin in Taipei, Taiwan) for producing and supplying the products we used
the lutein complex supplementation. in this study.

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