title: Oral Lutein Supplementation Enhances Macular Pigment Density and Contrast Sensitivity but Not in Combination With Polyunsaturated Fatty Acids.
abstract: OBJECTIVE
  It has been shown that lutein and zeaxanthin accumulate in the macula where they enhance contrast sensitivity and may reduce the risk of progression to advanced age-related macular degeneration (AMD). Furthermore, omega-3 long-chain polyunsaturated fatty acids (PUFA) might further reduce this risk. However, controversy exists regarding whether PUFA may reduce the bioavailability of lutein.
  
  
  METHODS
  This was a prospective 12-month, randomized, open label study evaluating the effect of supplementation with lutein, other antioxidants, and minerals on contrast sensitivity (CS) and macular pigment optical density (MPOD) in patients with age-related maculopathy. A total of 79 patients were randomized to either lutein (10 mg) and antioxidant supplement or lutein and antioxidant supplement in combination with PUFA. Patients received supplementation for a period of 6 months and were followed for a total of 12 months.
  
  
  RESULTS
  Serum lutein and zeaxanthin increased significantly by the first follow-up visit at 1 month, and remained elevated throughout the intervention period of 6 months in the lutein-only group but not in the lutein+PUFA group. Macular pigment optical density and CS increased significantly in the lutein-only group (P < 0.005) but not in the lutein+PUFA group (P = 0.059) compared to baseline. Best-corrected visual acuity remained unchanged during the entire study period in both groups.
  
  
  CONCLUSIONS
  Addition of PUFA may reduce the bioavailability of lutein and therefore lessen the beneficial effect on macular pigment and CS. This needs to be considered when prescribing lutein supplements to patients with low lutein levels. (ClinicalTrials.gov number, NCT00563979.).
authors.forename: Ute E K
authors.initials: UE
authors.lastname: Wolf-Schnurrbusch
authors.forename: Martin S
authors.initials: MS
authors.lastname: Zinkernagel
authors.forename: Marion R
authors.initials: MR
authors.lastname: Munk
authors.forename: Andreas
authors.initials: A
authors.lastname: Ebneter
authors.forename: Sebastian
authors.initials: S
authors.lastname: Wolf
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000008:administration & dosage; D015350:Contrast Sensitivity / Q000187:drug effects*; D019587:Dietary Supplements; D004311:Double-Blind Method; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D014975:Lutein / Q000008:administration & dosage* / Q000097:blood; D008268:Macular Degeneration / Q000188:drug therapy* / Q000378:metabolism; D065348:Macular Pigment / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014792:Visual Acuity / Q000187:drug effects; D065146:Zeaxanthins / Q000097:blood
chemical_list: D000975:Antioxidants; D005231:Fatty Acids, Unsaturated; D065348:Macular Pigment; D065146:Zeaxanthins; D014975:Lutein