Lutein

Lutein/Drug Interactions:

  • AlcoholAlcohol: In human research, moderate consumption of various types of alcoholic beverages (red wine, beer, and spirits) had counteracting effects on plasma antioxidant components but lacked a significant effect on overall antioxidant status (136). In human research, alcohol consumption decreased plasma lutein/zeaxanthin (84).
  • AntidiabeticsAntidiabetics: In epidemiological research, postload plasma glucose concentration and fasting insulin concentration decreased significantly as serum lutein/zeaxanthin increased (81). Although a relationship between carotenoid intake and risk of type 2 diabetes was examined, the relationship between lutein intake and risk of type 2 diabetes is unclear (137).
  • Anti-inflammatoriesAnti-inflammatories: According to a review, in vitro, lutein suppressed NF-kappaB and the expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (39).
  • AntilipemicsAntilipemics: In vitro, pretreatment of cells with lutein inhibited low-density lipoprotein (LDL)-induced monocyte migration in a dose-dependent manner (16).
  • AntineoplasticsAntineoplastics: In vitro, lutein induced apoptosis in transformed cells, although this effect was lacking in normal human mammary cells (138). Lutein also protected normal cells from apoptosis induced etoposide and cisplatin; however, this effect was lacking in transformed cells. Some preliminary human research suggests that circulating levels of lutein and zeaxanthin are associated with a reduced risk of breast cancer (139), non-Hodgkin's lymphoma (140), and urothelial cell cancer (141). However, results from some epidemiological studies suggest an increased cancer risk in individuals with higher plasma lutein levels (104; 105).
  • Antiobesity agentsAntiobesity agents: In epidemiological research, there was an inverse association between plasma lutein and body mass index (BMI) or fat mass (90; 142).
  • Cardiovascular agentsCardiovascular agents: In epidemiological research, higher concentrations of plasma lutein/zeaxanthin were associated with a moderate increase in cardiovascular disease risk (80). However, in other epidemiological research, combined carotenoid status (including lutein) had protective effects against atherosclerosis (143), and in animal research, chow plus lutein (0.2% by weight) reduced atherosclerotic lesion size by 44% in apo E-null mice and by 43% in LDL receptor-null mice.
  • Cholestyramine resinCholestyramine resin: According to secondary sources, concomitant intake of lutein/zeaxanthin and cholestyramine decreased the absorption of lutein/zeaxanthin.
  • ColestipolColestipol: According to secondary sources, concomitant intake of lutein/zeaxanthin and colestipol decreased the absorption of lutein/zeaxanthin.
  • Cytochrome P450-modifying agentsCytochrome P450-modifying agents: In human research, it was determined that lutein content in the diet is at least partially responsible for variability in CYP1A2 (82). In this study, plasma lutein explained the largest portion of the variance (7%) and was negatively associated with CYP1A2.
  • Dermatologic agentsDermatologic agents: According to secondary sources, excess carotenodermia has been reported with use of lutein.
  • Mineral oilMineral oil: According to secondary sources, concomitant intake of mineral oil and lutein/zeaxanthin reduced the absorption of lutein/zeaxanthin.
  • Nicotine (tobacco)Nicotine (tobacco): In epidemiological research, smokers had lower levels overall of plasma lutein than nonsmokers (90; 91).
  • Ophthalmic agentsOphthalmic agents: Epidemiological evidence has suggested that increased dietary intake of lutein, due in part to elevated consumption of lutein-rich vegetables such as spinach, broccoli, and collard greens, is associated with a reduced risk for age-related macular degeneration (AMD) (15; 144; 145) and cataracts (146; 147; 148; 149; 149; 150; 151). Moreover, an age-dependent, inverse relationship between eye lens density and macular pigment density (which comprises lutein and zeaxanthin) has also been described (152). In patients with early AMD, lutein improved visual acuity (112), contrast sensitivity (109), or multifocal electroretinogram response (110). In humans, the change in lutein and zeaxanthin levels of blood, associated with increased dietary intakes (spinach powder or supplements), or differences in regular blood levels, were associated with changes in macular pigment levels (153; 154). In preterm infants, lutein in the presence of other carotenoids resulted in greater rod photoreceptor sensitivity (33).
  • OrlistatOrlistat: According to secondary sources, orlistat decreased the absorption of lutein/zeaxanthin.
  • Pulmonary agentsPulmonary agents: Incidences of pneumonia have been reported following the administration of three 10mg lutein capsules (FloraGLO?) twice daily for 12 months (102) and 9mg of lutein combined with 8mg of zeaxanthin once daily for 12 months (103). In epidemiological research, the serum concentration of lutein and zeaxanthin has demonstrated an inverse association with the decline from maximal lung function, as measured by forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) (155).
  • RetinoidsRetinoids: In human research, retinol supplementation caused a significant increase in the plasma concentration of lutein (156).
  • SimvastatinSimvastatin: In individuals with mild-to-moderate hypercholesterolemia, simvastatin therapy reduced the level of carotenoids in the plasma (including lutein); however, after taking into account lipid levels, this effect was in fact reversed (simvastatin increased plasma lutein) (83).

    • Lutein/Herb/Supplement Interactions:

  • Alpha-tocopherolAlpha-tocopherol: In human research, consumption of a lutein-containing supplement decreased intestinal absorption of alpha-tocopherol (92) and lowered serum alpha-tocopherol concentration (93).
  • Anti-inflammatoriesAnti-inflammatories: According to a review, in vitro, lutein suppressed NF-kappaB, and the expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (39).
  • AntilipemicsAntilipemics: In vitro, pretreatment of cells with lutein inhibited low-density lipoprotein (LDL)-induced monocyte migration in a dose-dependent manner (16).
  • AntineoplasticsAntineoplastics: In vitro, lutein induced apoptosis in transformed cells, although this effect was lacking in normal human mammary cells (138). Lutein also protected normal cells from apoptosis induced etoposide and cisplatin; however, this effect was lacking in transformed cells. Some preliminary human research suggests that circulating levels of lutein and zeaxanthin are associated with a reduced risk of breast cancer (139), non-Hodgkin's lymphoma (140), and urothelial cell cancer (141). However, results from some epidemiological studies suggest an increased cancer risk in individuals with higher plasma lutein levels (104; 105).
  • Antiobesity agentsAntiobesity agents: In epidemiological research, there was an inverse association between plasma lutein and body mass index (BMI) or fat mass (90; 142).
  • AntioxidantsAntioxidants: In animal and in vitro research, lutein, whether administered as a monotherapy or a combination therapy, had antioxidant effects (157; 123; 158; 159; 160; 161).
  • AstaxanthinAstaxanthin: In human research, astaxanthin supplementation increased plasma concentration of carotenoids (including lutein) (162).
  • Beta-caroteneBeta-carotene: Results from various human studies suggest that beta-carotene may reduce or increase bioavailability of lutein (94; 95; 96). Some studies in humans suggest that beta-carotene lacks an effect on lutein levels (163). When combined, beta-carotene significantly reduced the serum area under the curve value for lutein to 54-61% of control values and lutein reduced the serum area under the curve value for beta-carotene in five subjects, but enhanced it in three subjects (97). In humans supplemented with lutein from two sources for seven days (yellow carrots, 1.7mg of lutein daily) or an oil-based lutein supplement (1.7mg of lutein daily), the peak serum beta-carotene was maintained in the yellow carrot group, although this effect was lacking in the lutein supplement group (98). In humans, lutein reduced beta-carotene absorption when the two were given simultaneously (100; 101). Beta-carotene supplementation of pregnant women resulted in increased lutein and zeaxanthin concentrations during pregnancy and postpartum (130).
  • Bilberry extractBilberry extract: In human research, lutein administered in combination with omega-3 fatty acid-rich fish oil and bilberry extract improved various symptoms of asthenopia (164).
  • Black currant extractBlack currant extract: In human research, lutein administered in combination with zeaxanthin and black currant extract improved physiological response to visual fatigue compared to placebo (165).
  • Cardiovascular agentsCardiovascular agents: In epidemiological research, higher concentrations of plasma lutein/zeaxanthin were associated with a moderate increase in cardiovascular disease risk (80). However, in other epidemiological research, combined carotenoid status (including lutein) had protective effects against atherosclerosis (143), and in animal research, chow plus lutein (0.2% by weight) reduced atherosclerotic lesion size by 44% in apo E-null mice and by 43% in LDL receptor-null mice.
  • Carotenoids (general)Carotenoids (general): Several human studies have demonstrated increased plasma levels of carotenoids in general, and lutein in particular, following increased dietary intake of fruits and vegetables or fruit and vegetable juice concentrate, or the adoption of a Mediterranean diet (166; 167; 168; 169; 170; 171; 172; 173; 174; 175; 176; 177). In humans, adding a second carotenoid (pill form) to a meal providing a first carotenoid (food form) reduced absorption of the first carotenoid (99).
  • Cytochrome P450-modifying agentsCytochrome P450-modifying agents: In human research, it was determined that lutein content in the diet is at least partially responsible for variability in CYP1A2 (82). In this study, plasma lutein explained the largest portion of the variance (7%) and was negatively associated with CYP1A2.
  • Dermatologic agentsDermatologic agents: According to secondary sources, excess carotenodermia has been reported with use of lutein.
  • Dietary fiberDietary fiber: Dietary fiber decreased the antioxidative effect of supplementary carotenoids, perhaps due to reduced bioavailability in the gut (178).
  • HypoglycemicsHypoglycemics: In epidemiological research, postload plasma glucose concentration and fasting insulin concentration decreased significantly as serum lutein/zeaxanthin increased (81). Although a relationship between carotenoid intake and risk of type 2 diabetes was examined, the relationship between lutein intake and the risk of type 2 diabetes is unclear (137).
  • IronIron: In human research, consumption of lutein-rich kiwifruit combined with ferrous sulfate-fortified cereal improved iron status (34).
  • Mineral oilMineral oil: According to secondary sources, concomitant intake of mineral oil and lutein/zeaxanthin reduced the absorption of lutein/zeaxanthin.
  • Omega-3 fatty acidsOmega-3 fatty acids: In human research, the intake of omega-3 polyunsaturated fatty acids has been shown to be selectively associated with increased risk of age-related macular degeneration (AMD) only in individuals with a low dietary intake of lutein (less than 1.1mg daily) (179). Lutein administered in combination with omega-3 fatty acid-rich fish oil and bilberry extract improved various symptoms of asthenopia (164). In human research, combined supplementation of lutein and the omega-3 fatty acid DHA resulted in an increase in both serum lutein level and macular pigment optical density (MPOD) (127). Similarly, lutein taken in conjunction with DHA improved verbal fluency, memory, and delayed recall (180). In epidemiological research, MPOD was associated with levels of the omega-3 fatty acids docosapentaenoic acid (DPA) and eicosapentaenoic acid (EPA); associations with DHA were lacking (154).
  • Ophthalmic agentsOphthalmic agents: Epidemiological evidence has suggested that increased dietary intake of lutein, due in part to elevated consumption of lutein-rich vegetables such as spinach, broccoli, and collard greens, is associated with a reduced risk for age-related macular degeneration (AMD) (15; 144; 145) and cataracts (146; 147; 148; 149; 149; 150; 151). Moreover, an age-dependent, inverse relationship between eye lens density and macular pigment density (which comprises lutein and zeaxanthin) has also been described (152). In patients with early AMD, lutein improved visual acuity (112), contrast sensitivity (109), or multifocal electroretinogram response (110). In humans, the change in lutein and zeaxanthin levels of blood, associated with increased dietary intakes (spinach powder or supplements), or differences in regular blood levels, were associated with changes in macular pigment levels (153; 154). In preterm infants, lutein in the presence of other carotenoids resulted in greater rod photoreceptor sensitivity (33).
  • Pulmonary agentsPulmonary agents: Incidences of pneumonia have been reported following the administration of three 10mg lutein capsules (FloraGLO?) twice daily for 12 months (102) and 9mg of lutein combined with 8mg of zeaxanthin once daily for 12 months (103). In epidemiological research, the serum concentration of lutein and zeaxanthin has demonstrated an inverse association with the decline from maximal lung function, as measured by forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) (155).
  • RetinolRetinol: In human research, retinol supplementation caused a significant increase in the plasma concentration of lutein (156).
  • SoySoy: In pregnant women with a low intake of dietary fat, the postpartum decline in serum lutein level was mitigated with soybean supplementation, compared to no supplementation (133).
  • SpinachSpinach: In human research, serum lutein level and MPOD both increased following the consumption of a high-lutein spinach cultivar (12.1mg/100g of fresh mass for lutein and 9.2mg/100g of fresh mass for beta-carotene) (181).
  • StanolsStanols: In human research, plant stanols decreased plasma levels of lutein (85).
  • SterolsSterols: In human research, plant sterols lowered both serum cholesterol and serum lutein levels; however, this effect may be influenced, in part, by the apolipoprotein E (apo E) genotype (86; 87; 88; 28).
  • TobaccoTobacco: In epidemiological research, smokers had lower levels overall of plasma lutein than nonsmokers (90; 91).
  • TomatoTomato: In human research, supplementation with tomato puree significantly increased plasma lutein (182).
  • WatercressWatercress: In human research, the plasma concentration of lutein increased by 100% following daily supplementation of 85g of raw watercress (183).
  • ZeaxanthinZeaxanthin: In humans, zeaxanthin is capable of being converted to lutein (184). Thus, zeaxanthin supplementation is expected to increase plasma lutein levels. MPOD increased following supplementation with both lutein alone and in combination with zeaxanthin (185; 186). Also in humans, lutein administered in combination with zeaxanthin and black currant extract improved physiological response to visual fatigue compared to placebo (165).

    • Lutein/Food Interactions:

  • Beta-carotene (food sources)Beta-carotene (food sources): Results from various human studies suggest that beta-carotene may reduce or increase bioavailability of lutein (94; 95; 96). Some studies in humans suggest that beta-carotene lacks an effect on lutein levels (163). When combined, beta-carotene significantly reduced the serum area under the curve value for lutein to 54-61% of control values, and lutein reduced the serum area under the curve value for beta-carotene in five subjects but enhanced it in three subjects (97). In humans supplemented with lutein from two sources for seven days (yellow carrots, 1.7mg of lutein daily) or an oil-based lutein supplement (1.7mg of lutein daily), the peak serum beta-carotene was maintained in the yellow carrot group, although this effect was lacking in the lutein supplement group (98). In humans, lutein reduced beta-carotene absorption when the two were given simultaneously (100; 101). Beta-carotene supplementation of pregnant women resulted in increased lutein and zeaxanthin concentrations during pregnancy and postpartum (130).
  • Carotenoids (general)Carotenoids (general): Several human studies have demonstrated increased plasma levels of carotenoids in general, and lutein in particular, following increased dietary intake of fruits and vegetables or fruit and vegetable juice concentrate, or the adoption of a Mediterranean diet (166; 167; 168; 169; 170; 171; 172; 173; 174; 175; 176; 177). In humans, adding a second carotenoid (pill form) to a meal providing a first carotenoid (food form) reduced absorption of the first carotenoid (99).
  • Egg yolkEgg yolk: Egg yolk, whether from organic or omega-3 fatty acid-enriched eggs, is a source of dietary lutein and may increase dietary lutein intake and plasma levels (1; 187; 188). Some research has suggested that increased plasma lutein following egg consumption is positively associated with both plasma cholesterol level and LDL and high-density lipoprotein (HDL) particle size (189; 190; 191). Other studies did not show any increase in serum lutein following egg supplementation (192).
  • Fats and oilsFats and oils: In human research, fat in the diet affected the bioavailability of lutein esters in humans (193). In human research, 20g of fat vs. 3g or 8g of fat increased the absorption of lutein (194).
  • FiberFiber: Dietary fiber decreased the antioxidative effect of supplementary carotenoids, perhaps due to reduced bioavailability in the gut (178).
  • Fruits and vegetablesFruits and vegetables: In human research, fruits and vegetables, good sources of lutein, increased dietary lutein intake and plasma lutein in humans (195; 196; 98).
  • Iron(food source)Iron(food source): In human research, consumption of lutein-rich kiwifruit combined with ferrous sulfate-fortified cereal improved iron status (34).
  • MayonnaiseMayonnaise: Mayonnaise taken in conjunction with broccoli, a lutein-rich food, increased the incremental area under the curve of serum lutein compared to the consumption of broccoli alone (197).
  • OlestraOlestra: In human research, olestra reduced serum lutein concentrations in healthy individuals (198; 199). The olestra-induced decrease in serum lutein was not prevented by a vitamin supplement (199).
  • Omega-3 fatty acidsOmega-3 fatty acids: In human research, the intake of omega-3 polyunsaturated fatty acids has been shown to be selectively associated with increased risk of age-related macular degeneration (AMD) only in individuals with a low dietary intake of lutein (less than 1.1mg daily) (179). Lutein administered in combination with omega-3 fatty acid-rich fish oil and bilberry extract improved various symptoms of asthenopia (164). In human research, combined supplementation of lutein and the omega-3 fatty acid DHA resulted in an increase in both serum lutein level and macular pigment optical density (MPOD) (127). Similarly, lutein taken in conjunction with DHA improved verbal fluency, memory, and delayed recall (180). In epidemiological research, MPOD was associated with levels of the omega-3 fatty acids docosapentaenoic acid (DPA) and eicosapentaenoic acid (EPA); associations with DHA were lacking (154).
  • PistachiosPistachios: In human research, consumption of a pistachio-enriched diet increased plasma lutein levels (200).
  • Retinol (food source)Retinol (food source): In human research, retinol supplementation caused a significant increase in the plasma concentration of lutein (156).
  • SoybeansSoybeans: In pregnant women with a low intake of dietary fat, the postpartum decline in serum lutein level was mitigated with soybean supplementation, compared to no supplementation (133).
  • SpinachSpinach: In human research, serum lutein level and MPOD both increased following the consumption of a high-lutein spinach cultivar (12.1mg/100g of fresh mass for lutein and 9.2mg/100g of fresh mass for beta-carotene) (181).
  • StanolsStanols: In human research, plant stanols decreased plasma levels of lutein (85).
  • SterolsSterols: In human research, plant sterols lowered both serum cholesterol and serum lutein levels; however, this effect may be influenced, in part, by the apolipoprotein E (apo E) genotype (86; 87; 88; 28).
  • Sucrose polyesterSucrose polyester: In human research, use of a sucrose polyester fat analog reduced the plasma concentration of lutein (89).
  • TomatoTomato: In human research, supplementation with tomato puree increased plasma lutein (182).
  • WatercressWatercress: In human research, the plasma concentration of lutein increased by 100% following daily supplementation of 85g of raw watercress (183).
  • Zeaxanthin (food source)Zeaxanthin (food source): In human research, zeaxanthin was capable of being converted to lutein (184) and therefore may increase plasma lutein levels.

    • Lutein/Lab Interactions:

  • Body mass index (BMI)Body mass index (BMI): In epidemiological research, there was an inverse association between plasma lutein and body mass index (BMI) or fat mass (90; 142).
  • C-reactive protein (CRP)C-reactive protein (CRP): In human research (infants), lutein decreased levels of CRP (33).
  • Erythrocyte glutathione reductaseErythrocyte glutathione reductase: In human research, consumption of a lutein-containing supplement resulted in greater erythrocyte glutathione reductase activity (93).
  • Erythrocyte spermidineErythrocyte spermidine: In human research, a significant inverse correlation was seen between erythrocyte spermidine and plasma level of lutein (r=-0.52) (201). The effect of lutein supplementation on spermidine levels is unknown.
  • Erythrocyte spermineErythrocyte spermine: In human research, a significant inverse correlation was seen between erythrocyte spermine and plasma levels of lutein (r=-0.544) (201). The effect of lutein supplementation on spermine levels is unknown.
  • GlucoseGlucose: In epidemiological research, postload plasma glucose concentration decreased significantly as serum lutein/zeaxanthin increased (81). Although a relationship between carotenoid intake and the risk of type 2 diabetes was examined, the relationship between lutein intake and the risk of type 2 diabetes is unclear (137).
  • InsulinInsulin: In epidemiological research, fasting insulin concentration decreased significantly as serum lutein/zeaxanthin increased (81).
  • Insulin-like growth factor-1 (IGF-1)Insulin-like growth factor-1 (IGF-1): In men, serum IGF binding protein (BP)-3 levels decreased with increased levels of serum lutein/zeaxanthin (202).
  • Lung function testsLung function tests: Incidences of pneumonia have been reported following the administration of three 10mg lutein capsules (FloraGLO?) twice daily for 12 months (102) and 9mg of lutein combined with 8mg of zeaxanthin once daily for 12 months (103). In epidemiological research, the serum concentration of lutein and zeaxanthin has demonstrated an inverse association with the decline from maximal lung function, as measured by forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) (155).
  • LuteinLutein: Multiple studies in humans have indicated that increased dietary lutein (food or supplement) increases levels of lutein in the blood (118; 117). In humans, lutein levels in the blood have been shown to be negatively modified by tobacco (90), reduced dietary lutein (203), beta-carotene intake (96), plant stanols (85), and sucrose polyester fat analogs (204), and positively modified by fruit and vegetable consumption (195; 98), egg yolk (1), and beta-carotene intake (95). In human research, lutein levels in breast milk have been shown to be modified with palm oil use, as well as beta-carotene supplementation (135).
  • Oxidative stress markersOxidative stress markers: In human research, lutein supplementation resulted in a decrease of oxidative stress markers in blood serum (205; 206).