Dietary Prevention of Age-Related Macular Degeneration

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Yellow plant pigments, such as lutein and zeaxanthin, build up in the back of our eyes to protect our retinas against age-related macular degeneration. Levels of these eyesight–saving nutrients in organic free-range eggs, vegetables, and goji berries are compared.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Anyone who’s ever got a sunburn knows how damaging the UV rays in sunlight can be. Imagine what those same rays are doing to the back of our eyeballs, our retinas. The eye is designed to take sunlight, and focus it like a magnifying glass into the back of our eyes. Thankfully, we have a layer of cells in our eye, called the retinal pigment epithelium, that supports and protects our delicate retinal eyesight machinery. The layer builds up yellow plant pigments from our diet, like zeaxanthin, which absorbs blue light, and protects the retina from the photo-oxidative damage.

The yellowing of the lenses in our eyes when we get cataracts may actually be our body’s defense mechanism to protect our retinas. In fact, when you go and surgically remove those cataracts, your risk of blindness from macular generation shoots up, since you removed that protection. Instead of trading one type of vision loss for another, instead of pigmenting the front of your eyes with cataracts, better to pigment the back of our eyes with diet. The pigment in the back of our eyes is entirely of dietary origin—thus suggesting that the most common cause of going blind in the Western world could be delayed, or even averted, with appropriate dietary modification.

Where in our diet do we get it? Well, the egg industry brags that eggs are a good source. But, have an egg nearly every day—six eggs a week—for three months, and the pigmentation in our eyes barely moves. And, these were the high-lutein, free-range, certified organic eggs—not purchased at a supermarket, but a local farm.

Instead of getting the phytonutrients from the egg, that came from the chicken, that came from the corn, and blades of grass she pecked on, what about getting it from the source? A cup of corn, and a half-cup of spinach a day, for three months. A dramatic boost in protective eye pigment. Just to compare to the eggs, here’s the best that eggs could do. But, if you cut out the middle hen, and get these nutrients from plants directly, you get up to here.

What’s neat about this study is that they went back and measured the levels three months after the study stopped, and the levels were still way up here. So, once we build up our macular pigment with a healthy diet, our eyeballs really try to hold on to it. So, even if we go on vacation, and end up eating more iceberg lettuce than spinach, our eyes will hold on until we get back.

Yes, eggs can increase zeaxanthin levels in the blood, but they also raise bad cholesterol levels, and risk of heart disease. “Therefore an egg yolk-based dietary strategy to increase plasma zeaxanthin cannot be recommended, and an alternative, cholesterol-free, food source is desirable”—like goji berries, for example, which have up to 60 times more zeaxanthin than eggs. A modest dose markedly increases levels in our body, an inexpensive, effective, safe, whole food strategy to increase zeaxanthin in the bloodstream. But we don’t need it in our blood; we need it in our eyes.

So, how about a double-blind, randomized, placebo-controlled trial? To preserve eyesight in the elderly in traditional Chinese medicine, people are often prescribed 40 to 100 goji berries a day. But here, they just used about 15 berries a day for three months, but still found it could protect against loss of pigment, and prevent the buildup of what’s called “soft drusen,” which is just debris that builds up in the back of the eye—both of which are associated with age-related macular degeneration, “the leading cause of legal blindness” in older men and women, affecting more than ten million Americans. Note they gave the berries with milk in this study, so the butterfat could increase the absorption of these carotenoid pigments. A healthier way to get the same effect would just be to eat goji berries with nuts or seeds—in other words, goji trail mix.

Please consider volunteering to help out on the site.

Images thanks to Kattebelletje and Kirinqueen via flickr, and Sun Ladder, Aney, Theornamentalist, Ashlyak, Dinkum, OsvaldoGago, and Kotoviski via Wikimedia. Thanks to Ellen Reid for her image-finding expertise, and Jeff Thomas for his Keynote help.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Anyone who’s ever got a sunburn knows how damaging the UV rays in sunlight can be. Imagine what those same rays are doing to the back of our eyeballs, our retinas. The eye is designed to take sunlight, and focus it like a magnifying glass into the back of our eyes. Thankfully, we have a layer of cells in our eye, called the retinal pigment epithelium, that supports and protects our delicate retinal eyesight machinery. The layer builds up yellow plant pigments from our diet, like zeaxanthin, which absorbs blue light, and protects the retina from the photo-oxidative damage.

The yellowing of the lenses in our eyes when we get cataracts may actually be our body’s defense mechanism to protect our retinas. In fact, when you go and surgically remove those cataracts, your risk of blindness from macular generation shoots up, since you removed that protection. Instead of trading one type of vision loss for another, instead of pigmenting the front of your eyes with cataracts, better to pigment the back of our eyes with diet. The pigment in the back of our eyes is entirely of dietary origin—thus suggesting that the most common cause of going blind in the Western world could be delayed, or even averted, with appropriate dietary modification.

Where in our diet do we get it? Well, the egg industry brags that eggs are a good source. But, have an egg nearly every day—six eggs a week—for three months, and the pigmentation in our eyes barely moves. And, these were the high-lutein, free-range, certified organic eggs—not purchased at a supermarket, but a local farm.

Instead of getting the phytonutrients from the egg, that came from the chicken, that came from the corn, and blades of grass she pecked on, what about getting it from the source? A cup of corn, and a half-cup of spinach a day, for three months. A dramatic boost in protective eye pigment. Just to compare to the eggs, here’s the best that eggs could do. But, if you cut out the middle hen, and get these nutrients from plants directly, you get up to here.

What’s neat about this study is that they went back and measured the levels three months after the study stopped, and the levels were still way up here. So, once we build up our macular pigment with a healthy diet, our eyeballs really try to hold on to it. So, even if we go on vacation, and end up eating more iceberg lettuce than spinach, our eyes will hold on until we get back.

Yes, eggs can increase zeaxanthin levels in the blood, but they also raise bad cholesterol levels, and risk of heart disease. “Therefore an egg yolk-based dietary strategy to increase plasma zeaxanthin cannot be recommended, and an alternative, cholesterol-free, food source is desirable”—like goji berries, for example, which have up to 60 times more zeaxanthin than eggs. A modest dose markedly increases levels in our body, an inexpensive, effective, safe, whole food strategy to increase zeaxanthin in the bloodstream. But we don’t need it in our blood; we need it in our eyes.

So, how about a double-blind, randomized, placebo-controlled trial? To preserve eyesight in the elderly in traditional Chinese medicine, people are often prescribed 40 to 100 goji berries a day. But here, they just used about 15 berries a day for three months, but still found it could protect against loss of pigment, and prevent the buildup of what’s called “soft drusen,” which is just debris that builds up in the back of the eye—both of which are associated with age-related macular degeneration, “the leading cause of legal blindness” in older men and women, affecting more than ten million Americans. Note they gave the berries with milk in this study, so the butterfat could increase the absorption of these carotenoid pigments. A healthier way to get the same effect would just be to eat goji berries with nuts or seeds—in other words, goji trail mix.

Please consider volunteering to help out on the site.

Images thanks to Kattebelletje and Kirinqueen via flickr, and Sun Ladder, Aney, Theornamentalist, Ashlyak, Dinkum, OsvaldoGago, and Kotoviski via Wikimedia. Thanks to Ellen Reid for her image-finding expertise, and Jeff Thomas for his Keynote help.

Doctor's Note

I’ve previously touched on this important topic in Preventing Macular Degeneration with Diet. I’ve also covered other leading causes of blindness, such as cataracts (see Preventing Cataracts with Diet) and glaucoma (see Greens vs. Glaucoma and Dietary Treatment of Glaucoma).

In Egg Industry Blind Spot, I compare the antioxidant levels in eggs to greens.

Though they didn’t appear to boost a measure of immune function (see Boosting Natural Killer Cell Activity), goji berries are one of the most antioxidant-packed snacks out there. 

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