Avocados, greens, and lutein and zeaxanthin supplements are put to the test for improving cognitive function.
Friday Favorites: Do Lutein Supplements Help with Brain Function?
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.
Dark green leafy vegetables are packed with a brain antioxidant called lutein. And so, increasing our greens intake could be an “important public health strategy for reducing the risk of visual or cognitive impairment.” Lutein is the dominant dietary pigment in the retina of the eye as well as the brain; and so, “not surprising that macular pigment,” the concentration of lutein in the center of the eye called the macula, “was found to be significantly correlated with levels in” the brain, which may explain the link between how much of these greens nutrients you can see in the back of the eye and cognitive function. The neuroprotection is assumed to be because lutein is such a powerful antioxidant, but it also has anti-inflammatory properties.
“This relationship between lutein and [another greens nutrient called] zeaxanthin and visual and cognitive health throughout the lifespan is compelling.” But that was based on observational studies, where you observe that higher lutein levels and brain function seem to go together, but you don’t know if it’s cause and effect until…you put it to the test. “Could [lutein] and [zeaxanthin] be supplemented as part of a lifestyle intervention to both improve [brain] function and reduce the [probability of slipping into dementia]?” The reason everyone is so excited about the possibility is because of the hopeful data from eye health studies that have convinced many ophthalmologists to start recommending people start increasing their lutein and zeaxanthin intake to prevent and treat macular degeneration, a leading cause of age-related vision loss. You don’t have to take pills, though. Adding as little as 60 grams of spinach a day for a month—that’s like one-fifth of a ten-ounce package of frozen spinach—can significantly boost macular pigment in most people.
And it’s not just good for treating diseased eyes. A randomized, placebo-controlled study found that these greens goodies can improve visual processing speed in young healthy people—that’s like when you’re trying to hit a fastball and your body has to start reacting before you even consciously register it, with real-world benefits outside the major leagues, improving, for example, visual performance during driving. Okay, but what about cognition?
A randomized, double-blind, placebo-controlled trial of adults, average age 73, given the equivalent of about a half-cup a day’s worth of cooked kale, or a full cup of cooked spinach, and got significant improvements in cognitive function compared to those randomized to the placebo.
It may even work in young adults too; average age 21. Daily supplementation with that same amount of lutein and zeaxanthin not only increased their macular pigment, but resulted in significant improvements in brain function—spatial memory, reasoning ability, and complex attention.
Have they ever tried putting whole foods to the test? Hard to get Americans to eat greens every day, but not so hard to get them to eat guacamole. “This study tested the effects of the intake of avocado on cognition. …[a] six-month, randomized, controlled trial.” What was the control? One avocado a day, or a potato, or a cup of chickpeas, and…those in the avocado group had a significant improvement cognitive function. But, to the Avocado Board’s chagrin…so did the tater and chickpea group. That’s the problem with having healthy placebos; maybe they should have used iceberg lettuce or something.
What about the impact on cognition of those who really need it: Alzheimer’s disease patients? Their vision got better; that’s good, but no significant changes in cognitive function. Now it’s possible that eating whole foods, like dark green leafies, might have worked better than just the pigments in pill form.
Yes, “oxidation and inflammation appear to be key” to both Alzheimer’s and macular degeneration, but “neither [disease] seems particularly amenable to late-stage treatments.” That’s why prevention is the key. Reducing oxidation and inflammation in the earliest stages may be “our most promising approach.”
Please consider volunteering to help out on the site.
- Erdman JW, Smith JW, Kuchan MJ, et al. Lutein and Brain Function. Foods. 2015;4(4):547-564.
- Johnson EJ. Role of lutein and zeaxanthin in visual and cognitive function throughout the lifespan. Nutr Rev. 2014;72(9):605-12.
- Renzi LM, Dengler MJ, Puente A, Miller LS, Hammond BR. Relationships between macular pigment optical density and cognitive function in unimpaired and mildly cognitively impaired older adults. Neurobiol Aging. 2014;35(7):1695-9.
- Hammond BR, Johnson EJ, Russell RM, et al. Dietary modification of human macular pigment density. Invest Ophthalmol Vis Sci. 1997;38(9):1795-801.
- Chew EY, Clemons TE, Sangiovanni JP, et al. Secondary analyses of the effects of lutein/zeaxanthin on age-related macular degeneration progression: AREDS2 report No. 3. JAMA Ophthalmol. 2014;132(2):142-9.
- Yao Y, Qiu QH, Wu XW, Cai ZY, Xu S, Liang XQ. Lutein supplementation improves visual performance in Chinese drivers: 1-year randomized, double-blind, placebo-controlled study. Nutrition. 2013;29(7-8):958-64.
- Bovier ER, Hammond BR. A randomized placebo-controlled study on the effects of lutein and zeaxanthin on visual processing speed in young healthy subjects. Arch Biochem Biophys. 2015;572:54-57.
- Hammond BR, Renzi-hammond LM. Perspective: A Critical Look at the Ancillary Age-Related Eye Disease Study 2: Nutrition and Cognitive Function Results in Older Individuals with Age-Related Macular Degeneration. Adv Nutr. 2016;7(3):433-7.
- Chew EY, Clemons TE, Agrón E, et al. Effect of Omega-3 Fatty Acids, Lutein/Zeaxanthin, or Other Nutrient Supplementation on Cognitive Function: The AREDS2 Randomized Clinical Trial. JAMA. 2015;314(8):791-801.
- Nolan JM, Loskutova E, Howard A, et al. The impact of supplemental macular carotenoids in Alzheimer's disease: a randomized clinical trial. J Alzheimers Dis. 2015;44(4):1157-69.
- Hammond BR, Miller LS, Bello MO, Lindbergh CA, Mewborn C, Renzi-hammond LM. Effects of Lutein/Zeaxanthin Supplementation on the Cognitive Function of Community Dwelling Older Adults: A Randomized, Double-Masked, Placebo-Controlled Trial. Front Aging Neurosci. 2017;9:254.
- Scott TM, Rasmussen HM, Chen O, Johnson EJ. Avocado Consumption Increases Macular Pigment Density in Older Adults: A Randomized, Controlled Trial. Nutrients. 2017;9(9).
- Renzi-hammond LM, Bovier ER, Fletcher LM, et al. Effects of a Lutein and Zeaxanthin Intervention on Cognitive Function: A Randomized, Double-Masked, Placebo-Controlled Trial of Younger Healthy Adults. Nutrients. 2017;9(11).
Image credit: Anna via Adobe Stock Photos. Image has been modified.
Motion graphics by Avocado Video
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.
Dark green leafy vegetables are packed with a brain antioxidant called lutein. And so, increasing our greens intake could be an “important public health strategy for reducing the risk of visual or cognitive impairment.” Lutein is the dominant dietary pigment in the retina of the eye as well as the brain; and so, “not surprising that macular pigment,” the concentration of lutein in the center of the eye called the macula, “was found to be significantly correlated with levels in” the brain, which may explain the link between how much of these greens nutrients you can see in the back of the eye and cognitive function. The neuroprotection is assumed to be because lutein is such a powerful antioxidant, but it also has anti-inflammatory properties.
“This relationship between lutein and [another greens nutrient called] zeaxanthin and visual and cognitive health throughout the lifespan is compelling.” But that was based on observational studies, where you observe that higher lutein levels and brain function seem to go together, but you don’t know if it’s cause and effect until…you put it to the test. “Could [lutein] and [zeaxanthin] be supplemented as part of a lifestyle intervention to both improve [brain] function and reduce the [probability of slipping into dementia]?” The reason everyone is so excited about the possibility is because of the hopeful data from eye health studies that have convinced many ophthalmologists to start recommending people start increasing their lutein and zeaxanthin intake to prevent and treat macular degeneration, a leading cause of age-related vision loss. You don’t have to take pills, though. Adding as little as 60 grams of spinach a day for a month—that’s like one-fifth of a ten-ounce package of frozen spinach—can significantly boost macular pigment in most people.
And it’s not just good for treating diseased eyes. A randomized, placebo-controlled study found that these greens goodies can improve visual processing speed in young healthy people—that’s like when you’re trying to hit a fastball and your body has to start reacting before you even consciously register it, with real-world benefits outside the major leagues, improving, for example, visual performance during driving. Okay, but what about cognition?
A randomized, double-blind, placebo-controlled trial of adults, average age 73, given the equivalent of about a half-cup a day’s worth of cooked kale, or a full cup of cooked spinach, and got significant improvements in cognitive function compared to those randomized to the placebo.
It may even work in young adults too; average age 21. Daily supplementation with that same amount of lutein and zeaxanthin not only increased their macular pigment, but resulted in significant improvements in brain function—spatial memory, reasoning ability, and complex attention.
Have they ever tried putting whole foods to the test? Hard to get Americans to eat greens every day, but not so hard to get them to eat guacamole. “This study tested the effects of the intake of avocado on cognition. …[a] six-month, randomized, controlled trial.” What was the control? One avocado a day, or a potato, or a cup of chickpeas, and…those in the avocado group had a significant improvement cognitive function. But, to the Avocado Board’s chagrin…so did the tater and chickpea group. That’s the problem with having healthy placebos; maybe they should have used iceberg lettuce or something.
What about the impact on cognition of those who really need it: Alzheimer’s disease patients? Their vision got better; that’s good, but no significant changes in cognitive function. Now it’s possible that eating whole foods, like dark green leafies, might have worked better than just the pigments in pill form.
Yes, “oxidation and inflammation appear to be key” to both Alzheimer’s and macular degeneration, but “neither [disease] seems particularly amenable to late-stage treatments.” That’s why prevention is the key. Reducing oxidation and inflammation in the earliest stages may be “our most promising approach.”
Please consider volunteering to help out on the site.
- Erdman JW, Smith JW, Kuchan MJ, et al. Lutein and Brain Function. Foods. 2015;4(4):547-564.
- Johnson EJ. Role of lutein and zeaxanthin in visual and cognitive function throughout the lifespan. Nutr Rev. 2014;72(9):605-12.
- Renzi LM, Dengler MJ, Puente A, Miller LS, Hammond BR. Relationships between macular pigment optical density and cognitive function in unimpaired and mildly cognitively impaired older adults. Neurobiol Aging. 2014;35(7):1695-9.
- Hammond BR, Johnson EJ, Russell RM, et al. Dietary modification of human macular pigment density. Invest Ophthalmol Vis Sci. 1997;38(9):1795-801.
- Chew EY, Clemons TE, Sangiovanni JP, et al. Secondary analyses of the effects of lutein/zeaxanthin on age-related macular degeneration progression: AREDS2 report No. 3. JAMA Ophthalmol. 2014;132(2):142-9.
- Yao Y, Qiu QH, Wu XW, Cai ZY, Xu S, Liang XQ. Lutein supplementation improves visual performance in Chinese drivers: 1-year randomized, double-blind, placebo-controlled study. Nutrition. 2013;29(7-8):958-64.
- Bovier ER, Hammond BR. A randomized placebo-controlled study on the effects of lutein and zeaxanthin on visual processing speed in young healthy subjects. Arch Biochem Biophys. 2015;572:54-57.
- Hammond BR, Renzi-hammond LM. Perspective: A Critical Look at the Ancillary Age-Related Eye Disease Study 2: Nutrition and Cognitive Function Results in Older Individuals with Age-Related Macular Degeneration. Adv Nutr. 2016;7(3):433-7.
- Chew EY, Clemons TE, Agrón E, et al. Effect of Omega-3 Fatty Acids, Lutein/Zeaxanthin, or Other Nutrient Supplementation on Cognitive Function: The AREDS2 Randomized Clinical Trial. JAMA. 2015;314(8):791-801.
- Nolan JM, Loskutova E, Howard A, et al. The impact of supplemental macular carotenoids in Alzheimer's disease: a randomized clinical trial. J Alzheimers Dis. 2015;44(4):1157-69.
- Hammond BR, Miller LS, Bello MO, Lindbergh CA, Mewborn C, Renzi-hammond LM. Effects of Lutein/Zeaxanthin Supplementation on the Cognitive Function of Community Dwelling Older Adults: A Randomized, Double-Masked, Placebo-Controlled Trial. Front Aging Neurosci. 2017;9:254.
- Scott TM, Rasmussen HM, Chen O, Johnson EJ. Avocado Consumption Increases Macular Pigment Density in Older Adults: A Randomized, Controlled Trial. Nutrients. 2017;9(9).
- Renzi-hammond LM, Bovier ER, Fletcher LM, et al. Effects of a Lutein and Zeaxanthin Intervention on Cognitive Function: A Randomized, Double-Masked, Placebo-Controlled Trial of Younger Healthy Adults. Nutrients. 2017;9(11).
Image credit: Anna via Adobe Stock Photos. Image has been modified.
Motion graphics by Avocado Video
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Friday Favorites: Do Lutein Supplements Help with Brain Function?
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Content URLDoctor's Note
What is this lutein stuff? Check out Brain-Healthy Foods to Fight Aging.
What’s one convenient way to pack in the greens? How about Green Smoothies: What Does the Science Say?
I also make a vegetable-based smoothie in one of my rare cooking show vids: Dr. Greger in the Kitchen: My New Favorite Beverage. For more recipes, check out our recipe page here.
The original video aired on December 31, 2018
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