Efficacy of Commercially Available Nutritional Supplements: Analysis of Serum Uptake, Macular Pigment Optical Density and Visual Functional Response

Richard A Bone, Pinakin Gunvant Davey, Betzabe O Roman, David W Evans, Richard A Bone, Pinakin Gunvant Davey, Betzabe O Roman, David W Evans

Abstract

Purpose: To compare the change in serum carotenoids, macular pigment optical density (MPOD) and visual function with the intake of two commercially available nutritional supplements. Methods: Participants were given a 24-week supply of a lipid-based micronized liquid medical food, Lumega-Z™ (LM), containing 28 mg of the macular carotenoids lutein (L), zeaxanthin (Z) and meso-zeaxanthin (MZ), or given PreserVision™ AREDS 2 Formula (gel-caps; PV) containing 12 mg of the macular carotenoids L and Z, but no reported MZ. Serum levels of L, Z and MZ were obtained at baseline and after 12 weeks. Macular pigment optical densities (MPOD) and visual function were assessed at baseline and after 24 weeks. Results: Average blood serum concentrations of L, Z and MZ in the two groups at baseline were similar. The increases in L, Z and MZ were 0.434, 0.063 and 0.086 mol/L vs. 0.100, 0.043 and 0.001 mol/L, respectively, in the LM vs. PV group. From baseline to week 24, average MPOD in the LM-group increased by 0.064 from 0.418 to 0.482, whereas in the PV-group, it was essentially unchanged (0.461 to 0.459;). Although log-contrast sensitivity was improved in all groups under three conditions (photopic, mesopic and mesopic with glare), the change in log-contrast sensitivity was not statistically significant. Conclusion: Despite only a 2.3-fold higher carotenoid concentration than PV, LM supplementation provides approximately 3-4-fold higher absorption, which leads to a significant elevation of MPOD levels.

Keywords: Lumega-Z; PreserVision; contrast sensitivity; lutein; macular pigment optical density; meso-zeaxanthin; zeaxanthin.

Conflict of interest statement

R.A.B. Science Advisory Board of Guardion Health Sciences and owns shares in the company, P.G.D. Serves as a consultant Guardion Health Sciences, ZeaVision LLC, D.W.E. Guardion Health Sciences and owns shares in the company consultant, BOR-none.

References

    1. Bernstein P.S., Delori F.C., Richer S., van Kuijk F.J., Wenzel A.J. The value of measurement of macular carotenoid pigment optical densities and distributions in age-related macular degeneration and other retinal disorders. Vis. Res. 2010;50:716–728. doi: 10.1016/j.visres.2009.10.014.
    1. Gruszecki W.I., Sielewiesiuk J. Orientation of xanthophylls in phosphatidylcholine multibilayers. Biochim. Biophys. Acta. 1990;1023:405–412. doi: 10.1016/0005-2736(90)90133-9.
    1. Leung I.Y. Macular pigment: New clinical methods of detection and the role of carotenoids in age-related macular degeneration. Optometry. 2008;79:266–272. doi: 10.1016/j.optm.2007.03.017.
    1. De Kinkelder R., van der Veen R.L., Verbaak F.D., Faber D.J., van Leeuwen T.G., Berendschot T.T. Macular pigment optical density measurements: Evaluation of a device using heterochromatic flicker photometry. Eye (Lond.) 2011;25:105–112. doi: 10.1038/eye.2010.164.
    1. Bone R.A., Landrum J.T., Hime G.W., Cains A., Zamor J. Stereochemistry of the human macular carotenoids. [(accessed on 7 April 2020)];Investig. Ophthalmol. Vis. Sci. 1993 34:2033–2040. Available online: .
    1. Scripsema N.K., Dan-Ning H., Rosen R.B. Lutein, zeaxanthin, and meso-zeaxanthin in the clinical management of eye diseases. J. Ophthalmol. 2015;2015:865179. doi: 10.1155/2015/865179.
    1. Howells O., Eperjesi F., Bartlett H. Measuring macular pigment optical density in vivo: A review of techniques. Graefes Arch. Clin. Exp. Ophthalmol. 2011;249:315–347. doi: 10.1007/s00417-010-1577-5.
    1. Bone R.A., Landrum J.T., Mayne S.T., Gomez C.M., Tibor S.E., Twaroska E.E. Macular pigment in donor eyes with and without AMD: A case-control study. Investig. Ophthalmol. Vis. Sci. 2001;42:235–240.
    1. Landrum J.T., Bone R.A., Joa H., Kilburn M.D., Moore L.L., Sprague K.E. A one year study of the macular pigment: The effect of 140 days of a lutein supplement. Exp. Eye Res. 1997;65:57–62. doi: 10.1006/exer.1997.0309.
    1. Raman R., Rajan R., Biswas S., Vaitheeswaran K., Sharma T. Macular pigment optical density in a South Indian population. Investig. Ophthalmol. Vis. Sci. 2011;52:7910–7916. doi: 10.1167/iovs.11-7636.
    1. Howells O., Eperjesi F., Barlett H. Improving the repeatability of heterochromatic flicker photometry for measurement of macular pigment optical density. Graefes Arch. Clin. Exp. Ophthalmol. 2013;251:871–880. doi: 10.1007/s00417-012-2127-0.
    1. Wong W.L., Su X., Li X., Cheung C.M., Klein R., Cheng C.Y., Wong T.Y. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: A systematic review and meta-analysis. Lancet Glob. Health. 2014;2:e106–e116. doi: 10.1016/S2214-109X(13)70145-1.
    1. Wang G., Brun T.A., Geissler C.A., Parpia B., Root M., Li M., Campbell T.C., Chen J. Vitamin A and carotenoid status in rural China. Br. J. Nutr. 1996;76:809–820. doi: 10.1079/BJN19960088.
    1. Zhou H., Zhao X., Johnson E.J., Lim A., Sun E., Yu J., Zhang Y., Liu X., Snellingen T., Shang F., et al. Serum carotenoids and risk of age-related macular degeneration in a chinese population sample. Investig. Ophthalmol. Vis. Sci. 2011;52:4338–4344. doi: 10.1167/iovs.10-6519.
    1. Nolan J.M., Stack J., O’Donovan O., Loane E., Beatty S. Risk factors for age-related maculopathy are associated with a relative lack of macular pigment. Exp. Eye Res. 2007;84:61–74. doi: 10.1016/j.exer.2006.08.016.
    1. Berendschott T.T., Goldbohm R.A., Klöpping W.A., van de Kraats J., van Norel J., van Norren D. Influence of lutein supplementation on macular pigment, assessed with two objective techniques. [(accessed on 7 April 2020)];Investig. Ophthalmol. Vis. Sci. 2000 41:3322–3326. Available online: .
    1. Khachik F., de Moura F.F., Chew E.Y., Douglass L.W., Ferris F.L., Kim J., Thompson D.J.S. The effect of lutein and zeaxanthin supplementation on metabolites of these carotenoids in the serum of persons aged 60 or older. Investig. Ophthalmol. Vis. Sci. 2006;47:5234–5242. doi: 10.1167/iovs.06-0504.
    1. Koh H.H., Murray I.J., Nolan D., Carden D., Feather J., Beatty S. Plasma and macular responses to lutein supplement in subjects with and without age-related maculopathy: A pilot study. Exp. Eye Res. 2004;79:21–27. doi: 10.1016/j.exer.2004.03.001.
    1. Trieschmann M., Beatty S., Nolan J.M., Hense H.W., Heimes B., Austermann U., Fobker M., Pauleikhoff D. Changes in macular pigment optical density and serum concentrations of its constituent carotenoids following supplemental lutein and zeaxanthin: The LUNA study. Exp. Eye Res. 2007;84:718–728. doi: 10.1016/j.exer.2006.12.010.
    1. Richer S., Devenport J., Lang J.C. LAST II: Differential temporal responses of macular pigment optical density in patients with atrophic age-related macular degeneration to dietary supplementation with xanthophylls. Optometry. 2007;78:213–219. doi: 10.1016/j.optm.2006.10.019.
    1. Loughman J., Nolan J.M., Howard A.N., Connolly E., Meagher K., Beatty S. The impact of macular pigment augmentation on visual performance using different carotenoid formulations. Investig. Ophthalmol. Vis. Sci. 2012;53:7871–7880. doi: 10.1167/iovs.12-10690.
    1. Age-Related Eye Disease Study 2 Research Group Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: The Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. JAMA. 2013;309:2005–2015. doi: 10.1001/jama.2013.4997.
    1. Johnson E.J., Vishwanathan R., Rasmussen H.M., Lang J.C. Bioavailability of AREDS1 micronutrients from softgel capsules and tablets: A pilot study. Mol. Vis. 2014;20:1228–1242.
    1. Jaiswal M., Dudhe R., Sharma P.K. Nanoemulsion: An advanced mode of drug delivery system. 3 Biotech. 2015;5:123–127. doi: 10.1007/s13205-014-0214-0.
    1. Hendler S., Guardion Health Sciences LLC Emulsion of Carotenoids and Ocular Antioxidants. US Patent 0189446A1. 2017 Jul 6;
    1. Lim C., Kim D., Sim T., Hoang N.H., Lee J.W., Lee E.S., Youn Y.S., Oh K.T. Preparation and characterization of lutein loading nanoemulsion system for ophthalmic eye drops. J. Drug Delivery Sci. Technol. 2016;36:168–174. doi: 10.1016/j.jddst.2016.10.009.
    1. Bone R.A., Mukherjee A. Innovative Troxler-free measurement of macular pigment and lens density with correction of the former for the aging lens. J. Biomed. Opt. 2013;18:107003-1–107003-8. doi: 10.1117/1.JBO.18.10.107003.
    1. Olive K.A., Agashe K., Amsler C., Antonelli M., Arguin J.-F., . Asner D.M., Baer H., Band H.R., Barnett R.M., Basaglia T., et al. Particle data group—Introduction. Chin. Phys. C. 2014;38:11–17.
    1. Thurman S.M., Davey P.G., McCray K.L., Paronian V., Seitz A.R. Predicting individual contrast sensitivity function from acuity and letter contrast sensitivity measurement. J. Vis. 2016;16:15. doi: 10.1167/16.15.15.
    1. Maniglia M., Thurman S.M., Seitz A.R., Davey P.G. Effect of varying levels of glare on contrast sensitivity measurements of young healthy individuals under photopic and mesopic vision. Front. Psychol. 2018;9:899. doi: 10.3389/fpsyg.2018.00899.
    1. Vector Vision, Inc. Normal Contrast Sensitivity Values for CSV-1000 2018. [(accessed on 30 December 2018)]; Available online:
    1. Shyam R., Gorusupudi A., Nelson K., Horvath M.P., Bernstein P.S. RPE65 has an additional function as the lutein to meso-zeaxanthin isomerase in the vertebrate eye. Proc. Natl. Acad. Sci. USA. 2017;114:10882–10887. doi: 10.1073/pnas.1706332114.
    1. Nolan J.M., Meagher K., Kashani S., Beatty S. What is mesozeaxanthin, and where does it come from? Eye. 2013;27:899–905. doi: 10.1038/eye.2013.98.
    1. Prado-Cabrero A., Beatty S., Howard A., Stack J., Bettin P., Nolan J.M. Assessment of lutein, zeaxanthin and meso-zeaxanthin concentrations in dietary supplements by chiral high-performance liquid chromatography. Eur. Food Res. Technol. 2016;242:599–608. doi: 10.1007/s00217-015-2569-9.
    1. Liu R., Wang T., Zhang B., Qin L., Wu C., Li Q., Ma L. Lutein and zeaxanthin supplementation and association with visual function in age-related macular degeneration. Investig. Ophthalmol. Vis. Sci. 2014;56:252–258. doi: 10.1167/iovs.14-15553.
    1. Kijlstra A., Tian Y., Kelly E.R., Berendschot T.T. Lutein: More than just a filter for blue light. Prog. Retin Eye Res. 2012;31:303–315. doi: 10.1016/j.preteyeres.2012.03.002.
    1. Weigert G., Kaya S., Pemp B., Sacu S., Lasta M., Werkmeister R.M., Dragostinoff N., Simader C., Garhöfer G., Schmidt-Erfurth U., et al. Effects of lutein supplementation on macular pigment optical density and visual acuity in patients with age-related macular degeneration. Investig. Ophthalmol. Vis. Sci. 2011;52:8174–8178. doi: 10.1167/iovs.11-7522.
    1. Ma L., Yan S.F., Huang Y.M., Lu X.R., Qian F., Pang H.L., Xu X.R., Zou Z.Y., Dong P.C., Xiao X., et al. Effect of lutein and zeaxanthin on macular pigment and visual function in patients with early age-related macular degeneration. Ophthalmology. 2012;119:2290–2297. doi: 10.1016/j.ophtha.2012.06.014.

Source: PubMed

3
구독하다