Lutein is found in a variety of vegetables, especially leafy greens like spinach and broccoli, but also in lettuce, tomatoes, oranges and orange juice, carrots, celery, egg yolks, corn, and summer squash.  Studies have found decreases in a variety of cancers, cataracts, and macular degeneration in people with higher dietary intakes of lutein.  Lutein supplements are now available but only one controlled study of their use in humans was found in my search.  The supplement did successfully decrease age-related cataracts.  It appears very wise to get a good dietary intake.  Lutein supplement is inexpensive, but doesn't seem indicated at this time except in someone developing cataracts or for someone who hates vegetables.  I recommended a serving of spinach, green peas, broccoli, or greens every day.

Lutein in Diet

Cancer: No Association Vegetables and Breast or Colon Cancer in Large Prospective Study: 56,000 women in Canadian Breast Cancer Study.

Cancer: Carotenoid Vegetables Decrease Cancer & Death in Japan Prospective: 949 males and 1495 females Hokkaido, Japan. In 9 yr f/u, 146 subjects died, with cancer 76. Serum collected at entry of beta- and alpha-carotenes, lycopene, beta-cryptoxanthin, canthaxanthin, zeaxanthin/lutein, tocopherols, and retinol. Age- and gender-adjusted hazard ratios of the groups with high serum levels of lycopene, beta-carotene, zeaxanthin/lutein, and total carotenoids compared to those with low serum levels were 0.36, 0.53, 0.73, and 0.52 for cancers of all sites, and 0.44, 0.59, 0.61, and 0.50 for all causes, respectively. Similar after adjusting for gender, age, smoking habits, alcohol consumption, and serum levels of total cholesterol and glutamic pyruvic transaminase (GPT) activity. Moreover, after excluding mortality within the first three years of follow-up, the hazard ratios of subjects with high serum levels of lycopene, total carotenes, and total carotenoids were significantly and inversely associated with subsequent mortality from all causes and cancers of all sites after adjusting for gender, age, and serum levels of total cholesterol, alpha-tocopherol, and retinol. However, high serum levels of tocopherols and retinol did not help. Serum antioxidants and subsequent mortality rates of all causes or cancer among rural Japanese inhabitants. Ito Y, Suzuki K, Suzuki S, Sasaki R, Otani M, Aoki K. Int J Vitam Nutr Res 2002 Jul;72(4):237-50

Cancer: Spinach, Lettuce, Apples for Breast Cancer: A case-control study of 198 with breast CA and 95 foods found adjusted odds ratio for the consumption of more than one slice of onion per day and BC was 0.27 (95% confidence interval = 0.16-0.47), with a statistically significant trend (p < 0.001). This protective effect remained after adjustment for known risk factors of BC. Among premenopausal women, there was also a protective and significant effect due to the intake of lettuce and spinach and nonsignificant protective effects for the consumption of apples and herbal tea. Nutr Cancer 2000;37(2):134-9

Cancer: Yogurt, Green Leafy Vegetables Lower Colorectal Cancer Risk: In a 9.9 year prospective study of 45,181 men and 62,643 women ages 40-79 in the Japan Collaborative Cohort Study. Between 1988 and 1990, 457 died of colon or rectal cancer. Eating green leafy vegetables was linked to a 40% decreased risk (HR = 0.6; p = 0.02]. Yogurt was linked to a 50% decrease in male rectal cancer mortality (HR = 0.5; p = 0.04). Egg consumption was associated with an increase male colon cancer mortality (P = 0.04). Women with high fruit consumption had increased colon cancer mortality (HR = 1.6; p = 0.04). Diet and colorectal cancer mortality: results from the Japan Collaborative Cohort Study. Kojima M, Wakai K,  Nagoya City University Graduate School of Medical Sciences, Mizuho, Nagoya, Japan. Nutr Cancer. 2004;50(1):23-32.

Dementia: Blueberries, Spinach Help Rats: Rats fed a diet rich in spinach reversed a normal loss of learning that occurs with age, according to a study by researchers at the University of South Florida. The study was presented at the Society for Neuroscience's annual meeting in San Diego. Rats fed a normal diet that contained 2 percent freeze-dried spinach. Blueberries are also rich in antioxidants. A study by researchers at the University of Houston at Clear Lake and the Universidad Nacional Autonoma de Mexico found that blueberries may help fight age-related declines in rats' memories. Aging rats that were fed a blueberry-supplemented diet for four months tested as well as younger rats in their abilities to recognize objects after an hour. Aging rats fed a normal diet failed to recognize the objects. This complete deficit was fully alleviated by diet. 11/13/01

Dementia: Spinach, Spirulina Help, Apples Help Some, Cucumbers Not at All: Two studies published 7/15/02. J Neurosciences found rats 6 weeks on spinach at 2% of chow had reversal of aging effects. Aged rats fed either spirulina-or apple-enriched diets for two weeks demonstrated improved neuron function, a suppression of inflammatory substances in the brain, and a decrease in malondialdehyde (MDA), a marker for oxidative damage. In fact, spirulina reversed the impairment in adrenergic neural function normally associated with aging. U S. Fla. 

Heart: Lutein May be Protective Salad Factor: 500 carotenoids red to yellow pigments. Beta carotene, most abundant in human blood, may offer no heart protection. Lutein in yolks, corn, summer squash and especially dark-green veggies like spinach and broccoli. USC studies. Monocytes contentrate yellow lutein. Carotids of 480 middle-aged before and after 18 mo. Highest lutein quartile showed no increase in thickening of artery walls and lower groups showed progressively more. Lutein protected arteries of susceptible mice. Decreases LDL oxidation of walls. Sci News 6/23/01

Cancer: Lutein Protects Against Colon Cancer: In a large case-control U.S. study, lutein was inversely associated with colon cancer in both men and women [odds ratio (OR) for upper quintile vs. lowest quintile of intake: 0.83; P = 0.04]. The greatest inverse association was observed among subjects in whom colon cancer was diagnosed when they were young (OR: 0.66; P = 0.02) and among those with tumors located in the proximal segment of the colon (OR: 0.65; P < 0.01). The associations with other carotenoids were unremarkable. The major dietary sources of lutein in subjects with colon cancer and in control subjects were spinach, broccoli, lettuce, tomatoes, oranges and orange juice, carrots, celery, and greens. Am J Clin Nutr 2000 Feb;71(2):575-82

Cancer: Carrots & Spinach Fight Breast Cancer: case-control study of breast cancer risk conducted in Maine, Massachusetts, New Hampshire, and Wisconsin in 1988-1991. Multivariate-adjusted models were fit to data for 3543 cases and 9406 controls. Eating carrots or spinach more than twice weekly, compared with no intake, was associated with an odds ratio of 0.56. Cancer Epidemiol Biomarkers Prev 1997 Nov;6(11):887-92. The supplementation of the diet with tomato, carrot or spinach products resulted in a significant decrease in endogenous levels of strand breaks in lymphocyte DNA. Oxidative base damage was significantly reduced during the carrot juice intervention. Carcinogenesis 1997 Sep;18(9):1847-50

Cancer: Spinach, Tofu Help Stomach Cancer: Stomach cancer Korea’s most prevalent cancer. case-control study increased risk from broiled meats and fishes, salted side dishes (salted/fermented fish products) and salty stewed foods, such as soybean paste thick stew. Frequent consumption of mung bean pancake, tofu, cabbage, spinach and sesame oil decreased the risk. For meat and fish, pan frying was associated with decreased risk, whereas stewing or broiling was associated with increased risk. Pickled vegetables increased the risk, whereas fresh vegetables did not. In a recent cohort study in Seoul, green vegetables and soybean foods were associated with a decreased risk of stomach cancer. Case-control and cohort studies have reported that ginseng intake decreased the risk of gastric cancer. : Int J Cancer 1997;Suppl 10:7-9

Cancer: Pickled Foods Bad, Greens Good Against Bladder Cancer: 130 cases with matched controls in Croatia = risk factors of bladder cancer were smoking habits (OR = 3.15), consumption of animal fats (RR = 2.10) and pickled food (RR = 21.28). Higher level of educational (RR = 0.51), frequent urination (RR = 0.21), consumption of greens (RR = 0.10), cherry (RR = 0.03) and tangerines (RR = 0.02) Srp Arh Celok Lek 2001 Jul-Aug;129(7-8):180-2

Cancer: Chlorophyll Reduces Aflatoxin-DNA Adducts: DB Chinese study in area of high hepatocellular CA found 55% decrease in adducts. Proc Natl Acad Sci U S A 2001 Dec 4;98(25):14601-6

Cataracts: Lutein Associated with Fewer Cataracts: Modestly lower risk of cataract extraction in men with higher intakes of lutein and zeaxanthin but not of other carotenoids (alpha-carotene, beta-carotene, lycopene, and beta-cryptoxanthin) or vitamin A after other potential risk factors, including age and smoking, were controlled for. Men in the highest fifth of lutein and zeaxanthin intake had a 19% lower risk of cataract relative to men in the lowest fifth (relative risk: 0.81; P = 0.03). Among specific foods high in carotenoids, broccoli and spinach were most consistently associated with a lower risk of cataract. Harvard health professional study of 36400. Am J Clin Nutr 1999 Oct;70(4):517-24

Cataracts: Lutein Fewer Cataracts in Nurses: After age, smoking, and other potential cataract risk factors were controlled for, those with the highest intake of lutein and zeaxanthin had a 22% decreased risk of cataract extraction compared with those in the lowest quintile (relative risk: 0.78; 95% CI: 0.63, 0.95; P for trend = 0.04). Other carotenoids (alpha-carotene, beta-carotene, lycopene, and beta-cryptoxanthin), vitamin A, and retinol were not associated with cataract in multivariate analysis. Increasing frequency of intakes of spinach and kale, foods rich in lutein, was associated with a moderate decrease in risk of cataract. U Mass 12 year follow-up of 50,461 RNs. Am J Clin Nutr 1999 Oct;70(4):509-16

Endometriosis: Green Vegetables and Fruit Good; Mammal Meat Bad: In two case-control studies from Northern Italy of 504 women under age 65 with a laparoscopically confirmed endometriosis, compared to women in the lowest tertile of intake, a higher intake of green vegetables [odds ratio (OR) = 0.3 for the highest tertile of intake] and fresh fruit (OR = 0.6) reduced the risk, whereas an increase in risk was associated with high intake of beef and other red meat (OR = 2.0) and ham (OR = 1.8). Consumption of milk, liver, carrots, cheese, fish and whole-grain foods, as well as coffee and alcohol consumption, were not significantly related to endometriosis. Selected food intake and risk of endometriosis. Parazzini F, Chiaffarino F, et al. Universita di Milano, Italy. Hum Reprod. 2004 Aug;19(8):1755-9. Ed: Fortunately, this is exactly the diet that is good in general.  Humans should not eat mammal meat since mammals are close relatives and eating close relatives is bad for your health.

Heart: Carotenoids & Tocopherols Didn’t Help Against Heart Attacks: Harvard’s medical professionals study with 13 years follow-up had 534 heart attack patients and compared these to matched controls. Blood levels of 5 major carotenoids (alpha- and beta-carotene, beta-cryptoxanthin, lutein, and lycopene), retinol, and alpha- and gamma-tocopherol) were not protective. Plasma carotenoids and tocopherols and risk of myocardial infarction in a low-risk population of US male physicians. Hak AE, Stampfer MJ, Campos H, Sesso HD, Gaziano JM, Willett W, Ma J. Circulation. 2003 Aug 19;108(7):802-7. 

Heart: Lutein Doesn’t Help Heart, Carotene Does: 73,286 female nurses 12 years of follow-up developed 998 incident cases of coronary artery disease. After adjustment for age, smoking, and other CAD risk factors, there was no significant relation with intakes of lutein/zeaxanthin, lycopene, or beta-cryptoxanthin. For highest compared to lowest quintile, relative risks for beta-carotene and alpha-carotene were 0.74 and 0.80. Harvard, Dietary carotenoids and risk of coronary artery disease in women. Osganian SK, Stampfer MJ, Rimm E, Spiegelman D, Manson JE, Willett W. Am J Clin Nutr. 2003 Jun;77(6):1390-9

Heart: Lutein Clears Arteries: Study of 480 found clearer carotids in those with higher lutein blood levels. Circ 103:2922 ’01.

Macular Degeneration: Lutein Improves Vision in Age-related Macular Degeneration:  In a DB PC 12-month trial, 90 patients with ARMD were randomized to 10 mg lutein alone, 10 mg lutein plus antioxidants/vitamins and minerals, or placebo. Low intake of lutein, the primary dietary carotenoid xanthophyll pigment responsible for macula pigment optical density (MPOD) in primates, is a major risk factor for advanced ARMD. In both lutein-treated groups, MPOD increased approximately 0.09 log units from baseline, and contrast sensitivity improved. Snellen equivalent visual acuity improved 5.4 letters in the lutein-only group and 3.5 letters in the lutein/antioxidant group. Stuart Richer. Optometry. 4/2004;75(4):1-15

Macular Degeneration: Spinach Helps Prevent Macular Degeneration: The highest quintile of carotenoid intake had a 43% lower risk for AMD compared with those in the lowest quintile (odds ratio, 0.57; 95% confidence interval, 0.35 to 0.92; P for trend = .02). Among the specific carotenoids, lutein and zeaxanthin, which are primarily obtained from dark green, leafy vegetables, were most strongly associated with a reduced risk for AMD (P for trend = .001). Several food items rich in carotenoids were inversely associated with AMD. In particular, a higher frequency of intake of spinach or collard greens was associated with a substantially lower risk for AMD (P for trend Ç .001). The intake of preformed vitamin A (retinol) was not appreciably related to AMD. Neither vitamin E nor total vitamin C consumption was associated with a statistically significant reduced risk for AMD. Mass Eye Inst. JAMA 1994 Nov 9;272(18):1413-20

Macular Degeneration: Lutein in Macula: The macular region of the primate retina is yellow in color due to the presence of the macular pigment, composed of two dietary xanthophylls, lutein and zeaxanthin, and another xanthophyll, meso-zeaxanthin. The latter is presumably formed from either lutein or zeaxanthin in the retina. By absorbing blue-light, the macular pigment protects the underlying photoreceptor cell layer from light damage, possibly initiated by the formation of reactive oxygen species during a photosensitized reaction. There is ample epidemiological evidence that the amount of macular pigment is inversely associated with the incidence of age-related macular degeneration, an irreversible process that is the major cause of blindness in the elderly. The macular pigment can be increased in primates by either increasing the intake. Biologic Mechanisms of the Protective Role of Lutein and Zeaxanthin in the Eye. Krinsky NI, Landrum JT, Bone RA. Tufts Univ., Annu Rev Nutr 2003 Feb 27

Liver: Iron Bad; Carotenoids Protect Against Liver Damage: 13,605 adults in third U.S. National Health and Nutrition Examination Survey (NHANES III), phlebotomy. Exclusions included excessive alcohol consumption, hepatitis B and C, and iron overload. Elevated ALT levels were found in 3.1%. In multivariate logistic regression analyses, elevated ALT with increasing deciles of transferrin saturation (odds ratio [OR] per decile, 1.10) and iron concentration (OR, 1.13). Abnormal ALT level was associated negatively with increasing deciles of alpha carotene (OR, 0.82), beta carotene (OR, 0.91), beta cryptoxanthin (OR, 0.91), lutein/zeaxanthin (OR, 0.90), and a variable combining the 5 carotenoid measures (OR, 0.89). Vitamin C was associated inversely, but only at the highest concentrations. Relation of elevated serum alanine aminotransferase activity with iron and antioxidant levels in the United States. Ruhl CE, Everhart JE. Gastroenterology. 2003 Jun;124(7):1821-

Peas, Cabbage, Spinach High in Grass Juice Factor: U Wisc animal research from 1930s (wheatgrass.com). Chlorophyll very similar to heme except with Mg instead of Fe and two different side groups. Greens a good addition to iron for iron deficiency anemia. Chlorophyll and greens good for wound healing. Chlorophyll good deodorant. Chlorophyll greens good against cancer and better than Vit A, E, C in animal studies. Darker green broccoli and greens better than light green cabbage. Supposedly proven of value against infections including sinus, vaginal, dental, endocarditis. Topical chlorophyll for decubiti, fractures, itching, sores, osteomyelitis, burns, peptic ulcers. Chlorophyll implants for ulcerative colitis. Pancreatitis. Decrease fecal odor, tabs for colostomies, bowel regularity. wheatgrass.com. However, DB study found no benefit for colostomy odor. Ugeskr Laeger 1989 Jul 3;151(27):1753-4. Also no benefit for incontinent elderly odor. Drug Intell Clin Pharm 1983 Oct;17(10):732-4

Cataracts Improved on Lutein Supplement in DB: A 2 year Spanish PC DB study of patients with age-related cataracts given 15 mg lutein or 100 mg alpha-tocopherol or placebo 3 times a week found visual improvement with the lutein and cataract progression with placebo. Lutein, but not alpha-tocopherol, supplementation improves visual function in patients with age-related cataracts: a 2-year double-blind, placebo-controlled pilot study. Olmedilla B, Granado F, Blanco I, Vaquero M. Nutrition. 2003 Jan;19(1):21-

Cost of Supplements: Lutein 6 mg and 20 mg capsules are available.  The 6 mg capsules cost $20 for 400 from one source in 2003.