Lutein is a carotenoid - a natural fat-soluble pigment which determines the yellow color of fruits and vegetables.

The main function of carotenoids is the antioxidant one, i.e. they protect the cells from oxidative disturbances caused by the free radicals formed under the influence of number of environmental factors – tobacco smoke, air pollution, radiation, toxic waste, administration of certain drugs, as well as those produced in result of metabolic functions. There are more than 600 known carotenoids existing in nature, but only about 20 of them are present in the human plasma and tissues. The main carotenoids found in human body are: alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein, lycopene, zeaxanthin. Within the human body, the levels of lutein and zeaxanthin are highest in the macula of the eye, high concentrations are also observed in the retina and lower quantities are found in the eye lens. Lutein and zeaxanthin are not synthesized by the human organism and their only source is the food.

The main source of lutein are predominantly the dark green leafy vegetables. Its content varies in the different vegetables, namely: cabbage - 14.4 mg/100 g; spinach - 7.4 mg/100 g; parsley - 5.8 mg/100 g; leafy greens - 4.4 mg/100 g; broccoli - 1.9 mg/100 g.

In 2004 a Scientific Expert Committee of FAO determined the minimum acceptable levels for daily intake of lutein at 2 mg per kg body weight or for one individual weighting 70 kg this makes about 140 mg daily intake of lutein. These amounts are considered as the minimum requirement. For good eye health, the recommended daily intake of lutein with meal is 6 mg.

High lutein concentration in the eyes has an important role for healthy vision. As an antioxidant, lutein inhibits the production of free radicals and protects the eye cells from their harmful effect. The ability of lutein to absorb the light, as well as its antioxidant capabilities are quantity-dependent and also age-dependent.

Age-related macular degeneration is one of the leading causes of vision impairment and blindness in both the developed and developing countries. There is reliable evidence about the link between the amount of lutein in the macula / determining the density of macular pigment/ and the risk of age-related macular degeneration.

The density of the macular pigment depends to a high extent on the dietary intake of lutein. Many scientific studies have shown that the density of macular pigment increased in parallel with the consumption of high amount of lutein. Lutein-rich food diet (60 g spinach daily) has been compared with the intake of dietary supplements containing high amounts of purified lutein in doses 10-30 mg daily and such with low amount of lutein -2.4 mg / day. Studies have proven that high doses of lutein (30 mg/day) caused significant increase of the macular pigment density. Following the intake of lutein (with food or in the form of supplements), the eyes not only accumulate the received lutein, but also are able to retain the accumulated lutein, and the latter retention process is longer when taking higher doses of lutein - 10-30 mg daily.

Numerous scientific research studies on the role of lutein have been conducted so far. The main conclusions made by experts are the following:

• Individuals suffering from age-related macular degeneration have lower levels of lutein in the macula;
• lutein protects the retina by blocking the damaging effects of blue light;
• Antioxidant function of lutein may reduce the progression of age-related macular degeneration;
• Lutein-rich diet improves the functions of the eye and visual acuity in patients with age-related macular degeneration;
• Lutein supplementation increases its own serum levels and also promotes the density of the macular pigment. This effect is more pronounced when taking higher doses of lutein (10-30 mg / day).
• Lutein is specifically deposited in the lens of the eye;
• Lutein reduces the risk of developing cataracts;
• Lutein-rich diet may slow the development of cataracts.

Several studies have confirmed the important role played by lutein in supporting the visual health and the interdependence between the lutein intake and the reduction of the risk of age-related macular degeneration and cataract development. Based on data obtained from a study of the normal intake of dietary lutein, experts recommend the consumption of foods rich in lutein and intake of dietary supplements containing high levels of lutein (10-30 mg /day). The provision of adequate plasma levels of lutein reduces the risk of developing the age-related macular degeneration and cataracts, improves visual acuity, contributes for the better protection of the eyes from the harmful effects of the environment and helps reducing the negative effects of fatigue and aging on the eyes.

Assoc. Prof. Dr. Veselka Duleva, MD
Specialist in Nutrition and Dietetics

The eyes are undoubtedly the most sensitive and delicate part of our body. They are a window to the world and are responsible for four fifths of the information our brain receives. Age-related macular degeneration is one of the main reasons for loss of vision in people over 50 years. Macula / patch / is a small circular area in the center of the retina. After a certain age this area begins to suffer. There are two forms of age-related macular degeneration (AMD). Dry-form - 85-90% of all cases. Wet form - 10-15% of all cases. The latter form of macular degeneration - which is age-associated – leads to about 90% of all cases of vision loss.

Normal macula.	Age-related macular degeneration

The age-related macular degeneration (AMD) affects the macula, which is responsible for the central vision. There are three forms of AMD - early, intermediate and advanced.

Normal vision	Advanced form

Which are the risk factors and how can we prevent the disease.

No effective therapy against age-related macular degeneration /AMD/ has been discovered thus far.

Smoking is one of the main risk factors. With smokers a significant loss of the pigment lutein in the macula is observed.

Obesity is another major risk factor – there is a co-relationship between the body mass index and the occurrence of age-related macular degeneration.

Hypertension and the cardiovascular diseases also contribute to the occurrence of degenerative changes in the macula.

There is also the gender factor - there are more women than men who suffer from age-related macular degeneration, which may be due to the fact that women live longer.

The visible light rays, like infrared rays have larger wave-length and lower energy charge. They exert thermal effect. The ultraviolet rays have a shorter wavelength and have chemical effects. Only a small number of these rays reach the retina and they are mostly localized at the level of cornea.

In the macula there are two important carotenoid / organic pigments / - lutein and zeaxanthin which give their yellow color. These are the so-called macular pigment. They protect the eye from the photo-oxidative effects caused by strong light. The high levels of macular pigment protect the eye from ultraviolet and infrared light, as well as the artificial light sources, computer and TV screen radiation. The lutein in its role of an antioxidant protects the cells from the striking effect of the free radicals, and acts as a filter for the macula, retina and lens. Free radicals are natural by-products and are produced by metabolic processes in the body. They can damage and destroy cells in our body. The antioxidant role of lutein is to find and destroy (neutralize) the free radicals.

Many leading research institutes around the world have discovered that the regular intake of antioxidants and vitamins significantly reduces the risk of age-related macular degeneration. The intake of high lutein doses (at least 3 mg per day) decreased the risk of macular degeneration by about 45%.

The regular intake of lutein contributes for the good eyesight.

Dr. G. Minkov

Specialist in Ophthalmology

The lutein complex enriched with bilberries is even more effective. What made Lutein Complex attractive to you as an expert in the field? "The results observed on my patients are truly exceptional. I am convinced as a specialist in the properties of Lutein Complex and recommend it for macular degeneration, cataracts and other eye diseases. Now Lutein Complex includes bilberry extract, which strengthens the capillaries and accelerates the regeneration of visual pigments in the cells of the retina. Bilberry is the most effective natural product to improve vision. It contains elements of the group of flavonoids and vitamin A which increases the adaptive capacity of the eye to light, resulting in increased visual acuity at different levels of illumination. Furthermore, bilberry reduces the possibility of clot formation, strengthens and improves the circulatory vessels activity - effects, especially important for the welfare of the retina. Therefore, I recommend the new Lutein Complex in patients with diabetes and high blood pressure because of their high risk of eye diseases."