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Suzen M. Moeller, PhD; Rick Voland, PhD; Lesley Tinker, PhD; Barbara A. Blodi, MD; Michael L. Klein, MD; Karen M. Gehrs, MD; Elizabeth J. Johnson, PhD; D. Max Snodderly, PhD; Robert B. Wallace, MD; Richard J. Chappell, PhD; Niyati Parekh, RD(India), PhD; Cheryl Ritenbaugh, PhD, MPH; Julie A. Mares, PhD; for the CAREDS Study Group

Arch Ophthalmol. 2008;126(3):354-364.

Objective  To evaluate associations between nuclear cataract (determined from slitlamp photographs between May 2001 and January 2004) and lutein and zeaxanthin in the diet and serum in patients between 1994 and 1998 and macula between 2001 and 2004.

Design  A total of 1802 women aged 50 to 79 years in Iowa, Wisconsin, and Oregon with intakes of lutein and zeaxanthin above the 78th (high) and below the 28th (low) percentiles in the Women's Health Initiative Observational Study (1994-1998) were recruited 4 to 7 years later (2001-2004) into the Carotenoids in Age-Related Eye Disease Study.

Results  Women in the group with high dietary levels of lutein and zeaxanthin had a 23% lower prevalence of nuclear cataract (age-adjusted odds ratio, 0.77; 95% confidence interval, 0.62-0.96) compared with those with low levels. Multivariable adjustment slightly attenuated the association (odds ratio, 0.81; 95% confidence interval, 0.65-1.01). Women in the highest quintile category of diet or serum levels of lutein and zeaxanthin as compared with those in the lowest quintile category were 32% less likely to have nuclear cataract (multivariable-adjusted odds ratio, 0.68; 95% confidence interval, 0.48-0.97; P for trend = .04; and multivariable-adjusted odds ratio, 0.68; 95% confidence interval, 0.47-0.98; P for trend = .01, respectively). Cross-sectional associations with macular pigment density were inverse but not statistically significant.

Conclusions  Diets rich in lutein and zeaxanthin are moderately associated with decreased prevalence of nuclear cataract in older women. However, other protective aspects of such diets may in part explain these relationships.

Author Affiliations: Departments of Ophthalmology and Visual Sciences (Drs Moeller, Voland, Blodi, Parekh, and Mares), Statistics and Biostatistics (Dr Chappell), and Nutritional Sciences (Dr Parekh), University of Wisconsin, Madison; Fred Hutchinson Cancer Research Center, Seattle, Washington (Dr Tinker); Casey Eye Institute, Oregon Health and Science University, Portland (Dr Klein); Departments of Ophthalmology and Visual Sciences (Dr Gehrs) and Epidemiology (Dr Wallace), University of Iowa, Iowa City; Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts (Dr Johnson); Medical College of Georgia, Augusta (Dr Snodderly); and Department of Family and Community Medicine, University of Arizona, Tucson (Dr Ritenbaugh). Dr Moeller is now with the Department of Science, Quality, and Public Health, American Medical Association, Chicago, Illinois. Dr Snodderly is now with the Department of Human Ecology, University of Texas at Austin. Dr Parekh is now with the Department of Nutrition, Food Studies, and Public Health, New York University, New York, New York.

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