Associations Between Age–Related Nuclear Cataract and Lutein and Zeaxanthin in the Diet and Serum in the Carotenoids in Age–Related Eye Disease Study (CAREDS), an Ancillary Study of the Womens Health Initiative

Abstract

Purpose: : To examine the relationship between lutein and zeaxanthin in the diet and serum and prevalence of age–related nuclear cataract in older women.

Methods: : Women’s Health Initiative Observational Study participants aged 50 y+, at 3 sites, who reported high (above the 78th percentile) or low (below the 28th percentile) intakes of lutein and zeaxanthin on their baseline food frequency questionnaire (1994–1998) were recruited approximately 5 years later (2001–2003) to participate in the Carotenoids in Age–Related Eye Disease Study (n=1,802). Nuclear cataract was determined from grading of slit–lamp lens photographs and defined as either a nuclear sclerosis score ≥ 4 (AREDS scale) or a history of cataract surgery in the worst eye.

Results: : Women in the high lutein intake group had a 23% lower prevalence of nuclear cataract (age–adjusted OR: 0.77; 95% Confidence Interval (CI) 0.62–0.96) compared to women in the low lutein intake group. After further adjustment for smoking status, iris pigmentation, physical activity, multivitamin use, hormone replacement therapy use, pulse pressure, and body mass index, the association was attentuated (OR (95% CI) = 0.81 (0.65–1.01)). The associations were strengthened when women in this sample were further categorized by quintiles of lutein and zeaxanthin in the diet or serum. Women in the highest vs. lowest quintile categories of diet or serum lutein+zeaxanthin were 32% less likely to have nuclear cataract (multivariable–adjusted OR (95% CI) = 0.68 (0.48–0.97), p trend = 0.051 and 0.68 (0.47–0.98), p trend = 0.046).

Conclusions: : Diets rich in lutein and zeaxanthin are moderately associated with decreased prevalence of nuclear cataract in older women.

Keywords: cataract • carotenoids/carotenoid binding proteins • nutritional factors