Carotenoids: lutein, zeaxanthin and lycopene

Q: What are lutein, zeaxanthin and lycopene?

They are carotenoid plant pigments. Lutein and zeaxanthin are yellow pigments in leafy greens, peas and corn; lycopene is the red pigment in tomatoes and watermelon. They are not essential nutrients.

Q: Which foods have the most lutein and zeaxanthin?

By USDA data, boiled spinach (about 20.4 mg per cup), boiled collard greens (about 11.8 mg), boiled kale (about 5.9 mg) and boiled green peas (about 4.1 mg) are rich sources. A large egg has about 0.2 mg.

Q: Which foods have the most lycopene?

By USDA data, canned tomato sauce (about 34.0 mg per cup), canned tomato juice (about 22.0 mg per cup), diced watermelon (about 6.9 mg per cup) and chopped raw tomato (about 4.6 mg per cup).

Q: Does fat help absorb these pigments?

Yes, in one small trial. Seven adults absorbed almost no carotenoid from a salad with fat-free dressing, and more with more fat in the dressing. The trial measured lycopene and carotenes.

Q: Do lutein and zeaxanthin help macular degeneration?

Only in people who already have it, and mainly as part of a formula. AREDS2 did not show a clear extra benefit in its main result, but a 10-year follow-up was slightly in favour. Cochrane rates the evidence for the pigments alone as low-certainty.

Q: Can they prevent macular degeneration?

No trial shows this. The National Eye Institute says AREDS and AREDS2 supplements do not prevent AMD from starting.

Q: Do they help cataracts?

Cohort studies link higher lutein and zeaxanthin intake to fewer cataracts, but supplement trials have not shown a benefit, and the National Eye Institute says the AREDS2 supplements had no effect on cataract.

Q: Is lycopene good for the heart?

Reviews disagree. A 2017 review found lower LDL cholesterol and blood pressure with tomato and lycopene; a 2023 review found no change in most markers. No trial of heart attacks was read.

Q: Does lycopene prevent prostate cancer?

Not shown. Observational studies link higher lycopene to about 12% lower prostate cancer risk, but lycopene pills did not change PSA overall in six trials.

Q: Does lycopene protect skin from the sun?

In small trials in healthy people, tomato and lycopene lowered skin redness after UV light. It does not replace sunscreen.

Lutein, zeaxanthin and lycopene (carotenoids) · also called Macular pigment carotenoids, xanthophylls, tomato red pigment

Lutein, zeaxanthin and lycopene are plant pigments found in leafy greens and in tomatoes. They are not essential nutrients. The best evidence is for eye health: an eye-vitamin formula containing lutein and zeaxanthin slows late macular degeneration in people who already have it, though the pigments' own benefit is low-certainty. Lycopene evidence for the heart, prostate and skin is weaker or mixed. The real harm seen in trials was from beta-carotene pills in smokers, a different carotenoid.

General information, not medical advice. Last substantive update October 26, 2026 · Not medically reviewed. A named clinician has not signed off on this page. How this page is made

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About Carotenoids: lutein, zeaxanthin and lycopene

Lutein, zeaxanthin and lycopene are carotenoid pigments from plants. The body does not need them to avoid a deficiency disease, but eating them in food is linked to better eye and general health in observational studies. In trials, the strongest result is for an eye-vitamin formula in people who already have macular degeneration.

What these pigments are

Lutein and zeaxanthin are yellow pigments in leafy greens, peas, corn and eggs. Lycopene is the red pigment in tomatoes and watermelon. All three are carotenoids, a family of plant pigments that also includes beta-carotene.

Lutein, zeaxanthin and a third pigment called meso-zeaxanthin collect in the macula, the small centre of the retina. Researchers think this may protect the eye, but that is still a hypothesis. Lycopene collects in skin.

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Where they come from in food

By USDA data, lutein plus zeaxanthin per portion: boiled spinach, 1 cup (180 g), about 20.4 mg; boiled collard greens, 1 cup, about 11.8 mg; boiled kale, 1 cup, about 5.9 mg; boiled green peas, 1 cup, about 4.1 mg; raw spinach, 1 cup, about 3.7 mg; raw sweet corn, 1 cup, about 0.9 mg; one large hard-boiled egg about 0.2 mg.

Lycopene per portion: canned tomato sauce, 1 cup, about 34.0 mg; canned tomato juice, 1 cup, about 22.0 mg; diced watermelon, 1 cup, about 6.9 mg; chopped raw tomato, 1 cup, about 4.6 mg; tomato paste, 1 tablespoon, about 4.6 mg.

Fat helps the body take these pigments in. In a 2004 trial of 7 adults, almost no carotenoid was absorbed from a salad eaten with fat-free dressing, and more was absorbed with more fat. That trial measured lycopene and carotenes, not lutein.

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What the research shows for the eyes

AREDS2 tested lutein plus zeaxanthin added to an eye-vitamin formula in 4,203 people at risk of advanced macular degeneration (AMD). The main result was not significant (hazard ratio 0.90). A 10-year follow-up found a slightly lower risk of late AMD with lutein and zeaxanthin (0.91). The National Eye Institute says the AREDS and AREDS2 formulas reduce progression from intermediate to advanced AMD by about 25 percent, but do not prevent AMD from starting and do not affect cataract.

The 2023 Cochrane review rates the whole antioxidant formula as moderate-certainty evidence, and lutein and zeaxanthin alone as low-certainty. Reviews of small trials also link the pigments to higher macular pigment density and slight gains in contrast sensitivity, but reviewers call this low-quality evidence.

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What the research shows for lycopene

Two reviews of trials disagree on the heart. A 2017 review found lower LDL cholesterol with tomato products and lower systolic blood pressure with lycopene pills. A 2023 review of 34 trials found no change in most heart risk factors.

In observational studies, higher lycopene intake and blood levels are linked to lower prostate cancer and overall cancer rates. In trials, lycopene did not change PSA overall. A 2024 review of 21 trials in healthy people found less skin redness after UV light with tomato and lycopene.

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Food versus pills

Most of the lutein and lycopene findings come from people who eat these pigments in food, and from blood levels. NCCIH says antioxidants taken as purified supplements might act differently than in foods. The beta-carotene lung cancer result is the best example of why food findings do not carry over to pills.

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At a glance

Traditional uses history, not proof

Natural pigments in leafy greens, corn, eggs and tomatoes
Sold as eye-health supplements (lutein and zeaxanthin) and prostate or skin supplements (lycopene)

Studied for research

Food sources and absorption, high certainty for the nutrient figures
Slowing late macular degeneration in people who already have it, low certainty for the pigments themselves
Contrast and glare recovery, mixed
Heart risk factors (lycopene), mixed
Cataract, prostate, overall cancer risk and skin redness after UV, low to very-low certainty
Preventing macular degeneration in healthy eyes, insufficient evidence

Main compounds

Lutein
Zeaxanthin
Meso-zeaxanthin
Lycopene

Common forms

Food sources (spinach, kale, collards, peas, corn, eggs, tomatoes, watermelon)
Lutein and zeaxanthin capsules and eye-vitamin formulas
Lycopene supplements and tomato products

Research links: 2013 AREDS2 trial: lutein and zeaxanthin for macular degeneration · 2022 AREDS2 10-year follow-up · 2023 Cochrane review: antioxidants and AMD · 2017 review: tomato, lycopene and heart risk factors · 2025 review: lycopene and cancer risk · 1996 CARET trial: beta-carotene and lung cancer · Research Library · Genes & Biomarkers Library

What it is and its history

Accepted scientific name: Not a species. Lutein, zeaxanthin and lycopene are three plant pigments of the carotenoid family. Lutein and zeaxanthin are xanthophylls (they contain oxygen); lycopene is a carotene (no oxygen).
Common names: Lutein (English); Zeaxanthin (English); Meso-zeaxanthin (English); Lycopene (English); Macular pigment carotenoids (English)
Family or group: Carotenoids (plant pigments). Not essential nutrients: the body does not need them to avoid a deficiency disease (per the existing nutrient summary; no deficiency-disease source was read).
Harvest and processing: Supplement raw materials were not researched. The nutrient summary says lycopene supplements are usually made from tomatoes.
Look-alikes and adulterants: Name: Beta-carotene; Note: A related carotenoid the body turns into vitamin A. It behaves differently: beta-carotene pills raised lung cancer in smokers. It has its own page.; Name: Astaxanthin; Note: A red carotenoid from algae, krill and salmon sold for skin and eyes. It has its own page.; Name: Vitamin A; Note: Some carotenoids, such as beta-carotene, can be turned into vitamin A in the body (NCCIH). It has its own page.
Sustainability and conservation: Not assessed.

Traditional use and history history, not clinical proof

Tradition or era	Documented use	Source
1992 to 1998: first Age-Related Eye Disease Study (AREDS)	The NEI says AREDS enrolled participants from November 1992 to January 1998 and tested antioxidants (vitamin C, vitamin E, beta-carotene) and zinc with copper for AMD and cataract.	s-nei-areds
2006 onward: AREDS2	The NEI says it launched AREDS2 in 2006 to test whether adding lutein plus zeaxanthin or omega-3 fatty acids would make the AREDS formula more effective, and to test removing beta-carotene because of the lung cancer link in smokers.	s-nei-areds
Traditional use	No traditional or historical use of these pigments as remedies was read from a source, so none is stated.

Traditional use shows how it was used. It does not show that it works or is safe today.

What is inside, and how it may work

What it contains and how those compounds act in cells and animals. Laboratory and animal mechanisms are not proven effects in people.

Main compounds

Compound	Family	Where it is concentrated	Activity studied	Level of evidence
Lutein PubChem 5281243	xanthophyll carotenoid	Dark leafy greens, peas, corn and eggs (per USDA lutein + zeaxanthin values) USDA lutein + zeaxanthin: raw spinach 12,198 ug per 100 g; boiled kale 4,983 ug per 100 g	One of the carotenoids found in the macula of the eye. Tested in AREDS2 at 10 mg a day together with zeaxanthin 2 mg. ^{21 22 1}	Human data
Zeaxanthin PubChem 5280899	xanthophyll carotenoid	Same foods as lutein (USDA lists lutein and zeaxanthin together) USDA reports lutein + zeaxanthin as a combined value	A macular carotenoid, same formula as lutein but a different arrangement of atoms. ^{21 22 1}	Human data
Meso-zeaxanthin PubChem 6442658	xanthophyll carotenoid	Not read from a source. Not read from a source.	A third carotenoid found in the macula, sold in some eye products. No trial of it alone was read. ²¹	Human data
Lycopene PubChem 446925	carotene	Tomatoes and tomato products, watermelon (USDA) USDA per 100 g: raw tomato 2,573 ug; canned tomato paste 28,764 ug; raw watermelon 4,532 ug	Gives tomatoes their red colour. Studied in trials for blood pressure, cholesterol, PSA and skin redness after UV light. ^{21 22 5 18}	Human data

Mechanisms, receptors and pathways

Target or pathway	Gene or receptor	What was found	Level
Macular pigment	Not read from a source.	Lutein, zeaxanthin and meso-zeaxanthin collect in the central retina. Reviews measure this as macular pigment optical density and found supplements raise it. Whether this protects the eye is a hypothesis. ⁸	Human data
Antioxidant activity	Not applicable	Carotenoids neutralise free radicals in laboratory tests. The trial evidence does not show that this prevents disease. A 2023 meta-analysis found lycopene lowered one oxidative stress marker (malondialdehyde) but little else. ^{17 19}	In vitro and human
Skin deposition of lycopene	Not applicable	A case report found that carotenoids from the diet collect in the outer layer of the skin and may be released in sweat. This is a single case. ¹⁵	Human case

Absorption, metabolism and elimination

Absorption: Fat helps absorption: in a 2004 crossover trial of 7 adults, almost no carotenoid appeared in the blood after salad eaten with fat-free dressing, and more with more fat. (The trial measured alpha-carotene, beta-carotene and lycopene.)
Distribution: Lutein and zeaxanthin build up in the macula; lycopene deposits in skin (case report). No further data read.
Metabolism: Not researched.
Elimination: Not researched.
Bioavailability: A 2006 dose-ranging trial found blood lutein rose with the amount taken (about 2, 3 and 4 times baseline at three amounts over 6 months). Food versus pill absorption was not compared in any source read.

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Isolated compounds versus whole extracts

Foods bring many substances together; pills give a purified pigment. NCCIH says antioxidants taken as purified chemicals might act differently than in foods, and that high doses in supplements may have different effects than the smaller amounts in foods. The harm seen with beta-carotene pills in smokers is an example. Observational links between lycopene or lutein and lower disease risk come from diet and blood levels, not pills.

Nutritional composition

Food amounts come from USDA FoodData Central SR Legacy (April 2018 release), read 2026-10-26 from a saved local copy; micrograms per 100 g, converted to mg per household portion by our arithmetic. Lutein plus zeaxanthin, per portion: boiled spinach 1 cup (180 g) about 20.4 mg; boiled collard greens 1 cup chopped (190 g) about 11.8 mg; boiled kale 1 cup (118 g) about 5.9 mg; boiled green peas 1 cup (160 g) about 4.1 mg; raw spinach 1 cup (30 g) about 3.7 mg; raw kale 1 cup (21 g) about 1.3 mg; raw sweet yellow corn 1 cup (145 g) about 0.9 mg; boiled broccoli 1/2 cup (78 g) about 0.8 mg; hard-boiled egg, 1 large (50 g) about 0.2 mg. Lycopene, per portion: canned tomato sauce 1 cup (245 g) about 34.0 mg; canned tomato juice 1 cup (243 g) about 22.0 mg; diced watermelon 1 cup (152 g) about 6.9 mg; chopped raw tomato 1 cup (180 g) about 4.6 mg; tomato paste 1 tablespoon (16 g) about 4.6 mg; ketchup 1 tablespoon (17 g) about 2.1 mg. These numbers describe foods, not how much to eat.

9benefits and uses looked at

22studies and sources checked

Moderate certaintybest evidence rating found

8lab markers tracked in trials

1 moderate certainty2 mixed findings4 low certainty1 very low certainty1 not enough evidence

What was looked at

The 9 benefits and uses checked for Carotenoids: lutein, zeaxanthin and lycopene, each with how strong the evidence is. Tap one to open it.

Food sources and how well they are absorbedModerate certainty
Slowing late macular degeneration (AMD) in people who already have intermediate AMDLow certainty
Preventing AMD in people with healthy eyesNot enough evidence
Vision measures: contrast, clarity and glare recoveryMixed findings
Heart risk factors (lycopene and tomato products)Mixed findings
Prostate health and prostate cancer (lycopene)Low certainty
Overall cancer risk (diet and blood lycopene)Very low certainty
Skin redness after sunlight (tomato and lycopene)Low certainty
Cataract (lutein and zeaxanthin)Low certainty

Lab markers tracked in the studies

Macular pigment optical density (MPOD)Blood lutein levelProgression to late AMDLDL cholesterolSystolic blood pressurePSA (prostate-specific antigen)Skin redness after UV lightMalondialdehyde (MDA)

What is Carotenoids: lutein, zeaxanthin and lycopene good for?

The main studied uses and how strong the human evidence is for each. Most eye results come from people who already have macular degeneration. Food and pills are not the same thing.

Food sources and absorptionModerate certaintyLutein and zeaxanthin are richest in dark leafy greens, and lycopene in tomatoes and watermelon. By USDA data, 1 cup of boiled spinach has about 20.4 mg of lutein plus zeaxanthin, and 1 cup of canned tomato juice about 22.0 mg of lycopene. Fat in the same meal helps the body absorb them: in one small trial almost none was absorbed from salad with fat-free dressing. Slowing late macular degeneration (in people who already have it)Low certaintyIn AREDS2, adding lutein and zeaxanthin to an eye-vitamin formula did not clearly lower progression to advanced AMD (hazard ratio 0.90, not significant). In a 10-year follow-up the risk was slightly lower (0.91). A Cochrane review rates the whole formula as moderate evidence but lutein and zeaxanthin alone as low. Preventing AMD in healthy eyesNot enough evidenceNo trial shows that these pigments stop AMD from starting. The National Eye Institute says AREDS and AREDS2 supplements do not prevent AMD onset. Contrast, clarity and glare recoveryMixed findingsSmall trials found slightly better contrast sensitivity and glare recovery, mostly in people with eye disease, but reviewers rate the evidence low quality. Lutein and zeaxanthin made little or no difference to vision loss in the Cochrane review (risk ratio 0.98). CataractLow certaintyPeople who eat more lutein and zeaxanthin had fewer cataracts in cohort studies (risk ratio 0.81), but supplement trials have not shown a benefit, and the National Eye Institute says the AREDS2 supplements had no effect on cataract. Heart risk factors (lycopene and tomato)Mixed findingsA 2017 review found lower LDL cholesterol with tomato products (-0.22 mmol/L) and lower systolic blood pressure with lycopene pills (-5.66 mmHg). A 2023 review found no significant change in most heart risk factors. No trial of heart attacks or strokes was read. Prostate health (lycopene)Low certaintyHigher lycopene intake and blood levels were linked to about 12% lower prostate cancer risk in observational studies. Lycopene pills did not change PSA overall in six trials in men with prostate cancer. Overall cancer risk (diet and blood lycopene)Very low certaintyObservational studies link higher lycopene intake and blood levels to slightly lower cancer rates. This does not show pills prevent cancer, and NCCIH says current evidence does not support antioxidant supplements for cancer prevention. Skin redness after sunlight (lycopene and tomato)Low certaintyIn small trials in healthy people, tomato products and lycopene pills lowered skin redness after UV light. They do not replace sunscreen or shade.

Benefits, one by one

Each card is a research question, not a promise. Tap a goal to filter. Open a card to see the studies, doses and limits.

Food sources and how well they are absorbed

Moderate certainty

Lutein and zeaxanthin come mostly from dark leafy greens, and lycopene mostly from tomatoes and red fruit. Fat in the same meal helps the body absorb these pigments.

2 studiesFoods and supplement forms differ. This section is about food.

Studies, doses and limits

What the trials found

USDA FoodData Central lists lutein plus zeaxanthin and lycopene for foods. A 2004 trial in 7 healthy adults found almost no carotenoid absorbed from a salad eaten with fat-free dressing, and more with more fat in the dressing.

Results

By USDA SR Legacy data, 1 cup (180 g) of boiled spinach has about 20.4 mg of lutein plus zeaxanthin, 1 cup of boiled collard greens (190 g) about 11.8 mg, 1 cup of boiled kale (118 g) about 5.9 mg, 1 cup of boiled green peas (160 g) about 4.1 mg, 1 cup of raw spinach (30 g) about 3.7 mg, 1 cup of raw sweet yellow corn (145 g) about 0.9 mg, and 1 large hard-boiled egg (50 g) about 0.2 mg. For lycopene, 1 cup (243 g) of canned tomato juice has about 22.0 mg, 1 cup (180 g) of chopped raw tomato about 4.6 mg, 1 cup (152 g) of diced watermelon about 6.9 mg, and 1 tablespoon (16 g) of tomato paste about 4.6 mg. The absorption trial measured lycopene, alpha-carotene and beta-carotene, not lutein.

Effect sizes as reported

No effect sizes apply to food amounts. In the absorption trial, absorption was negligible with fat-free dressing (P < 0.04 for reduced-fat versus fat-free; P < 0.02 for full-fat versus reduced-fat).

Why this rating

Food content figures come from a standard database (high confidence in the numbers). The fat-absorption finding comes from one small crossover trial of 7 people, so it is rated low on its own; together moderate.

Form and dose studied

Foods and supplement forms differ. This section is about food.

Who was studied

General adults; no deficiency state exists for these pigments.

Limits

USDA values are for the foods as sampled and vary by crop and cooking. The absorption trial was small and did not measure lutein.

Why researchers looked

People ask which foods supply these pigments and whether pills are needed.

Traditional use

Lutein, zeaxanthin and lycopene are plant pigments, not medicines with a traditional use. They are not essential nutrients: the body does not need them to avoid a deficiency disease. They are studied for what they might add.

Proposed mechanism Human study observation

Carotenoids are fat-soluble, so they travel with dietary fat when the gut takes them up. This is a study finding, not a full mechanism.

A proposed mechanism does not show that the effect happens in people.

Foods are not linked to harm in the sources read.

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Slowing late macular degeneration (AMD) in people who already have intermediate AMD

Low certainty

In AREDS2, adding lutein and zeaxanthin to an eye-vitamin formula did not clearly lower progression to advanced AMD overall. A 10-year follow-up and exploratory analyses suggest they are a safer swap for beta-carotene in that formula.

4 studiesThe AREDS2 formula studied lutein and zeaxanthin together with vitami…

Studies, doses and limits

What the trials found

AREDS2 randomised 4,203 people with intermediate or advanced AMD risk to lutein plus zeaxanthin, omega-3, both or placebo on top of an AREDS-type formula. The main analysis found no significant extra benefit. A 2022 10-year follow-up reported a small benefit and no extra lung cancer risk for lutein/zeaxanthin. The 2023 Cochrane review rated the formula evidence moderate but the lutein/zeaxanthin-only evidence low.

Results

Lutein and zeaxanthin were not clearly better than placebo in the main AREDS2 analysis (five-year progression 29% versus 31%). In the 10-year follow-up the risk of late AMD was slightly lower with lutein/zeaxanthin than without. The NEI says AREDS and AREDS2 supplements reduce progression from intermediate to advanced AMD by about 25 percent.

Effect sizes as reported

AREDS2 main analysis: hazard ratio 0.90 (98.7% CI 0.76 to 1.07). 10-year follow-up: hazard ratio 0.91 (0.84 to 0.99). Cochrane: lutein/zeaxanthin versus control, late AMD RR 0.94 (0.87 to 1.01), low certainty; the whole AREDS antioxidant formula, odds ratio 0.72 (0.58 to 0.90), moderate certainty.

Why this rating

Moderate for the whole antioxidant and zinc formula (Cochrane), but low for lutein and zeaxanthin on their own: the main trial was not significant, and the 10-year result is a follow-up of a trial, not a new randomised test.

Form and dose studied

The AREDS2 formula studied lutein and zeaxanthin together with vitamins C and E, zinc and copper.

Who was studied

People who already have intermediate AMD (or advanced AMD in one eye). Not tested in healthy eyes.

Limits

Almost everyone in AREDS2 also took the AREDS formula. The long follow-up is observational after year 5. Part of the AREDS record is linked to a company licence (see the study entry).

Why researchers looked

AMD is a common cause of central vision loss in older people, and lutein and zeaxanthin collect in the macula.

Traditional use

Proposed mechanism Hypothesis

Lutein, zeaxanthin and meso-zeaxanthin are the carotenoids found in the macula. It is proposed that they protect the retina, but this is a hypothesis.

A proposed mechanism does not show that the effect happens in people.

Beta-carotene, the older ingredient, raised lung cancer in smokers; see the Safety tab. The AREDS formula also contains high-dose zinc, which has its own cautions.

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Preventing AMD in people with healthy eyes

Not enough evidence

No trial shows that these pigments prevent AMD in people who do not have it.

2 studiesNot applicable.

Studies, doses and limits

What the trials found

The NEI states that AREDS and AREDS2 supplements do not prevent AMD from starting. AREDS2 left out people without AMD or with early AMD, because earlier AREDS data showed no benefit for them.

Results

No benefit for preventing AMD onset is shown in the sources read. Supplements were studied only in people who already had AMD.

Effect sizes as reported

No effect size applies.

Why this rating

No trial in people with healthy eyes was read, and the NEI says the formulas do not prevent onset.

Who was studied

People without AMD: not tested in the AREDS2 trial.

Limits

No prevention trial of lutein or zeaxanthin alone was found in the sources read.

Why researchers looked

Many people take eye supplements hoping to prevent AMD.

Traditional use

Proposed mechanism Not established

Not established.

A proposed mechanism does not show that the effect happens in people.

Ask an eye doctor before starting any eye supplement.

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Vision measures: contrast, clarity and glare recovery

Mixed findings

Small trials link lutein and zeaxanthin to better contrast sensitivity and glare recovery, mostly in people with eye disease, but the evidence is low quality.

3 studiesLutein and zeaxanthin supplements, with or without other antioxidants…

Studies, doses and limits

What the trials found

A 2014 meta-analysis of 8 trials (1,176 people with AMD) found small gains in visual acuity and contrast sensitivity. A 2024 network meta-analysis of 38 trials found gains in contrast sensitivity at low spatial frequency and, for lutein plus zeaxanthin, faster recovery after bright light, but rated the evidence low quality. The Cochrane review found lutein/zeaxanthin made little or no difference to loss of 15 or more letters of vision.

Results

Small improvements in some vision measures; no clear reduction in vision loss. Results differ between reviews.

Effect sizes as reported

Visual acuity (logMAR) mean difference -0.04 (95% CI -0.06 to -0.03) in AMD (2014); photostress recovery -5.75 (-8.80 to -1.70) with lutein plus zeaxanthin (2024); vision loss RR 0.98 (0.91 to 1.05, Cochrane).

Why this rating

The 2014 and 2024 reviews report gains, but the 2024 authors call the evidence low quality, and the Cochrane trial data show no change in vision loss.

Form and dose studied

Lutein and zeaxanthin supplements, with or without other antioxidants or fatty acids.

Who was studied

Mainly people with AMD; some trials in healthy adults.

Limits

Many small trials, different products, possible publication bias.

Why researchers looked

People ask whether these pigments make sight sharper or help in bright light.

Traditional use

Proposed mechanism Hypothesis

Macular pigment may filter some blue light and reduce glare. This is proposed, not proven for screen use.

A proposed mechanism does not show that the effect happens in people.

No harm was reported in these reviews' abstracts.

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Heart risk factors (lycopene and tomato products)

Mixed findings

Reviews disagree. One found lower LDL cholesterol with tomato products and lower systolic blood pressure with lycopene pills; a newer one found no effect on most heart risk factors.

2 studiesTomato foods and lycopene supplements are mixed in these reviews.

Studies, doses and limits

What the trials found

A 2017 meta-analysis of 21 trials found tomato products lowered LDL cholesterol and IL-6 and improved flow-mediated dilation, and lycopene supplements lowered systolic blood pressure. A 2023 GRADE meta-analysis of 34 trials found no significant effect on cholesterol, blood sugar, blood pressure or inflammation, except lower malondialdehyde (an oxidative stress marker).

Results

Mixed. Some blood markers moved in 2017; the 2023 review found no change in most markers. No trial of heart attacks or strokes was in these abstracts.

Effect sizes as reported

2017: LDL -0.22 mmol/L (tomato products, P = 0.006); systolic blood pressure -5.66 mmHg (lycopene, P = 0.002). 2023: no significant change in LDL, blood pressure or CRP; lower malondialdehyde.

Why this rating

Two meta-analyses reach different conclusions on LDL and blood pressure, and the studies are small and varied.

Form and dose studied

Tomato foods and lycopene supplements are mixed in these reviews.

Who was studied

Adults, with and without risk factors.

Limits

Markers, not heart attacks. Different products and trial lengths.

Why researchers looked

Tomato eaters tend to have less heart disease in observational studies, so trials tested tomato foods and lycopene pills.

Traditional use

Proposed mechanism Lab hypothesis

Lycopene is an antioxidant in lab tests; whether this explains any heart effect is not shown.

A proposed mechanism does not show that the effect happens in people.

No harm reported in the abstracts.

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Prostate health and prostate cancer (lycopene)

Low certainty

Men who eat more lycopene have somewhat lower prostate cancer rates in observational studies, but lycopene pills did not change PSA overall in trials.

2 studiesDietary lycopene and blood levels (observational); lycopene supplemen…

Studies, doses and limits

What the trials found

A 2017 meta-analysis of 42 observational studies (692,012 participants, 43,851 cases) linked higher dietary and blood lycopene to about 12% lower prostate cancer risk but not to advanced disease. A 2021 meta-analysis of 6 randomised trials in men with non-metastatic prostate cancer found no significant change in PSA overall.

Results

A link in observational studies (low certainty); no trial shows that lycopene prevents or treats prostate cancer.

Effect sizes as reported

Observational: dietary RR 0.88 (0.78 to 0.98); blood RR 0.88 (0.79 to 0.98). Trials: PSA mean difference -0.60 ug/L (-2.01 to 0.81).

Why this rating

Observational links cannot show cause, and the trials only measured PSA, not cancer.

Form and dose studied

Dietary lycopene and blood levels (observational); lycopene supplements (trials).

Who was studied

Men in observational studies; men with non-metastatic prostate cancer in trials.

Limits

Observational bias; few trials; PSA is a marker.

Why researchers looked

Tomato and lycopene intake has been linked to prostate health for years.

Traditional use

Proposed mechanism Lab hypothesis

Lycopene is an antioxidant in lab tests; the pathway in people is not established.

A proposed mechanism does not show that the effect happens in people.

Anyone with prostate cancer should ask their care team before using supplements.

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Overall cancer risk (diet and blood lycopene)

Very low certainty

People with higher lycopene intake or blood levels had slightly lower cancer rates in observational studies. This does not show that lycopene pills lower cancer risk.

2 studiesDiet and blood levels; not pills.

Studies, doses and limits

What the trials found

A 2025 meta-analysis of 119 prospective studies (108,574 cancer cases) linked higher lycopene intake and blood levels to 5% and 11% lower overall cancer risk and to lower cancer deaths.

Results

Observational links only. No trial of lycopene supplements for preventing cancer was read.

Effect sizes as reported

Overall cancer: intake RR 0.95 (0.92 to 0.98); blood level RR 0.89 (0.84 to 0.95).

Why this rating

Observational data with possible bias and in some analyses high heterogeneity. The NCCIH states that current evidence does not support antioxidant supplements to prevent cancer.

Form and dose studied

Diet and blood levels; not pills.

Who was studied

Adults in cohort studies.

Limits

Cannot separate lycopene from the rest of a healthy diet.

Why researchers looked

Tomato-rich diets are linked to better health in cohort studies.

Traditional use

Proposed mechanism Not established

Not established; the same people may also eat more fruit and vegetables.

A proposed mechanism does not show that the effect happens in people.

See the Safety tab for beta-carotene and chemotherapy cautions.

^{3 19}

Skin redness after sunlight (tomato and lycopene)

Low certainty

In small trials in healthy people, tomato products and lycopene pills lowered skin redness after UV light. They do not replace sun protection.

1 studiesTomato foods and lycopene supplements are pooled.

Studies, doses and limits

What the trials found

A 2024 meta-analysis of 21 intervention trials in healthy people reported lower skin redness after UV exposure and a higher UV dose needed to cause redness with tomato and lycopene.

Results

Lower redness after UV light in healthy people. No effect sizes are given in the abstract.

Effect sizes as reported

The abstract gives significance but no numbers or certainty rating.

Why this rating

Many small trials of different products and lengths; the abstract has no certainty rating or effect sizes.

Form and dose studied

Tomato foods and lycopene supplements are pooled.

Who was studied

Healthy adults.

Limits

No numbers read; this is a skin response to UV, not skin cancer prevention.

Why researchers looked

Lycopene collects in skin, so trials tested whether it helps skin cope with UV light.

Traditional use

Proposed mechanism Lab hypothesis

Lycopene is an antioxidant and collects in skin; whether this explains the findings is not established.

A proposed mechanism does not show that the effect happens in people.

Not a substitute for sunscreen or shade.

¹⁸

Cataract (lutein and zeaxanthin)

Low certainty

People who eat more lutein and zeaxanthin tend to have fewer cataracts in observational studies, but supplement trials have not shown a benefit.

2 studiesDietary intake (cohorts); supplements (trials).

Studies, doses and limits

What the trials found

A 2019 meta-analysis of 12 cohort studies and 8 randomised trials found that, in the cohorts, higher lutein or zeaxanthin intake was linked to lower cataract risk. In the randomised trials, beta-carotene and vitamin E supplements did not lower it. The NEI says AREDS and AREDS2 supplements had no effect on cataract.

Results

Observational link; no benefit in supplement trials.

Effect sizes as reported

Cohorts: RR 0.81 (0.75 to 0.89) for lutein or zeaxanthin; trials: beta-carotene RR 0.99 (0.92 to 1.07).

Why this rating

Observational links can reflect other healthy habits, and the NEI reports no effect from the AREDS2 supplements.

Form and dose studied

Dietary intake (cohorts); supplements (trials).

Who was studied

Older adults.

Limits

The randomised trials in the abstract tested beta-carotene and vitamin E, not lutein alone.

Why researchers looked

Lutein and zeaxanthin are also found in the lens of the eye.

Traditional use

Proposed mechanism Not established

Not established.

A proposed mechanism does not show that the effect happens in people.

No harm reported in the abstract.

^{9 20}

Connections to the rest of health

How Carotenoids: lutein, zeaxanthin and lycopene connects to the rest of our health knowledge graph. Every link says what kind of connection it is. A safety link (for example to the liver) is a warning, not a benefit. A study that merely mentions a topic never creates a benefit link.

Explore every connection: goals, body systems, organs, symptoms, genes

Kind of connection Connected to Search

A. Wellness goals

Connected to	Evidence status	Context	Studies
Balanced Nutrition	Moderate certainty	Food sources and how well they are absorbed: Lutein and zeaxanthin come mostly from dark leafy greens, and lycopene mostly from tomatoes and red fruit. Fat in the same meal helps the body absorb these pigments.	^{22 4}
Healthy Aging	Low certainty	Slowing late macular degeneration (AMD) in people who already have intermediate AMD: In AREDS2, adding lutein and zeaxanthin to an eye-vitamin formula did not clearly lower progression to advanced AMD overall. A 10-year follow-up and exploratory analyses suggest they are a safer swap for beta-carotene in that formula. Vision measures: contrast, clarity and glare recovery: Small trials link lutein and zeaxanthin to better contrast sensitivity and glare recovery, mostly in people with eye disease, but the evidence is low quality.	^{1 6 7 20 10 8}
Healthy Aging	Not enough evidence	Preventing AMD in people with healthy eyes: No trial shows that these pigments prevent AMD in people who do not have it.	^{20 19}
Heart Health	Mixed findings	Heart risk factors (lycopene and tomato products): Reviews disagree. One found lower LDL cholesterol with tomato products and lower systolic blood pressure with lycopene pills; a newer one found no effect on most heart risk factors.	^{5 17}
Preventive Wellness	Low certainty	Prostate health and prostate cancer (lycopene): Men who eat more lycopene have somewhat lower prostate cancer rates in observational studies, but lycopene pills did not change PSA overall in trials.	^{13 14}
Preventive Wellness	Very low certainty	Overall cancer risk (diet and blood lycopene): People with higher lycopene intake or blood levels had slightly lower cancer rates in observational studies. This does not show that lycopene pills lower cancer risk.	^{3 19}
Healthy Skin	Low certainty	Skin redness after sunlight (tomato and lycopene): In small trials in healthy people, tomato products and lycopene pills lowered skin redness after UV light. They do not replace sun protection.	¹⁸
Healthy Aging	Low certainty	Cataract (lutein and zeaxanthin): People who eat more lutein and zeaxanthin tend to have fewer cataracts in observational studies, but supplement trials have not shown a benefit.	^{9 20}

B. Body systems

Connected to	Kind of connection	Evidence status	Context	Studies
Nutrition	Biological association	Moderate certainty	Studied for: Food sources and how well they are absorbed	^{22 4}
Eyes	Biological association	Moderate certainty	Studied for: Food sources and how well they are absorbed Studied for: Slowing late macular degeneration (AMD) in people who already have intermediate AMD	^{22 4 1 6 7 20 19 10 8 9}
Circulatory System	Biological association	Mixed findings	Studied for: Heart risk factors (lycopene and tomato products)	^{5 17}
Reproductive System	Biological association	Low certainty	Studied for: Prostate health and prostate cancer (lycopene)	^{13 14}
Whole Body	Biological association	Very low certainty	Studied for: Overall cancer risk (diet and blood lycopene)	^{3 19}
Skin	Biological association	Low certainty	Studied for: Skin redness after sunlight (tomato and lycopene)	¹⁸

E. Health conditions

Connected to	Kind of connection	Evidence status	Context	Studies
Age-related macular degeneration		Preliminary	Part of a formula that slows progression in people who already have intermediate AMD; their own added benefit is low-certainty. Part of a formula that slows progression in people who already have intermediate AMD; the pigments alone are low-certainty. Preparation or compound: Lutein plus zeaxanthin in the AREDS2 formula	^{1 6 7}
Cataract		Observational	Higher lutein and zeaxanthin intake linked to fewer cataracts in cohorts; supplements showed no effect. Preparation or compound: Dietary lutein and zeaxanthin	^{9 20}

I. Biomarkers

Connected to	Kind of connection	Evidence status	Context	Studies
Macular pigment optical density (MPOD)	Biological association	Low certainty	Measured in trials: higher. A lab change is not the same as a health benefit.	⁸
Blood lutein level	Biological association	Low certainty	Measured in trials: higher. A lab change is not the same as a health benefit.	¹²
Progression to late AMD	Biological association	Low certainty	Measured in trials: lower with the full formula; uncertain for lutein/zeaxanthin alone. A lab change is not the same as a health benefit.	^{1 6 7}
LDL cholesterol	Biological association	Mixed findings	Measured in trials: lower in one review; no change in another. A lab change is not the same as a health benefit.	^{5 17}
Systolic blood pressure	Biological association	Mixed findings	Measured in trials: lower in one review; no change in another. A lab change is not the same as a health benefit.	^{5 17}
PSA (prostate-specific antigen)	Biological association	Low certainty	Measured in trials: no overall change. A lab change is not the same as a health benefit.	¹⁴
Skin redness after UV light	Biological association	Low certainty	Measured in trials: lower redness. A lab change is not the same as a health benefit.	¹⁸
Malondialdehyde (MDA)	Biological association	Low certainty	Measured in trials: lower. A lab change is not the same as a health benefit.	¹⁷

K. Biological pathways

Connected to	Kind of connection	Evidence status	Context	Studies
Beta-carotene	Preliminary mechanism	Human	Related carotenoid; pills raised lung cancer in smokers, and lutein/zeaxanthin replaced it in the AREDS2 formula.	^{6 20}
Zinc and copper	Preliminary mechanism	Human	Part of the AREDS and AREDS2 formulas with lutein and zeaxanthin.	²⁰
Eyes (macula)	Preliminary mechanism	Human	Lutein, zeaxanthin and meso-zeaxanthin collect in the macula.	⁸

L. Active compounds

Connected to	Kind of connection	Evidence status	Context	Studies
Lutein	Biological association	Human	One of the carotenoids found in the macula of the eye. Tested in AREDS2 at 10 mg a day together with zeaxanthin 2 mg. Preparation or compound: Dark leafy greens, peas, corn and eggs (per USDA lutein + zeaxanthin values)	^{21 22 1}
Zeaxanthin	Biological association	Human	A macular carotenoid, same formula as lutein but a different arrangement of atoms. Preparation or compound: Same foods as lutein (USDA lists lutein and zeaxanthin together)	^{21 22 1}
Meso-zeaxanthin	Biological association	Human	A third carotenoid found in the macula, sold in some eye products. No trial of it alone was read. Preparation or compound: Not read from a source.	²¹
Lycopene	Biological association	Human	Gives tomatoes their red colour. Studied in trials for blood pressure, cholesterol, PSA and skin redness after UV light. Preparation or compound: Tomatoes and tomato products, watermelon (USDA)	^{21 22 5 18}

Each connection is stored with the ingredient, the connected record, the kind of connection, the evidence status, the supporting studies, the preparation or compound involved, and a review date (last reviewed October 26, 2026).

Evidence at a glance: what the research found for 9 outcomes

1Moderate certainty

4Low certainty

1Very low certainty

2Mixed findings

1Not enough evidence

Each outcome below is one thing researchers measured. Certainty is how far the evidence can be trusted, not how well it works. The full studies are on the next tab.

Food sources and how well they are absorbed 2 studies Moderate certainty Slowing late macular degeneration (AMD) in people who already have intermediate AMD 4 studies Low certainty Preventing AMD in people with healthy eyes 2 studies Not enough evidence Vision measures: contrast, clarity and glare recovery 3 studies Mixed findings Heart risk factors (lycopene and tomato products) 2 studies Mixed findings Prostate health and prostate cancer (lycopene) 2 studies Low certainty Overall cancer risk (diet and blood lycopene) 2 studies Very low certainty Skin redness after sunlight (tomato and lycopene) 1 study Low certainty Cataract (lutein and zeaxanthin) 2 studies Low certainty

The evidence

The research centre for Carotenoids: lutein, zeaxanthin and lycopene. Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.

Evidence by outcome

Bars show how many studies we found for each outcome, not how well it works. People are added up across trials only (reviews are not added, to avoid double counting).

How we rate evidence

High certainty

Several well-run trials or reviews agree; further research is unlikely to change the picture much.

Moderate certainty

Good trials point the same way, but some doubt remains.

Low certainty

Small, short or inconsistent trials. The finding could change with better research.

Very low certainty

Very little or very weak human data. Treat as a possibility only.

Mixed findings

Trials or reviews disagree with each other.

Not enough evidence

Not enough human research to say either way.

Evidence against

Good research found no benefit, or found harm.

We take the reviewers' own risk-of-bias and GRADE statements where they exist, and otherwise judge from study size, design, consistency, directness and whether a product matches what is sold. Many publications do not make evidence high. Method note: We started from our existing summary, read the National Eye Institute and NCCIH pages, re-checked food values in saved USDA FoodData Central data, checked chemical identifiers in PubChem, and re-read PubMed abstracts for reviews and trials. Only abstracts were read for studies. The NIH Office of Dietary Supplements page was blocked and is marked unread.

Study library: every study we checked 22

Design Research type Year from Search

Study	Design	People	Product, dose, length	Result
Age-Related Eye Disease Study 2 Research Group 2013 Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. JAMA · PMID 23644932 · DOI	Randomised controlled trial	4203 People aged 50 to 85 with large drusen in both eyes, or large drusen in one eye and advanced AMD in the other; median follow-up 5 years	Lutein plus zeaxanthin (capsules), with or without omega-3, added to the AREDS formula Capsule Lutein 10 mg plus zeaxanthin 2 mg a day (studied in the trial) Median 5 years · vs Placebo (all took the AREDS formula or a variation of it)	Adding lutein plus zeaxanthin did not significantly lower progression to advanced AMD in the main analysis. Five-year progression was 31% with placebo and 29% with lutein plus zeaxanthin. More lung cancers occurred in the beta-carotene group than the no beta-carotene group, mostly in former smokers. Lutein plus zeaxanthin versus placebo: hazard ratio 0.90. Lung cancer with versus without beta-carotene: 23 (2.0%) versus 11 (0.9%) (98.7% CI 0.76 to 1.07 (P = 0.12); lung cancer nominal P = 0.04) Methods, limits and funding Outcomes: Progression to advanced AMD (by eye); lung cancer as a safety finding Limitations: Everyone also took an AREDS-type formula, so this tests lutein plus zeaxanthin as an add-on. The lung cancer finding was a secondary result and not the main question. Funding and conflicts: Funding is not stated in the abstract. The NEI page says the National Eye Institute conducted AREDS2. Read: abstract
Alpha-Tocopherol 1994 The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med · PMID 8127329 · DOI	Randomised controlled trial	29133 Male smokers aged 50 to 69 in Finland	Beta-carotene (and alpha-tocopherol) Supplement Beta-carotene 20 mg a day (studied in the trial) 5 to 8 years · vs Placebo	No reduction in lung cancer with beta-carotene. Lung cancer was more common in the beta-carotene group, and total deaths were higher. Lung cancer incidence +18% with beta-carotene; total deaths +8% (Lung cancer 3 to 36%; total deaths 1 to 16%) Methods, limits and funding Outcomes: Lung cancer and other cancers; total deaths Limitations: Tested beta-carotene, a different carotenoid from lutein, zeaxanthin or lycopene. It does not show the same effect for them. Funding and conflicts: Not stated in the abstract. Read: abstract
Balali 2025 Dietary intake of tomato and lycopene, blood levels of lycopene, and risk of total and specific cancers in adults: a systematic review and dose-response meta-analysis of prospective cohort studies. Front Nutr · PMID 40013157 · DOI	Systematic review meta analysis	121 prospective studies (119 in the meta-analysis); 108,574 cancer cases	Dietary tomato and lycopene; blood lycopene Diet and blood levels 2 to 32 years of follow-up · vs Low versus high	High lycopene intake and high blood levels were linked to 5% and 11% lower overall cancer risk, and to lower cancer deaths. These are links in observational studies. Overall cancer: intake RR 0.95; blood level RR 0.89 (Intake 0.92 to 0.98; blood level 0.84 to 0.95) Methods, limits and funding Outcomes: Total and specific cancer incidence and cancer deaths Limitations: Observational; people with higher lycopene may also eat more fruit and vegetables. Some results had high heterogeneity. Funding and conflicts: Authors declare no commercial or financial relationships. Read: abstract
Brown 2004 Carotenoid bioavailability is higher from salads ingested with full-fat than with fat-reduced salad dressings as measured with electrochemical detection. Am J Clin Nutr · PMID 15277161 · DOI	Randomised crossover trial	7 7 healthy adults eating spinach, lettuce, cherry tomato and carrot salads	Carotenoids from salad (alpha-carotene, beta-carotene and lycopene measured) Food (salad) Dressings with 0, 6 or 28 g canola oil Single meals, 2 weeks apart · vs Fat-free dressing	With fat-free dressing, almost no carotenoid was absorbed. More was absorbed with reduced-fat dressing, and most with full-fat dressing. Higher absorption with more fat in the dressing (P < 0.04 (reduced-fat vs fat-free); P < 0.02 (full-fat vs reduced-fat)) Methods, limits and funding Outcomes: Carotenoids appearing in blood chylomicrons after the meal Limitations: Only 7 people, single meals. Measured alpha-carotene, beta-carotene and lycopene, not lutein. Funding and conflicts: Not stated in the abstract. Read: abstract
Cheng 2017 Tomato and lycopene supplementation and cardiovascular risk factors: A systematic review and meta-analysis. Atherosclerosis · PMID 28129549 · DOI	Systematic review meta analysis	21 intervention trials in adults	Tomato products and lycopene supplements Tomato foods and lycopene supplements Varies Varies · vs Control	Tomato products were linked to lower LDL cholesterol, lower IL-6 and better flow-mediated dilation. Lycopene supplements were linked to lower systolic blood pressure. No other outcome changed significantly. LDL cholesterol -0.22 mmol/L (tomato); systolic blood pressure -5.66 mmHg (lycopene) (P = 0.006 (LDL); P = 0.002 (systolic blood pressure)) Methods, limits and funding Outcomes: Blood lipids, blood pressure, endothelial function, inflammation markers Limitations: Pooled from varied, mostly small trials; the abstract gives no certainty rating. Funding and conflicts: Not stated in the abstract. Read: abstract
Chew 2022 Long-term Outcomes of Adding Lutein/Zeaxanthin and omega-3 Fatty Acids to the AREDS Supplements on Age-Related Macular Degeneration Progression: AREDS2 Report 28. JAMA Ophthalmol · PMID 35653117 · DOI	Cohort follow up of rct	3882 AREDS2 participants (mean age 72) with intermediate AMD, followed for 10 years in total	Lutein plus zeaxanthin; beta-carotene (as randomised in the original trial) Capsule 10 years (5-year trial plus 5-year follow-up, when everyone took lutein/zeaxanthin supplements) · vs No lutein/zeaxanthin; beta-carotene versus none	At 10 years, lutein plus zeaxanthin was linked to slightly lower progression to late AMD. Beta-carotene nearly doubled the odds of lung cancer; lutein plus zeaxanthin did not significantly raise it. Late AMD: hazard ratio 0.91 for lutein/zeaxanthin versus none. Lung cancer odds ratio 1.82 for beta-carotene and 1.15 for lutein/zeaxanthin (Late AMD 0.84 to 0.99; lung cancer beta-carotene 1.06 to 3.12, lutein/zeaxanthin 0.79 to 1.66) Methods, limits and funding Outcomes: Late AMD; self-reported lung cancer Limitations: An observational follow-up of a trial, not a new randomised comparison; lung cancer was self-reported; after year 5 all took lutein/zeaxanthin. Funding and conflicts: The US National Institutes of Health held a royalty-bearing licence with Bausch and Lomb for the AREDS supplement (ended 2021); Bausch and Lomb supplied supplements in the last 5 years. Read: abstract
Evans 2023 Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration. Cochrane Database Syst Rev · PMID 37702300 · DOI	Systematic review meta analysis	11952 26 trials in people aged 65 to 75 with AMD; most evidence from AREDS and AREDS2	Antioxidant vitamin and mineral supplements, including lutein/zeaxanthin Tablets and capsules Varies; see the full review 6 months to 5 years · vs Placebo or no treatment	Moderate-certainty evidence that an antioxidant vitamin and mineral formula (AREDS) probably slows progression to late AMD. Lutein/zeaxanthin alone versus placebo showed a similar or slightly lower risk, with low-certainty evidence. Exploratory AREDS2 analyses suggest lutein/zeaxanthin is a suitable replacement for beta-carotene. AREDS formula: late AMD OR 0.72 (moderate certainty). Lutein/zeaxanthin versus control: late AMD RR 0.94 (low certainty); vision loss RR 0.98 (AREDS formula 0.58 to 0.90; lutein/zeaxanthin late AMD 0.87 to 1.01; vision loss 0.91 to 1.05) Methods, limits and funding Outcomes: Progression to late AMD; vision loss; quality of life; side effects Limitations: Lutein/zeaxanthin results come from one large trial in which almost everyone also took the AREDS formula. Most studies were too small to detect rare side effects. Funding and conflicts: Review authors declare no known conflicts. Read: abstract
Hu 2024 Effect of Antioxidant Supplementation on Macular Pigment Optical Density and Visual Functions: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Adv Nutr · PMID 38582248 · DOI	Systematic review meta analysis	60 articles in the review, 38 in the network meta-analysis of randomised trials of antioxidant supplements	Antioxidant groups including lutein, zeaxanthin and fatty acids Supplements Varies by trial Varies · vs Placebo	All antioxidant groups raised macular pigment optical density and contrast sensitivity at low spatial frequency. Only some combinations improved visual acuity or photostress recovery time. The authors call the evidence low quality. MPOD and low-frequency contrast sensitivity rose in every group; photostress recovery with lutein plus zeaxanthin: -5.75 (Photostress recovery -8.80 to -1.70) Methods, limits and funding Outcomes: Macular pigment optical density (MPOD); contrast sensitivity; visual acuity; photostress recovery Limitations: Low-quality evidence because of indirectness and possible publication bias. MPOD is a measurement, not a vision outcome. Funding and conflicts: Not stated in the abstract. Read: abstract
Jiang 2019 Dietary vitamin and carotenoid intake and risk of age-related cataract. Am J Clin Nutr · PMID 30624584 · DOI	Systematic review meta analysis	8 randomised trials and 12 cohort studies of age-related cataract	Dietary lutein/zeaxanthin and beta-carotene (cohorts); beta-carotene and vitamin E supplements (trials) Diet (cohorts) and supplements (trials) Varies · vs Lower versus higher intake; placebo in trials	In cohort studies, higher lutein or zeaxanthin intake was linked to lower cataract risk. In randomised trials, beta-carotene and vitamin E supplements did not reduce cataract risk. Cohorts: lutein/zeaxanthin RR 0.81. Trials: beta-carotene RR 0.99 (Cohorts 0.75 to 0.89; trials 0.92 to 1.07) Methods, limits and funding Outcomes: Risk of age-related cataract Limitations: Cohort links can be caused by other healthy habits. No randomised trial of lutein or zeaxanthin alone on cataract was in the abstract. Funding and conflicts: Not stated in the abstract. Read: abstract
Liu 2014 Lutein and zeaxanthin supplementation and association with visual function in age-related macular degeneration. Invest Ophthalmol Vis Sci · PMID 25515572 · DOI	Systematic review meta analysis	1176 8 randomised trials in people with AMD	Lutein and zeaxanthin supplements Supplements Varies; the review related each extra 1 mg a day to a small change in acuity Varies · vs Placebo	Lutein and zeaxanthin were linked to small improvements in visual acuity and contrast sensitivity in people with AMD. Visual acuity (logMAR) weighted mean difference -0.04 (95% CI -0.06 to -0.03) Methods, limits and funding Outcomes: Visual acuity, contrast sensitivity, glare recovery Limitations: An older review (searches to April 2014) of small trials; later Cochrane work rated the overall evidence low-certainty. Funding and conflicts: Not stated in the abstract. Read: abstract
Omenn 1996 Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med · PMID 8602180 · DOI	Randomised controlled trial	18314 Smokers, former smokers and workers exposed to asbestos (the CARET trial)	Beta-carotene plus vitamin A (retinyl palmitate) Supplement Beta-carotene 30 mg and retinol 25,000 IU a day (studied in the trial) Average 4 years; stopped 21 months early · vs Placebo	The combination had no benefit and may have raised lung cancer and deaths from lung cancer, heart disease and any cause. The trial was stopped early. Lung cancer RR 1.28; death from any cause RR 1.17; death from lung cancer RR 1.46 (Lung cancer 1.04 to 1.57; any-cause death 1.03 to 1.33; lung cancer death 1.07 to 2.00) Methods, limits and funding Outcomes: Lung cancer; deaths Limitations: A combination of beta-carotene with vitamin A, in people at high risk of lung cancer. Not a test of lutein, zeaxanthin or lycopene. Funding and conflicts: Not stated in the abstract. Read: abstract
Rosenthal 2006 Dose-ranging study of lutein supplementation in persons aged 60 years or older. Invest Ophthalmol Vis Sci · PMID 17122107 · DOI	Randomised controlled trial	45 People aged 60 to 91 with no AMD, large drusen or advanced AMD	Lutein supplement Supplement Lutein 2.5, 5 or 10 mg a day (studied in the trial) 6 months, then 6 months off · vs Dose groups compared; no placebo group mentioned in the abstract	Blood lutein rose in a dose-linked way (about 2, 3 and 4 times baseline). No toxicity was seen with any dose and visual tests did not change. Median blood lutein rose from 15.1 to 66.8 ug/dL in the 10 mg group (P < 0.001) Methods, limits and funding Outcomes: Blood lutein levels; safety; visual acuity Limitations: Only 45 people and 6 months, so rare or long-term effects could not be seen. The authors call for a larger long-term trial. Funding and conflicts: Authors include National Eye Institute researchers; funding is not stated in the abstract. Read: abstract
Rowles JL 3rd 2017 Increased dietary and circulating lycopene are associated with reduced prostate cancer risk: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis · PMID 28440323 · DOI	Systematic review meta analysis	692012 42 observational studies with 43,851 prostate cancer cases	Dietary and blood lycopene Diet and blood levels Varies · vs Low versus high lycopene	Higher dietary and blood lycopene were linked to about 12% lower prostate cancer risk. No link was found with advanced prostate cancer. Dietary RR 0.88; blood RR 0.88; advanced prostate cancer not associated (Dietary 0.78 to 0.98; blood 0.79 to 0.98) Methods, limits and funding Outcomes: Prostate cancer risk Limitations: Observational, so it cannot show that lycopene itself lowers risk. Funding is not stated in the abstract. Funding and conflicts: Not stated in the abstract. Read: abstract
Sadeghian 2021 Lycopene Does Not Affect Prostate-Specific Antigen in Men with Non-Metastatic Prostate Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutr Cancer · PMID 33355018 · DOI	Systematic review meta analysis	6 randomised trials in men with non-metastatic prostate cancer	Lycopene supplements Supplements Dose-response analysis found no significant effect of dose Varies · vs Control	Lycopene did not significantly change PSA overall. In men with higher starting PSA the pooled change was larger, but the trials differed a lot. Overall PSA weighted mean difference -0.60 ug/L; higher-PSA subgroup -3.74 ug/L (Overall -2.01 to 0.81; subgroup -5.15 to -2.32) Methods, limits and funding Outcomes: Serum PSA (prostate-specific antigen) Limitations: Only six trials; the authors note heterogeneity. PSA is a marker, not a cancer outcome. Funding and conflicts: Not stated in the abstract. Read: abstract
Tanaka 2022 Carotenoderma due to lycopenemia: A case report and evaluation of lycopene deposition in the skin. J Dermatol · PMID 35938228 · DOI	Case report	1 One patient who ate large amounts of lycopene-rich fruits and vegetables	Dietary lycopene Food	A yellow-orange skin colour (carotenoderma) from very high carotenoid intake, mostly on the palms, soles and creases beside the nose. The authors call it benign and harmless. Skin carotenoid score higher than the average of 24 healthy volunteers (Not applicable) Methods, limits and funding Outcomes: Skin colour and skin carotenoid level Limitations: A single case; it shows the effect exists, not how often it happens. Funding and conflicts: Not stated in the abstract. Read: abstract
Tenorio 2018 Oral antioxidant therapy for prevention and treatment of preeclampsia: Meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis · PMID 30111493 · DOI	Systematic review meta analysis	29 trials in pregnant women (19 prevention, 10 treatment)	Oral antioxidants, including lycopene, vitamins C and E, selenium, arginine, allicin and coenzyme Q10 Supplements Varies Varies · vs Control	None of the antioxidants showed a benefit in preventing preeclampsia. Lycopene was only one of several antioxidants pooled, so the abstract does not give a lycopene-only result. Preeclampsia prevention RR 0.89 (not significant) (95% CI 0.79 to 1.02) Methods, limits and funding Outcomes: Preeclampsia incidence; perinatal death Limitations: Lycopene is mixed in with other antioxidants; it says nothing separate about lycopene safety in pregnancy. Funding and conflicts: Not stated in the abstract. Read: abstract
Zamani 2023 The Effects of Lycopene and Tomato Consumption on Cardiovascular Risk Factors in Adults: A Grade Assessment Systematic Review and Meta-analysis. Curr Pharm Des · PMID 37496241 · DOI	Systematic review meta analysis	34 randomised trials in adults	Lycopene supplements and tomato foods Supplements and tomato foods Varies Varies · vs Control	Lycopene was linked to lower malondialdehyde (an oxidative stress marker). Lycopene and tomato did not significantly change cholesterol, blood sugar, blood pressure, inflammation markers or weight. Significant only for malondialdehyde; no other outcome (Not given in the abstract) Methods, limits and funding Outcomes: Blood lipids, glucose, blood pressure, inflammation, oxidative stress, weight Limitations: Authors call for longer trials. It disagrees with the 2017 review on LDL and blood pressure, so the overall picture is mixed. Funding and conflicts: Not stated in the abstract. Read: abstract
Zhang 2024 The effect of tomato and lycopene on clinical characteristics and molecular markers of UV-induced skin deterioration: A systematic review and meta-analysis of intervention trials. Crit Rev Food Sci Nutr · PMID 36606553 · DOI	Systematic review meta analysis	21 intervention trials in healthy people	Tomato products and lycopene supplements Tomato foods and supplements Varies Varies · vs Control	Tomato and lycopene were linked to less skin redness after UV light and a higher dose of UV needed to cause redness. The authors say tomato or lycopene might add some protection from sunlight. Significant reductions in redness (delta a) and skin pigmentation; significant rises in minimal erythema dose, skin thickness and density (Not given in the abstract) Methods, limits and funding Outcomes:* Skin redness after UV light (erythema), minimal erythema dose, skin markers Limitations: The abstract gives no effect sizes or certainty rating. Trials were in healthy people and varied in product and length. Funding and conflicts: Not stated in the abstract. Read: abstract
s-nccih-antioxidants NCCIH (US National Center for Complementary and Integrative Health): Antioxidants: In Depth (last updated July 2023) · Source	Reference database n/a			Methods, limits and funding Read: full-text
s-nei-areds National Eye Institute: AREDS/AREDS2 Clinical Trials (last updated 2025-10-22) · Source	Reference database n/a			Methods, limits and funding Read: full-text
s-pubchem-carotenoids PubChem compound records: lutein (CID 5281243), zeaxanthin (CID 5280899), meso-zeaxanthin (CID 6442658), lycopene (CID 446925) · Source	Reference database n/a			Methods, limits and funding Read: full-text
s-usda-sr-legacy-carotenoids USDA FoodData Central, SR Legacy (April 2018 release): lutein + zeaxanthin and lycopene in foods · Source	Reference database n/a			Methods, limits and funding Read: full-text

What we do not know yet

No trial shows that these pigments prevent macular degeneration in healthy eyes.
Lutein and zeaxanthin on their own, without the other AREDS nutrients, have only low-certainty evidence.
Official upper limits could not be read (the NIH Office of Dietary Supplements page was blocked), so none are stated.
No interaction studies with prescription medicines were found.
Contamination and label accuracy of carotenoid supplements were not researched.
Thinking and memory, children, bone and fertility were not researched here.

How new research is added

New studies are found by a saved PubMed search and placed in a review queue before the page changes.

Lab markers

What changed in blood or saliva tests during trials. A changed number is not the same as feeling or being healthier, and we give no "normal ranges".

Metabolic 1

●

LDL cholesterol

Lower in one review; no change in another in trials

The "bad" cholesterol carried in the blood.

Mixed findings

Results and what it means

Why it was measured

To see whether tomato products or lycopene change heart risk factors.

Statistical vs. clinical meaning

A lab marker; not proof of fewer heart attacks.

Safety implication

None found in the abstracts.

Study	Result	People	Product
⁵	LDL -0.22 mmol/L with tomato products	21 trials in adults	Tomato products
¹⁷	No significant change in LDL-C	34 trials in adults	Lycopene and tomato

^{5 17}

Other 7

●

Macular pigment optical density (MPOD)

Higher in trials

A measurement of how much lutein and zeaxanthin pigment sits in the centre of the retina.

Low certainty

Results and what it means

Why it was measured

To check whether supplements actually raise the pigment in the macula.

Statistical vs. clinical meaning

A higher MPOD is a measured change in the eye. It is not proof of better vision or protection from AMD.

Safety implication

None found in the abstract.

Study	Result	People	Product
⁸	All antioxidant groups significantly raised MPOD; lutein plus zeaxanthin plus fatty acids ranked best (SUCRA 99.3%)	Network meta-analysis of 38 randomised trials	Lutein, zeaxanthin and other antioxidant supplements

⁸

●

Blood lutein level

Higher in trials

Lutein in the blood after supplementation.

Low certainty

Results and what it means

Why it was measured

To see how supplement amounts change blood levels.

Statistical vs. clinical meaning

Shows the supplement is absorbed; it does not show a health benefit.

Safety implication

No toxicity was seen with any dose in this small trial.

Study	Result	People	Product
¹²	Median blood lutein roughly doubled, tripled and quadrupled over 6 months at the three amounts tested (2.0, 2.9 and 4.0 times baseline)	45 people aged 60 or older	Lutein 2.5, 5 or 10 mg a day

¹²

●

Progression to late AMD

Lower with the full formula; uncertain for lutein/zeaxanthin alone in trials

Move from intermediate to advanced (late) AMD, the stage that threatens central vision.

Low certainty

Results and what it means

Why it was measured

This is the outcome that matters most in AMD trials.

Statistical vs. clinical meaning

A clinical outcome, but the benefit of lutein and zeaxanthin on their own is not firmly shown.

Safety implication

Beta-carotene in the older formula raised lung cancer in former smokers.

Study	Result	People	Product
¹	No significant extra reduction with lutein plus zeaxanthin; five-year progression 29% versus 31% with placebo	4,203 people at risk of advanced AMD	Lutein 10 mg plus zeaxanthin 2 mg added to an AREDS-type formula
⁶	Hazard ratio 0.91 (0.84 to 0.99) for lutein/zeaxanthin over 10 years	3,882 people in the follow-up	Lutein/zeaxanthin versus none
⁷	Lutein/zeaxanthin versus control RR 0.94 (0.87 to 1.01), low certainty; whole AREDS antioxidant formula OR 0.72 (0.58 to 0.90), moderate certainty	26 trials, 11,952 people	Antioxidant formulas and lutein/zeaxanthin

^{1 6 7}

●

Systolic blood pressure

Lower in one review; no change in another in trials

The top number in a blood pressure reading.

Mixed findings

Results and what it means

Why it was measured

To test for a blood pressure effect of lycopene.

Statistical vs. clinical meaning

The two reviews disagree.

Safety implication

None found in the abstracts.

Study	Result	People	Product
⁵	Systolic blood pressure -5.66 mmHg with lycopene supplements	Trials in adults	Lycopene supplements
¹⁷	No significant change in systolic blood pressure	34 trials in adults	Lycopene and tomato

^{5 17}

●

PSA (prostate-specific antigen)

No overall change in trials

A blood marker used to follow prostate disease.

Low certainty

Results and what it means

Why it was measured

To see whether lycopene lowers PSA in men with prostate cancer.

Statistical vs. clinical meaning

Not a cancer outcome; trials differ a lot.

Safety implication

None found in the abstract.

Study	Result	People	Product
¹⁴	Weighted mean difference -0.60 ug/L (95% CI -2.01 to 0.81) overall; -3.74 ug/L in men with higher starting PSA	6 randomised trials	Lycopene supplements

¹⁴

●

Skin redness after UV light

Lower redness in trials

How red the skin gets after a measured dose of UV light (erythema).

Low certainty

Results and what it means

Why it was measured

To test whether tomato or lycopene protects skin from UV.

Statistical vs. clinical meaning

A skin response measure, not skin cancer prevention.

Safety implication

None found in the abstract.

Study	Result	People	Product
¹⁸	Significant reductions in redness and rises in the UV dose needed to cause redness (numbers not in the abstract)	21 trials in healthy people	Tomato products and lycopene

¹⁸

●

Malondialdehyde (MDA)

Lower in trials

A blood marker of oxidative stress.

Low certainty

Results and what it means

Why it was measured

To test whether lycopene lowers oxidative stress.

Statistical vs. clinical meaning

A lab marker; the link to health is not shown.

Safety implication

None found in the abstract.

Study	Result	People	Product
¹⁷	Significantly lower MDA with lycopene	34 trials in adults	Lycopene supplements

¹⁷

Safety

What studies and official sources say about side effects, medicines and who should check first. Each point shows what kind of evidence it comes from.

Main points to know 4

Beta-carotene pills raised lung cancer in smokers (a different carotenoid). Beta-carotene is a related carotenoid, not lutein, zeaxanthin or lycopene. In two large trials of smokers, former smokers and asbestos-exposed workers, beta-carotene pills raised lung cancer: by 18% in a Finnish trial of male smokers and by 28% in the CARET trial (which also gave vitamin A). In AREDS2, lung cancer was more common with beta-carotene (2.0% versus 0.9%), mostly in former smokers. The 10-year follow-up found lutein and zeaxanthin did not significantly raise lung cancer risk. The National Eye Institute says current and former smokers should avoid the AREDS formula with beta-carotene. Randomised trials and authoritative guidance ^{2 11 1 6 20}
Antioxidant supplements and cancer treatment. NCCIH says antioxidants might reduce the effect of cancer treatments that work by making reactive oxygen. In a 2019 study of 1,134 women with breast cancer, using any antioxidant supplement (including carotenoids) during chemotherapy was linked with higher risks of recurrence and death. NCCIH notes the result may be biased because women chose their own supplements. Observational study reported by authoritative guidance ¹⁹
Very high intake can turn the skin yellow-orange. A case report described yellow-orange skin colour (carotenoderma) from eating very large amounts of lycopene-rich fruits and vegetables. It showed on the palms, soles and creases beside the nose. The authors call the condition benign and harmless. It can look alarming, so it is worth asking a doctor if the colour appears. Case report ¹⁵
Supplements are not a replacement for an eye exam. NCCIH advises people with AMD to ask their health care providers whether AREDS-type supplements are appropriate. Supplements have not been shown to prevent AMD, and the trials were done in people who already had it. Authoritative guidance ^{19 20}

Side effects 4

Effect	How often	Severity and recovery	Evidence
Yellow-orange skin colour (carotenoderma) Seen with very high food intake of lycopene-rich produce, not with usual diets.	Rare; a single case report was read	Cosmetic; the authors call it benign Not stated in the abstract.	Case report ¹⁵
No toxicity seen in a 6-month dose-ranging trial of lutein The trial was small and short, so it cannot rule out rare or long-term effects.	45 people; no toxicity at any of the three amounts studied	None reported Not applicable	Randomised controlled trial ¹²
Stomach and bowel symptoms with antioxidant eye formulas The Cochrane review says stomach and bowel symptoms were the main side effect across antioxidant vitamin and mineral trials, and that most studies were too small to detect rare effects. This is not specific to lutein or zeaxanthin.	Not given	Not stated Not stated	Systematic review ⁷
More lung cancer with beta-carotene in former smokers This is a beta-carotene finding. Lutein and zeaxanthin did not significantly raise lung cancer (odds ratio 1.15, 0.79 to 1.66).	AREDS2: 23 (2.0%) with beta-carotene versus 11 (0.9%) without	Serious Not applicable	Randomised controlled trial ^{1 6}

Liver

No liver injury linked to lutein, zeaxanthin or lycopene was found in the sources read. A liver-safety reference (LiverTox) was not opened for this page.

How often. No frequency was found.

Monitoring. No agency monitoring advice was found.

This is a safety connection. It is not evidence that Carotenoids: lutein, zeaxanthin and lycopene supports liver health.

Medicines and supplements 4

With	Why it matters	Importance	Evidence	What to do
Chemotherapy and radiation for cancer prescription	Antioxidants might reduce treatments that work by generating reactive oxygen (NCCIH).	In a 2019 breast cancer study, antioxidant supplement use during chemotherapy was linked with higher recurrence and death risk; NCCIH says this may be biased.	Observational study Low certainty ¹⁹	Talk to your cancer care team before using any antioxidant supplement.
Zinc and copper in AREDS-type eye formulas supplement	High zinc lowers copper absorption, so copper is added to the formula (NEI table note).	The AREDS and AREDS2 formulas contain zinc 80 mg with copper 2 mg; the zinc has its own cautions.	Authoritative guidance Moderate certainty ²⁰	See the zinc page and ask a pharmacist before combining mineral supplements.
Beta-carotene supplements (smokers and former smokers) supplement	Not established.	Beta-carotene raised lung cancer in smokers and former smokers in three trials; the NEI says smokers should avoid the AREDS formula with beta-carotene.	Randomised trials High certainty ^{2 11 1 20}	Check whether an eye-vitamin or multivitamin contains beta-carotene; ask a doctor or pharmacist.
Blood thinners, cholesterol medicines and other prescription drugs prescription		No interaction study was read for lutein, zeaxanthin or lycopene with these medicines.	None found Not enough evidence	Ask a pharmacist before adding any supplement to your medicines.

Who should check first 5

Situation	Advice	Evidence
Current or former smokers, and workers exposed to asbestos	Avoid supplements that contain beta-carotene (the NEI says this for the AREDS formula). Lutein and zeaxanthin did not significantly raise lung cancer in the AREDS2 follow-up. Ask a doctor.	Randomised trials and authoritative guidance ^{2 11 6 20}
People having cancer treatment	Ask the cancer care team before using antioxidant supplements, including carotenoids.	Authoritative guidance ¹⁹
Pregnancy and breastfeeding	No source read set safe amounts of lutein, zeaxanthin or lycopene supplements in pregnancy or breastfeeding. A meta-analysis of antioxidants (lycopene among them) found no benefit for preventing preeclampsia. NCCIH says people who are pregnant or nursing should ask their health care provider first.	Meta analysis and authoritative guidance ^{16 19}
Children	NCCIH says to consult a child's health care provider before giving a child any dietary supplement. Trials in children were not read for this page.	Authoritative guidance ¹⁹
People with eye disease	Supplements do not replace an eye exam. NCCIH advises people with AMD to ask their health care providers whether AREDS-type supplements are appropriate.	Authoritative guidance ^{19 20}

Overdose, product quality and regulators

Summary. In a small 6-month trial no toxicity was seen with lutein. Food sources are not linked to harm in the sources read. Very high intake of carotenoid-rich foods can colour the skin yellow-orange. The harm seen in trials was with beta-carotene pills in smokers.

Animal. Not reviewed.

High dose or long term signals. Beta-carotene: more lung cancer in smokers (see key safety). For lutein, zeaxanthin and lycopene: no long-term harm was found in the sources read, but long-term trials of lutein alone are lacking (the 2006 trial authors called for one).

Overdose response. No poisoning from these pigments was read. If someone swallows a large amount of any supplement, call poison control or emergency services.

Genotoxicity. Not researched.

Contamination and label accuracy of carotenoid supplements were not researched for this page.

Label content. NCCIH reminds readers that dietary supplements may interact with medicines or other supplements and may contain ingredients not listed on the label. It makes this point about supplements in general, not carotenoids in particular. ¹⁹

Beta-carotene hidden in combination products. The NEI table lists beta-carotene in the original AREDS formula but not in the AREDS2 formula, and says commercial formulas are based on each. So the label matters for smokers and former smokers. ²⁰

Body	Action	Date
National Eye Institute (US National Institutes of Health) (United States)	States that AREDS and AREDS2 supplements reduce progression from intermediate to advanced AMD by about 25 percent, do not prevent AMD from starting and do not affect cataract. Says current and former smokers should take the AREDS2 formula and avoid the AREDS formula with beta-carotene, which increases lung cancer risk. The AREDS2 formula lists lutein 10 mg and zeaxanthin 2 mg with vitamin C 500 mg, vitamin E 400 IU, zinc 80 mg and copper 2 mg. source	2025-10-22
NCCIH (US National Center for Complementary and Integrative Health) (United States)	States that, apart from AMD, there is no current evidence that antioxidant supplements help the diseases studied, that high doses of beta-carotene may increase lung cancer risk, and that in 2022 the US Preventive Services Task Force recommended against beta-carotene or vitamin E supplements for cancer prevention. Advises asking a health care provider about antioxidant supplements during cancer treatment and about AREDS-type supplements. source	2023-07

When to get medical help

A sudden change in central vision, a dark or blurred spot in the middle of vision, or straight lines that look wavy: see an eye doctor straight away. Supplements do not replace eye exams.
Someone has swallowed a large amount of any supplement, or a child has swallowed supplements: call poison control or emergency services.
Swelling of the face or lips, hives, trouble breathing or a fast heartbeat after taking a supplement: get emergency help.
A smoker or former smoker with a cough that does not go away, coughing up blood or unexplained weight loss: see a doctor soon, whatever supplements you have taken.

Stop using the product and contact a clinician or emergency service. In the US, Poison Control is 1-800-222-1222.

General information only, not medical advice. Ask a clinician or pharmacist before use, especially with medicines, in pregnancy or with a health condition. See the Natural Remedy Safety guide.

Frequently asked questions

What are lutein, zeaxanthin and lycopene?

They are carotenoid plant pigments. Lutein and zeaxanthin are yellow pigments in leafy greens, peas and corn; lycopene is the red pigment in tomatoes and watermelon. They are not essential nutrients.

^{21 22}

Which foods have the most lutein and zeaxanthin?

By USDA data, boiled spinach (about 20.4 mg per cup), boiled collard greens (about 11.8 mg), boiled kale (about 5.9 mg) and boiled green peas (about 4.1 mg) are rich sources. A large egg has about 0.2 mg.

²²

Which foods have the most lycopene?

By USDA data, canned tomato sauce (about 34.0 mg per cup), canned tomato juice (about 22.0 mg per cup), diced watermelon (about 6.9 mg per cup) and chopped raw tomato (about 4.6 mg per cup).

²²

Does fat help absorb these pigments?

Yes, in one small trial. Seven adults absorbed almost no carotenoid from a salad with fat-free dressing, and more with more fat in the dressing. The trial measured lycopene and carotenes.

⁴

Do lutein and zeaxanthin help macular degeneration?

Only in people who already have it, and mainly as part of a formula. AREDS2 did not show a clear extra benefit in its main result, but a 10-year follow-up was slightly in favour. Cochrane rates the evidence for the pigments alone as low-certainty.

^{1 6 7}

Can they prevent macular degeneration?

No trial shows this. The National Eye Institute says AREDS and AREDS2 supplements do not prevent AMD from starting.

²⁰

Do they help cataracts?

Cohort studies link higher lutein and zeaxanthin intake to fewer cataracts, but supplement trials have not shown a benefit, and the National Eye Institute says the AREDS2 supplements had no effect on cataract.

^{9 20}

Is lycopene good for the heart?

Reviews disagree. A 2017 review found lower LDL cholesterol and blood pressure with tomato and lycopene; a 2023 review found no change in most markers. No trial of heart attacks was read.

^{5 17}

Does lycopene prevent prostate cancer?

Not shown. Observational studies link higher lycopene to about 12% lower prostate cancer risk, but lycopene pills did not change PSA overall in six trials.

^{13 14}

Does lycopene protect skin from the sun?

In small trials in healthy people, tomato and lycopene lowered skin redness after UV light. It does not replace sunscreen.

¹⁸

Are they safe for smokers?

Beta-carotene pills raised lung cancer in smokers, a different carotenoid. Lutein and zeaxanthin did not significantly raise it in the AREDS2 follow-up. The National Eye Institute says smokers should avoid the AREDS formula that contains beta-carotene. Ask a doctor.

^{2 11 6 20}

Are they safe in pregnancy, for children, or during cancer treatment?

No source set safe amounts of the pills for pregnancy or children. NCCIH says to ask a health care provider first, and says antioxidant supplements, carotenoids included, might interfere with cancer treatment.

^{19 16}

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Editorial transparency

Written by: AlternativeMed editorial team. Research compiled with AI assistance, then checked against the sources listed.
Medical review: None. This page has not been reviewed by a physician or pharmacist.
First published: 2026-10-26
Last substantive update: 2026-10-26
How we research: We started from our existing summary, read the National Eye Institute and NCCIH pages, re-checked food values in saved USDA FoodData Central data, checked chemical identifiers in PubChem, and re-read PubMed abstracts for reviews and trials. Only abstracts were read for studies. The NIH Office of Dietary Supplements page was blocked and is marked unread.
How we rate evidence: See "How we rate evidence" in the Evidence tab.
Independence: No product is promoted on this page. No affiliate links are shown. Trials of supplements may have manufacturer links not stated in abstracts; the AREDS2 follow-up reports a company licence and supplies.

Sources 22

Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.

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. PMID 23644932. DOI 10.1001/jama.2013.4997. (abstract)
Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers.. N Engl J Med. 1994. PMID 8127329. DOI 10.1056/NEJM199404143301501. (abstract)
Balali A, Fathzadeh K, Askari G, Sadeghi O. Dietary intake of tomato and lycopene, blood levels of lycopene, and risk of total and specific cancers in adults: a systematic review and dose-response meta-analysis of prospective cohort studies.. Front Nutr. 2025. PMID 40013157. DOI 10.3389/fnut.2025.1516048. (abstract)
Brown MJ, Ferruzzi MG, Nguyen ML, Cooper DA, Eldridge AL, Schwartz SJ, White WS. Carotenoid bioavailability is higher from salads ingested with full-fat than with fat-reduced salad dressings as measured with electrochemical detection.. Am J Clin Nutr. 2004. PMID 15277161. DOI 10.1093/ajcn/80.2.396. (abstract)
Cheng HM, Koutsidis G, Lodge JK, Ashor A, Siervo M, Lara J. Tomato and lycopene supplementation and cardiovascular risk factors: A systematic review and meta-analysis.. Atherosclerosis. 2017. PMID 28129549. DOI 10.1016/j.atherosclerosis.2017.01.009. (abstract)
Chew EY, Clemons TE, Agron E et al.. Long-term Outcomes of Adding Lutein/Zeaxanthin and omega-3 Fatty Acids to the AREDS Supplements on Age-Related Macular Degeneration Progression: AREDS2 Report 28.. JAMA Ophthalmol. 2022. PMID 35653117. DOI 10.1001/jamaophthalmol.2022.1640. (abstract)
Evans JR, Lawrenson JG. Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration.. Cochrane Database Syst Rev. 2023. PMID 37702300. DOI 10.1002/14651858.CD000254.pub5. (abstract)
Hu W, Seah V, Huang V, Kim JE. Effect of Antioxidant Supplementation on Macular Pigment Optical Density and Visual Functions: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.. Adv Nutr. 2024. PMID 38582248. DOI 10.1016/j.advnut.2024.100216. (abstract)
Jiang H, Yin Y, Wu CR, Liu Y, Guo F, Li M, Ma L. Dietary vitamin and carotenoid intake and risk of age-related cataract.. Am J Clin Nutr. 2019. PMID 30624584. DOI 10.1093/ajcn/nqy270. (abstract)
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.. Invest Ophthalmol Vis Sci. 2014. PMID 25515572. DOI 10.1167/iovs.14-15553. (abstract)
Omenn GS, Goodman GE, Thornquist MD et al.. Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease.. N Engl J Med. 1996. PMID 8602180. DOI 10.1056/NEJM199605023341802. (abstract)
Rosenthal JM, Kim J, de Monasterio F et al.. Dose-ranging study of lutein supplementation in persons aged 60 years or older.. Invest Ophthalmol Vis Sci. 2006. PMID 17122107. DOI 10.1167/iovs.05-1513. (abstract)
Rowles JL 3rd, Ranard KM, Smith JW, An R, Erdman JW Jr. Increased dietary and circulating lycopene are associated with reduced prostate cancer risk: a systematic review and meta-analysis.. Prostate Cancer Prostatic Dis. 2017. PMID 28440323. DOI 10.1038/pcan.2017.25. (abstract)
Sadeghian M, Asadi M, Rahmani S, Sadeghi N, Hosseini SA, Zare Javid A. Lycopene Does Not Affect Prostate-Specific Antigen in Men with Non-Metastatic Prostate Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.. Nutr Cancer. 2021. PMID 33355018. DOI 10.1080/01635581.2020.1862254. (abstract)
Tanaka A, Miyauchi T, Kitamura S, Iwata H, Hata H, Ujiie H. Carotenoderma due to lycopenemia: A case report and evaluation of lycopene deposition in the skin.. J Dermatol. 2022. PMID 35938228. DOI 10.1111/1346-8138.16537. (abstract)
Tenorio MB, Ferreira RC, Moura FA, Bueno NB, Goulart MOF, Oliveira ACM. Oral antioxidant therapy for prevention and treatment of preeclampsia: Meta-analysis of randomized controlled trials.. Nutr Metab Cardiovasc Dis. 2018. PMID 30111493. DOI 10.1016/j.numecd.2018.06.002. (abstract)
Zamani M, Behmanesh Nia F, Ghaedi K et al.. The Effects of Lycopene and Tomato Consumption on Cardiovascular Risk Factors in Adults: A Grade Assessment Systematic Review and Meta-analysis.. Curr Pharm Des. 2023. PMID 37496241. DOI 10.2174/1381612829666230726112510. (abstract)
Zhang X, Zhou Q, Qi Y et al.. The effect of tomato and lycopene on clinical characteristics and molecular markers of UV-induced skin deterioration: A systematic review and meta-analysis of intervention trials.. Crit Rev Food Sci Nutr. 2024. PMID 36606553. DOI 10.1080/10408398.2022.2164557. (abstract)
. NCCIH (US National Center for Complementary and Integrative Health): Antioxidants: In Depth (last updated July 2023). . . (full-text)
. National Eye Institute: AREDS/AREDS2 Clinical Trials (last updated 2025-10-22). . . (full-text)
. PubChem compound records: lutein (CID 5281243), zeaxanthin (CID 5280899), meso-zeaxanthin (CID 6442658), lycopene (CID 446925). . . (full-text)
. USDA FoodData Central, SR Legacy (April 2018 release): lutein + zeaxanthin and lycopene in foods. . . (full-text)

Where to buy

Check the label first. Whatever you buy, look for these:

The amount of the active ingredient per serving, not just the front-label claim
A third-party testing mark (USP, NSF or ConsumerLab)
Other ingredients and allergens
Ask a pharmacist about interactions with your medicines

Talk to a pharmacist or doctor before you start any supplement, especially if you take medicines. See the Safety tab for interactions.

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Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.