Why Do the Antioxidants Lutein and Zeaxanthin need Meso-Zeaxanthin?

Spinach is rich in Lutein and Zeaxanthin.

Written by MacuHealth
Reviewed by Jim Stringham, Ph.D.

Many AREDS2-based eye supplements list the antioxidants Lutein and Zeaxanthin as active ingredients. These are two of the three antioxidants known as carotenoids found in the macular pigment – the part of the eye that facilitates central vision.

But researchers have determined that Meso-Zeaxanthin is the most potent carotenoid in the macular pigment. Despite its importance to eye health, our bodies don’t receive enough of this vital ingredient, and it’s not typically found in eye supplements, putting us at risk for diseases such as age-related macular degeneration (AMD).

To clarify, Professor Riona Mulcahy said in an interview on Sky News, “The difficulty is that to get the amount of these nutrients that you need per day to achieve [optimal] results isn’t possible from your normal everyday diet.”

But what makes this ingredient so important, and how can we increase our intake? We’ll explain the benefits of this carotenoid and how it benefits eye health.

What Is Meso-Zeaxanthin, and How Does the Body Get It?

Meso-Zeaxanthin, like Lutein and Zeaxanthin, is a carotenoid – a plant-based antioxidant known for its effectiveness in promoting healthy tissue function and preventing disease. But the average person consumes only one to two milligrams of these macular carotenoids daily in their diet. This is because modern farming conditions have caused a decline in the nutritional value of fruits and vegetables. 2 Yet, there are three ways that the body can receive this carotenoid:

  • Found in leafy green vegetables, the body can convert the antioxidant Lutein into Meso-Zeaxanthin. But there’s a catch: Some people cannot convert Lutein into Meso-Zeaxanthin. This condition, present in roughly 20 percent of patients, is particularly prevalent in those with AMD.
  • Meso-Zeaxanthin can also be found in the skin of some fish, such as salmon. But you would have to eat over 200,000 trout to reach the amount needed to start rebuilding the macular pigment.
  • Additionally, high quality eye supplements use marigold flower petals to provide a natural extract rich in the carotenoids Meso-Zeaxanthin, Lutein and Zeaxanthin.

What Does Meso-Zeaxanthin Do When Combined With Lutein and Zeaxanthin?

Of the three macular carotenoids in the eye, Meso-Zeaxanthin is the most powerful. It exists at the center of the macula, and studies show that when Meso-Zeaxanthin combines with Lutein and Zeaxanthin, they become even more effective than they are on their own. When they work together, these critical ingredients are useful in rebuilding the macular pigment, screening out harmful blue light, fighting inflammation and reducing oxidative stress in the eyes and brain.

The CREST Study

Many eye supplements don’t have Meso-Zeaxanthin as an ingredient, using the rationale that the body creates this carotenoid by converting it from Lutein. Others say there aren’t enough scientific studies on Meso-Zeaxanthin to draw a firm conclusion about its significance. However, over 25 placebo-controlled trials involving supplements with Meso-Zeaxanthin prove its effectiveness.

But what about patients who cannot convert Lutein into Meso-Zeaxanthin?  Without a supplement that contains Meso-Zeaxanthin, improvement of visual performance and reduction of risk for developing age-related macular degeneration may be severely compromised.  Therefore, to realize the benefits of using all three carotenoids, the inclusion of Meso-Zeaxanthin is essential. 

For that reason, two clinical trials published in 2016 and 2017 show the significant benefits of supplementing with all three macular carotenoids – Meso-Zeaxanthin, Lutein and Zeaxanthin. In the first trial, known as CREST3 (Central Retinal Enrichment Supplementation Trials), the evidence showed that those taking supplements with all three carotenoids improved their visual function – including contrast sensitivity, vision in glare, and reading speed.


Then in the second major two-year clinical trial with those diagnosed with the early stages of AMD, CREST AMD4, the results showed that those taking supplements with all three carotenoids improved their visual function – including contrast sensitivity, vision in glare, and reading speed.



Despite the clinical studies that prove Meso-Zeaxanthin’s importance to our vision, getting this carotenoid into our diet is challenging. Thankfully, supplementation offers a safe and proven way to do it. As a result of high-level studies, the evidence shows that consistent, daily use of high-quality supplements like MacuHealth is a great way to ensure that the body receives the proper amount of Meso-Zeaxanthin, Lutein and Zeaxanthin to support visual health and performance.


  1. [1] Akuffo, K. O., Beatty, S., Stack, J., Dennison, J., O’Regan, S., Meagher, K. A., Peto, T., & Nolan, J. (2014). Central Retinal Enrichment Supplementation Trials (CREST): design and methodology of the CREST randomized controlled trials. Ophthalmic epidemiology, 21(2), 111–123. https://doi.org/10.3109/09286586.2014.888085

  2.  Kwadwo Akuffo, Jessica Dennison, Sarah O’Regan, Stephen Beatty, John Nolan, Macular Pigment Research Group; Central Retinal Enrichment Supplementation Trials (CREST): Design and Methodology. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3773.

  3.  Li, B., Ahmed, F., & Bernstein, P. S. (2010). Studies on the singlet oxygen scavenging mechanism of human macular pigment. Archives of biochemistry and biophysics504(1), 56–60. https://doi.org/10.1016/j.abb.2010.07.024

  4. Akuffo KO, Beatty S, Peto T, Stack J, Stringham J, Kelly D, Leung I, Corcoran L, Nolan JM. The Impact of Supplemental Antioxidants on Visual Function in Nonadvanced Age-Related Macular Degeneration: A Head-to-Head Randomized Clinical Trial. Invest Ophthalmol Vis Sci. 2017 Oct 1;58(12):5347-5360.