Seeing Green

The quick answer:  Spinach, kale, other dark greens, and eggs contain two antioxidants important to eye health: lutein and zeaxanthin. 


The Rise and Fall of Diseases

Changes in society bring new diseases.  In the rise of the Industrial Revolution, people left the farm and crowded into cities to work in factories.  My ancestor Robert Hellewell was an example:  In England’s first general census, taken in 1841, he and his wife Mary had left the villages of their birth for the textile mills in the city of Leeds.  He was a machinist, she a loom tender.

It was spontaneous—cities weren’t designed, they just happened.  Systems for delivering clean water and taking away sewage didn’t exist.  Increasingly, the perishable foods of the farm were replaced with foods processed to extend shelf life.   In times past, you ate what you or a neighbor could grow; now you could eat whatever was for sale, including a modern treat once reserved for kings: sugar.  The body was used to scarcity, but it had few controls to protect against this new year-around bounty.  The times were a changing and food traditions were tossed aside.

In crowded cities infectious diseases, once rare, became common.  Children were the primary victims; in 1900 half the funerals in our largest East Coast cities were for children.  Of the diseases, tuberculosis was the most frightening but epidemics like colera were scary too. 

It was cholera that gave birth to a new science, epidemiology—the study of epidemics.  A London doctor named John Snow observed how a cholera outbreak centered on a public well.  He had the well shut down and the outbreak stopped.  (The well's source was sewage-polluted water from the river Thames.)  In retrospect, the infectious diseases were simple: one bacterium caused one disease. 

Though simple, it took a century to control the infectious diseases and the solution was through public works: clean water, sewage systems, and street drains.  By the middle of the 20th century mortality among children had declined and the rise of vaccines and antibiotics added a further measure of control.

A New Paradigm

Unfortunately, a new health threat arose—the chronic diseases.  Epidemiology, the old paradigm, caused us to look in the wrong places for a solution to these modern diseases. 

  • First, they weren’t diseases of a single cause; they have multiple causes. 
  • Second, because of their complexity the cure is elusive.  Now prevention would be the "cure" but society doesn't easily change its paradigms. 
  • Third, these diseases develop slowly, over decades, so in a lifetime of living it’s difficult to find causes hidden, like needles, in a haystack as big as society. 
  • Maybe there is a fourth issue: diet is a big part of these diseases and in a free society we can’t control what people eat, so observational studies—which use occasional “food frequency questionnaires”—are an ineffective tool.

The effect of chronic disease can be seen in one statistic, longevity.  We imagine that longevity has greatly increased in the last century, and it has for children but not for adults.  The life expectancy for a 65-year old in 1900 was 12 additional years, in 2000 it was 18 years—only a six-year improvement despite an enormous investment in health care.

A New Strategy

Though society moves at glacial speed, individuals can respond quickly, if they don't mind being different.  The wise person understands that a new paradigm calls for a new strategy.  If you read this blog and apply the Healthy Changes, you’ve on the leading edge.  To use a quaint term from the past, you're a pioneer.  People have different needs, but the new strategy for saving one's health looks something like this:

  1. Focus on prevention; let the scientists chase the elusive cure.
  2. Make many changes.  It’s not one thing; the chronic diseases are multifactorial so you must change many risk factors. 
  3. Focus on what you can change.  Scientists are in love with genetics, it’s the new thing, but you’ve already chosen your parents.
  4. Start with diet.  We eat  15-20 pounds of food a week plus we live in a toxic food environment.  Over the years, unhealthy food is a giant source of toxins.
  5. Start early and be patient.  These diseases develop over decades and though the body has remarkable healing powers if well fed, it takes time.

Lutein and Zeaxanthin

Vegetables (and fruits) contain hundreds of antioxidants from the carotenoid family.  (Carotenoids get their name from carrots, but they come in other colors.)  Dark green veggies are a key source of antioxidants.  Two—lutein and zeaxanthin—found in spinach and other dark greens (and natural eggs, too) play a special role in eye health.  Of all the carotenoids, only zeaxanthin and lutein are found in the retina.  As these are fat-soluble nutrients, eating them with healthy fats aids absorption.  There's hidden wisdom in the tradition of splashing olive oil on salads. 

The diseases of the week are cataracts and age-related macular degeneration (AMD).

Macular degeneration:  Zeaxanthin protects the retina against oxidative stress.  The center of the retina, the macula, provides the sharp vision needed for reading, and is rich in leutin.  Leutin protects the macula against harmful blue light.  In 2007, a 6-year National Eye Institute study confirmed that lutein and zeaxanthin protect against AMD blindness.  The study also found the omega-3 fats EPA and DHA  protective.  We discussed the role of these omega-3 fats in a prior post, “The Worst Food Mistake of the Last Century” and suggested they be included in every meal.  

Lutein and zeaxanthin are traveling cousins; foods like spinach, kale, and eggs that contain one, contain the other.  Science has not yet determined an optimum level for lutein and zeaxanthin in the diet.  Until we know more, it’s important to eat a diet rich in whole foods, especially greens and other colored fruits and vegetables.  These foods are also rich in beneficial vitamins, minerals, other antioxidants, fiber, and yet undiscovered nutrients which likely work together in a synergistic way.

What about lutein and zeaxanthin in pill form?  While supplements provide certain nutrients, most studies do not find a benefit from eating supplements alone and adverse effects have been seen.  A 2006 Cochrane Review of the AMD research did not find a protective role for supplements.  So get your lutein, zeaxanthin, omega-3s and other nutrients in whole foods, unless a qualified doctor recommends otherwise. 


Cataracts form from degraded protein buildup in the eye lens.  There are many causes, though age is always a factor.   Causes noted in the last post included cigarette smoke, excessive UV exposure, heavy alcohol consumption, and certain drugs.  Photosensitizing drugs (steroids, antihistamines, birth control pills, tranquilizers, NSAIDS, and antidepressants) are a cataract risk factor if used long-term.  Occupational exposure to radiation is another cause.  Astronauts and airline pilots (cosmic radiation), and radiologists (X-rays and other ionizing radiation) have a high risk for cataract formation. 

How about your kitchen microwave?  There is no credible evidence, to my knowledge, showing increased cataract risk from kitchen microwaves.  On the other hand, I find no serious studies of the subject.  If there is an influence, it is likely small but should not be ignored.  My personal conclusion is to limit microwave use to warming food (not cooking) and try not to stand with my face to the door waiting to eat (which in my impatience I have done many times).

Does cell phone radiation contribute to cataracts?  Same answer, I think.  We don’t really know but the influence is most likely small.  Still, it's a good reason to text, as the phone isn’t near your head.  Speaking of cell phones, there is a new iPhone app for checking cataracts in 3rd world countries.  MIT researchers just announced a hand-held device they named Catra that attaches to an iPhone to scan your eye for cataracts.  Termed “a radar for the human eye” it opens the door to an idea many would like: do-it-yourself eye care.  Catra is still in beta stage but it's a way cool idea.

The Bottom Line

Because of the way research is funded, there is surprisingly little solid guidance on how we should protect our eyes.  I know someone who was diagnosed with early-stage cataracts.  The doctor made no recommendation for protective action and almost seemed pleased to have a new candidate for their cataract surgery business. Protecting vision is a little like the immune system—what’s good for the whole body is likely also good for the immune system . . . and your eyes.  But for starters, eat a naturally colorful diet that includes antioxidants like lutein and zeaxanthin, and get plenty of exercise.  Maintain a healthy weight and occasionally check your blood pressure and blood sugar levels.  And try to find a doctor passionate about preventing eye diseases.  In upcoming posts we’ll talk about the importance of getting enough sleep and managing the stresses in our lives.

Please comment on your experience with eye health.  This is a subject too seldom discussed so lets share what we’ve learned.

PrintView Printer Friendly Version

EmailEmail Article to Friend

Reader Comments (6)

I inherited my horrible eye sight from my father. He now has glaucoma and has undergone several surgeries for that. Seeing things is very important to me, so eye health is particularly important as well. I am grateful for this post. Funny how if we eat lots of vegetables (in all their varieties) and whole foods, we should be able to hit all the areas of health we are looking for. This is just another reason to really focus on eating plenty of vegetable each and every day.

September 12, 2011 | Unregistered CommenterLaura

Laura, you're right on target. Adding vegetables to the diet really is the hardest but most necessary step for most folks. It's easy to eat fruit, or nuts, maybe because they can be eaten as is. thanks for your comment.

September 12, 2011 | Unregistered Commenterskip hellewell

I used to use the eye drops all the time that "get the red out". My eye doctor told me that this cuts down the oxygen to the eye and I should use it sparingly. A plain saline solution is fine.
I just figure that red is a nice color! My eyes just to seem to have a few more of those red blood vessels. I finally got myself some prescription sunglasses this year.

September 13, 2011 | Unregistered CommenterNancy O

This really interests me because my youngest daughter was born with a congenital cataract. Thankfully, it is a tiny pinpoint, in only one eye, and no surgery was required. However, she is definitely at risk for the cataract to grow, and I would love to do anything I can to help prevent that, as well as prevent any more cataracts. I have not received any preventative advice from our doctors yet. Next time I see them I will ask for their thoughts on diet and prevention. Thanks for this post--I honestly had not thought about this angle before now, but it gives me even more reason to include these healthy foods in our diet, and to make sure my 3-year-old eats them too.

September 18, 2011 | Unregistered CommenterMichelle

Great post. I happen to have an eye doctor who is progressive and urges his patients to eat a good diet for good vision health. I'd love to find a physician who has the same views - i.e. healthy lifestyle for disease prevention vs. treating the symptoms. Any ideas on how one would search for such a dr.? I've tried various google searches w/out any luck.

September 19, 2011 | Unregistered CommenterSusan

I had an interesting experience a few months ago during my annual eye exam. The doctor discovered that the astigmatism, that is only in my left eye, had improved to the point where she felt it didnt need to be corrected any more. That has never happened before and I made a smart remark about drinking so many green smoothies. She confirmed the information contained in this blog post regarding the beneficial effects of lutein (and the other which I can't spell).

September 25, 2011 | Unregistered CommenterMarilyn

PostPost a New Comment

Enter your information below to add a new comment.

My response is on my own website »
Author Email (optional):
Author URL (optional):
Some HTML allowed: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <code> <em> <i> <strike> <strong>