AREDS and AREDS2 trials

The original Age-Related Eye Disease Study (AREDS) performed by the US National Institute of Health (NIH) started in 1996. It involved over 4,000 participants and found that specific high doses of Vitamins C and E, anti-oxidant carotenoid beta-carotene and the minerals zinc and copper (known as the AREDS formulation) can help slow the progression to advanced Age-related Macular Degeneration (AMD).

  • Beta-carotene (15mg)
  • Vitamin C (500mg)
  • Vitamin E (400IU)
  • Zinc (80mg)
  • Copper

In this first AREDS trial, the risk of developing advanced AMD was reduced by 25% in those who took the AREDS formulation. The trial lasted for five years until 2001 and was placebo-controlled, meaning the comparison group took a tablet that did not contain the AREDS formulation.

Since then, other ingredients thought to be beneficial to the eyes have been tested. The AREDS2 trial started in 2006 and again involved more than 4,000 participants. Over the next five years it examined whether these other ingredients could improve the original AREDS formulation. They are two carotenoid vitamins from plant sources, lutein and zeaxanthin and EPA/DHA (omega 3 fatty acids), such as those found in oily fish. The trial also tested the removal of beta-carotene and lower zinc levels than the original formulation as these can cause side effects in some people.

Supplements

Not all supplements are the same, ensure you have one which conforms to the AREDS2 formula

The results were announced during a Special Session at ARVO (Association for Research in Vision and Ophthalmology) on May 5th 2013 and published simultaneously online by the JAMA (Journal of the American Medical Association. Analyses of the AREDS2 data showed:

  • Supplementation is even more important for people with poor diets
  • Care should be taken recommending a supplement which contains a mix of carotenoids as this may be counterproductive. So where a supplement contains the main carotenoids of lutein and zeaxanthin others such as beta-carotene, meso-zeaxanthin or astaxanthin should be avoided.
  • Lutein + zeaxanthin could be a suitable substitute for beta-carotene in the original AREDS formula

With regard to beta-carotene the study confirmed that taking the high dose of beta-carotene used in the original AREDS formula is linked to an increased risk of lung cancer in ex-smokers (as well as smokers). Finally, while there appeared to be little difference in the results for the sub-groups receiving higher and lower doses of zinc, there was insufficient evidence to suggest changing the original AREDS formula.

In summary, when announcing these results the team ended by suggesting that the new AREDS2 formulation would be suitable for everyone and should be:

  • Vitamin C (500mg)
  • Vitamin E (400IU)
  • Lutein (10mg)
  • Zeaxanthin (2mg)
  • Zinc (25mg)
  • Copper

For more information visit www.areds2.org.uk