Recent research in the eye health industry is paving the way for new supplement options.
The eye health dietary supplements market is growing rapidly. One market researcher recently predicted that the global market will be worth over $2.85 billion by 2024.1 The 2017 report by Persistence Market Research noted the consumer concerns driving market growth: “Prevalence of cataracts, macular degeneration, glaucoma, and many other eye diseases is prompting people to get eye health supplements prescribed from their ophthalmologists.” Even more specifically, the report predicted, more than two-thirds of eye health supplements produced around the world will be used by those concerned with age-related macular degeneration (AMD).
The report, which also took a deeper look at eye health supplement leaders like Vitabiotics, Valeant Pharmaceuticals International, Alliance Pharma, Novartis, Amway, Pfizer, and Nature’s Bounty, stated that North America will continue to lead the global eye health supplements market, with more than 30% revenue share. Strong growth is also predicted in Europe, as well as in Asia-Pacific, where Persistence predicted revenue will grow at 6.7% CAGR through 2024.
As for product manufacturing, Persistence said that lutein and zeaxanthin will remain core ingredients, accounting for more than 60% share of the market. “Demand for these ingredients will continue [to] gain traction during the forecast period,” the market researcher predicted.
These ingredients are especially crucial nutrients in the fight against AMD. “Dietary supplementation with lutein and zeaxanthin has been recommended for the prevention of AMD for more than 25 years, and it is still the most effective way to prevent, or delay, the onset of AMD,” says Cecilia McCollum, executive vice president of Blue California Ingredients (Rancho Santa Margarita, CA), supplier of the Biolut lutein ester ingredient with 2.5% zeaxanthin. “Loss of vision due to AMD is not reversible, so prevention is the only way to control the onset of the disease,” she adds.
As the eye health market evolves, newer concerns related to healthy vision, such as the damaging effect of blue light, are opening up new avenues in the market. One thing hasn’t changed, however: consumers are still demanding solutions backed by research and high-quality data. Here is a quick update on some of eye health’s biggest ingredient stars as well as developing market opportunities.
Lutein and Zeaxanthin
Together, lutein and zeaxanthin-both RR-zeaxanthin (also referred to as “dietary zeaxanthin”) and RS-zeaxanthin (also known as “meso-zeaxanthin”)-form the macular pigment that protects the optic nerve from UV light, explains Blue California’s McCollum. An effective supplement for eye health should therefore offer both lutein and zeaxanthin, as these same pigments are present in the human macula, she says.
Lutein and zeaxanthin work in concert to provide benefits for eye health. “We’re now learning that lutein and zeaxanthin should be consumed together,” says Ceci Snyder, global manager of vision products for ingredient supplier Kemin (Des Moines, IA). “Lutein predominantly accumulates in the rods of the eyes, while zeaxanthin accumulates in the cones.” Kemin supplies its branded and patented FloraGlo lutein and ZeaOne zeaxanthin (in the form of RR-zeaxanthin, or “dietary zeaxanthin.”)
Kemin says it is continually engaged in more research projects examining the synergistic efficacy of lutein and zeaxanthin as a combination eye health supplement, with preliminary results expected soon. Many studies have already demonstrated the importance of both ingredients as eye health supplements, thanks to their ability to increase macular pigment density, improve visual function, and decrease “the risk of progression of intermediate age-related macular degeneration to late age-related macular degeneration.”2
Snyder notes that she’s also seeing more supplement manufacturers like Wiley’s Finest combine lutein with omega-3 fatty acids, taking advantage of lutein’s fat solubility to further improve ingredient delivery.
Until recently, it was posited that lycopene plays some kind of a role in eye health, but the exact mechanism remained elusive. Now, research is demonstrating that lycopene plays a supplementary role in eye health by serving as a protective barrier that prevents lutein oxidation.
“Lycopene sacrifices itself for lutein by protecting it from oxidation, allowing lutein to be effectively transported to the eye,” said Karin Hermoni, PhD, head of science and nutrition for lycopene-ingredient specialist Lycored (Secaucus, NJ), in a company press release.
Late last year, Lycored announced the results of an ex vivo study3 the company funded that found that “although lycopene does not contribute directly to macular pigmentation-like lutein does-it works in tandem with other nutrients to help create the most potent combination of eye-protecting nutrients,” Hermoni said.
The study was performed on cells isolated from seven female and three male patients between the ages of 65 and 88 who suffered from neovascular age-related macular degeneration. Study researchers sought to determine whether carotene supplementation could modulate the phenotypes of macrophages to halt their pro-angiogenic effects and stop the progression of AMD. Cell samples were divided into four supplement groups and one vehicle control group. All supplement groups received a combination supplement containing 1) 1 micrometer of lutein, and 2) 0.2 micrometers of zeaxanthin.
Three of the four supplement groups also received additional supplements. The second supplement group added 10 micrometers of zinc to the lutein-zeaxanthin compound. The third supplement group incorporated lutein-zeaxanthin, zinc, and 2 micrometers of Lycored’s branded and patented natural tomato lycopene extract Lyc-O-Mato, as well as 2 micrometers of carnosic acid in the form of rosemary extract. The fourth supplement group received 2 micrometers of carnosic acid and 2 micrometers of beta-carotene.
The study found that the combination therapy including the lycopene ingredient produced anti-inflammatory and antioxidative effects by upregulating the HMOX1 and SOD1 genes and downregulating the SDF-1, TNF-alpha, IL-6, and MCP-1 genes. This combination was more effective than lutein and zinc or lutein alone, the researchers said.3
Lycored says it is currently carrying out phase two of its research program, focusing on clinical studies on macular blood flow. Golan Raz, head of Lycored’s global health division, says that ongoing research will better illuminate the ways that different kinds of natural carotenoids work together to promote eye health.
“Right now in the industry, there’s more investment into research that examines the synergies between ingredients,” Raz says. “This approach may suggest that the next phase of commitment to scientific professionalism is here. This phase involves true research on the actual composition of ingredients that will be sold to the consumer, not just basic research at the individual ingredient level.”
Blue Light Protection…and Sleep?
While macular carotenoids have long been known to play an important role in eye health, a recent clinical trial has shown that macular carotenoid supplementation can improve not just eye health, but also sleep quality.
In 2017, results were published from a randomized, double-blind, placebo-controlled trial4 called the B.L.U.E. (Blue Light User Exposure) Study. This study followed 48 healthy subjects (25 female, 23 male) between 18 and 25 years of age for six months. The B.L.U.E. study sought to determine the effects of lutein/zeaxanthin supplementation on visual performance, sleep quality, eye strain, and eye fatigue in young adults exposed to blue light for long periods of time.
All subjects were non-smokers with a BMI of under 27 who had 20/20 or better visual acuity in the right eye and no current or prior history of ocular pathology. The study excluded subjects who wear corrective lenses, and included only subjects who spend at least 6 hours per day viewing electronic screens from less than 3 feet away.
Subjects were randomly assigned to a placebo (n=13) or macular carotenoid supplementation (n=35) group. The supplement group received a once-daily 24-mg dose of OmniActive Health Technologies’ (Morristown, NJ) branded and patented Lutemax 2020 supplement, consisting of lutein (83%), RR-zeaxanthin (10%), and RS-zeaxanthin (“meso-zeaxanthin”) (7%) suspended in safflower oil in the form of a soft gelatin capsule. Subjects were instructed to ingest one pill with food per day, and researchers ensured compliance using weekly phone calls and pill counts.
Relative to the placebo group, the supplement group saw statistically significant improvements in temporal vision as well as in sleep quality. After six months, the supplement group saw improvements in macular pigment ocular density, temporal vision, sleep quality, contrast sensitivity, disability glare, photostress recovery, headache frequency, eye strain, and eye fatigue compared to the placebo group.4
Brian Appell, marketing manager for OmniActive Health Technologies, says that the B.L.U.E. study underscores the effectiveness of macular carotenoids. “This study establishes a direct link between macular carotenoid supplementation and protection against prolonged blue light exposure,” Appell says. “It further highlights the role macular carotenoids serve to support healthy vision.”
The B.L.U.E. study, and OmniActive’s accompanying “What’s Your B.L.U.E.?” awareness campaign, won the NutrAward for Best Functional Ingredient at the 2018 at the Natural Products Expo West trade show in Anaheim, CA.
Blue Light Exposure Concerns Drive New Children’s Formulations
Constant exposure to blue light from electronic devices is changing the needs and demands in the eye health market. Ingredient suppliers like OmniActive and Kemin describe how this problem is presenting new opportunities in the children’s supplement arena especially.
“We’ve seen a lot of interest from brands who want to use [Kemin’s patented lutein ingredient] FloraGlo in children’s products,” Kemin’s Snyder notes. “People are starting to grasp that children’s exposure to blue light is going to be a problem in the future, so people are starting to show more interest in children’s products with blue light claims.”
But it’s not just children who benefit from supplements that counteract blue light. Snyder notes that the adult market is also ripe for blue light–oriented products; luckily, Snyder says, eye health can be an easier sell because consumers tend to appreciate the benefits up front. “A lot of consumers are looking for solutions that create a difference they can see,” Snyder says. “People don’t necessarily think about getting cancer in 30 years, but they do realize that their eyes get tired after staring at a computer screen all day.”
More recently, in a mouse study5 on OmniActive’s Lutemax 2020, researchers investigating how lutein and zeaxanthin combat blue light–induced eye degeneration discovered that the mechanism of action might be related to their ability to regulate genes involved in photoreceptor degeneration. After being fed Lutemax 2020 for five days, the mice were exposed to blue light. After the mice were euthanized, researchers examined the mice’s retinal tissue. They found that compared to placebo, Lutemax 2020 supplementation resulted in changes in gene expression and cell composition that the researchers said would align with a reduction in oxidative stress and a reduction in endoplasmic reticulum stress.
The company says it will continue studying the effects of Lutemax 2020 and potential protection against blue light exposure.
New Product Trends
Snyder says manufacturers are now pushing the boundaries of the eye health supplement niche, with non-traditional product formats emerging to challenge the typical capsule-style supplement. “People are really pushing the envelope to see what they can do,” Snyder explains. “We’re seeing a lot of eye health gummies out there, and stick packs as well. There’s also continued interest in natural ingredients and clean-label products.”
Manufacturers looking to capitalize on the expanding eye health market would do well to observe these trends and consumer health concerns. The future of eye health supplements will involve convenient formats, natural ingredients, clean-label formulations, and emphasis on immediate functional benefits.