Eyesight is one of the things that is often taken for granted by most people, until it is too late. Just like other body parts like the heart and the stomach, the eyes also deserve proper care and nutrition. Millions of people around the world suffer from various eye disorders like cataracts (blurred vision, due to the eye lens becoming progressively opaque), and macular degeneration (a deterioration of the macula, the small central portion of the retina). Diet plays an important role in every cell in your body and eye cells are no different. A nutrient-poor diet may lead to eye problems later in life, as well as other complications. It is thus essential to eat the right foods in order to ensure the eyes are protected from damage, and vision loss through age.

Nutrients for eye health
Your eyes require specific nutrients to keep them in top condition, and to prevent eye disorders. Antioxidants are usually part of the group of nutrients that maintain the eyes, because they prevent toxic molecules called free-radicals from damaging the delicate tissues of the eye.

Here Are The Top Nutrients Essential For Eye Health:

1. Vitamin A
Also known as retinol in its active form, vitamin A is important in maintaining eye health. It helps the body produce the eye pigment retinoid, which play a significant role in the vision mechanism. Specifically, vitamin A maintains good vision in dim light. A deficiency in vitamin A leads to a condition called night blindness, which renders the affected person unable to see clearly in dimly lit areas.¹

Vitamin A can be found in a variety of food sources. It is particularly high in colored (yellow, orange, and green) fruits and vegetables like squash, carrot, cantaloupe, sweet potato, spinach, broccoli, and other dark green leafy vegetables.

Processed foods are often fortified with vitamin A to ensure that the consumer gets the recommended daily intake of 700 mcg (adult females) and 900 mcg (adult males), although this form of vitamin A is almost always synthetic (retinyl palmitate or retinyl acetate).

2. Vitamin C
Another antioxidant that is important to eye health is vitamin C or ascorbic acid. As an antioxidant, its main function is to prevent free radicals from damaging body tissues. In fact, researchers from the Department of Ophthalmology, at the University of Medical Sciences in Zabjan, Iran, discovered that plasma vitamin C levels is lower in those suffering from cataracts, as opposed to normal individuals.²

The most common sources of vitamin C are citrus fruits like oranges, lemons, and grapefruit. Non-citrus sources include papaya, strawberries, broccoli, tomatoes, and peppers (green and red). One can also find vitamin C-fortified products in the supermarket like bottled fruit juices.

3. Lutein and Zeaxanthin
Lutein and zeaxanthin belong to a group of molecules called carotenoids. They comprise the majority of the carotenoids found in the human eye. Like vitamins A and C, they function as antioxidants and protect the eye by filtering harmful light and preventing glare. A recent study appearing in the journal Ophthalmology, indicated that people with the highest intakes of lutein and zeaxanthin, can experience a 20 percent reduced risk of early age related macular degeneration.³

These nutrients are not hard to obtain, as they are found in a variety of foods. A study in 1998 by researchers from the Department of Ophthalmology and Visual Sciences, concluded that corn and egg yolk contain the highest percentage of lutein and zeaxanthin, followed by kiwi, grapes, zucchini, orange juice, and spinach.⁴ The study further recommends that, in order to increase lutein and zeaxanthin levels, colorful fruits and vegetables should be incorporated into one’s diet.

4. Zinc
Zinc is a trace element that plays an important role in many body processes. In the eye, zinc works together with vitamin A to produce a substance called melanin that helps protect the eye from damage.⁵ High levels of zinc are found in the macula of the eye. Deficiency in zinc has been linked to an increased risk of developing macular degeneration,⁶ which can be easily prevented through proper nutrition. The recommended daily intake for zinc is 11 milligrams for adult males and 8 milligrams for adult females.

Foods that are rich in zinc include oysters, pork, beef, dairy products like milk and yogurt, whole grains, chickpeas, and lobster. Zinc-fortified foods are also available in the typical supermarket aisle.

5. Omega-3 fatty acids
Also known as the “good fats,” omega-3 fatty (DHA and EPA) acids maintain the fluidity and structural integrity of body cells and tissues, and have anti-inflammatory properties. They are also important in proper visual development in infants. In adults, omega-3 fatty acids are important in preventing macular degeneration and subsequent vision loss.⁷

The best dietary sources of omega-3 fatty acids are coldwater fish like salmon and mackerel. Tuna is also a good source of omega-3 fatty acids. For vegetarians, algae, flaxseed, hempseed and their oils are the best sources.

6. Vitamin E
Vitamin E is a fat-soluble antioxidant that protects cells and tissues from oxidative damage. While more research needs to be done on its importance to eye health, initial studies suggest that vitamin E works together with lutein and zeaxanthin to prevent cataract formation. The American Optometric Association recommends a daily intake of 400 IU of vitamin E to maintain good eye health.

Dietary sources of vitamin E include sunflower seeds, almonds, wheat germ, vegetable oils, and avocados.

References

1. Sarubin Fragaakis A, Thomson C. The Health Professional's Guide to Popular Dietary Supplements Amer Dietetic Assn; 3 edition (November 30, 2006).
2. Jalal D, et al. Comparative study of plasma ascorbic acid levels in senile cataract patients and in normal individuals. Current Eye Research. 2009 Feb;34(2):118–22.
3. Wang JJ, et al. Genetic susceptibility, dietary antioxidants, and long-term incidence of age-related macular degeneration in two populations. Ophthalmology. 2014 Mar;121(3):667–75.
4. Sommerburg O, et al. Fruits and vegetables that are sources for lutein and zeaxanthin: the macular pigment in human eyes. Br J Ophthalmol. 1998 Aug;82(8):907–10.
5. Ultra-violet and Blue Light Aggravating Macular Degeneration American Macular Degeneration Foundation. https://www.macular.org/ultra-violetand-blue-light.
6. Smailhodzic D, et al. Zinc supplementation inhibits complement activation in age-related macular degeneration. PLoS One.2014 Nov 13;9(11):e112682.
7. Lawrenson JG, Evans JR. Omega 3 fatty acids for preventing or slowing the progression of age-related macular degeneration. Cochrane Database System Review. 2015 Apr 9;4:CD010015. [Epub ahead of print]
8. Head KA. Natural therapies for ocular disorders, part two: cataracts and glaucoma. Alternative Medical Reviews. 2001 Apr;6(2):141–66.

The health of the body is often reflected in the eyes. Circulatory problems, which are hidden elsewhere in the body, can manifest visibly in these organs. Similarly, the antioxidant status of the aging body often will have a profound effect upon the eyes. Age-related macular degeneration (AMD, a deterioration in the retina at the point at which images are focused) is a typical result of the aging process, as the formation of cataracts (opaque defects in the transparency of the lens of the eye). Prevent Blindness America estimates that AMD may affect 13 million individuals in this country. Cataracts impair the vision of roughly four million Americans. Some authorities estimate that thirty percent of all adults aged 70 and older suffer from some form of vision impairment.

Diet, through its effects upon antioxidant status, may play a significant role in these age-related degenerations. Indeed, the eyes are especially prone to certain types of oxidative damage. In one study of 40 to 70 year olds, for instance, those who consumed fewer than 3.5 servings of fruits and vegetables per day had five times the risk for developing one type of cataract and 13 times the risk for developing another type of cataract when compared to those who ate more than 3.5 servings of fruits and vegetables daily.1 Hence, a prudent plan would be to use diet and supplements to insure the intake of a comprehensive combination of nutrients which support the various aspects of visual functioning and which help to maintain optimal ocular antioxidant status.

LUTEIN AND ZEAXANTHIN, EYE SAVERS?
Lutein and zeaxanthin are important antioxidants used by the body for a number of physiological functions. Of all the currently recommended nutrients for the eyes, these have perhaps received the widest general endorsement. They are found in a variety of foods and now are also available in significant amounts in supplemental form.

Lutein is a carotenoid, which does not supply vitamin A activity to the body. It is chemically distinctive in that it lacks part of the terminal “ring” structure of the other carotenoids. Like its close relative zeaxanthin, lutein is what is termed a xanthophyll carotenoid. Both of these related carotenoids are better antioxidants than is beta-carotene under normal oxygen conditions. Lutein is the more important of the two. According to Optometry (the Journal of the American Optometric Association), “Lutein can be metabolized into zeaxanthin and is therefore the more essential carotenoid.” Zeaxanthin has been shown to be present in the center of the macula. Lutein and zeaxanthin are usually found together in leafy green vegetables, such as kale, broccoli, spinach and mustard greens.

One of the primary functions of lutein and zeaxanthin is to provide protection against oxidative and free radical damage. These yellow-colored carotenoids are found in high concentrations within the macula lutea (the yellow spot in the center of the retina) and in smaller amounts throughout the retina and the eye lens. They are also concentrated in the skin, breast and cervical tissues. These stores, however, appear to diminish at an increasing rate with age if not regularly replenished through dietary means.

LUTEIN/ZEAXANTHIN AND THE AMD CONNECTION
Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in people over age 65. The exact cause of AMD is not yet known, although the protective role of nutrition against the condition is being researched at major universities and other institutions. A study published in the Journal of the American Medical Association concluded that a daily intake of six mg per day of lutein led to a 43 percent lower risk of developing AMD.2

Scientists believe that lutein and zeaxanthin contribute to the density of macular pigment3—the component of the retina of the eye which typically absorbs and filters out 40 to 60 percent of damaging near-ultraviolet blue light (near-UV blue light) which strikes the retina. The denser the pigment, the more the inner retina is protected from light-induced damage. Lutein/ zeaxanthin also helps limit blue light damage to the inner retina by inhibiting lipid peroxidation and by neutralizing free radicals.

LUTEIN/ZEAXANTHIN AND HEALTH OF THE EYE LENS
Considerable evidence shows the importance of lutein and zeaxanthin in reducing changes in the opacity of the eye lens as we age. A study published in the British Medical Journal examined cataract formation among 50,000 women over an eight-year period.⁴ The results clearly showed that the consumption of spinach, which is an excellent source of lutein and zeaxanthin, led to a much lower level of such eye lens changes than did the consumption of other vegetables, such as carrots, sweet potatoes and winter squash, which contain primarily betacarotene and very little lutein. Similarly, according to a study published in the Journal of the American Medical Association, people who eat foods rich in lutein—particularly kale and spinach—are less likely to develop macular degeneration.⁵ The intake of carotenoids other than beta-carotene, that is, alpha-carotene, lutein and lycopene, has been inversely correlated with the risk of developing cataracts. In other words, the more alpha-carotene, lutein and lycopene consumed, the lower the incidence of cataracts.⁶ Protection most likely comes from the scavenging of free radicals. Oxidative/free radical damage to the eye lens is believed to play an important part in the development of cataracts. Lutein/zeaxanthin prevent peroxidation in the lens, thus limiting damage to the opacity of this tissue. However, there is no evidence that lutein/ zeaxanthin can help to reverse an existing cataract.

BILBERRY: FOOD FOR THE EYES
Another food that has an especially strong affinity for the eyes is bilberry. The bilberry (Vaccinium myrtillus) is a close relative of American blueberry. It grows in Northern Europe, Canada, and in parts of the Northern United States, where the berries are known as huckleberries. There are over 100 species with similar names and fruit. The English call bilberries whortleberries. The Scots know them as blaeberries.

The bilberry has many historical or traditional uses based upon both the dried berries and the leaves. It has been used as a medicinal herb since the 16th century. Modern interest in the bilberry is partly based on the fruit’s use by British pilots during the Second World War. These pilots noticed that their night vision improved when they ate bilberry jam prior to night bombing raids. In the intervening years, scientists discovered that anthocyanosides, the bioflavonoid complex in bilberries, are potent antioxidants.⁷ Many of the traditionally suggested uses of bilberry, such as against scurvy and urinary tract complaints, no doubt reflect the antioxidant, vitamin C-sparing and anti-inflammatory properties of the berry. However, the astringent qualities of the dried bilberry fruit and of bilberry tea also may provide some benefits and help to explain the use of these in folk medicine to soothe the gastrointestinal tract.⁸ In Europe, bilberry extracts are accepted conventionally as a normal part of health care for the eyes.

Much of the modern research on bilberry extract has focused upon the benefits to the eyes. Bilberry anthcyanosides provide three primary benefits to these organs. First, these highly colored plant pigments nourish the retina. Night vision depends upon the retina’s ability to constantly regenerate visual purple (rhodopsin), and anthocyanosides serve as “building blocks” for this important substance. Tests have confirmed these benefits. When subjects with normal vision supplemented with bilberry extract, it was found that the acuity of their nighttime vision improved, as did the speed at which they adjusted to darkness and the rate at which they recovered from blinding glare.^9,10 After reviewing the literature, some authors have suggested that bilberry extract provides benefits even in cases of myopia.¹¹ These findings may reflect the importance of visual purple for visual acuity in general.

The benefits of bilberry anthcyanosides extend beyond the regeneration of visual purple, however. The eye depends upon a very high relative blood flow and is exposed to large amounts of oxygen. Such factors mean that the eye is extremely vulnerable to problems arising from capillary fragility and that prevention of damage by free radicals plays a major role in maintaining eye health. In Europe, bilberry extracts are widely supplemented by individuals who are known to be subject to eye capillary permeability and retinopathy. The expected benefit is improved integrity of the collagen that is integral to the support structure of the capillaries.¹²

Similarly, several types of deterioration, which are typical of aging eyes, such as cataracts and macular degeneration, appear to be influenced by the rate of generation of free radicals. In laboratory trials, changing the diets from commercial laboratory chow to "well-defined" diets rich in flavonoids has been shown to be beneficial.^13,14 Interesting results have been found with human trials in which bilberry extract was supplemented, either alone or in combination with vitamin E.^15,16

GRAPE SEED EXTRACT AND GINKGO BILOBA EXTRACT
Both grape seed extract and Ginkgo biloba extract enhance the circulatory health of the eyes. Grape seed extract has been studied very widely for it ability to reduce capillary fragility and excessive permeability.¹⁸ It benefits to the circulatory system are not in doubt; nor are its antioxidant benefits. Somewhat surprising, however, are grape seed extract's benefit with regard to recovery from glare, an important aspect of night vision. It now appears that grape seed extract complements the benefits in the area of night vision that are found with bilberry.

As is true of the Chinese herbal tradition, the Indian Ayurvedic healing tradition associates Ginkgo with long life. Modern Western research supports these beliefs from two ancient healing traditions and has led to Ginkgo biloba extract becoming one of the most widely used of all herbal products.¹⁹ The extract often is recommended for improving memory and reaction time²⁰, for improving circulation²¹, and for protecting against free radical damage. Ginkgo biloba also is suggested in traditional practices for improving the physiologic effects of other herbs and nutrients.

SUPPORTING ANTIOXIDANT AND GLUCOSE METABOLISM
The eyes are particularly vulnerable to certain of the long-term effects of poor blood sugar control. As is true of the nerves, the eyes can be damaged by the products of the enzyme known as aldose reductase. Poor control of blood sugar levels also places the tissues of the body under oxidative stress. Blood glucose-related vulnerabilities need to be taken into account when considering eye health. Alpha-lipoic acid has been shown to be a potent antioxidant for the eye in both cataract²² and glaucoma.²³ It is complemented in these actions by the flavonoid quercitin, an inhibitor of the actions of aldose reductase.

CONCLUSION
The eyes are vulnerable organs, but deterioration can be protected against to a remarkable degree through sound dietary practices. Dark green vegetables and fruits in shades of blue, purple and red can be highly protective. The secret is to consume these items daily, or at least several times per week. A judicious use of special herbs and other supplements will complement—not substitute for—these dietary measures.

1. Jacques PF, Chylack LT Jr. Epidemiologic evidence of a role for the antioxidant vitamins and carotenoids in cataract prevention. Am J Clin Nutr. 1991 Jan;53(1 Suppl):352S-355S.
2. Seddon JM, Ajani UA, Sperduto RD, Hiller R, Blair N, Burton TC, Farber MD, Gragoudas ES, Haller J, Miller DT, et al. Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group. JAMA. 1994 Nov 9;272(18):1413.20.
3. Johnson EJ, Hammond BR, Yeum KJ, Qin J, Wang XD, Castaneda C, Snodderly DM, Russell RM. Relation among serum and tissue concentrations of lutein and zeaxanthin and macular pigment density. Am J Clin Nutr. 2000 Jun;71(6):1555.62.
4. 4 Hankinson SE, Stampfer MJ, Seddon JM, Colditz GA, Rosner B, Speizer FE, Willett WC. Nutrient intake and cataract extraction in women: a prospective study. BMJ. 1992 Aug 8;305(6849):335.9.
5. Seddon JM, Ajani UA, Sperduto RD, Hiller R, Blair N, Burton TC, Farber MD, Gragoudas ES, Haller J, Miller DT, et al. Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group. JAMA. 1994 Nov 9;272(18):1413. 20; Jacques PF. The potential preventive effects of vitamins for cataract and age-related macular degeneration. Int J Vitam Nutr Res. 1999 May;69(3):198.205.
6. Mares-Perlman JA, Brady WE, Klein BE, Klein R, Haus GJ, Palta M, Ritter LL, Shoff SM. Diet and nuclear lens opacities. Am J Epidemiol. 1995 Feb 15;141(4):322.34.
7. Salvayre R, Braquet P, et al. Comparison of the scavenger effect of bilberry anthocyanosides with various flavonoids. Proceed Int'l Bioflavonoids Symposium, Munich, 1981, 437.42.
8. Grieve M. A Modern Herbal, vol. 1. (New York: Dover Publications, 1971)385.6.
9. Jayle GE, Aubert L. Action des glucosides d'anthocyanes sur la vision scotopique et mesopique du sujet normal. Thereapie 1964;19:171.85.
10. Caselli L. Clinical and electroretinographic study on activity of anthocyanosides. Arch Med Int1985;37:29.35.
11. Mowrey D. Next Generation Herbal Medicine. (Comorant Books, 1988)15ff.
12. Mian E, et al. Anthocyanosides and the walls of microvessels: Further aspects of the mechanism of action of their protective effect in syndromes due to abnormal capillary fragility. Minerva Med 1977;68:3565.81.
13. Hess H, et al. Dietary prevention of cataracts in the pink-eyed RCS rat. Lab Anim Sci 1985;35:47.53.
14. Pautler EL, et al. A pharmacologically potent natural product in the bovine retina. Exp Eye Res 1986;42:285.8.
15. Bravetti G. Preventive medical treatment of senile cataract with vitamin E and anthocyanosides: Clinical evaluation. Ann Ottamol Clin Ocul 1989;115:109.
16. Scharrer A, Ober M. Anthocyanosides in the treatment of retinopathies. Klin Monatsbl Augenheilkd 1981;178:386.9.
17. Delacrois P. Double-blind study of Endotelon in chronic venous insufficiency. La Revue De Med. 1981;27:28.31.
18. Boissin JP, Corbe C, Siou A. [Chorioretinal circulation and dazzling: use of procyanidolic oligomers (Endotelon)]. Bull Soc Ophtalmol Fr. 1988;88(2):173-4, 177.9. [French text]
19. Castleman M. The Healing Herbs (Rodale Press, 1991).
20. Schmidt U, Rabinovici K, Lande S. Enfluss eines Ginkgo biloba Specialextraktes auf doe befomdlickeit bei zerebraler Onsufficizienz. Muench Med Wochenschr 1991;133( Suppl. 1): S15-S18.
21. Ernst E. Pentoxifylline for intermittent claudication. A critical review. Angiology 1994 ;45: 339.45.
22. Maitra I, Serbinova E, Trischler H, Packer L. Alpha-lipoic acid prevents buthionine sulfoximine-induced cataract formation in newborn rats. Free Radic Biol Med. 1995 Apr;18:823.9.
23. Filina AA, Davydova NG, Endrikhovskii SN, Shamshinova AM. [Lipoic acid as a means of metabolic therapy of open-angle glaucoma] Vestn Oftalmol 1995 Oct-Dec.;111 : 6.8.

Do you have insomnia? Perhaps you just have occasional difficulty getting to sleep or staying asleep. Either way, lack of sleep is a relatively common problem and is frequently treated with medications or alcohol. A consensus from population-based studies¹ and other research² indicate that approximately 30 percent of adult samples drawn from different countries report one or more of the symptoms of insomnia. A U.S. regional survey³ reported that about 20 percent or more of older American adults use some form of sleep aid, including prescription or over-the-counter drugs or alcohol.

MEDICATIONS AND ALCOHOL USE FOR SLEEP
The U.S. National Library of Medicine's PubMed Health⁴ website indicates that while over-the-counter sleep medicines to treat insomnia can sometimes be useful, there can be side effects such as daytime sleepiness, dry mouth, and blurred vision. These effects may be worse in the elderly. Furthermore, stopping these medications suddenly can cause rebound insomnia and withdrawal. Likewise, the Mayo Clinic⁵ indicates that taking prescription sleeping pills, such as zolpidem (Ambien), eszopiclone (Lunesta), zaleplon (Sonata) or ramelteon (Rozerem) may also help induce sleep. Side effects, which are often more pronounced in older people, may include excessive drowsiness, impaired thinking, night wandering, agitation, and balance problems. Prescription sleeping pills are generally not recommended for more than a few weeks, but several newer medications are approved for indefinite use. Nevertheless, some of these medications are habit-forming. Finally, alcohol is a sedative that may help induce sleep, but it also prevents deeper stages of sleep and often causes an awakening in the middle of the night.⁶

NATURAL ALTERNATIVES FOR SLEEP
So, what are the natural alternatives? Certainly, a variety of dietary supplements are commonly self-prescribed for treating sleep problems. Some of the most well known—of which include melatonin and valerian root—"old school" remedies which, nevertheless, do have adequate research to support their use for this purpose. However, it should be noted that melatonin and valerian are not always without side effects. Although generally well tolerated, the most common side effects of melatonin include daytime drowsiness, headache, and dizziness—although these don't seem to occur any more frequently than with placebo.⁷ Likewise, although generally well tolerated, valerian side effects reported in clinical studies include headaches, gastrointestinal upset, mental dullness, excitability, uneasiness, and cardiac disturbances.^8,9 Luckily, there are some other natural remedies, which have shown promising results for promoting healthy sleep, but without these side effects. These remedies include GABA, Apocynum venetum, ashwagandha, and lutein/zeaxanthin.

GABA AND Apocynum venetum
GABA (gamma amino butyric acid) is the primary neurotransmitter in the central nervous system for exerting sedative and anti-anxiety effects.¹⁰ Apocynum venetum is an herbal remedy with a long history of use in traditional Chinese medicine for soothing the nerves, insomnia, and for other purposes.¹¹ These two nutraceuticals have been used together and individually in human clinical research for their stress reducing, mood enhancing, and sleep-promoting effects. The stress-reducing effects are also important for sleep since stress can make it difficult to get to sleep and sustain sleep.

GABA AND Apocynum venetum STUDY 1
A double-blind, placebo-controlled crossover study¹² was conducted to examine the stress-reducing effect of ingesting 25 mg/day GABA, and 25 mg/day Apocynum venetum leaf extract (Venetron®), a combination of both, or a placebo. Following intake, subjects were exposed to a stress-inducing mental task and then tested for the stress marker known as salivary chromogranin A (CgA), and scored on a mental questionnaire. Results showed that the combination significantly reduced salivary CgA secretion compared to placebo. Individually, GABA and Apocynum venetum leaf extract also reduced CgA secretion, but they did not reach statistical significance over placebo. In conclusion, the combination of GABA and Apocynum venetum leaf extract was able to reduce markers of cognitive-induced mental stress.

GABA AND Apocynum venetum STUDY 2
In another study, the effects of 100 mg/day GABA and 25 mg/ day Apocynum venetum leaf extract (Venetron), were investigated on sleep improvement in a single-blind, placebo-controlled study.¹³ The electroencephalogram (EEG) test revealed that both nutraceuticals had beneficial effects on sleep. GABA shortened the time it took to fall asleep and increased non-rapid eye movement (REM) sleep time. Simultaneous intake of GABA and Apocynum venetum leaf extract shortened the time it took to fall asleep and increased non-REM sleep time. The result of questionnaires showed that GABA and Apocynum venetum leaf extract enabled subjects to realize the effects on sleep. These results mean that GABA can help people to fall asleep quickly, Apocynum venetum leaf extract induces deep sleep, and they function complementarily with a simultaneous intake. The researchers concluded that this combination can be regarded as safe and appropriate for daily intake in order to improve the quality of sleep.

Apocynum venetum LEAF EXTRACT STUDY 1
In a double-blind, randomized trial¹⁴, individuals with mild depression and symptoms of anxiety, were treated with 50 mg/ day Apocynum venetum leaf extract (Venetron) or placebo at different times over eight weeks. Global scores of depression and blood samples for serotonin levels were measured at baseline and after eight weeks. The changes were assessed using a 17-item Hamilton Depression (HAM-D) rating scale that evaluates depressed mood, vegetative and cognitive symptoms of depression, and anxiety symptoms. Global scores of depression and blood samples for serotonin levels were measured at baseline and after eight weeks. The results were that after eight weeks of treatment, 40 percent of the subjects in Apocynum venetum leaf extract group showed a greater-than-10-point decrease in HAM-D scores. Likewise, 50 percent had a decrease of 50 percent or greater in the symptoms of depression as compared with the placebo group. There were also significant improvements of decreased anxiety and reductions of insomnia in the middle of the night and later in the sleep cycle. In the Apocynum venetum leaf extract group, 50 percent of subjects had increased serotonin concentrations, demonstrating biochemical evidence of improvement (since maintaining healthy serotonin levels are necessary for healthy mood and sleep). HAM-D scores decreased by 50 percent or greater in the Apocynum venetum leaf extract group. Also, 60 percent of the Venetron group had a HAM-D score of eight or less by week eight. Other symptoms that showed significant improvements within the Apocynum venetum leaf extract group included middle- and late-night insomnia, work, activities, and anxiety. In conclusion Apocynum venetum leaf extract significantly improved anxiety and reduced insomnia in the middle of the night and later in the sleep cycle.

Apocynum venetum LEAF EXTRACT STUDY 2
In this human clinical intervention trial¹⁵, the symptoms of depression were assessed in subjects having widely varying severity using the Sheehan Disability Scale (SDS). This scale used to measure depression was developed to assess functional impairment using three interrelated areas: work/school, social, and family life. The patient is able to rate the extent that work/ school, social life, and home life or family responsibilities are impaired by symptoms of depression as a composite of three self-rated items designed to measure the extent to which these three major life sectors are impaired by panic, anxiety, phobic, or depressive symptoms. Patients took 50 mg/day Apocynum venetum leaf extract for 14 days. Results were that the SDS scores of subjects improved in symptoms of depression ranging from minimal to mild depression and moderate to severe depression. The mean measurement significantly declined to the normal range after 14 days of ingestion. In conclusion, Apocynum venetum leaf extract improved depression in patients with varying degrees of symptom severity.

VENETRON STUDY 3
A human clinical intervention trial¹⁶ consisting of case studies was conducted. Subjects included one 29-year-old woman with PMS, a 39-year-old woman with PMS, a 55-year-old woman, a man, 36 years old, and two older men, one 66 and the other 75 years of age. All subjects received 50 mg/day Apocynum venetum leaf extract. The results were as follows: In the 29-year-old woman with PMS, Apocynum venetum leaf extract for one month reduced melancholy and overeating. In the 39-year-old woman with PMS, Apocynum venetum leaf extract for two weeks before menses and over a 3-month period, improved emotional symptoms such as irritability and depression. In the 36-year-old man, Apocynum venetum leaf extract for six months resulted in improvements in concentration and his feeling more optimistic. The 55-year-old woman, using Apocynum venetum leaf extract decreased fatigue and grief. In the 66- and the 75-year-old men, Apocynum venetum leaf extract for two weeks resulted in decreases in the frequency of waking up throughout the night and promoted deeper sleep. In conclusion, case studies have shown very good results in patients with depressive PMS disorders, and in younger and older depressed patients. The types of symptoms that improved include melancholy, overeating, emotional symptoms such as irritability, difficulty in concentrating, optimistic outlook, fatigue, and grief, and improvements in sleep.

^{GABA STUDY 1}
Two studies¹⁷ investigated the effect of GABA on relaxation and stress in humans. The first study evaluated the effect of GABA intake on their brain waves. Electroencephalograms (EEG) were obtained after three tests on each volunteer as follows: intake only water, 100 mg GABA, or 200 mg L-theanine. After 60 minutes of administration, GABA significantly increases alpha waves (i.e. relaxing brain waves) and decreases beta waves compared to water or L-theanine. These findings denote that GABA not only induces relaxation but also reduces anxiety. The second study was conducted to see the role of relaxant and anxiolytic effects of 100 mg GABA intake on immunity in stressed volunteers. Eight acrophobic subjects were divided into two groups (placebo and GABA). All subjects were crossing a suspended bridge as a stressful stimulus. Immunoglobulin A (IgA) levels in their saliva were monitored during bridge crossing. The placebo group showed a marked decrease of their IgA levels, while GABA group showed significantly higher levels. In conclusion, GABA could work effectively as a natural relaxant and its effects could be seen within one hour of its administration to induce relaxation and diminish anxiety. Moreover, GABA administration could enhance immunity under stress conditions.

GABA STUDY 2
Researchers studied¹⁸ the psychological stress reducing effect of chocolate enriched with 28 mg/day GABA, on stress induced by an arithmetic task using changes of heart rate variability (HRV) and salivary chromogranin A (CgA). Fifteen minutes after eating GABA-enriched chocolate, subjects were assigned an arithmetic task for 15 minutes. After that, an electrocardiogram was recorded and saliva samples were collected. HRV was determined from the electrocardiogram, and the activity of the autonomic nervous system was estimated through HRV. The CgA concentration of all saliva samples, an index for acute psychological stress, was measured. From HRV, those taking GABA chocolate made a quick recovery to the normal state from the stressful state. The CgA value after the task in those taking GABA chocolate did not increase in comparison with that before ingestion. From these results, GABA chocolate was considered to have a psychological stress reducing effect.

ASHWAGANDHA STUDY
Withania somnifera, also known as ashwagandha, has historically been used in Asia for treating stress-related health conditions. In this study,¹⁹ researchers investigated the effects of standardized ashwagandha root and leaf extract (Sensoril®) in chronically stressed humans in a clinical trial. Participants were randomly assigned to receive different doses of ashwagandha root and leaf extract, or placebo. Stress levels were assessed at Days 0, 30, and 60 using a modified Hamilton anxiety (mHAM-A) scale. Between Days 0 and 60, those receiving 125 mg/day ashwagandha root and leaf extract experienced a significantly greater decrease than placebo for the average mHAM-A score, serum cortisol, serum C-reactive protein, pulse rate, and blood pressure. In addition, those receiving 125 mg/day ashwagandha root and leaf extract had an improvement in the sleeplessness score from 3.1 on day 0, to 1.9 on day 30, to 0.9 on day 60—a percentage change of about 71 percent. Therefore, this study provides evidence that the consumption of ashwagandha root and leaf extract significantly reduced experiential and biochemical indicators of stress without adverse effects.

LUTEIN/ZEAXANTHIN
To understand why lutein/zeaxanthin is beneficial for sleep, you must first understand a little bit about blue light, a powerful and potentially damaging component of visible light from the sun, digital devices (computers, tablets, smartphones, etc.) and artificial light.^{20,21,22,23,24,25} As it passes through the lens of the human eye, the visible wavelengths of light, including ultraviolet and blue light, focus upon the macular area of the retina. In particular, the blue wavelengths penetrate deeply into the eye, and have the greatest potential to damage retinal tissue by inducing free radicals, etc.^26,27,28,29 In fact, ongoing exposure to blue light (regardless of the source) is a major risk factor for various retinal damage.^30,31,32,33

SYMPTOMS OF CHRONIC BLUE LIGHT EXPOSURE
Research indicates that chronic exposure to blue light can cause a variety of symptoms. These include headaches, eye fatigue and other indications of eye strain are associated with the daily use of video display terminals on computers and other electronic devices and are common with three or more hours/day of exposure. In addition, blue light has been shown to delay or suppress the release of melatonin, your body's sleep hormone.^34,35,36 Unfortunately, 30 percent of adults spend more than half their waking hours (more than nine hours) using a digital device, 50 percent of Americans use digital devices more than five hours a day, and 70 percent use two or more digital devices at the same time.³⁷ Consequently, it's not surprising that so many people have problems with eye fatigue, eye strain and sleep.

PROTECTION WITH LUTEIN AND ZEAXANTHIN ISOMERS
The good news is that lutein and zeaxanthin isomers (rr- and rs-(meso)-zeaxanthin), macular carotenoids well known for the role they play in supporting eye health, can help mitigate the effects that blue light has on common retinal damage. The way it works is that lutein/zeaxanthin have a yellow coloration. Because yellow pigments absorb blue light, lutein effectively protects the retina from the region of the light spectrum that can cause tissue damage, and also limits the ability of light to generate free radicals. Basically, lutein/zeaxanthin act as a sort of internal pair of sunglasses, protecting the macular region of the retina from blue light damage. In addition, various studies have shown that supplementation with 10 mg/2 mg–20 mg/4 mg lutein/zeaxanthin (Lutemax®2020 Marigold flower extract) can help make users of computers and other digital devices more comfortable throughout the day, reducing eye strain and relieving tired eyes. Supplementation also protects eyes against harmful blue light and against oxidative stress and harmful free radicals.^38,39,40

LUTEIN AND ZEAXANTHIN ISOMERS, AND SLEEP
More specific to the subject of this article, there is a direct connection between blue light, lutein/zeaxanthin, and sleep. It has to do with melatonin, a hormone, secreted by the pineal gland,⁴¹ whose primary role is regulation of the body's circadian rhythm, and sleep patterns.^42,43 Specifically, light, including blue light, inhibits melatonin secretion and darkness stimulates secretion.^44,45 Consequently, too much light exposure, particularly at night, can inhibit melatonin secretion and interfere with sleep. Interestingly, research has shown that, at night, even blue light from smartphones can negatively impact sleep.⁴⁶ That's where blue-light filtering lutein and zeaxanthin isomers can help.

To determine if increasing macular levels of lutein/zeaxanthin, by supplementing lutein/zeaxanthin isomers, would affect sleep quality, a two-part study⁴⁷ was conducted. The first part was a 3-month, double-blind, placebo-controlled trial. Subjects in the active supplement group ingested lutein/zeaxanthin isomers daily (LutemaxR2020 Marigold flower extract). Sleep quality was evaluated with the Pittsburgh Sleep Quality Index (PSQI). Critical flicker fusion frequency1 (CFF) and contrast sensitivity (CS) were also measured. Outdoor and indoor exposure to light (UV) and electronic devices before and after supplementation were recorded. The results showed that the lutein/zeaxanthin group exhibited significant improvement in overall sleep quality and levels of macular pigments, as well as CS and CFF, at three months. There were no changes in the placebo group. This trial found that increasing macular pigments via lutein/zeaxanthin isomers supplementation, might serve to absorb more blue light from sources (such as computer screens, tablets, or smartphones) that can be used during nighttime hours, and would otherwise provide a circadian signal to stay awake.

(1. CFF is a diagnostic tool used for several purposes, including the degree of light or dark adaptation, i.e., the duration and intensity of previous exposure to background light, which affects both the intensity sensitivity and the time resolution of vision.)

The second part was also a 6-month, double-blind, placebo-controlled trial in which 34 healthy individuals participated. The same supplementation regimen and assessment methods were used as with the 3-month study. Results were that at six months macular pigments, CFF, CS, sleep quality improved with lutein/ zeaxanthin supplementation, with no changes in the placebo group.

Endnotes

1. Ancoli-Israel S, Roth T. Characteristics of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. I. Sleep. 1999;22(Suppl 2):S347.53.
2. Morin CM, LeBlanc M, Daley M, Gregoire JP, Merette C. Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors. Sleep Med. 2006;7(2):123.30.
3. Johnson EO, Roehrs T, Roth T, Breslau N. Epidemiology of alcohol and medication as aids to sleep in early adulthood. Sleep. 1998 Mar 15;21(2):178.86.
4. PubMed Health: Insomina. National Center for Biotechnology Information, U.S. National Library of Medicine Bethesda MD. Review Date: 8/16/2011. Retrieved December 2, 2011 from Insomnia/.
5. Insomnia: Treatment & Drugs. Mayo Foundation for Medical Education and Research. Jan. 7, 2011. Retrieved December 2, 2011 from Insomnia.
6. Insomnia: Ibid.
7. Buscemi N, Vandermeer B, Pandya R, et al. Melatonin for treatment of sleep disorders. Summary, Evidence Report/Technology Assessment #108. (Prepared by the Univ of Alberta Evidence-based Practice Center, under Contract#290-02-0023.) AHRQ Publ #05-E002-2. Rockville, MD: Agency for Healthcare Research & Quality. November 2004.
8. Klepser TB, Klepser ME. Unsafe and potentially safe herbal therapies. Am J Health Syst Pharm 1999;56:125.38.
9. National Toxicology Program, US Department of Health and Human Services. Chemical Information Review Document for Valerian (Valeriana officinalis L.) [CAS No. 8057-49-6] and Oils [CAS No. 8008-88-6]. Supporting Nomination for Toxicological Evaluation by the National Toxicology Program. November 2009.
10. Kalant H, Roschlau WHE, Eds. Principles of Med. Pharmacology. New York, NY: Oxford Univ Press, 1998.
11. Xie W, Zhang X, Wang T, Hu J. Botany, traditional uses, phytochemistry and pharmacology of Apocynum venetum L. (Luobuma): A review. J Ethnopharmacol. 2012 May 7;141(1):1.8.
12. Yoto A, Ishihara S, Li-Yang J, Butterweck V, Yokogoshi H. The Stress Reducing Effect of γ-Aminobutyric Acid and Apocynum venetum Leaf Extract on Changes in Concentration of Salivary Chromogranin A. Japanese Journal of Physiological Anthropology. 2009 14(3): 55.59.
13. Yamatsu A, Yamashita Y, Maru I, Yang J, Tatsuzaki J, Kim M. The Improvement of Sleep by Oral Intake of GABA and Apocynum venetum Leaf Extract. J Nutr Sci Vitaminol(Tokyo). 2015;61(2):182.7.
14. Venetron® brochure, Tokiwa. Summarized in Maypro document "Venetron Clinical Evidence." Topic: What was the effect of a daily dose of 50 mg of Venetron® in individuals with mild depression over 8 weeks?
15. Venetron® brochure, Tokiwa. Summarized in Maypro document "Venetron Clinical Evidence." Topic: What effect does Venetron® have on patients with various degrees of depression?
16. Venetron® brochure, Tokiwa. Summarized in Maypro document "Venetron Clinical Evidence." Topic: What have been the results of Venetron® in case studies of patients having depression, PMS, anxiety, and/or insomnia?
17. Abdou AM, Higashiguchi S, Horie K, Kim M, Hatta H, Yokogoshi H. Relaxation and immunity enhancement effects of gammaaminobutyric acid (GABA) administration in humans. Biofactors. 2006;26(3):201-8.
18. Nakamura H, Takishima T, Kometani T, Yokogoshi H. Psychological stress-reducing effect of chocolate enriched with gamma-aminobutyric acid (GABA) in humans: assessment of stress using heart rate variability and salivary chromogranin A. Int J Food Sci Nutr. 2009;60 Suppl 5:106.13.
19. Auddy B, Hazra J, Mitra A, Abedon B, Ghosal S. A Standardized Withania Somnifera Extract Significantly Reduces Stress-Related Parameters in Chronically Stressed Humans: A Double-Blind, Randomized, Placebo-Controlled Study. JANA. 2008;11(1):2008:50.56.
20. Nakashima Y, Ohta S1, Wolf AM2. Blue light-induced oxidative stress in live skin. Free Radic Biol Med. 2017 Mar 15. pii: S0891. 5849(17)30134-X.
21. Tosini G, Ferguson I, Tsubota K. Effects of blue light on the circadian system and eye physiology. Mol Vis. 2016 Jan 24;22:61.72.
22. The Vision Council. Eyes Overexposed: The Digital Device Dilemma. 2016 Digital Eye Strain Report. Thevisioncouncil.org.
23. The Vision Council. Hindsight is 20/20/20: Protect your eyes from digital devices. 2015 Digital Eye Strain Report. Thevisioncouncil.org.
24. Smick K, et al. Blue Light Hazard: New Knowledge, New Approaches to Maintaining Ocular Health. Report of a Roundtable: March 16, 2013, New York City, NY, USA. Essilor of America.
25. Kuse Y, Ogawa K, Tsruma K, Shimazawa M, Hara H. Damage of photoreceptor-derived cells in culture induced by light emitting diode-derived blue light. Sci Rep. 2014 Jun 9;4:5223.
26. Tosini, Ibid.
27. Wu J, Seregard S, Algvere PV. Photochemical damage of the retina. Surv Ophthalmol. 2006 Sep-Oct;51(5):461–81.
28. Algvere PV, Marshall J, Seregard S. Age-related maculopathy and the impact of blue light hazard. Acta Ophthalmol Scand. 2006 Feb;84(1):4–15.
29. Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR). 2012. Health Effects of Artificial Light. Accessed from http://ec.europa.eu/health/scientific_committees/emerging/docs/scenihr_o_035.pdf.
30. Cruickshanks KJ, Klein R, Klein BEK. Sunlight and age-related macular degeneration—the Beaver Dam Eye Study. Arch Ophthalmol. 1993;111:514–8.
31. Klein R, Klein BEK, Jensen SC, Cruickshanks KJ. The relationship of ocular factors to the incidence and progression of agerelated maculopathy. Arch Ophthalmol. 1998;116:506–13.
32. Algvere, Ibid.
33. Taylor HR, Muñoz B, West S, Bressler NM, Bressler SB, Rosenthal FS. Visible light and risk of age-related macular degeneration. Trans Am Ophthalmol Soc. 1990;88:163–73.
34. Figueiro MG. Individually tailored light intervention through closed eyelids to promote circadian alignment and sleep health. Sleep Health. 2015 Mar 1;1(1):75–82.
35. Daneault V, Dumont M, Massé É, Vandewalle G, Carrier J. Light-sensitive brain pathways and aging. J Physiol Anthropol. 2016; Mar 15;35:9.
36. Lockley SW, Evans EE, Scheer FA, Brainard GC, Czeisler CA, Aeschbach D. Short-wavelength sensitivity for the direct effects of light on alertness, vigilance, and the waking electroencephalogram in humans. Sleep. 2006 Feb;29(2):161–8.
37. Richer S. Lutein and zeaxanthin protect against "bad blue" light. Eye Health Insider. December 2016: 4.
38. Stringham J. Effects of three levels of lutein supplementation on macular pigment optical density, psychological stress levels, and overall health. Nutritional Neuroscience Laboratory, University of Georgia. Unpublished. 2016:17 pgs.
39. Lutein/Zeaxanthin Isomers Supplementation Impact on Vision Health. Unpublished. 2016:8 pgs.
40. Blue Light Study Eye Stress. Unpublished. 2016: 2 pgs.
41. Nurnberger JI Jr, Adkins S, Lahiri DK, et al. Melatonin suppression by light in euthymic bipolar and unipolar patients. Arch Gen Psychiatr 2000;57:572-9.
42. Brzezinski A. Melatonin in humans. N Engl J Med 1997;336:186-95.
43. Lissoni P, Barni S, Meregalli S, et al. Modulation of cancer endocrine therapy by melatonin: a phase II study of tamoxifen plus melatonin in metastatic breast cancer patients progressing under tamoxifen alone. Br J Cancer 1995;71:854-6.
44. Brzezinski, Ibid.
45. Daneault, Ibid.
46. Yoshimura M, Kitazawa M, Maeda Y, Mimura M, Tsubota K, Kishimoto T. Smartphone viewing distance and sleep: an experimental study utilizing motion capture technology. Nat Sci Sleep. 2017 Mar 8;9:59-65.
47. Stringham JM et al. Short-term macular carotenois supplementation improves overall sleep quality. ARVO 2016 Annual Meeting Abstracts

Dear Readers,

Welcome to the July 2018 issue of TotalHealth Magazine Online.

This July issue 2018 celebrates the Fourth of July and the USA—United We Stand. Let our voices be heard at the voting booth and in the meantime treat others with kindness. Good for our health.

This issue begins with Charles K. Bens, PhD, "Drug Resistant Germs, A Real Threat," educates us on what natural medicine has for you to use to conquer the bad viruses.

Dallas Clouatre, PhD, provides information on a natural therapy many of us are not yet familiar with: Shilajit, Fulvic, And Humic Acids. "Shilajit typically is a blackish brown rock exudate that contains fulvic and humic acids (up to 85 percent of the total weight) along with a number of non-humic components, including local plant metabolites." Other names include "mineral pitch" and "moomio." Revered in the Indian Ayurvedic tradition," it is found exuding from rock fissures in the mountains of Asia. Most often it is found in the Himalayan foothills.

Gene Bruno, MS, MHS, discusses, "GABA, Apocynum Venetum, Ashwagandha, And Lutein/Zeaxanthin For Healthy Sleep." These natural remedies have shown promising results for promoting healthy sleep, but without the side effects of many of the pharmaceutical brands prescribed today. It is unwise to stop the prescription medications without the guidance of a healthcare professional.

Jacob Teitelbaum, MD begins a four-part series on "Night Sweats—No Sweat." Taking a look at the causes and the remedies on how to address them. Don't be surprised if more than one underlying process is contributing.

Shawn Messonnier, DVM, focuses this month on, "Treating Feline Leukemia." What causes this condition and the treatment available to treat cats.

Gloria Gilbère, CDP, DAHom, PhD, presents "French Fry Nightshade-FREE Alternatives." Those photos alone will make your mouth water and inspire you to purchase the ingredients on your next trip to the grocery store.

Ann Louise Gittleman, PhD, CNS, continues her Smart Fats Series with "Omega-7 And Butter," for all of us struggling to take off weight. Gittleman's expert experience will be of interest. And there will be no question of what you purchase in the future.

Thanks to all the authors who make TotalHealthOnline possible.

Happy 4th!

Best in health,

TWIP—The Wellness Imperative People

Click here to read the full July 2018 issue.

• Drug Resistant Germs, A Real Threat,
  Charles Bens, PhD
• Shilajit, Fulvic, And Humic Acids
  Dallas Clouatre, PhD
• GABA, Apocynum Venetum, Ashwagandha, And Lutein/Zeaxanthin For Healthy Sleep
  Gene Bruno, MS, MHS
• Night Sweats—No Sweats
  Jacob Teitelbaum, MD
• French Fry Nightshade-FREE Alternatives.
  Gloria Gilbère, CDP, DAHom, PhD
• Omega-7 And Butter
  Ann Louise Gittleman, PhD, CNS
• Treating Feline Leukemia
  Shawn Messonnier, DVM

Click here to read the full July 2018 issue.

Blue light-which comes from sunlight, digital devices (computers, tablets, smartphones, etc.) and artificial light,^1,2,3,4,5,6 penetrates deeply into the human eye and has great potential to damage retinal tissue.^7,8,9,10 This ongoing exposure to blue light (regardless of the source) is a major risk factor for various retinal pathologies.^11,12,13,14 In fact, research¹⁵ has demonstrated that headaches, eye fatigue, disturbed visual acuity, mucosal dryness, and eye burning and other indications of eye strain are associated with the daily use of video display terminals on computers and other electronic devices, and are common with three or more hours/day of exposure. Furthermore, some research indicates blue light exposure from sunlight is a risk factor for the development of age-related macular degeneration.^16,17 Such visual health-related symptoms in adults and children resulting from blue light digital exposure is now referred to as Computer Vision Syndrome (CVS).¹⁸ Perhaps most alarming, children may be at higher risk for blue light retinal damage than adults, since their eyes absorb more blue light than adults from digital device screens.^19,20

Children's exposure to blue light
More than 70 percent of American adults report their children receive more than two hours of screen time per day-and among the most popular activities children engage in are playing on a digital device (23.1 percent) and watching TV (20.1 percent). Not surprisingly, American adults report their children experience the following after being exposed to two or more hours of screen time:²¹

• Headaches (8.8%)
• Neck/shoulder pain (5%)
• Eye strain, dry or irritated eyes (9.1%)
• Reduced attention span (15.2%)
• Poor behavior (13.3%)
• Irritability (13.5%)

Now consider that personal electronic devices are able to stimulate blue-light-sensitive ganglion cell photoreceptors that regulate circadian rhythms.²² As a result, cellular telephone, tablet and personal computer use before bedtime can delay sleep onset, degrade sleep quality and impair alertness the following day.²³ Extended use of these devices has also been shown to cause symptoms of dry eyes, blurred vision and headaches.²⁴ Limitation of personal electronic device use before bedtime is recommended to be the most effective method for reducing light-induced sleep disruption in children.

The importance of lutein and zeaxanthin isomers
So besides restricting digital device us, what can concerned parents do to help protect their children's eyes from damaging blue light? Enter lutein and zeaxanthin isomers (rr- and rs-(meso)-zeaxanthin). These carotenoids (related to beta-carotene and lycopene) are found in high concentrations in the part of the retina where they play a critical role in protecting against blue light.²⁵ Furthermore, supplementation with lutein and zeaxanthin isomers can provide substantial protection against blue light damage.

Of all the carotenoids, only lutein and zeaxanthin isomers are located in the eye, and make up the macular pigment. As a result of these carotenoids being yellow, they selectively absorb blue light, which protects the retina from associated damage. In short, they act as primary filters of blue light.

However, the average daily intake of lutein and zeaxanthin in the U.S. is less than 2 mg and less than 0.5 mg, respectively-which is far below the 10-20 mg of lutein and 2-4 mg of zeaxanthin shown in research to be beneficial. That's why supplementation with these carotenoids is so important.

Eye strain, eye fatigue, headache and visual performance

A study conducted at the University of Georgia showed a relationship between exposure to blue light from digital devices and visual performance. They found that supplementing with lutein and zeaxanthin isomers (as Lutemax® 2020 from OmniActive Health Technologies) reduced headaches, eye fatigue, and eye strain. Another double-blind, placebo-controlled, 12-month trial^26,27,28 examined the effects of lutein and zeaxanthin isomers (as Lutemax® 2020) versus placebo. Two levels of daily lutein supplementation were used: 10 mg (2 mg Z), and 20 mg (4 mg Z). The results were that both doses significantly improved contrast sensitivity (CS), glare performance, and photo stress recovery (i.e. a clinical procedure measuring the amount of time required for the macula to return to its normal level of function after being exposed to a bright light source). In addition, lutein/zeaxanthin improved levels of BDNF, a neurotrophin that is particularly active in hippocampus, cortex, and basal forebrain-areas that are involved in learning, memory, and higher cognitive processes.²⁹

Stress and health
Another 12-week, double-blind, placebo-controlled trial30 was conducted at the University of Georgia in 28 healthy subjects using three different daily dosage levels of lutein and zeaxanthin isomers (as Lutemax® 2020) versus placebo. The three doses of lutein were 6 mg (1.5 mg Z), 10 mg (2 mg Z), and 20 mg (4 mg Z), versus placebo. The results were that supplementation with lutein/zeaxanthin isomers increased the amount of optical pigment density (greater increase with higher doses), which helped subjects maintain a lower psychological stress profile (p = 0.0087). After 12 weeks of lutein supplementation, psychological stress levels were found to be reduced significantly. The placebo group did not change in this regard. Furthermore, those with higher optical pigment density tended to have fewer health-related problems, such as being sick less often and suffering less from allergies (p = 0.002). After 12 weeks of lutein supplementation, each group exhibited a significant reduction in health-related problems (6 mg: p = 0.041; 10 mg: p = 0.029; 20 mg: p = 0.047).

Quality of sleep
The primary function of melatonin, a hormone, secreted by the pineal gland,³¹ is regulation of the body's circadian rhythm, and sleep patterns.^32,33 However, too much light exposure, particularly at night, can inhibit melatonin secretion and interfere with sleep.^34,35 Even blue light from smart phones can negatively impact sleep with nighttime exposure.³⁶ But lutein and zeaxanthin isomers can help. A 3-month, double-blind, placebo-controlled trial with 45 healthy individuals (the first of a two-part study³⁷) found that 20 mg lutein and 4 mg zeaxanthin isomers daily (as Lutemax® 2020) significantly improved overall sleep quality (p = 0.0063), with no changes in the placebo group. The second 6-month, double-blind, placebo-controlled trial in 34 healthy individuals found similar results.

Delivery forms
Generally, lutein/zeaxanthin isomers are readily available as capsule or tablet supplements for adults. Children, however, cannot easily swallow capsules or tablets. Consequently, chewable tablets or gummies are preferable lutein/zeaxanthin isomer delivery forms for children. Gummies, in particular, are likely the best choice as children tend to see gummies as a treat, rather than treatment-so to speak.

Conclusion
Blue light, especially from digital devices, has the potential to damage retinal tissue and cause a variety of eye-related problems, including eye strain, eye fatigue, headache, visual impairment, psychological stress, and poor sleep quality. This is particularly true in children since their eyes absorb more blue light than adults. The good news is that daily supplementation with lutein (10-20 mg) and zeaxanthin isomers (2-4 mg)-most likely in a gummy supplement-can help reduce these risks and support eye health.

References

1. Nakashima Y, Ohta S1, Wolf AM2. Blue light-induced oxidative stress in live skin. Free Radic Biol Med. 2017 Mar 15. pii: S0891-5849(17)30134-X.
2. Tosini G, Ferguson I, Tsubota K. Effects of blue light on the circadian system and eye physiology. Mol Vis. 2016 Jan 24;22:61-72.
3. The Vision Council. Eyes Overexposed: The Digital Device Dilemma. 2016 Digital Eye Strain Report. Thevisioncouncil.org.
4. The Vision Council. Hindsight is 20/20/20: Protect your eyes from digital devices. 2015 Digital Eye Strain Report. Thevisioncouncil.org.
5. Smick K, et al. Blue Light Hazard: New Knowledge, New Approaches to Maintaining Ocular Health. Report of a Roundtable: March 16, 2013, New York City, NY, USA. Essilor of America.
6. Kuse Y, Ogawa K, Tsruma K, Shimazawa M, Hara H. Damage of photoreceptor-derived cells in culture induced by light emitting diode-derived blue light. Sci Rep. 2014 Jun 9;4:5223.
7. Tosini G, Ferguson I, Tsubota K. Effects of blue light on the circadian system and eye physiology. Mol Vis. 2016 Jan 24;22:61-72.
8. Wu J, Seregard S, Algvere PV. Photochemical damage of the retina. Surv Ophthalmol. 2006 Sep-Oct;51(5):461-81.
9. Algvere PV, Marshall J, Seregard S. Age-related maculopathy and the impact of blue light hazard. Acta Ophthalmol Scand. 2006 Feb;84(1):4-15.
10. Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR). 2012. Health Effects of Artificial Light. Accessed from http://ec.europa.eu/health/scientific_committees/emerging/docs/scenihr_o_035.pdf.
11. Cruickshanks KJ, Klein R, Klein BEK. Sunlight and age-related macular degeneration-the Beaver Dam Eye Study. Arch Ophthalmol. 1993;111:514-8.
12. Klein R, Klein BEK, Jensen SC, Cruickshanks KJ. The relationship of ocular factors to the incidence and progression of age-related maculopathy. Arch Ophthalmol.1998;116:506-13.
13. Algvere PV, Marshall J, Seregard S. Age-related maculopathy and the impact of blue light hazard. Acta Ophthalmol Scand. 2006;84:4-15.
14. Taylor HR, Muñoz B, West S, Bressler NM, Bressler SB, Rosenthal FS. Visible light and risk of age-related macular degeneration. Trans Am Ophthalmol Soc. 1990;88:163-73.
15. Kowalska M, Zejda JE, Bugajska J, Braczkowska B, Brozek G, Mali?ska M. [Eye symptoms in office employees working at computer stations]. [Article in Polish] Med Pr. 2011;62(1):1-8.
16. Tomany SC, Cruickshanks KJ, Klein R, Klein BE, Knudtson MD. Sunlight and the 10-year incidence of age-related maculopathy: the Beaver Dam Eye Study. Arch Ophthalmol. 2004;122:750-7.
17. Cruickshanks KJ, Klein R, Klein BE, Nondahl DM. Sunlight and the 5-year incidence of early age-related maculopathy: the beaver dam eye study. Arch Ophthalmol. 2001;119:246-50.
18. Akinbinu TR, Mashalla YJ. Impact of computer technology on health: Computer Vision Syndrome (CVS). Medical Practice and Review. 2014;5(3):20-30.
19. Boettner EA, Wolter JR. Transmission of the Ocular Media. Investigative Ophthalmology 1962;1:776-83.
20. Behar-Cohen F, Martinsons C, Viénot F, Zissis G, Barlier-Salsi A, Cesarini JP, Enouf O, Garcia M, Picaud S, Attia D. Light-emitting diodes (LED) for domestic lighting: any risks for the eye? Prog Retin Eye Res. 2011 Jul;30(4):239-57.
21. Digital Eye Strain. The Vision Council. Retrieved February 19, 2019 from https://www.thevisioncouncil.org/content/digital-eye-strain.
22. Berson DM, Dunn FA, Takao M. Phototransduction by retinal ganglion cells that set the circadian clock. Science 2002;295:1070-3.
23. Chang AM, Aeschbach D, Duffy JF, Czeisler CA. Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness. Proc Natl Acad Sci U S A 2015;112:1232-7.
24. Klamm J, Tarnow KG. Computer Vision Syndrome: A Review of Literature. Medsurg Nurs 2015;24:89-93.
25. Bone RA. Landrum JT. Distribution of macular pigment components, zeaxanthin and lutein, in human retina. Methods Enzymol 1992:213:360-6.
26. Stringham JM, O'Brien KJ, Stringham NT. Macular carotenoid supplementation improves disability glare performance and dynamics of photo stress recovery. Eye Vis (Lond). 2016 Nov 11;3:30.
27. Stringham NT, Holmes PV, Stringham JM. Supplementation with macular carotenoids reduces psychological stress, serum cortisol, and sub-optimal symptoms of physical and emotional health in young adults. Nutr Neurosci. 2017 Feb 15:1-11.
28. Contrast sensitivity - Accepted (IOVS) in press.
29. Stringham NT et al. Macular Carotenoid Supplementation Increases Serum BDNF in Healthy Young Adults. EB Abstract 2016.
30. Stringham J. Effects of three levels of lutein supplementation on macular pigment optical density, psychological stress levels, and overall health. Nutritional Neuroscience Laboratory, University of Georgia. Unpublished. 2016:17 pgs.
31. Nurnberger JI Jr, Adkins S, Lahiri DK, et al. Melatonin suppression by light in euthymic bipolar and unipolar patients. Arch Gen Psychiatr 2000;57:572-9.
32. Brzezinski A. Melatonin in humans. N Engl J Med 1997;336:186-95.
33. Lissoni P, Barni S, Meregalli S, et al. Modulation of cancer endocrine therapy by melatonin: a phase II study of tamoxifen plus melatonin in metastatic breast cancer patients progressing under tamoxifen alone. Br J Cancer 1995;71:854-6.
34. Brzezinski A. Melatonin in humans. N Engl J Med 1997;336:186-95.
35. Daneault V, Dumont M, Massé É, Vandewalle G, Carrier J. Light-sensitive brain pathways and aging. J Physiol Anthropol. 2016 Mar 15;35:9.
36. Yoshimura M, Kitazawa M, Maeda Y, Mimura M, Tsubota K, Kishimoto T. Smartphone viewing distance and sleep: an experimental study utilizing motion capture technology. Nat Sci Sleep. 2017 Mar 8;9:59-65.
37. Stringham JM et al. Short-term macular carotenois supplementation improves overall sleep quality. ARVO 2016 Annual Meeting Abstracts.

Dear Readers,

Welcome to the March 2019 issue of TotalHealth Magazine.

Charles K. Bens, PhD, in “The Biochemistry Of Smoking: Helping the Brain To Live Without Nicotine” gives us an explanation on the effects of nicotine on the brain, showing why it is so difficult to quit smoking. Bens goes on with his experience with several individuals who were able to change their lifestyle through diet and exercise, and lead healthy lives. This is not to say one shouldn’t quit smoking but changing one’s lifestyle is a big influence on one’s health.

In “Lutein & Zeaxanthin: Protectors for Your Children,” Gene Bruno, MS, MHS, RH(AHG), enlightens readers on blue light, especially from digital devices. It has the potential to damage retinal tissue and cause a variety of eye-related problems, including eye strain, eye fatigue, headache, visual impairment, psychological stress and poor sleep quality. This is particularly true in children since their eyes absorb more blue light than adults.

“How Smart Fats Reset Your Hunger Hormones,” Ann Louise Gittleman, PhD, CNS, focus is on Adiponectin; a real hormone game changer that you may not be very familiar with. It is a big player in firing up belly fat burn and is known as the body’s “fat burning torch.” This special super hormone that flips your body’s fat burning switch is already circulating in your bloodstream because it is made in your fat cells. Adiponectin is balanced by monounsaturated omega-rich foods and oils as: olives and olive oil, avocados and avocado oil, and macadamias and macadamia nut oil.

Jacob E. Teitelbaum, MD, offers “X-Rays Meaningless for Arthritis and Back Pain?” We’ve known for decades that spinal X-Rays, MRIs and CT scans add very little information about back pain. They most often DON’T tell doctors whether the pain is coming from the spine or from disc, arthritic or bone disease. (Though they MAY reveal if the problem can be fixed with a chiropractic adjustment.)

Gloria Gilbère, CDP, DAHom, PhD, contributes “One Dish Baked Caprese Chicken.” Another of Gilbère’s fabulous recipes from her test kitchen in Ecuador. In addition to this recipe Gilbère offers two recipes to use for leftovers. Included is background on the health benefits of organic chicken.

Shawn Messonnier’s, DVM, topic this month is “Pinellia Combination in Pets.” Pinellia combination is a Chinese herbal mix. This formula contains ginseng, ginger, jujube, Coptis and Scute, along with pinellia, and is for vomiting in pets. Because of the Chinese diagnosis and classification of diseases, the ingredients in each formula may vary. Individual Chinese pharmacists include herbs in their tented formulas based upon their experience. However, they can compound formulas to the needs of an individual pet.

Best in health,

TWIP—The Wellness Imperative People

Click here to read the full March 2019 issue.

• The Biochemistry Of Smoking: Helping the Brain To Live Without Nicotine
  Charles Bens, PhD
• Lutein & Zeaxanthin: Protectors For Your Children
  Gene Bruno, MS, MHS
• How Smart Fats Reset Your Hunger Hormones
  Anne Louise Gittleman, PhD, CNS
• X-Rays Meaningless For Arthritis And Back Pain?
  Jacob Teitelbaum, MD
• One Dish Baked Caprese Chicken
  Gloria Gilbère, CDP, DAHom, PhD
• Pinellia Combination in Pets
  Shawn Messonnier, DVM