Nutrition, Supplements & AREDS2

Can what we eat help protect our eyesight as we grow older?

Researchers have investigated the relationship between nutrition and age-related macular degeneration (AMD) for decades.

The encouraging news is that certain nutritional supplements have been shown in major clinical trials to slow AMD progression in some patients.

However, the benefits depend on the stage of the disease, and not all supplements have demonstrated effectiveness.

What Is AREDS2?

AREDS stands for Age-Related Eye Disease Study, a major research program sponsored by the National Eye Institute (NEI).

The original AREDS trial and its follow-up, AREDS2, investigated whether combinations of vitamins, minerals, and antioxidants could slow macular degeneration.

The studies found that a specific supplement formula could reduce the risk of progression to advanced AMD by approximately 25% over five years in people at higher risk.

Importantly, the supplements did not prevent AMD from developing in people without the condition. 

What Is in the AREDS2 Formula?

The standard AREDS2 formula contains:

These amounts are considerably higher than those found in most ordinary multivitamins.

Copper is included to help prevent copper deficiency associated with high-dose zinc.

The original AREDS formula contained beta-carotene, but this was replaced with lutein and zeaxanthin because beta-carotene supplements increased lung cancer risk, particularly among current and former smokers.

AREDS2 is now the preferred formulation. 

Who Benefits From AREDS2?

AREDS2 supplements are generally recommended for people with:

They have not demonstrated benefits for people without AMD or those with early AMD.

A 2024 National Institutes of Health analysis also found that AREDS-type supplements may slow the expansion of geographic atrophy toward the central retina in some patients with advanced dry AMD.

The decision to take AREDS2 should be based on an ophthalmologist's assessment of the stage of the disease. 

Lutein and Zeaxanthin

Lutein and zeaxanthin are natural pigments concentrated in the macula.

They help filter certain wavelengths of light and may protect retinal cells from oxidative damage.

Good dietary sources include spinach, kale, collard greens, and egg yolks.

Studies suggest that diets rich in these nutrients may be associated with better eye health.

However, eating these foods has not been shown to produce the same benefits as the specific AREDS2 supplement formula in people with intermediate AMD.

What About Omega-3 Fatty Acids?

Omega-3 fatty acids, particularly EPA and DHA, are important components of cell membranes, including those in the retina.

Observational studies have associated eating fish with a lower risk of AMD.

However, the AREDS2 clinical trial found that adding omega-3 supplements did not significantly reduce progression to advanced AMD.

Eating fish may be part of a healthy diet, but fish oil supplements have not been proven to slow AMD progression.

Can a Low-Carbohydrate Diet Help?

Researchers are exploring whether blood glucose, insulin resistance, inflammation, and metabolic health influence AMD.

Some observational studies have associated diets with a high glycemic index with increased AMD risk.

A low-carbohydrate diet can improve blood glucose and insulin resistance in some people, but there is currently insufficient clinical evidence that it prevents or treats macular degeneration.

Maintaining good metabolic health remains worthwhile for cardiovascular and overall health.

Are There Risks From AREDS2 Supplements?

Although AREDS2 supplements are available without a prescription, they contain high doses of several nutrients.

High-dose zinc can cause digestive symptoms and interfere with copper balance. Vitamin E and other ingredients may also require consideration in people taking certain medications.

People should review their medications and other supplements with their healthcare provider before beginning AREDS2.

More is not necessarily better. Taking additional vitamins or minerals beyond the studied formula has not been shown to improve AMD outcomes.

Bottom Line

Nutrition may play an important role in maintaining eye health.

A diet that includes leafy green vegetables, fish, and other nutrient-rich foods is a sensible approach.

For people with intermediate AMD or advanced AMD in one eye, AREDS2 is one of the best-supported nutritional interventions for slowing progression.

But supplements are not a cure, and their benefits depend on the stage of the disease.

Learn More

National Eye Institute — AREDS and AREDS2 Clinical Trials

Major research findings on nutritional supplements and AMD progression.

National Eye Institute — AREDS2 Supplements for AMD

Explains the formula, recommended ingredients, and who may benefit.

American Academy of Ophthalmology — Vitamins for AMD

Practical guidance on supplement benefits, limitations, and risks.

NIH — Supplements Slow Progression of Late Dry AMD

Discusses the 2024 analysis of geographic atrophy.


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