Key takeaways

• AREDS 2 vitamins reduce the risk of progression to advanced AMD by approximately 25% over 5 years in people with intermediate AMD. 
• The AREDS 2 vitamins formula includes lutein, zeaxanthin, vitamin C, vitamin E, zinc, and copper. AREDS 2 vitamins are safer than the original AREDS vitamins due to the removal of beta carotene.
• The protective effects of AREDS 2 vitamins persist for at least 10 years with continued use. AREDS 2 vitamins are most effective for individuals who already have intermediate AMD or advanced AMD in one eye.

Overview

Vision loss affects millions of Americans, with age-related macular degeneration (AMD) being the leading cause of blindness in developed countries. You’ve probably heard about AREDS 2 vitamins, but you may wonder: do they work?

Nearly 20 million U.S. adults have some form of age-related macular degeneration. Without effective prevention strategies, these numbers are expected to double over the next 20 years. The National Eye Institute (NEI) led the AREDS and AREDS2 clinical trials, which established the effectiveness of these nutritional supplements for patients with AMD.

Losing central vision means struggling with everyday activities, such as reading, driving, and recognizing faces. Many people don’t realize that specific vitamins, such as those in the AREDS 2 formula, a type of nutritional supplement specifically formulated for patients with AMD, can play a crucial role in preventing AMD progression until it’s too late.

The Age-Related Eye Disease Study (AREDS) and its follow-up study, AREDS2, both conducted by the National Eye Institute, have provided groundbreaking evidence that AREDS 2 vitamins can significantly reduce the risk of AMD progression by 25% over 5 years, significantly impacting patient care.

What are the AREDS 2 vitamins?

AREDS 2 vitamins are a scientifically formulated combination of nutrients specifically designed to slow the progression of age-related macular degeneration. These vitamins and minerals were developed based on the most extensive eye nutrition study ever conducted—the Age-Related Eye Disease Study 2 (AREDS2), which enrolled 4,203 participants aged 50 to 85 years at risk for AMD progression. The formula contains specific vitamins and minerals that have been shown to slow the progression of AMD.

The AREDS 2 vitamins formula contains:

• Lutein: 10 mg
• Zeaxanthin: 2 mg
• Vitamin C: 500 mg
• Vitamin E: 400 IU
• Zinc oxide: 80 mg (or 25 mg in some formulations)
• Cupric oxide: 2 mg

These minerals are included in precise amounts based on clinical research to ensure optimal benefit. Based on the results of the AREDS2 study, beta carotene was removed from the original formula and replaced with lutein and zeaxanthin, resulting in what is now known as the AREDS 2 vitamins. AREDS 2 vitamins are specifically designed for individuals with a specific type of AMD, including intermediate or late AMD.

The science behind AREDS 2 vitamins

AREDS 2 vitamins have become a cornerstone in eye health supplements, especially for people at risk of age-related macular degeneration (AMD). Backed by large-scale clinical trials, these formulations combine lutein and zeaxanthin, two carotenoids that concentrate in the macula, to reduce oxidative stress, protect against harmful blue light, and slow the progression of AMD. Notably, the AREDS 2 formula delivers these protective effects without the cancer risks linked to beta-carotene, making it a safer and more effective option for long-term vision preservation.

Clinical trial results for AREDS 2 vitamins

When researchers evaluated the main effects of AREDS 2 vitamins containing lutein/zeaxanthin, the hazard ratio for progression to late AMD by 10 years was 0.91 (95% CI, 0.84-0.99; P = .02). This translates to approximately a 9% reduction in risk when taking AREDS 2 vitamins consistently.

In a direct comparison, people taking AREDS 2 vitamins with lutein/zeaxanthin had an 85% lower risk of AMD progression compared to those taking the original formula with beta-carotene (HR, 0.85; 95% CI, 0.73-0.98; P = .02).

How do AREDS 2 vitamins work for your eyes?

Lutein and Zeaxanthin in AREDS 2 Vitamins:

• These carotenoids are the main components of the macular pigment in your retina
• AREDS 2 vitamins deliver these nutrients directly to your macula, where they act as natural sunglasses
• They provide antioxidant and anti-inflammatory protection against damaging blue light

The Power of Targeted Nutrition: For individuals with the lowest dietary intake of these nutrients, AREDS 2 vitamins demonstrated even greater benefits, with a 26% reduction in AMD progression risk (HR of 0.74, 95% CI 0.59-0.94; P = .01).

Why AREDS 2 vitamins are safer than the original AREDS?

The most significant improvement in AREDS 2 vitamins is the removal of beta carotene. Research showed that beta carotene nearly doubled the risk of lung cancer in former smokers, with an odds ratio of 1.82 (95% CI, 1.06-3.12; P = .03).

In contrast, the AREDS 2 vitamins containing lutein showed no increased risk of cancer, with an odds ratio of 1.15 (95% CI, 0.79-1.66; P = .46) for lung cancer development.

Long-term benefits of AREDS 2 vitamins

The long-term benefits of AREDS 2 vitamins are supported by a decade of research, demonstrating that their protective effects against age-related macular degeneration (AMD) are sustained over time. Here’s what research says:

10-year follow-up results

The most encouraging news about AREDS 2 vitamins comes from long-term studies. Results from the 10-year follow-up study suggest that the beneficial effects of AREDS 2 vitamins persist throughout the entire follow-up period. Key long-term findings include: 

• AREDS 2 vitamins maintained their protective effects for the whole 10-year study period
• No increased risk of serious adverse events with long-term AREDS 2 vitamins use
• Participants who stopped taking AREDS 2 vitamins lost their protective benefits

Sustained protection with AREDS 2 vitamins

Even though all participants were offered AREDS 2 vitamins during the follow-up study (eliminating the actual placebo effect), researchers still found persistent beneficial associations. Early and consistent use of AREDS 2 vitamins provides lasting protection.

Who should take AREDS 2 vitamins?

AREDS 2 vitamins aren’t meant for everyone; they are specifically designed for individuals at moderate to high risk of developing advanced age-related macular degeneration (AMD). While a diet rich in leafy greens and colorful vegetables supports general eye health, the concentrated doses of lutein and zeaxanthin in AREDS 2 vitamins provide therapeutic levels that exceed what a diet alone can offer. 

Ideal candidates for AREDS 2 vitamins

AREDS 2 vitamins are specifically recommended for people with:

• Intermediate AMD (bilateral large drusen visible on eye exam)
• Advanced AMD in one eye with large drusen in the fellow eye
• Family history of AMD and existing early signs detected by an eye care professional

AREDS 2 vitamins vs. dietary sources

While eating foods rich in lutein and zeaxanthin (like leafy greens) is beneficial, AREDS 2 vitamins provide concentrated doses that are difficult to achieve through diet alone. The therapeutic levels in AREDS 2 vitamins – 10mg lutein and 2mg zeaxanthin – would require eating approximately 2 cups of cooked spinach daily.

What about people with healthy eyes?

AREDS 2 vitamins haven’t been proven effective for primary prevention in people with completely healthy eyes. The studies focused specifically on individuals who had already shown signs of AMD progression.

What’s not in AREDS 2 vitamins (And why that matters)?

Omega-3 fatty acids

Unlike some eye supplements on the market, evidence-based AREDS 2 vitamins do not contain omega-3 fatty acids. The AREDS2 study found no significant benefit from omega-3s in slowing the progression of AMD, with a hazard ratio of 1.01 (95% CI, 0.93-1.09; P = .91).

Beta carotene

As mentioned earlier, the AREDS 2 vitamins specifically exclude beta-carotene due to safety concerns. This makes AREDS 2 vitamins much safer for long-term use, especially for former smokers.

Choosing the right AREDS 2 vitamins

When selecting AREDS 2 vitamins, ensure they contain the exact research-proven formula:

• Look for products specifically labeled as “AREDS 2” or “AREDS2”
• Verify the lutein/zeaxanthin ratio is 10mg/2mg
• Confirm the absence of beta carotene
• Check that all six key ingredients are included in proper amounts

Common mistakes when buying AREDS 2 vitamins

Avoid these pitfalls:

• Generic “eye vitamins” that don’t follow the AREDS 2 vitamins formula
• Products that still contain beta carotene
• Supplements with added ingredients not proven in the studies
• Formulas with incorrect dosing ratios

Bottom line

The development of AREDS 2 vitamins represents one of the most significant advances in nutritional ophthalmology. With over 288 million people expected to be affected by AMD globally by 2040, even a modest improvement in preventing vision loss has enormous public health implications.

Your next steps:

1. Schedule a comprehensive eye exam to determine if you’re a candidate for AREDS 2 vitamins
2. Discuss AREDS 2 vitamins with your eye care professional to ensure they’re appropriate for your specific situation
3. If recommended, commit to daily use – the benefits of AREDS 2 vitamins require consistent, long-term supplementation

Remember, AREDS 2 vitamins are most effective when started early in the AMD process and taken consistently over time. They represent a proactive approach to preserving your vision based on solid scientific evidence.

Frequently asked questions (FAQs)

1. How do AREDS 2 vitamins differ from regular eye vitamins?

AREDS 2 vitamins contain a specific, research-proven formula developed through the most extensive eye nutrition study ever conducted. Unlike generic eye vitamins, AREDS 2 vitamins have clinical evidence showing that they can reduce the progression of AMD by 25% over 5 years.

2. Can I take AREDS 2 vitamins if I don’t have AMD yet?

AREDS 2 vitamins are specifically studied and recommended for people with intermediate AMD or advanced AMD in one eye. They haven’t been proven effective for primary prevention in people with completely healthy eyes.

3. How long should I take AREDS 2 vitamins?

The 10-year follow-up data suggest that the benefits of AREDS 2 vitamins persist with continued use. Most eye care professionals recommend taking AREDS 2 vitamins long-term if you’re a candidate, as stopping may allow AMD progression to resume.

4. Are there any side effects of AREDS 2 vitamins?

AREDS 2 vitamins have an excellent safety profile. No clinically significant adverse events were noted in the studies, and the removal of beta carotene eliminated the lung cancer risk seen with the original AREDS vitamins.

5. Can I get the same benefits from eating foods instead of taking AREDS 2 vitamins?

While a diet rich in leafy greens and colorful vegetables is beneficial, AREDS 2 vitamins provide concentrated therapeutic doses that are difficult to achieve through food alone. The protective effects were most pronounced in people taking the specific AREDS 2 vitamins formula rather than relying on dietary sources alone.

References

1. Broadhead, Geoffrey K., et al. “Association of Dietary Nitrate and a Mediterranean Diet With Age-Related Macular Degeneration Among US Adults: The Age-Related Eye Disease Study (AREDS) and AREDS2.” JAMA Ophthalmology, vol. 141, no. 2, Feb. 2023, p. 130. 
2. Chew, Emily Y., et al. “Long-Term Outcomes of Adding Lutein/Zeaxanthin and ω-3 Fatty Acids to the AREDS Supplements on Age-Related Macular Degeneration Progression: AREDS2 Report 28.” JAMA Ophthalmology, vol. 140, no. 7, July 2022, p. 692. 
3. Evans, Jennifer R., and John G. Lawrenson. “Antioxidant Vitamin and Mineral Supplements for Slowing the Progression of Age-Related Macular Degeneration.” Cochrane Database of Systematic Reviews, edited by Cochrane Eyes and Vision Group, vol. 2023, no. 9, Sept. 2023. 
4. “Lutein + Zeaxanthin and Omega-3 Fatty Acids for Age-Related Macular Degeneration: The Age-Related Eye Disease Study 2 (AREDS2) Randomized Clinical Trial.” JAMA, vol. 309, no. 19, May 2013, p. 2005.