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Once again a study finds an association between a Western diet (lots of processed meat, red meat, fried food, desserts, low fiber, high in refined grains, sugar sweetened beverages, and high-fat dairy) and a poor health outcome - this time a significantly higher incidence of late-stage age-related macular degeneration (AMD).

Interestingly though, a Western dietary pattern did not seem to be associated with whether a person developed early AMD - only with whether it would progress to late-stage AMD. And late-stage AMD is the one that results in loss of central vision (in the retina), which means a person will then be unable to drive.

This study followed 1278 people over an 18 year period. Those who ate a Western style diet (considered unhealthy) had a 3 times higher rate of late-stage AMD as compared to those who had a "prudent" (healthy) dietary pattern. Out of 1278 persons - 117 developed early AMD and 27 developed late AMD (20 of them progressed from no AMD to late AMD over the 18 years, and 7 progressed from early AMD to late AMD).

What kinds of foods seemed especially protective? The researchers said that eating the following  foods appeared protective: cruciferous (e.g. broccoli), foods high in carotene (e.g. carrots), dark green leafy and other vegetables, poultry, fresh fruits, legumes, fish and sea foods - what they called part of a "prudent" diet, but can also be thought of as a Mediterranean dietary pattern.

One thing I question is whether "high fat dairy" (which they said was margarine & butter) should have lumped together margarine and butter. After all, margarine is a concoction made with trans fats and linked to health problems, while butter (made from milk/cream) is very different.

From Science Daily: Poor diet linked to age-related macular degeneration  ...continue reading "A Person’s Diet And Age-Related Macular Degeneration"

One of the dreaded afflictions of getting older is age-related macular degeneration (AMD), which is a leading cause of vision loss in Americans 60 years and older. It has no cure. Thus this study finding that eating a Mediterranean diet, and especially lots of fruit, was associated with a lower risk of macular degeneration was welcome news. They also found a protective effect from drinking caffeinated beverages - about 78 mg of caffeine per day (about one cup of coffee or one shot of espresso). A Mediterranean diet stresses eating fruits, vegetables, nuts, whole grains, legumes, fish, seeds, and olive oil. From Science Daily:

Fruit-rich Mediterranean diet with antioxidants may cut age-related macular degeneration risk by more than a third

People who closely follow the Mediterranean diet -- especially by eating fruit -- may be more than a third less likely to develop age-related macular degeneration, a leading cause of blindness, according to a study presented at AAO 2016, the 120th annual meeting of the American Academy of Ophthalmology. The study is the first to identify that caffeine may be especially protective against AMD.

Many studies have confirmed the health benefits of the Mediterranean diet, which emphasizes eating fruits, vegetables, whole grains, legumes, nuts, healthy fats and fish, and limiting red meat and butter. The diet has been shown to improve heart health and reduced risk of cancer, but there has been little research on whether its benefits can extend to eye disease. To determine this, researchers studied a Portuguese population to see whether adherence to the diet impacted people's risk of AMD. Their findings revealed a significant reduction in risk in those who ate a Mediterranean diet most frequently, and particularly among those who consumed more fruit and caffeine.

Researchers at the University of Coimbra in Portugal studied 883 people age 55 or older in the central region of the country between 2013 and 2015. Of those, 449 had AMD in its early stages before vision loss, and 434 did not have AMD. Researchers assessed their diets based on a questionnaire asking how often they ate foods associated with the Mediterranean diet. The more they ate foods associated with the diet, the higher the score, from 0-9. Those who closely followed the diet scored a 6 or greater. Their findings were as follows:

Higher diet adherence scores meant lower AMD risk Of those who did not closely follow the diet (scored below a 6), 50 percent had AMD. Of those who did closely follow the diet (scored 6 or above), only 39 percent had AMD. This represents a 35 percent lower risk compared to those who did not adhere to the diet.

Fruits were especially beneficial Researchers analyzed consumption of foods and found that people who consumed higher levels of fruit were significantly less likely to have AMD. Of those who consumed 150 grams (about five ounces) or more of fruit a day: 54.5 percent did not have AMD and 45.5 percent had AMD. Overall, people who ate that much fruit or more each day were almost 15 percent less likely to have AMD, based on an odds ratio calculation.

Caffeine and antioxidants also were protective Researchers used a computer program to analyze the participants' consumption of micronutrients, according to their answers on the questionnaire. They found higher consumption of antioxidants such as caffeine, beta-carotene and vitamins C and E was protective against AMD. Of those who consumed high levels of caffeine (about 78 mg a day, or the equivalent of one shot of espresso): 54.4 percent did not have AMD and 45.1 percent had AMD....The researchers opted to look at caffeine because it is a powerful antioxidant that is known to be protective against other conditions, such as Alzheimer's disease.

A new study that tracked people more than 20 years found that a diet high in carotenoids - found in brightly colored fruits and vegetables (such as carrots, orange peppers, spinach, broccoli) - is linked to lower levels of macular degenaration (an age linked vision ailment).

Note that the link is found with real foods and not supplements (the researchers did not look at supplements). From Medical Xpress:

Carrots do help aging eyes, study shows

Your parents may have told you, "Eat your carrots, they're good for your eyes," and a new study suggests they were on to something. Pigments called carotenoids—which give red or orange hues to carrots, sweet potatoes and orange peppers, or deep greens to produce like spinach, broccoli and kale—may help ward off the age-linked vision ailment known as macular degeneration, researchers said.

Age-related macular degeneration (AMD) is one of the most common causes of vision loss, especially in the elderly. It affects the macula, the center part of the retina, and can lead to declines in sharp central vision and even blindness, experts say. 

Scientists have already linked a variety of factors to the condition including genetics, smoking and nutrition, said Bernstein, who was not involved in the new study. Prior research has produced mixed findings about links between carotenoids and macular degeneration, the researchers said. 

In the new study, Wu's team looked at data from health surveys that tracked people aged 50 and older—more than 63,000 women and almost 39,000 men—from 1984 or 1986 until 2010. Participants were all nurses and other health professionals. Overall, about 2.5 percent of study participants developed either intermediate or advanced forms of the eye condition during the years of the study.

Wu's team found that people who consumed the very highest levels of carotenoids known as lutein and zeaxanthin had a 40 percent lower risk of the advanced form of AMD compared to those who ate the veryleast. Other carotenoids, including beta cryptoxanthin, alpha carotene and beta carotene, may also play protective roles," Wu added. People who consumed the very highest amount of these carotenoids—found in foods such as carrots and sweet potatohad a 25 to 35 percent lower risk of the advanced form of the illness, the findings showed.

Researchers did not find any link between the carotenoids and the intermediate form of macular degeneration, however. Lutein is found in eggs and dark leafy vegetables including broccoli, kale and spinach, Bernstein said. Zeaxanthin is harder to find in the diet, he said, but you can get it from corn, orange peppers and goji berries. Wu noted that both lutein and zeaxanthin concentrate in the macula, where they are thought to protect it from damage from oxygen and light.

Bernstein cautioned that the study has some weaknesses. It's based on people's recollections of their diets, he said, and doesn't examine the levels of the carotenoids that actually made it into their bodies and eyes. Still, he praised the research.... However, he said, a diet high in fruits and vegetables is important, especially colorful vegetables. Consume several servings a day, he advised.

Again, more benefits of vitamin D. Think of it as the sunshine vitamin, but supplements also work, especially vitamin D3 (rather than D2). This time higher levels of vitamin D in the blood (as measured by the vitamin D biomarker, 25-hydroxyvitamin D [25(OH)D) are linked to lower incidence of macular degeneration among those women genetically prone to it.

Macular degeneration is thought to have both genetic (inherited) and environmental components. Currently macular degeneration is the leading cause of vision loss and affects about 2.07 million Americans (this is according to the National Eye Institute). Note that this number is very different than that given by the American Macular Degeneration Foundation in the article. From Medical Xpress:

Vitamin D may play key role in preventing macular degeneration

Vitamin D has been studied extensively in relation to bone health as well as cancer. Now, a team led by a researcher at the University at Buffalo has discovered that vitamin D may play a significant role in eye health, specifically in the possible prevention of age-related macular degeneration, or AMD, among women who are more genetically prone to developing the sight-damaging disease.

In a paper published today (Aug. 27) in JAMA Ophthalmology online, Amy Millen, associate professor of epidemiology and environmental health in UB's School of Public Health and Health Professions, and her team found that women who are deficient in vitamin D and have a specific high-risk genotype are 6.7 times more likely to develop AMD than women with sufficient vitamin D status and no high risk genotype.

Macular degeneration is characterized by the deterioration of the macula, a small part of the central retina where the eye's photoreceptors (rods and cones) are most highly concentrated. The leading cause of legal blindness, macular degeneration affects more than 10 million Americans—more than cataracts and glaucoma combined—according to the American Macular Degeneration Foundation. The disease affects a person's central vision, which is needed for common tasks such as reading and driving. The effect is similar to that of a rain drop on the center of a camera lens.

Researchers analyzed data compiled on 1,230 women ages 54 to 74 who participated in the Carotenoids in Age-related Eye Disease Study (CAREDS),..... CAREDS was conducted among participants at three of the centers: University of Wisconsin (Madison), the University of Iowa (Iowa City) and the Kaiser Center for Health Research (Portland, Oregon). Researchers were able to determine participants' vitamin D status by analyzing serum samples for a vitamin D biomarker, 25-hydroxyvitamin D [25(OH)D], which provided a glimpse into vitamin D intake through all sources: diet, supplements and sunlight.

Human skin can synthesize vitamin D when exposed to ultraviolet light, Millen explains. However, for many people, 15 to 30 minutes a day with 10 percent of their skin exposed might be sufficient. In winter months, when there is a lower solar angle, sun exposure may not be not sufficient to maintain blood level for people who live north of a line from about Washington, D.C., to Los Angeles. At these times and locations, dietary intake may be needed. Dietary sources of vitamin D include fortified foods such as milk and foods that naturally contain vitamin D such as fatty fish like salmon and mackerel.

"Macular degeneration has been found to be strongly associated with genetic risk," Millen says. Among many genes linked to AMD, one of the strongest is a specific genetic variant (Y402H) in the complement factor H gene, called CFH for short. This gene codes for the CFH protein that is involved in the body's immune response to destroy bacteria and viruses. Inflammation is believed to be involved in the development of macular degeneration.  "People who have early stage AMD develop drusen, lipid and protein deposits that build up in the eye. Your body sees this drusen as a foreign substance and attacks it, in part via the complement cascade response," explains Millen.

Vitamin D shows promise for protecting against because of its anti-inflammatory and antiangiogenic properties; antiangiogenic refers to slowing the growth of new blood vessels, often seen in late stages of AMD."Our message is not that achieving really high levels of vitamin D are good for the eye, but that having deficient vitamin D levels may be unhealthy for your eyes," Millen says. 

Although the odds of having AMD was higher in women who were deficient for vitamin D, with 25(OH)D levels below 12 ng/mL (30 nmol/L), increasing vitamin D levels beyond 12 ng/mL did not further lower the odds of AMD to any meaningful extent, she explains.