PURPOSE: To assess the relationship between baseline dietary and supplement intakes of antioxidants and the long-term risk of incident age-related macular degeneration (AMD). DESIGN: Australian population-based cohort study. PARTICIPANTS: Of 3654 baseline (1992-1994) participants initially 49 years of older, 2454 were reexamined after 5 years, 10 years, or both. METHODS: Stereoscopic retinal photographs were graded using the Wisconsin Grading System. Data on potential risk factors were collected. Energy-adjusted intakes of alpha-carotene; beta-carotene; beta-cryptoxanthin; lutein and zeaxanthin; lycopene; vitamins A, C, and E; and iron and zinc were the study factors. Discrete logistic models assessed AMD risk. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated after adjusting for age, gender, smoking, and other risk factors. MAIN OUTCOME MEASURES: Incident early, late, and any AMD. RESULTS: For dietary lutein and zeaxanthin, participants in the top tertile of intake had a reduced risk of incident neovascular AMD (RR, 0.35; 95% CI, 0.13-0.92), and those with above median intakes had a reduced risk of indistinct soft or reticular drusen (RR, 0.66; 95% CI, 0.48-0.92). For total zinc intake the RR comparing the top decile intake with the remaining population was 0.56 (95% CI, 0.32-0.97) for any AMD and 0.54 (95% CI, 0.30-0.97) for early AMD. The highest compared with the lowest tertile of total beta-carotene intake predicted incident neovascular AMD (RR, 2.68; 95% CI, 1.03-6.96; P = 0.029, for trend). Similarly, beta-carotene intake from diet alone predicted neovascular AMD (RR comparing tertile 3 with tertile 1, 2.40; 95% CI, 0.98-5.91; P = 0.027, for trend). This association was evident in both ever and never smokers. Higher intakes of total vitamin E predicted late AMD (RR compared with the lowest tertile, 2.83; 95% CI, 1.28-6.23; and RR, 2.55; 95% CI, 1.14-5.70 for the middle and highest tertiles, respectively; P = 0.22, for trend). CONCLUSIONS: In this population-based cohort study, higher dietary lutein and zeaxanthin intake reduced the risk of long-term incident AMD. This study confirmed the Age-Related Eye Disease Study finding of protective influences from zinc against AMD. Higher beta-carotene intake was associated with an increased risk of AMD.
PURPOSE: To assess the relationship between baseline dietary and supplement intakes of antioxidants and the long-term risk of incident age-related macular degeneration (AMD). DESIGN: Australian population-based cohort study. PARTICIPANTS: Of 3654 baseline (1992-1994) participants initially 49 years of older, 2454 were reexamined after 5 years, 10 years, or both. METHODS: Stereoscopic retinal photographs were graded using the Wisconsin Grading System. Data on potential risk factors were collected. Energy-adjusted intakes of alpha-carotene; beta-carotene; beta-cryptoxanthin; lutein and zeaxanthin; lycopene; vitamins A, C, and E; and iron and zinc were the study factors. Discrete logistic models assessed AMD risk. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated after adjusting for age, gender, smoking, and other risk factors. MAIN OUTCOME MEASURES: Incident early, late, and any AMD. RESULTS: For dietary lutein and zeaxanthin, participants in the top tertile of intake had a reduced risk of incident neovascular AMD (RR, 0.35; 95% CI, 0.13-0.92), and those with above median intakes had a reduced risk of indistinct soft or reticular drusen (RR, 0.66; 95% CI, 0.48-0.92). For total zinc intake the RR comparing the top decile intake with the remaining population was 0.56 (95% CI, 0.32-0.97) for any AMD and 0.54 (95% CI, 0.30-0.97) for early AMD. The highest compared with the lowest tertile of total beta-carotene intake predicted incident neovascular AMD (RR, 2.68; 95% CI, 1.03-6.96; P = 0.029, for trend). Similarly, beta-carotene intake from diet alone predicted neovascular AMD (RR comparing tertile 3 with tertile 1, 2.40; 95% CI, 0.98-5.91; P = 0.027, for trend). This association was evident in both ever and never smokers. Higher intakes of total vitamin E predicted late AMD (RR compared with the lowest tertile, 2.83; 95% CI, 1.28-6.23; and RR, 2.55; 95% CI, 1.14-5.70 for the middle and highest tertiles, respectively; P = 0.22, for trend). CONCLUSIONS: In this population-based cohort study, higher dietary lutein and zeaxanthin intake reduced the risk of long-term incident AMD. This study confirmed the Age-Related Eye Disease Study finding of protective influences from zinc against AMD. Higher beta-carotene intake was associated with an increased risk of AMD.
Authors: Gabriëlle H S Buitendijk; Elena Rochtchina; Chelsea Myers; Cornelia M van Duijn; Kristine E Lee; Barbara E K Klein; Stacy M Meuer; Paulus T V M de Jong; Elizabeth G Holliday; Ava G Tan; André G Uitterlinden; Theru S Sivakumaran; John Attia; Albert Hofman; Paul Mitchell; Johannes R Vingerling; Sudha K Iyengar; A Cecile J W Janssens; Jie Jin Wang; Ronald Klein; Caroline C W Klaver Journal: Ophthalmology Date: 2013-10-10 Impact factor: 12.079
Authors: Jie Jin Wang; Elena Rochtchina; Wayne Smith; Ronald Klein; Barbara E K Klein; Tripti Joshi; Theru A Sivakumaran; Sudha Iyengar; Paul Mitchell Journal: Am J Epidemiol Date: 2008-12-13 Impact factor: 4.897
Authors: Emily Y Chew; Traci Clemons; John Paul SanGiovanni; Ronald Danis; Amitha Domalpally; Wendy McBee; Robert Sperduto; Frederick L Ferris Journal: Ophthalmology Date: 2012-07-26 Impact factor: 12.079
Authors: Paul P Connell; Pearse A Keane; Evelyn C O'Neill; Rasha W Altaie; Edward Loane; Kumari Neelam; John M Nolan; Stephen Beatty Journal: J Ophthalmol Date: 2009-09-06 Impact factor: 1.909