Sandrina Nunes1, Dalila Alves2, Patrícia Barreto2, Miguel Raimundo3, Maria da Luz Cachulo4, Cláudia Farinha5, Inês Laíns6, João Rodrigues7, Carlos Almeida8, Luísa Ribeiro2, João Figueira4, Lelita Santos9, Rufino Silva4. 1. Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal. Electronic address: Sandrina@aibili.pt. 2. Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal. 3. Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. 4. Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal; Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculty of Medicine, Institute for Biomedical Imaging and Life Sciences University of Coimbra, Coimbra, Portugal. 5. Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal; Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. 6. Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts. 7. Primary Health Care Unit of Lousã, Unidade de Saúde Familiar da Serra da Lousã e Trevim Sol, Coimbra, Portugal. 8. Primary Health Care Center of Mira, Coimbra, Portugal. 9. Faculty of Medicine, Institute for Biomedical Imaging and Life Sciences University of Coimbra, Coimbra, Portugal; Serviço de Medicina Interna, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Abstract
OBJECTIVES: This study aimed to characterize the association of lifestyle and nutritional risk profiles with age-related macular degeneration (AMD) in two subpopulations with differing AMD prevalence. METHODS: This case-control study (n = 1992) included 768 patients with AMD and 1224 age- and sex-matched participants without AMD with a single visit at a primary health care unit. Enrolled participants completed a validated lifestyle and food frequency questionnaire. A score to measure adherence to the Mediterranean diet (mediSCORE; Range, 0-9) was constructed from individual food intakes, which were further analyzed by conversion to nutrient consumption. RESULTS: Higher adherence to the Mediterranean diet (mediSCORE ≥6) was significantly associated with no AMD (odds ratio [OR] = 0.73; P = 0.009). The subpopulation with lower AMD prevalence presented significantly higher adherence to the Mediterranean diet in relation to all individual food groups that comprised the mediSCORE (P < 0.014) with the exception of cereals. Food group analysis showed significant associations between the increased consumption of vegetables (OR = 0.63; P < 0.001) and fruit and nuts (OR = 0.78; P = 0.010) with no AMD. Nutrient analysis revealed that an increased ingestion of water, fibers, total fat, monounsaturated and polyunsaturated fatty acids, linoleic acid, vitamins A and C, carotene, alpha-tocopherol, folate, magnesium, iron, and zinc were significantly associated with no AMD (P < 0.0013). Finally, regular physical activity was associated with no AMD (P = 0.003). CONCLUSIONS: High adherence to a Mediterranean diet and regular physical activity seem to be protective factors for AMD in a Portuguese population. The effect of the diet is likely driven by the increased consumption of vegetables, fruits, and nuts.
OBJECTIVES: This study aimed to characterize the association of lifestyle and nutritional risk profiles with age-related macular degeneration (AMD) in two subpopulations with differing AMD prevalence. METHODS: This case-control study (n = 1992) included 768 patients with AMD and 1224 age- and sex-matched participants without AMD with a single visit at a primary health care unit. Enrolled participants completed a validated lifestyle and food frequency questionnaire. A score to measure adherence to the Mediterranean diet (mediSCORE; Range, 0-9) was constructed from individual food intakes, which were further analyzed by conversion to nutrient consumption. RESULTS: Higher adherence to the Mediterranean diet (mediSCORE ≥6) was significantly associated with no AMD (odds ratio [OR] = 0.73; P = 0.009). The subpopulation with lower AMD prevalence presented significantly higher adherence to the Mediterranean diet in relation to all individual food groups that comprised the mediSCORE (P < 0.014) with the exception of cereals. Food group analysis showed significant associations between the increased consumption of vegetables (OR = 0.63; P < 0.001) and fruit and nuts (OR = 0.78; P = 0.010) with no AMD. Nutrient analysis revealed that an increased ingestion of water, fibers, total fat, monounsaturated and polyunsaturated fatty acids, linoleic acid, vitamins A and C, carotene, alpha-tocopherol, folate, magnesium, iron, and zinc were significantly associated with no AMD (P < 0.0013). Finally, regular physical activity was associated with no AMD (P = 0.003). CONCLUSIONS: High adherence to a Mediterranean diet and regular physical activity seem to be protective factors for AMD in a Portuguese population. The effect of the diet is likely driven by the increased consumption of vegetables, fruits, and nuts.
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