Elvira Agrón1, Julie Mares2, Traci E Clemons3, Anand Swaroop4, Emily Y Chew5, Tiarnan D L Keenan6. 1. Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland. 2. Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin. 3. The Emmes Company LLC, Rockville, Maryland. 4. Neurobiology-Neurodegeneration and Repair Laboratory, National Eye Institute, National Institutes of Health, Bethesda, Maryland. 5. Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland. Electronic address: echew@nei.nih.gov. 6. Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland. Electronic address: tiarnan.keenan@nih.gov.
Abstract
PURPOSE: To analyze associations between the dietary intake of multiple nutrients and risk of progression to late age-related macular degeneration (AMD), its subtypes, and large drusen. DESIGN: Post hoc analysis of 2 controlled clinical trial cohorts: Age-Related Eye Disease Study (AREDS) and AREDS2. PARTICIPANTS: Eyes with no late AMD at baseline among AREDS participants (n = 4504) and AREDS2 participants (n = 3738) totaled 14 135 eyes. Mean age was 71.0 years (standard deviation, 6.7 years), and 56.5% of patients were women. METHODS: Fundus photographs were collected at annual study visits and graded centrally for late AMD. Dietary intake of multiple nutrients was calculated from food frequency questionnaires. MAIN OUTCOME MEASURES: Progression to late AMD, geographic atrophy (GA), neovascular AMD, and (separate analyses) large drusen. RESULTS: Over median follow-up of 10.2 years, of the 14 135 eyes, 32.7% progressed to late AMD. For 9 nutrients, intake quintiles 4 or 5 (vs. 1) were associated significantly (P ≤ 0.0005) with decreased risk of late AMD: vitamin A, vitamin B6, vitamin C, folate, β-carotene, lutein and zeaxanthin, magnesium, copper, and alcohol. For 3 nutrients, quintiles 4 or 5 were associated significantly with increased risk: saturated fatty acid, monounsaturated fatty acid, and oleic acid. Similar results were observed for GA. Regarding neovascular AMD, 9 nutrients were associated nominally with decreased risk-vitamin A, vitamin B6, β-carotene, lutein and zeaxanthin, magnesium, copper, docosahexaenoic acid, omega-3 fatty acid, and alcohol-and 3 nutrients were associated with increased risk-saturated fatty acid, monounsaturated fatty acid, and oleic acid. In separate analyses (n = 5399 eyes of 3164 AREDS participants), 12 nutrients were associated nominally with decreased risk of large drusen. CONCLUSIONS: Higher dietary intake of multiple nutrients, including minerals, vitamins, and carotenoids, is associated with decreased risk of progression to late AMD. These associations are stronger for GA than for neovascular AMD. The same nutrients also tend to show protective associations against large drusen development. Strong genetic interactions exist for some nutrient-genotype combinations, particularly omega-3 fatty acids and CFH. These data may justify further research into underlying mechanisms and randomized trials of supplementation. Published by Elsevier Inc.
PURPOSE: To analyze associations between the dietary intake of multiple nutrients and risk of progression to late age-related macular degeneration (AMD), its subtypes, and large drusen. DESIGN: Post hoc analysis of 2 controlled clinical trial cohorts: Age-Related Eye Disease Study (AREDS) and AREDS2. PARTICIPANTS: Eyes with no late AMD at baseline among AREDS participants (n = 4504) and AREDS2 participants (n = 3738) totaled 14 135 eyes. Mean age was 71.0 years (standard deviation, 6.7 years), and 56.5% of patients were women. METHODS: Fundus photographs were collected at annual study visits and graded centrally for late AMD. Dietary intake of multiple nutrients was calculated from food frequency questionnaires. MAIN OUTCOME MEASURES: Progression to late AMD, geographic atrophy (GA), neovascular AMD, and (separate analyses) large drusen. RESULTS: Over median follow-up of 10.2 years, of the 14 135 eyes, 32.7% progressed to late AMD. For 9 nutrients, intake quintiles 4 or 5 (vs. 1) were associated significantly (P ≤ 0.0005) with decreased risk of late AMD: vitamin A, vitamin B6, vitamin C, folate, β-carotene, lutein and zeaxanthin, magnesium, copper, and alcohol. For 3 nutrients, quintiles 4 or 5 were associated significantly with increased risk: saturated fatty acid, monounsaturated fatty acid, and oleic acid. Similar results were observed for GA. Regarding neovascular AMD, 9 nutrients were associated nominally with decreased risk-vitamin A, vitamin B6, β-carotene, lutein and zeaxanthin, magnesium, copper, docosahexaenoic acid, omega-3 fatty acid, and alcohol-and 3 nutrients were associated with increased risk-saturated fatty acid, monounsaturated fatty acid, and oleic acid. In separate analyses (n = 5399 eyes of 3164 AREDS participants), 12 nutrients were associated nominally with decreased risk of large drusen. CONCLUSIONS: Higher dietary intake of multiple nutrients, including minerals, vitamins, and carotenoids, is associated with decreased risk of progression to late AMD. These associations are stronger for GA than for neovascular AMD. The same nutrients also tend to show protective associations against large drusen development. Strong genetic interactions exist for some nutrient-genotype combinations, particularly omega-3 fatty acids and CFH. These data may justify further research into underlying mechanisms and randomized trials of supplementation. Published by Elsevier Inc.
Authors: Ronald P Danis; Amitha Domalpally; Emily Y Chew; Traci E Clemons; Jane Armstrong; John Paul SanGiovanni; Frederick L Ferris Journal: Invest Ophthalmol Vis Sci Date: 2013-07-08 Impact factor: 4.799
Authors: Lars G Fritsche; Robert N Fariss; Dwight Stambolian; Gonçalo R Abecasis; Christine A Curcio; Anand Swaroop Journal: Annu Rev Genomics Hum Genet Date: 2014-04-16 Impact factor: 8.929
Authors: Jae H Kang; Walter C Willett; Bernard A Rosner; Emmanuel Buys; Janey L Wiggs; Louis R Pasquale Journal: JAMA Ophthalmol Date: 2016-03 Impact factor: 7.389
Authors: Amy B Karger; Weihua Guan; Sarah O Nomura; Natalie L Weir; Barbara E K Klein; Gregory L Burke; W Craig Johnson; Michael Y Tsai Journal: Retina Date: 2022-07-01 Impact factor: 3.975
Authors: Eszter Emri; Elod Kortvely; Sascha Dammeier; Franziska Klose; David Simpson; Eye-Risk Consortium; Anneke I Den Hollander; Marius Ueffing; Imre Lengyel Journal: Nutrients Date: 2020-10-06 Impact factor: 5.717
Authors: Maria D Pinazo-Durán; Jose J García-Medina; Silvia M Sanz-González; Jose E O'Connor; Ricardo P Casaroli-Marano; Mar Valero-Velló; Maribel López-Gálvez; Cristina Peris-Martínez; Vicente Zanón-Moreno; Manuel Diaz-Llopis Journal: Diagnostics (Basel) Date: 2021-04-19
Authors: Amir H Kashani; Jane S Lebkowski; Firas M Rahhal; Robert L Avery; Hani Salehi-Had; Sanford Chen; Clement Chan; Neal Palejwala; April Ingram; Wei Dang; Chih-Min Lin; Debbie Mitra; Britney O Pennington; Cassidy Hinman; Mohamed A Faynus; Jeffrey K Bailey; Sukriti Mohan; Narsing Rao; Lincoln V Johnson; Dennis O Clegg; David R Hinton; Mark S Humayun Journal: Transl Vis Sci Technol Date: 2021-08-12 Impact factor: 3.283
Authors: Mar Valero-Vello; Cristina Peris-Martínez; José J García-Medina; Silvia M Sanz-González; Ana I Ramírez; José A Fernández-Albarral; David Galarreta-Mira; Vicente Zanón-Moreno; Ricardo P Casaroli-Marano; María D Pinazo-Duran Journal: Foods Date: 2021-05-28
Authors: Marina Green-Gomez; Rachel Moran; James Stringham; Cesar Hernández-Alcaraz; Kenny Mendoza-Herrera; J Jans Fromow-Guerra; Alfonso Prado-Cabrero; John Nolan Journal: Invest Ophthalmol Vis Sci Date: 2021-07-01 Impact factor: 4.799