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Bejarano E, Domenech-Bendaña A, Avila-Portillo N, Rowan S, Edirisinghe S, Taylor A. Glycative stress as a cause of macular degeneration. Prog Retin Eye Res 2024; 101:101260. [PMID: 38521386 DOI: 10.1016/j.preteyeres.2024.101260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/08/2024] [Accepted: 03/11/2024] [Indexed: 03/25/2024]
Abstract
People are living longer and rates of age-related diseases such as age-related macular degeneration (AMD) are accelerating, placing enormous burdens on patients and health care systems. The quality of carbohydrate foods consumed by an individual impacts health. The glycemic index (GI) is a kinetic measure of the rate at which glucose arrives in the blood stream after consuming various carbohydrates. Consuming diets that favor slowly digested carbohydrates releases sugar into the bloodstream gradually after consuming a meal (low glycemic index). This is associated with reduced risk for major age-related diseases including AMD, cardiovascular disease, and diabetes. In comparison, consuming the same amounts of different carbohydrates in higher GI diets, releases glucose into the blood rapidly, causing glycative stress as well as accumulation of advanced glycation end products (AGEs). Such AGEs are cytotoxic by virtue of their forming abnormal proteins and protein aggregates, as well as inhibiting proteolytic and other protective pathways that might otherwise selectively recognize and remove toxic species. Using in vitro and animal models of glycative stress, we observed that consuming higher GI diets perturbs metabolism and the microbiome, resulting in a shift to more lipid-rich metabolomic profiles. Interactions between aging, diet, eye phenotypes and physiology were observed. A large body of laboratory animal and human clinical epidemiologic data indicates that consuming lower GI diets, or lower glycemia diets, is protective against features of early AMD (AMDf) in mice and AMD prevalence or AMD progression in humans. Drugs may be optimized to diminish the ravages of higher glycemic diets. Human trials are indicated to determine if AMD progression can be retarded using lower GI diets. Here we summarized the current knowledge regarding the pathological role of glycative stress in retinal dysfunction and how dietary strategies might diminish retinal disease.
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Affiliation(s)
- Eloy Bejarano
- Department of Biomedical Sciences, School of Health Sciences and Veterinary School, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Alicia Domenech-Bendaña
- Department of Biomedical Sciences, School of Health Sciences and Veterinary School, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | | | - Sheldon Rowan
- JM USDA Human Nutrition Research Center on Aging at Tufts University, United States
| | - Sachini Edirisinghe
- Tufts University Friedman School of Nutrition Science and Policy, United States
| | - Allen Taylor
- Tufts University Friedman School of Nutrition Science and Policy, United States.
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Koçyiğit E, Gövez NE, Arslan S, Ağagündüz D. A narrative review on dietary components and patterns and age-related macular degeneration. Nutr Res Rev 2024:1-28. [PMID: 38221852 DOI: 10.1017/s0954422424000015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Age-related macular degeneration (AMD) is one of the most prevalent eye diseases among the ageing population worldwide. It is a leading cause of blindness in individuals over 55, particularly in industrialised Western countries. The prevalence of AMD increases with age, and genetic factors and environmental influences are believed to contribute to its development. Among the environmental factors, diet plays a significant role in AMD. This review explores the association between dietary components, dietary patterns and AMD. Various nutrients, non-nutrient substances and dietary models that have the potential to counteract oxidative stress and inflammation, which are underlying mechanisms of AMD, are discussed. Consuming fruits, vegetables, fish and seafood, whole grains, olive oil, nuts and low-glycaemic-index foods has been highlighted as beneficial for reducing the risk of AMD. Adhering to the Mediterranean diet, which encompasses these elements, can be recommended as a dietary pattern for AMD. Furthermore, the modulation of the gut microbiota through dietary interventions and probiotics has shown promise in managing AMD.
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Affiliation(s)
- Emine Koçyiğit
- Department of Nutrition and Dietetics, Ordu University, Ordu, Türkiye
| | - Nazlıcan Erdoğan Gövez
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara, Türkiye
| | - Sabriye Arslan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara, Türkiye
| | - Duygu Ağagündüz
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara, Türkiye
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Nita M, Grzybowski A. Antioxidative Role of Heterophagy, Autophagy, and Mitophagy in the Retina and Their Association with the Age-Related Macular Degeneration (AMD) Etiopathogenesis. Antioxidants (Basel) 2023; 12:1368. [PMID: 37507908 PMCID: PMC10376332 DOI: 10.3390/antiox12071368] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/09/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
Age-related macular degeneration (AMD), an oxidative stress-linked neurodegenerative disease, leads to irreversible damage of the central retina and severe visual impairment. Advanced age and the long-standing influence of oxidative stress and oxidative cellular damage play crucial roles in AMD etiopathogenesis. Many authors emphasize the role of heterophagy, autophagy, and mitophagy in maintaining homeostasis in the retina. Relevantly modifying the activity of both macroautophagy and mitophagy pathways represents one of the new therapeutic strategies in AMD. Our review provides an overview of the antioxidative roles of heterophagy, autophagy, and mitophagy and presents associations between dysregulations of these molecular mechanisms and AMD etiopathogenesis. The authors performed an extensive analysis of the literature, employing PubMed and Google Scholar, complying with the 2013-2023 period, and using the following keywords: age-related macular degeneration, RPE cells, reactive oxygen species, oxidative stress, heterophagy, autophagy, and mitophagy. Heterophagy, autophagy, and mitophagy play antioxidative roles in the retina; however, they become sluggish and dysregulated with age and contribute to AMD development and progression. In the retina, antioxidative roles also play in RPE cells, NFE2L2 and PGC-1α proteins, NFE2L2/PGC-1α/ARE signaling cascade, Nrf2 factor, p62/SQSTM1/Keap1-Nrf2/ARE pathway, circulating miRNAs, and Yttrium oxide nanoparticles performed experimentally in animal studies.
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Affiliation(s)
- Małgorzata Nita
- Domestic and Specialized Medicine Centre "Dilmed", 40-231 Katowice, Poland
| | - Andrzej Grzybowski
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Gorczyczewskiego 2/3, 61-553 Poznań, Poland
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Šalková Kráľová J, Kolář P, Kapounová Z, Veselý P, Derflerová Brázdová Z. Dietary habits and dietary nutrient intake in patients with age-related macular degeneration: A case-control study. Cent Eur J Public Health 2023; 31:140-143. [PMID: 37451248 DOI: 10.21101/cejph.a7617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 04/19/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES Age-related macular degeneration (AMD) is the leading cause of irreversible blindness among older adults in developed countries. Although many risk factors are known, the pathogenesis of AMD is still unclear. However, oxidative stress probably plays a vital role in the process of AMD. The increasing prevalence of AMD, risk of vision loss, limited treatment of dry form, expensive treatment of wet form, and decreased quality of life are factors that lead to considering modifiable risk factors of AMD, such as nutrition. This is the first study describing the relationship between dietary habits, dietary nutrient intake and AMD in the Czech Republic. METHODS In this research, a total of 93 cases with AMD and 58 controls without AMD and cataracts participated. All participants were ophthalmologically examined at the Clinic of Eye Treatments at the University Hospital Brno. Data were collected using a pre-tested self-report questionnaire in a face-to-face interview. Food consumption frequency was assessed by an 18-item semiquantitative food-frequency questionnaire (FFQ). Dietary nutrient intakes were calculated from a 24-hour recall. RESULTS Patients with AMD compared with controls had significantly higher consumption of legumes and lower consumption of meat products, salt and salty products. In men, we found statistically significant differences in alcohol consumption. The case group consumed alcoholic beverages more frequently (median: 2 times a week) than the control group (median: 1-3 times a month). No differences in alcohol consumption were found in women. In comparison to the case group, the control group had a significantly higher dietary intake of energy (5,783.8 vs. 4,849.3 kJ/day; p = 0.002), proteins (65.3 vs. 52.3 g/day; p = 0.002), fats (57.6 vs. 49.4 g/day; p = 0.046), saturated fatty acids (21.7 vs. 18.9 g/day; p = 0.026), carbohydrates (150.4 vs. 127.1 g/day; p = 0.017), dietary fibre (13.2 vs. 11.3 g/day; p = 0.044), vitamin B2 (1.0 vs. 0.9 mg/day; p = 0.029), vitamin B3 (13.9 vs. 10.0 mg/day; p = 0.011), pantothenic acid (3.5 vs. 2.8 mg/day; p = 0.001), vitamin B6 (1.3 vs. 1.0 mg/day; p = 0.001), potassium (1,656.5 vs. 1,418.0 mg/day; p = 0.022), phosphorus (845.4 vs. 718.7 mg/day; p = 0.020), magnesium (176.5 vs. 143.0 mg/day; p = 0.012), copper (1.0 vs. 0.8 mg/day; p = 0.011), and zinc (7.1 vs. 6.1 mg/day; p = 0.012) counted from a 24-hour recall. CONCLUSIONS According to FFQ, dietary habits in the patients with AMD and controls were similar. In men from the case group, we found statistically significant higher alcohol consumption. According to a 24-hour recall, the controls achieved recommended dietary intakes rather than cases. In comparison to the case group, the control group had a significantly higher dietary intake of energy, proteins, fats, saturated fatty acids, carbohydrates, dietary fibre, vitamin B2, vitamin B3, pantothenic acid, vitamin B6, potassium, phosphorus, magnesium, copper, and zinc.
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Affiliation(s)
- Jana Šalková Kráľová
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Petr Kolář
- Department of Ophthalmology, Slovak Medical University and University Hospital Bratislava, Bratislava, Slovak Republic
| | - Zlata Kapounová
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Petr Veselý
- Department of Optometry and Orthoptics, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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Rondanelli M, Gasparri C, Riva A, Petrangolini G, Barrile GC, Cavioni A, Razza C, Tartara A, Perna S. Diet and ideal food pyramid to prevent or support the treatment of diabetic retinopathy, age-related macular degeneration, and cataracts. Front Med (Lausanne) 2023; 10:1168560. [PMID: 37324128 PMCID: PMC10265999 DOI: 10.3389/fmed.2023.1168560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/09/2023] [Indexed: 06/17/2023] Open
Abstract
Many eye diseases, such as diabetic retinopathy (DR), age-related macular degeneration (AMD), and cataracts are preventable and treatable with lifestyle. The objective of this review is to assess the most recent research on the ideal dietary approach to prevent or support the treatment of DR, AMD, and cataracts, as well as to construct a food pyramid that makes it simple for people who are at risk of developing these pathologies to decide what to eat. The food pyramid presented here proposes what should be consumed every day: 3 portions of low glycemic index (GI) grains (for fiber and zinc content), 5 portions (each portion: ≥200 g/day) of fruits and vegetables (spinach, broccoli, zucchini cooked, green leafy vegetables, orange, kiwi, grapefruit for folic acid, vitamin C, and lutein/zeaxanthin content, at least ≥42 μg/day, are to be preferred), extra virgin olive (EVO) oil (almost 20 mg/day for vitamin E and polyphenols content), nuts or oil seeds (20-30 g/day, for zinc content, at least ≥15.8 mg/day); weekly: fish (4 portions, for omega-3 content and eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA) 0.35-1.4 g/day), white meat (3 portions for vitamin B12 content), legumes (2 portions for vegetal proteins), eggs (2 portions for lutein/zeaxanthin content), light cheeses (2 portions for vitamin B6 content), and almost 3-4 times/week microgreen and spices (saffron and curcumin). At the top of the pyramid, there are two pennants: one green, which indicates the need for personalized supplementation (if daily requirements cannot be met through diet, omega-3, and L-methylfolate supplementation), and one red, which indicates that certain foods are prohibited (salt and sugar). Finally, 3-4 times per week, 30-40 min of aerobic and resistance exercises are required.
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Affiliation(s)
- Mariangela Rondanelli
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Mondino Foundation, Pavia, Italy
- Unit of Human and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Clara Gasparri
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, Pavia, Italy
| | | | | | - Gaetan Claude Barrile
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, Pavia, Italy
| | - Alessandro Cavioni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, Pavia, Italy
| | - Claudia Razza
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, Pavia, Italy
| | - Alice Tartara
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, Pavia, Italy
| | - Simone Perna
- Department of Biology, College of Science, University of Bahrain, Zallaq, Bahrain
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Yin C, Gan Q, Xu P, Yang T, Xu J, Cao W, Wang H, Pan H, Ren Z, Xiao H, Wang K, Xu Y, Zhang Q. Dietary Patterns and Associations with Myopia in Chinese Children. Nutrients 2023; 15:nu15081946. [PMID: 37111164 PMCID: PMC10142016 DOI: 10.3390/nu15081946] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/13/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Dietary shifts in populations undergoing rapid economic transitions have been proposed as partly contributing toward the rapid intergenerational rise in myopia prevalence; however, empirical evidence of the effect of dietary factors on myopia is limited. This study investigated the association between dietary factors and incident myopia in Chinese children aged 10-11 years. We evaluated dietary habits using a 72-item food frequency questionnaire (FFQ) among 7423 children. Myopic status was assessed using the "General Personal Information Questionnaire". Principal component analysis was used to extract dietary patterns and investigate their association with myopia. After adjusting for potential confounders, participants with the highest adherence to dietary pattern A (95% confidence interval (CI): 0.66-0.92, p for trend = 0.007) and dietary pattern C (95% CI: 0.58-0.80, p for trend < 0.001) had a lower risk of myopia than participants with the least adherence. Both of these dietary patterns are characterized by high consumption of meats, aquatic product, dairy and its products, eggs, legumes, vegetables, fruits, grains, and potatoes. Our findings suggest that other environmental factors, such as those related to the dietary environment, may contribute to the development of myopia. These findings can serve as a reference for diet-related primary prevention of myopia.
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Affiliation(s)
- Chunjie Yin
- School of Public Health, Xinjiang Medical University, Urumqi 830017, China
| | - Qian Gan
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Peipei Xu
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Titi Yang
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Juan Xu
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Wei Cao
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Hongliang Wang
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Hui Pan
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Zhibin Ren
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Hui Xiao
- School of Public Health, Xinjiang Medical University, Urumqi 830017, China
| | - Kai Wang
- School of Medical Engineering and Technology, Xinjiang Medical University, Urumqi 830017, China
| | - Ying Xu
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Qian Zhang
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
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Cirone C, Cirone KD, Malvankar-Mehta MS. Linkage between a plant-based diet and age-related eye diseases: a systematic review and meta-analysis. Nutr Rev 2023; 81:428-440. [PMID: 36102832 DOI: 10.1093/nutrit/nuac067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
CONTEXT An increased risk of age-related eye disease has been observed in individuals lacking a balanced diet. Following a plant-based diet may result in nutritional insufficiencies and negatively affect health if an effort is not made to ensure the consumption of fortified foods or specific supplements. OBJECTIVE The purpose of this article is to characterize the relationship between plant-based diets and age-related ocular outcomes among adults. DATA SOURCES A comprehensive literature review was performed using the MEDLINE, Embase, Cochrane, and PubMed databases up until December 19, 2021. STUDY SELECTION Studies that focused on observed visual changes due to a reduced intake of animal products and that included a minimum of 50 eyes were eligible for inclusion. DATA EXTRACTION Two levels of screening, quality assessment, and data extraction were conducted by 2 reviewers independently. The 21 studies identified from 814 unique studies progressed to data extraction and 15 were included in the quantitative analysis using STATA 15.0 fixed-effect and random-effect models computed on the basis of heterogeneity. RESULTS The 15 (n = 51 695 participants) assessed the impact of fish consumption, 8 studies (n = 28 753 participants) analyzed the effect of red meat intake, and 3 studies (n = 7723 participants) assessed the impact of omission of skim milk, poultry, and non-meat animal products and the presence of disease incidence as indicated by age-related macular degeneration or cataract development. Meta-analysis indicated regular consumption of fish (odds ratio [OR], 0.70; 95%CI, 0.62-0.79) and skim milk, poultry, and non-meat animal products (OR, 0.70; 95%CI, 0.61-0.79) reduced the risk of age-related eye disease development among adults. Consumption of red meat (OR, 1.41; 95%CI, 1.07-1.86) may increase the risk of age-related eye disease development. CONCLUSION A pescatarian diet is associated with the most favorable visual outcomes among adults, whereas consumption of red meat negatively affects ocular health. Results suggest a need for more initiatives promoting a healthy and balanced diet. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021269925.
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Affiliation(s)
- Cristina Cirone
- is with the School of Nutrition, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Katrina D Cirone
- is with the Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Monali S Malvankar-Mehta
- is with the Department of Ophthalmology, and the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
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Association of objective and subjective far vision impairment with perceived stress among older adults in six low- and middle-income countries. Eye (Lond) 2022; 36:1274-1280. [PMID: 34145418 PMCID: PMC9151919 DOI: 10.1038/s41433-021-01634-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 05/28/2021] [Accepted: 06/10/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To assess the association between far vision impairment (objective and subjective) and perceived stress among older adults from six low- and middle-income countries (LMICs, i.e., China, Ghana, India, Mexico, Russia, and South Africa). METHODS Data from the WHO Study on global AGEing and adult health were analyzed. Objective visual acuity was measured using the tumbling E LogMAR chart and was used as a four-category variable (no, mild, moderate, and severe visual impairment). Subjective visual impairment referred to difficulty in seeing and recognizing an object or a person across the road. Using two questions from the Perceived Stress Scale, a perceived stress variable was computed, and ranged from 0 (lowest stress) to 100 (highest stress). Multivariable linear regression with perceived stress as the outcome was conducted. RESULTS Data on 14,585 adults aged ≥65 years [mean (SD) age 72.6 (11.5) years; 55.0% females] were analyzed. Only severe objective visual impairment (versus no visual impairment) was significantly associated with higher levels of stress (b = 6.91; 95% CI = 0.94-12.89). In terms of subjective visual impairment, compared with no visual impairment, mild (b = 2.67; 95% CI = 0.56-4.78), moderate (b = 8.18; 95% CI = 5.84-10.52), and severe (b = 11.86; 95% CI = 9.11-14.61) visual impairment were associated with significantly higher levels of perceived stress. CONCLUSIONS This large study showed that far vision impairment was associated with increased perceived stress levels among older adults in LMICs. Increased availability of eye care services may reduce stress among those with visual impairment in LMICs, while more research is needed to better characterize the directionality of the far vision impairment-perceived stress relationship.
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Sasaki M, Miyagawa N, Harada S, Tsubota K, Takebayashi T, Nishiwaki Y, Kawasaki R. Dietary Patterns and Their Associations with Intermediate Age-Related Macular Degeneration in a Japanese Population. J Clin Med 2022; 11:jcm11061617. [PMID: 35329943 PMCID: PMC8955354 DOI: 10.3390/jcm11061617] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 11/22/2022] Open
Abstract
This population-based cross-sectional study investigated the influence of dietary patterns on age-related macular degeneration (AMD) in a Japanese population. The Tsuruoka Metabolomics Cohort Study enrolled a general population aged 35–74 years from among participants in annual health check-up programs in Tsuruoka City, Japan. Eating habits were assessed using a food frequency questionnaire. Principal component analysis was used to identify dietary patterns among food items. The association between quartiles of scores for each dietary pattern and intermediate AMD was assessed using multivariate logistic regression models. Of 3433 participants, 415 had intermediate AMD. We identified four principal components comprising the Vegetable-rich pattern, Varied staple food pattern, Animal-rich pattern, and Seafood-rich pattern. After adjusting for potential confounders, higher Varied staple food diet scores were associated with a lower prevalence of intermediate AMD (fourth vs. first quartile) (OR, 0.63; 95% confidence interval [CI], 0.46–0.86). A significant trend of decreasing ORs for intermediate AMD associated with increasing Varied staple food diet scores was noted (p for trend = 0.002). There was no significant association between the other dietary patterns and intermediate AMD. In a Japanese population, individuals with a dietary pattern score high in the Varied staple food pattern had a lower prevalence of intermediate AMD.
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Affiliation(s)
- Mariko Sasaki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan;
- Department of Ophthalmology, Tachikawa Hospital, Tokyo 190-8531, Japan
- National Institute of Sensory Organs, National Tokyo Medical Center, Tokyo 152-8902, Japan
- Correspondence:
| | - Naoko Miyagawa
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo 160-8582, Japan; (N.M.); (S.H.); (T.T.)
| | - Sei Harada
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo 160-8582, Japan; (N.M.); (S.H.); (T.T.)
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan;
| | - Toru Takebayashi
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo 160-8582, Japan; (N.M.); (S.H.); (T.T.)
| | - Yuji Nishiwaki
- Department of Environmental and Occupational Health, Toho University, Tokyo 143-8540, Japan;
| | - Ryo Kawasaki
- Department of Vision Informatics (Topcon), Osaka University Graduate School of Medicine, Osaka 565-0871, Japan;
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10
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Boadi-Kusi SB, Asiamah E, Ocansey S, Abu SL. Nutrition knowledge and dietary patterns in ophthalmic patients. Clin Exp Optom 2021; 104:78-84. [PMID: 32363741 DOI: 10.1111/cxo.13083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
CLINICAL SIGNIFICANCE Ophthalmic nutrition education programs and good dietary patterns are of considerable significance to ocular health outcomes. BACKGROUND The study aimed at assessing the level of ophthalmic nutrition knowledge and to compare the dietary patterns between different ophthalmic patients. METHODS Four hundred and ninety-two adults (mean age 54.7 ± 19.4-years) receiving care at three eye-care facilities in Ghana were surveyed: 171 had senile cataract, 162 had open-angle glaucoma, and 159 had healthy eyes. A modified food frequency questionnaire was administered to elicit ophthalmic nutrition knowledge and dietary intake information of participants over the last 30-days. The results were compared between the three groups. RESULTS More than half of the participants (n = 267; 54.3 per cent) had received some form of education on food sources that are good for the eyes and vision, with healthy participants accounting for 50.6 per cent of this proportion. Television (55.1 per cent; 147/267), radio (49.1 per cent; 131/267) and the eye doctor (34.1 per cent; 91/267) were the most frequent sources of ophthalmic nutritional knowledge. Overall, less than one-quarter of the participants (n = 108; 22.2 per cent) were able to correctly identify one food source for at least four out of seven selected ophthalmic nutrients. Vitamin C was the most frequently consumed ophthalmic nutrient, whereas lycopene was the least taken across all groups. The average ophthalmic nutrients intake score for those with healthy eyes (59.16 [53.39-64.93]) was significantly greater than for both glaucoma patients (37.73 [32.01-43.44]) and cataract patients (34.81 [29.24-40.37]). CONCLUSION In addition to poor ophthalmic nutrition awareness and knowledge, both cataract and glaucoma patients, compared to those with healthy eyes, consumed a lesser amount of nutrients considered vital for eye health and vision. Ophthalmic nutrition education is needed to improve eye-health outcomes.
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Affiliation(s)
- Samuel B Boadi-Kusi
- Department of Optometry and Vision Science, University of Cape Coast , Cape Coast, Ghana
| | - Edward Asiamah
- Eye Department, Kumasi South Government Hospital , Kumasi, Ghana
| | - Stephen Ocansey
- Department of Optometry and Vision Science, University of Cape Coast , Cape Coast, Ghana
| | - Sampson L Abu
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham , Birmingham, Alabama, USA
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Dietary flavonoids are associated with longitudinal treatment outcomes in neovascular age-related macular degeneration. Eur J Nutr 2021; 60:4243-4250. [PMID: 34009430 DOI: 10.1007/s00394-021-02582-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 05/05/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE To assess whether dietary intake of flavonoids are associated with longitudinal treatment outcomes of patients with neovascular age-related macular degeneration (nAMD). METHODS 547 participants with nAMD were recruited at baseline, 494 were followed-up after receiving 12 months of anti-vascular endothelial growth factor (anti-VEGF) therapy. Baseline dietary intake of flavonoids was determined using a validated food frequency questionnaire. At follow-up, presence of intra-retinal and sub-retinal fluid (IRF and SRF), retinal pigment epithelium detachment and measurements of central macular thickness (CMT) were recorded from optical coherence tomography scans. Visual acuity (VA) was documented using LogMAR charts. RESULTS Participants in the first tertile of intake of the flavonol quercetin, and the flavan-3-ols epigallocatechin-3-gallate and epigallocatechin had significantly worse vision than participants in the third tertile-multivariable-adjusted least square (LS) mean VA: 14.68 vs. 19.53 (p = 0.04); 14.06 vs. 18.89 (p = 0.04); 13.86 vs. 18.86 (p = 0.03), respectively. Participants in the first compared to the third tertile of flavan-3-ol, epigallocatechin-3-gallate and epigallocatechin intake all had a twofold higher risk of IRF, multivariable-adjusted p trend of: 0.03, 0.01 and 0.02, respectively. The first vs. the third tertile of tea intake had significantly worse vision (LS mean VA: 13.49 vs. 19.04, p = 0.02), increased risk of IRF (OR 2.13, 95% CI 1.18-3.85) and greater mean CMT (279.59 μm vs. 256.52 μm, p = 0.04). CONCLUSIONS Higher intakes of dietary flavonoids, specifically flavonols and flavan-3-ols, could be associated with better long-term treatment outcomes in nAMD patients receiving anti-VEGF therapy. Confirmation of these associations in interventional studies could result in promising new therapeutic approaches to the treatment of nAMD.
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12
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Krueger K, Boehme E, Klettner AK, Zille M. The potential of marine resources for retinal diseases: a systematic review of the molecular mechanisms. Crit Rev Food Sci Nutr 2021; 62:7518-7560. [PMID: 33970706 DOI: 10.1080/10408398.2021.1915242] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
We rely on vision more than on any other sense to obtain information about our environment. Hence, the loss or even impairment of vision profoundly affects our quality of life. Diet or food components have already demonstrated beneficial effects on the development of retinal diseases. Recently, there has been a growing interest in resources from marine animals and plants for the prevention of retinal diseases through nutrition. Especially fish intake and omega-3 fatty acids have already led to promising results, including associations with a reduced incidence of retinal diseases. However, the underlying molecular mechanisms are insufficiently explained. The aim of this review was to summarize the known mechanistic effects of marine resources on the pathophysiological processes in retinal diseases. We performed a systematic literature review following the PRISMA guidelines and identified 107 studies investigating marine resources in the context of retinal diseases. Of these, 46 studies described the underlying mechanisms including anti-inflammatory, antioxidant, antiangiogenic/vasoprotective, cytoprotective, metabolic, and retinal function effects, which we critically summarize. We further discuss perspectives on the use of marine resources for human nutrition to prevent retinal diseases with a particular focus on regulatory aspects, health claims, safety, and bioavailability.
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Affiliation(s)
- Kristin Krueger
- Department of Marine Biotechnology, Fraunhofer Research and Development Center for Marine and Cellular Biotechnology EMB, Lübeck, Germany
| | - Elke Boehme
- Department of Marine Biotechnology, Fraunhofer Research and Development Center for Marine and Cellular Biotechnology EMB, Lübeck, Germany
| | - Alexa Karina Klettner
- Department of Ophthalmology, University Medical Center, University of Kiel, Quincke Research Center, Kiel, Germany
| | - Marietta Zille
- Department of Marine Biotechnology, Fraunhofer Research and Development Center for Marine and Cellular Biotechnology EMB, Lübeck, Germany.,Institute for Experimental and Clinical Pharmacology and Toxicology, University of Lübeck, Lübeck, Germany
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13
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Dharamdasani Detaram H, Liew G, Russell J, Vu KV, Burlutsky G, Mitchell P, Gopinath B. Dietary antioxidants are associated with presence of intra- and sub-retinal fluid in neovascular age-related macular degeneration after 1 year. Acta Ophthalmol 2020; 98:e814-e819. [PMID: 32162461 DOI: 10.1111/aos.14394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 02/20/2020] [Indexed: 01/16/2023]
Abstract
PURPOSE To assess whether dietary intake of antioxidants, fruits, vegetables and fish is associated with 12-month treatment outcomes in neovascular age-related macular degeneration (nAMD) patients. METHODS A total of 547 participants were diagnosed with nAMD at baseline, of whom 494 were followed up after 12 months of antivascular endothelial growth factor therapy. Dietary intakes were determined using a validated food frequency questionnaire. Presence of intra-retinal and sub-retinal fluid (IRF, SRF), pigment epithelial detachment (PED) and central macular thickness (CMT) were recorded from optical coherence tomography images. Best-corrected visual acuity was recorded using log of the Minimum Angle of Resolution (LogMAR) charts. RESULTS Participants in the upper three quartiles combined compared to those in the first quartile of baseline dietary zinc intake had 49% reduced odds of SRF 12 months later, multivariable-adjusted odds ratio (OR) 0.51 [95% confidence interval (CI) 0.30-0.89]. The upper three quartiles combined compared to the first quartile of β-carotene intake had 90% greater odds of IRF presence at 12-month follow-up, multivariable-adjusted OR 1.90 (95% CI 1.04-3.46). The highest versus lowest quartile of dietary β-carotene intake had a nearly twofold greater odds of PED presence, multivariable-adjusted OR 1.99 (95% CI 1.03-3.84). CONCLUSION A higher intake of dietary zinc was associated with a reduced likelihood of SRF at 1 year. Conversely, a higher intake of dietary β-carotene was associated with an increased risk of IRF and PED. These findings underscore the importance of ongoing nutritional advice for nAMD patients presenting for treatment.
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Affiliation(s)
- Harshil Dharamdasani Detaram
- Centre for Vision Research Department of Ophthalmology and The Westmead Institute for Medical Research The University of Sydney Sydney New South Wales Australia
| | - Gerald Liew
- Centre for Vision Research Department of Ophthalmology and The Westmead Institute for Medical Research The University of Sydney Sydney New South Wales Australia
| | - Joanna Russell
- Faculty of Social Sciences School of Health and Society University of Wollongong Sydney New South Wales Australia
| | - Kim Van Vu
- Centre for Vision Research Department of Ophthalmology and The Westmead Institute for Medical Research The University of Sydney Sydney New South Wales Australia
| | - George Burlutsky
- Centre for Vision Research Department of Ophthalmology and The Westmead Institute for Medical Research The University of Sydney Sydney New South Wales Australia
| | - Paul Mitchell
- Centre for Vision Research Department of Ophthalmology and The Westmead Institute for Medical Research The University of Sydney Sydney New South Wales Australia
| | - Bamini Gopinath
- Centre for Vision Research Department of Ophthalmology and The Westmead Institute for Medical Research The University of Sydney Sydney New South Wales Australia
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14
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Tang D, Mitchell P, Liew G, Burlutsky G, Flood VM, Gopinath B. Telephone-Delivered Dietary Intervention in Patients with Age-Related Macular Degeneration: 3-Month Post-Intervention Findings of a Randomised Controlled Trial. Nutrients 2020; 12:E3083. [PMID: 33050401 PMCID: PMC7650817 DOI: 10.3390/nu12103083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/02/2020] [Accepted: 10/06/2020] [Indexed: 11/17/2022] Open
Abstract
There is an evidence-practice gap between the dietary recommendations for age-related macular degeneration (AMD) presented in the literature and those practiced by patients. This study reports on the 3-month post-intervention results of a randomised controlled trial (RCT) evaluating telephone-delivered counselling to improve dietary behaviours among AMD patients. A total of 155 AMD patients (57% female, aged 78 ± 8 years; control: 78, intervention: 77), primarily residing in New South Wales, Australia, were recruited. Participants completed a baseline questionnaire and a short dietary questionnaire (SDQ-AMD). The intervention included an evidence-based nutrition resource and four monthly calls with a dietitian. Immediately post-intervention, intervention participants repeated the SDQ-AMD and completed a feedback form. At 3 months post-intervention, both study arms repeated the SDQ-AMD. Statistical analyses included t-tests and McNemar's test. Intervention participants reported satisfaction with the tailored phone calls, nutrition resource and nutrition education provided. At 3 months post-intervention, there was no statistically significant difference between study arms in the proportion of participants meeting the dietary goals nor in intake (mean servings ± SE) of total vegetables (primary outcome) and other key food groups; however, there was a significantly higher intake of nuts (secondary outcome) (3.96 ± 0.51 vs. 2.71 ± 0.32; p = 0.04) among participants in the intervention versus control group. Within the intervention arm, there were also significant improvements in intakes of the following secondary outcomes: dark green leafy vegetables (0.99 ± 0.17 vs. 1.71 ± 0.22; p = 0.003) and legumes (0.69 ± 0.10 vs. 1.12 ± 0.16; p = 0.02) and intake of sweets and processed/prepared foods (8.31 ± 0.76 vs. 6.54 ± 0.58, p = 0.01). In summary, although there were few dietary differences between study arms at 3 months post-intervention, the intervention involving four monthly calls was acceptable and helpful to the participants. This type of intervention therefore has the potential to provide people with AMD the needed support for improving their nutrition knowledge and dietary practices, especially if continued over a longer period.
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Affiliation(s)
- Diana Tang
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, Camperdown, NSW 2006, Australia; (P.M.); (G.L.); (G.B.); (B.G.)
| | - Paul Mitchell
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, Camperdown, NSW 2006, Australia; (P.M.); (G.L.); (G.B.); (B.G.)
| | - Gerald Liew
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, Camperdown, NSW 2006, Australia; (P.M.); (G.L.); (G.B.); (B.G.)
| | - George Burlutsky
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, Camperdown, NSW 2006, Australia; (P.M.); (G.L.); (G.B.); (B.G.)
| | - Victoria M. Flood
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia;
- Western Sydney Local Health District, Westmead Hospital, Westmead, NSW 2145, Australia
| | - Bamini Gopinath
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, Camperdown, NSW 2006, Australia; (P.M.); (G.L.); (G.B.); (B.G.)
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15
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Dietary Patterns, Carbohydrates, and Age-Related Eye Diseases. Nutrients 2020; 12:nu12092862. [PMID: 32962100 PMCID: PMC7551870 DOI: 10.3390/nu12092862] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 12/19/2022] Open
Abstract
Over a third of older adults in the U.S. experience significant vision loss, which decreases independence and is a biomarker of decreased health span. As the global aging population is expanding, it is imperative to uncover strategies to increase health span and reduce the economic burden of this age-related disease. While there are some treatments available for age-related vision loss, such as surgical removal of cataracts, many causes of vision loss, such as dry age-related macular degeneration (AMD), remain poorly understood and no treatments are currently available. Therefore, it is necessary to better understand the factors that contribute to disease progression for age-related vision loss and to uncover methods for disease prevention. One such factor is the effect of diet on ocular diseases. There are many reviews regarding micronutrients and their effect on eye health. Here, we discuss the impact of dietary patterns on the incidence and progression of age-related eye diseases, namely AMD, cataracts, diabetic retinopathy, and glaucoma. Then, we focus on the specific role of dietary carbohydrates, first by outlining the physiological effects of carbohydrates on the body and then how these changes translate into eye and age-related ocular diseases. Finally, we discuss future directions of nutrition research as it relates to aging and vision loss, with a discussion of caloric restriction, intermittent fasting, drug interventions, and emerging randomized clinical trials. This is a rich field with the capacity to improve life quality for millions of people so they may live with clear vision for longer and avoid the high cost of vision-saving surgeries.
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16
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Autophagy in Age-Related Macular Degeneration: A Regulatory Mechanism of Oxidative Stress. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:2896036. [PMID: 32831993 PMCID: PMC7429811 DOI: 10.1155/2020/2896036] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/18/2020] [Indexed: 02/06/2023]
Abstract
Age-related macular degeneration (AMD) is a leading cause of severe visual loss and irreversible blindness in the elderly population worldwide. Retinal pigment epithelial (RPE) cells are the major site of pathological alterations in AMD. They are responsible for the phagocytosis of shed photoreceptor outer segments (POSs) and clearance of cellular waste under physiological conditions. Age-related, cumulative oxidative stimuli contribute to the pathogenesis of AMD. Excessive oxidative stress induces RPE cell degeneration and incomplete digestion of POSs, leading to the continuous accumulation of cellular waste (such as lipofuscin). Autophagy is a major system of degradation of damaged or unnecessary proteins. However, degenerative RPE cells in AMD patients cannot perform autophagy sufficiently to resist oxidative damage. Increasing evidence supports the idea that enhancing the autophagic process can properly alleviate oxidative injury in AMD and protect RPE and photoreceptor cells from degeneration and death, although overactivated autophagy may lead to cell death at early stages of retinal degenerative diseases. The crosstalk among the NFE2L2, PGC-1, p62, AMPK, and PI3K/Akt/mTOR pathways may play a crucial role in improving disturbed autophagy and mitigating the progression of AMD. In this review, we discuss how autophagy prevents oxidative damage in AMD, summarize potential neuroprotective strategies for therapeutic interventions, and provide an overview of these neuroprotective mechanisms.
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17
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Dighe S, Zhao J, Steffen L, Mares JA, Meuer SM, Klein BEK, Klein R, Millen AE. Diet patterns and the incidence of age-related macular degeneration in the Atherosclerosis Risk in Communities (ARIC) study. Br J Ophthalmol 2020; 104:1070-1076. [PMID: 31810976 PMCID: PMC8218331 DOI: 10.1136/bjophthalmol-2019-314813] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 10/28/2019] [Accepted: 11/05/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss among the elderly. OBJECTIVE This study aimed to determine the association between dietary patterns and food groups (used to make them) with the 18-year incidence of AMD. METHODS ARIC (Atherosclerosis Risk in Communities) participants who showed change in AMD lesions between retinal photographs taken at visit 3 and visit 5 were graded side by side to determine incident AMD (any=144; early=117; late=27). A 66-line item food frequency questionnaire, administered at visit 1 and visit 3, was used to identify 29 food groups. Principal component analysis was used to derive dietary patterns from average food group servings. Logistic regression was used to estimate ORs and 95% CIs for incident AMD (any, early and late) by tertiles of dietary pattern scores, adjusted for age, race, education, total calories and smoking status. P-trend was estimated using continuous scores. RESULTS Western (unhealthy) and Prudent (healthy) dietary patterns were identified. No significant associations were observed between either dietary pattern and incident any or incident early AMD. However, a threefold higher incidence of late AMD was observed among participants with a Western pattern score above, as compared with below, the median (OR=3.44 (95% CI 1.33 to 8.87), p-trend=0.014). The risk of developing late AMD was decreased, but not statistically significant, among participants with a Prudent pattern score above, as compared with below, the median (OR=0.51 (95% CI 0.22 to 1.18), p-trend=0.054). CONCLUSIONS Diet patterns were not significantly associated with incident any or incident early AMD. However, consumption of a Western pattern diet may be a risk factor for development of late AMD.
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Affiliation(s)
- Shruti Dighe
- Department of Epidemiology and Environmental health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Jiwei Zhao
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Lyn Steffen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, Minneapolis, Minnesota, USA
| | - J A Mares
- Department of Ophthalmology and Visual Sciences, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Stacy M Meuer
- Department of Ophthalmology and Visual Sciences, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Amy E Millen
- Department of Epidemiology and Environmental health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York, USA
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18
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Jones M, Whitton C, Tan AG, Holliday EG, Oldmeadow C, Flood VM, Sim X, Chai JF, Hamzah H, Klein R, Teo YY, Mitchell P, Wong TY, Tai ES, Van Dam RM, Attia J, Wang JJ. Exploring Factors Underlying Ethnic Difference in Age-related Macular Degeneration Prevalence. Ophthalmic Epidemiol 2020; 27:399-408. [PMID: 32511069 DOI: 10.1080/09286586.2020.1762229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIMS To assess contributions of dietary and genetic factors to ethnic differences in AMD prevalence. DESIGN Population-based analytical study. METHODS In the Blue Mountains Eye Study, Australia (European ancestry n = 2826) and Multi-Ethnic Cohort Study, Singapore (Asian ancestry, n = 1900), AMD was assessed from retinal photographs. Patterns of dietary composition and scores of the Alternative Healthy Eating Index were computed using food frequency questionnaire data. Genetic susceptibility to AMD was determined using either single nucleotide polymorphisms (SNPs) of the complement factor H and age-related maculopathy susceptibility 2 genes, or combined odds-weighted genetic risk scores of 24 AMD-associated SNPs. Associations of AMD with ethnicity, diet, and genetics were assessed using logistic regression. Six potential mediators covering genetic, diet and lifestyle factors were assessed for their contributions to AMD risk difference between the two samples using mediation analyses. RESULTS Age-standardized prevalence of any (early or late) AMD was higher in the European (16%) compared to Asian samples (9%, p < .01). Mean AMD-related genetic risk scores were also higher in European (33.3 ± 4.4) than Asian (Chinese) samples (31.7 ± 3.7, p < .001). In a model simultaneously adjusting for age, ethnicity, genetic susceptibility and Alternative Healthy Eating Index scores, only age and genetic susceptibility were significantly associated with AMD. Genetic risk scores contributed 19% of AMD risk difference between the two samples while intake of polyunsaturated fatty acids contributed 7.2%. CONCLUSION Genetic susceptibility to AMD was higher in European compared to Chinese samples and explained more of the AMD risk difference between the two samples than the dietary factors investigated.
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Affiliation(s)
- Mark Jones
- , Hunter Medical Research Institute , Newcastle, NSW, Australia
| | - Clare Whitton
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System , Singapore
| | - Ava G Tan
- Centre for Vision Research, Department of Ophthalmology, Westmead Institute for Medical Research, University of Sydney , Westmead, NSW, Australia
| | - Elizabeth G Holliday
- Centre for Clinical Epidemiology and Biostatistics, and School of Medicine and Public Health, University of Newcastle , Newcastle, NSW, Australia
| | - Christopher Oldmeadow
- , Hunter Medical Research Institute , Newcastle, NSW, Australia.,Centre for Clinical Epidemiology and Biostatistics, and School of Medicine and Public Health, University of Newcastle , Newcastle, NSW, Australia
| | - Victoria M Flood
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney , Sydney, NSW, Australia.,Westmead Hospital, Western Sydney Local Health District , Sydney, NSW, Australia
| | - Xueling Sim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System , Singapore
| | - Jin-Fang Chai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System , Singapore
| | - Haslina Hamzah
- Ocular Reading Centre, Singapore National Eye Centre , Singapore
| | - Ronald Klein
- Department of Ophthalmology & Visual Sciences, University of Wisconsin Medical School , Madison, Wisconsin, USA
| | - Yik-Ying Teo
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System , Singapore
| | - Paul Mitchell
- Centre for Vision Research, Department of Ophthalmology, Westmead Institute for Medical Research, University of Sydney , Westmead, NSW, Australia
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Center , Singapore.,Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School , Singapore
| | - E Shyong Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System , Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore , Singapore.,Cardiovascular and Metabolic Disease Signature Research Program, Duke-NUS Medical School , Singapore
| | - Rob M Van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System , Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore , Singapore.,Department of Nutrition, Harvard T.H. Chan School of Public Health , Boston, Massachusetts, USA
| | - John Attia
- , Hunter Medical Research Institute , Newcastle, NSW, Australia.,Centre for Clinical Epidemiology and Biostatistics, and School of Medicine and Public Health, University of Newcastle , Newcastle, NSW, Australia
| | - Jie Jin Wang
- Centre for Vision Research, Department of Ophthalmology, Westmead Institute for Medical Research, University of Sydney , Westmead, NSW, Australia.,Health Services and Systems Research, Duke-NUS Medical School , Singapore
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19
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McGuinness MB, Kasza J, Karahalios A, Guymer RH, Finger RP, Simpson JA. A comparison of methods to estimate the survivor average causal effect in the presence of missing data: a simulation study. BMC Med Res Methodol 2019; 19:223. [PMID: 31795945 PMCID: PMC6892197 DOI: 10.1186/s12874-019-0874-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 11/20/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Attrition due to death and non-attendance are common sources of bias in studies of age-related diseases. A simulation study is presented to compare two methods for estimating the survivor average causal effect (SACE) of a binary exposure (sex-specific dietary iron intake) on a binary outcome (age-related macular degeneration, AMD) in this setting. METHODS A dataset of 10,000 participants was simulated 1200 times under each scenario with outcome data missing dependent on measured and unmeasured covariates and survival. Scenarios differed by the magnitude and direction of effect of an unmeasured confounder on both survival and the outcome, and whether participants who died following a protective exposure would also die if they had not received the exposure (validity of the monotonicity assumption). The performance of a marginal structural model (MSM, weighting for exposure, survival and missing data) was compared to a sensitivity approach for estimating the SACE. As an illustrative example, the SACE of iron intake on AMD was estimated using data from 39,918 participants of the Melbourne Collaborative Cohort Study. RESULTS The MSM approach tended to underestimate the true magnitude of effect when the unmeasured confounder had opposing directions of effect on survival and the outcome. Overestimation was observed when the unmeasured confounder had the same direction of effect on survival and the outcome. Violation of the monotonicity assumption did not increase bias. The estimates were similar between the MSM approach and the sensitivity approach assessed at the sensitivity parameter of 1 (assuming no survival bias). In the illustrative example, high iron intake was found to be protective of AMD (adjusted OR 0.57, 95% CI 0.40-0.82) using complete case analysis via traditional logistic regression. The adjusted SACE odds ratio did not differ substantially from the complete case estimate, ranging from 0.54 to 0.58 for each of the SACE methods. CONCLUSIONS On average, MSMs with weighting for exposure, missing data and survival produced biased estimates of the SACE in the presence of an unmeasured survival-outcome confounder. The direction and magnitude of effect of unmeasured survival-outcome confounders should be considered when assessing exposure-outcome associations in the presence of attrition due to death.
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Affiliation(s)
- Myra B. McGuinness
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Jessica Kasza
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria 3010 Australia
| | - Amalia Karahalios
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Robyn H. Guymer
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
| | | | - Julie A. Simpson
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
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20
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Dharamdasani Detaram H, Mitchell P, Russell J, Burlutsky G, Liew G, Gopinath B. Dietary zinc intake is associated with macular fluid in neovascular age‐related macular degeneration. Clin Exp Ophthalmol 2019; 48:61-68. [DOI: 10.1111/ceo.13644] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 09/14/2019] [Indexed: 01/29/2023]
Affiliation(s)
- Harshil Dharamdasani Detaram
- Centre for Vision Research, Department of Ophthalmology and The Westmead Institute for Medical ResearchThe University of Sydney Sydney New South Wales Australia
| | - Paul Mitchell
- Centre for Vision Research, Department of Ophthalmology and The Westmead Institute for Medical ResearchThe University of Sydney Sydney New South Wales Australia
| | - Joanna Russell
- Faculty of Social Sciences, School of Health and SocietyUniversity of Wollongong Sydney New South Wales Australia
| | - George Burlutsky
- Centre for Vision Research, Department of Ophthalmology and The Westmead Institute for Medical ResearchThe University of Sydney Sydney New South Wales Australia
| | - Gerald Liew
- Centre for Vision Research, Department of Ophthalmology and The Westmead Institute for Medical ResearchThe University of Sydney Sydney New South Wales Australia
| | - Bamini Gopinath
- Centre for Vision Research, Department of Ophthalmology and The Westmead Institute for Medical ResearchThe University of Sydney Sydney New South Wales Australia
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21
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Hart KM, Abbott C, Ly A, Kalff S, Lek JJ, Milston R, Page G, Robertson B, Ayton L. Optometry Australia's chairside reference for the diagnosis and management of age-related macular degeneration. Clin Exp Optom 2019; 103:254-264. [PMID: 31566818 DOI: 10.1111/cxo.12964] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/02/2019] [Accepted: 08/02/2019] [Indexed: 01/13/2023] Open
Abstract
Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss in people over the age of 50 years in Australia. Optometry Australia has developed this AMD chairside reference in consultation with a member-based working group comprised of experienced practitioners. It provides an evidence-based approach to current best practice in the diagnosis and management of AMD. Optometrists should be competent in assessing patients with or at risk of developing AMD, so that they are able to provide evidence-based management including appropriate communication, diagnosis and referral when indicated. This AMD chairside reference covers risk factors for the development of AMD or progression to late-stage AMD; the current clinical classification of AMD; common signs and symptoms; optometric assessment including ocular imaging and biomarkers; differential diagnoses; and management of early, intermediate and late AMD. Optometry Australia's chairside reference is intended as a general guide for optometrists, and is not a formal management protocol.
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Affiliation(s)
- Kerryn M Hart
- Member Support and Optometry Advancement, Optometry Australia, Melbourne, Australia.,School of Medicine (Optometry), Faculty of Health, Deakin University, Geelong, Australia
| | - Carla Abbott
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.,Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Angelica Ly
- Centre for Eye Health, The University of New South Wales, Sydney, Australia
| | | | - Jia Jia Lek
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Rebecca Milston
- Centre for Eye Health, The University of New South Wales, Sydney, Australia
| | - Gary Page
- Private Practitioner, Townsville, Australia
| | | | - Lauren Ayton
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.,Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.,Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
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22
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Li S, Chaudhary SC, Zhao X, Gaur U, Fang J, Yan F, Zheng W. Artemisinin Protects Human Retinal Pigmented Epithelial Cells Against Hydrogen Peroxide-induced Oxidative Damage by Enhancing the Activation of AMP-active Protein Kinase. Int J Biol Sci 2019; 15:2016-2028. [PMID: 31523201 PMCID: PMC6743300 DOI: 10.7150/ijbs.30536] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 05/27/2019] [Indexed: 12/12/2022] Open
Abstract
Dry age-related macular degeneration (AMD), a leading cause of blindness in aged population, is directly associated with oxidative stress induced damage of the retinal pigmented epithelial (RPE) cells. In the current study, we investigated the role of AMPK in the protective effect of artemisinin, an FDA approved anti-malarial Chinese herbal drug, on RPE cell line D407, against H2O2 induced oxidative stress. Our results showed that artemisinin promoted the survival of D407 cells from H2O2. Artemisinin reduced intracellular ROS generation and oxidative stress, decreased LDH release and the loss of mitochondrial membrane potential in D407 cells treated with H2O2. Western blotting showed that artemisinin concentration- and time-dependently stimulated the phosphorylation of AMP-activated protein kinase (AMPK) in D407 cells while AMPK inhibitor Compound C or knock-down of AMPK by si-RNA, inhibited the survival protective effect of artemisinin. More importantly, artemisinin produced a similar protective effect in primary cultured retinal pigment cells which was also blocked by inhibitors of AMPK. Taken together, these results suggested that artemisinin promotes survival of human retinal pigment cells against H2O2-induced cell death at least in part through enhancing the activation of AMPK. Therefore, artemisinin may be a beneficial therapeutic candidate for the treatment of age-related diseases, including retinal disorders like AMD.
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Affiliation(s)
- Shuai Li
- Center of Reproduction, Development & Aging, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China.,Institute of Translation Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China
| | - Shubhash Chandra Chaudhary
- Center of Reproduction, Development & Aging, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China.,Institute of Translation Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China
| | - Xia Zhao
- Center of Reproduction, Development & Aging, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China.,Institute of Translation Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China
| | - Uma Gaur
- Center of Reproduction, Development & Aging, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China.,Institute of Translation Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China
| | - Jiankang Fang
- Center of Reproduction, Development & Aging, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China.,Institute of Translation Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China
| | - Fengxia Yan
- Center of Reproduction, Development & Aging, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China
| | - Wenhua Zheng
- Center of Reproduction, Development & Aging, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China.,Institute of Translation Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China
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23
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Dietary Patterns and Age-Related Macular Degeneration in Korea: The Korea National Health and Nutrition Examination Survey 2010-2011. Sci Rep 2019; 9:8200. [PMID: 31160668 PMCID: PMC6546709 DOI: 10.1038/s41598-019-44632-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 05/08/2019] [Indexed: 12/23/2022] Open
Abstract
This study was performed to reveal dietary patterns and age-related macular degeneration risk association in general Korean population. A retrospective cross-sectional database analysis using the data collected from January 2010 to December 2011 at a Korea nationwide survey was conducted. The present analysis was performed from December 2016 to November 2017. Detailed grading with fundus photographs was performed by observers blinded to the patient characteristics. The current study focused on subjects forty year and older who had fundus photographs that is assessable from at least one eye (7,899 participants). Participants were excluded if they reported extreme energy intake (142 participants) or if they were likely to have changed dietary behavior (1,171 participants), or with missing data (n = 764). After exclusion, 5,843 participants data were analyzed in the current study. As the result, 6.8% of the participants exhibited early stages of age-related macular degeneration and 0.6% exhibited late stages. Furthermore, relatively more frequent fish consumption was associated reduced odds of early age-related macular degeneration when comparing the third quartile with the first quartile groups, however, relatively more frequent legume consumption was associated with reduced odds of late age-related macular degeneration when comparing the third quartile with the first quartile groups. In conclusion, the current study insists that the diet pattern rich in fish and legume might have protective effect against age-related macular degeneration in Korean population.
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24
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Waugh N, Loveman E, Colquitt J, Royle P, Yeong JL, Hoad G, Lois N. Treatments for dry age-related macular degeneration and Stargardt disease: a systematic review. Health Technol Assess 2019; 22:1-168. [PMID: 29846169 DOI: 10.3310/hta22270] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Age-related macular degeneration (AMD) is the leading cause of visual loss in older people. Advanced AMD takes two forms, neovascular (wet) and atrophic (dry). Stargardt disease (STGD) is the commonest form of inherited macular dystrophy. OBJECTIVE To carry out a systematic review of treatments for dry AMD and STGD, and to identify emerging treatments where future NIHR research might be commissioned. DESIGN Systematic review. METHODS We searched MEDLINE, EMBASE, Web of Science and The Cochrane Library from 2005 to 13 July 2017 for reviews, journal articles and meeting abstracts. We looked for studies of interventions that aim to preserve or restore vision in people with dry AMD or STGD. The most important outcomes are those that matter to patients: visual acuity (VA), contrast sensitivity, reading speed, ability to drive, adverse effects of treatment, quality of life, progression of disease and patient preference. However, visual loss is a late event and intermediate predictors of future decline were accepted if there was good evidence that they are strong predictors of subsequent visual outcomes. These include changes detectable by investigation, but not necessarily noticed by people with AMD or STGD. ClinicalTrials.gov, the World Health Organization search portal and the UK Clinical Trials gateway were searched for ongoing and recently completed clinical trials. RESULTS The titles and abstracts of 7948 articles were screened for inclusion. The full text of 398 articles were obtained for further screening and checking of references and 112 articles were included in the final report. Overall, there were disappointingly few good-quality studies (including of sufficient size and duration) reporting useful outcomes, particularly in STGD. However we did identify a number of promising research topics, including drug treatments, stem cells, new forms of laser treatment, and implantable intraocular lens telescopes. In many cases, research is already under way, funded by industry or governments. LIMITATIONS In AMD, the main limitation came from the poor quality of much of the evidence. Many studies used VA as their main outcome despite not having sufficient duration to observe changes. The evidence on treatments for STGD is sparse. Most studies tested interventions with no comparison group, were far too short term, and the quality of some studies was poor. FUTURE WORK We think that the topics on which the Health Technology Assessment (HTA) and Efficacy Mechanism and Evaluation (EME) programmes might consider commissioning primary research are in STGD, a HTA trial of fenretinide (ReVision Therapeutics, San Diego, CA, USA), a visual cycle inhibitor, and EME research into the value of lutein and zeaxanthin supplements, using short-term measures of retinal function. In AMD, we suggest trials of fenretinide and of a potent statin. There is epidemiological evidence from the USA that the drug, levodopa, used for treating Parkinson's disease, may reduce the incidence of AMD. We suggest that similar research should be carried out using the large general practice databases in the UK. Ideally, future research should be at earlier stages in both diseases, before vision is impaired, using sensitive measures of macular function. This may require early detection of AMD by screening. STUDY REGISTRATION This study is registered as PROSPERO CRD42016038708. FUNDING The National Institute for Health Research HTA programme.
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Affiliation(s)
- Norman Waugh
- Division of Health Sciences, University of Warwick, Coventry, UK
| | | | | | - Pamela Royle
- Division of Health Sciences, University of Warwick, Coventry, UK
| | | | | | - Noemi Lois
- Ophthalmology, Royal Victoria Hospital, Belfast, UK.,Wellcome-Wolfson Centre for Experimental Medicine, Queens University, Belfast, UK
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25
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Tang D, Mitchell P, Flood V, Kifley A, Hayes A, Liew G, Gopinath B. Dietary intervention in patients with age-related macular degeneration: protocol for a randomised controlled trial. BMJ Open 2019; 9:e024774. [PMID: 30782917 PMCID: PMC6377551 DOI: 10.1136/bmjopen-2018-024774] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Age-related macular degeneration (AMD) is a leading cause of blindness. After smoking, nutrition is the key modifiable factor in reducing AMD incidence and progression, and no other preventative treatments are currently available. At present, there is an evidence-practice gap of dietary recommendations made by eye care practitioners and those actually practised by patients with AMD. To address this gap, a telephone-delivered dietary intervention tailored to patients with AMD will be piloted. The study aims to improve dietary intake and behaviours in patients with AMD. This type of nutrition-focused healthcare is currently not considered in the long-term management of AMD and represents the first empirical evaluation of a telephone-supported application encouraging adherence to dietary recommendations for AMD. METHODS AND ANALYSIS 140 participants with AMD will be recruited for this randomised controlled trial. Those lacking English fluency; unwilling to engage in the intervention or provide informed consent were excluded. Following the completion of the baseline questionnaire, participants will be randomised into one of two arms: intervention or wait-list control (70 each in the intervention and control groups). Intervention participants will receive a detailed mail-delivered workbook containing information on healthy eating behaviours that promote optimal macular health, as well as scheduled phone calls over 4 months from an accredited practising dietitian. Descriptive statistics and multivariate stepwise linear regressions analyses will be used to summarise and determine the changes in dietary intakes, respectively. Economic analysis will be conducted to determine intervention feasibility and possibility of a large-scale rollout. ETHICS AND DISSEMINATION The study was approved by the University of Sydney Human Research Ethics Committee (HREC) (Reference: HREC 2018/219). Study findings will be disseminated via presentations at national/international conferences and peer-reviewed journal articles. TRIAL REGISTRATION NUMBER ACTRN12618000527268; Pre-results.
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Affiliation(s)
- Diana Tang
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Paul Mitchell
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Victoria Flood
- Western Sydney Local Health District, Westmead Hospital, Westmead, New South Wales, Australia
- Faculty of Health Sciences, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Annette Kifley
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Alison Hayes
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Gerald Liew
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Bamini Gopinath
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
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26
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de Koning-Backus AP, Buitendijk GH, Kiefte-de Jong JC, Colijn JM, Hofman A, Vingerling JR, Haverkort EB, Franco OH, Klaver CC. Intake of Vegetables, Fruit, and Fish is Beneficial for Age-Related Macular Degeneration. Am J Ophthalmol 2019; 198:70-79. [PMID: 30312575 DOI: 10.1016/j.ajo.2018.09.036] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 09/27/2018] [Accepted: 09/28/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE What patients should eat to reduce their risk of age-related macular degeneration (AMD) is still unclear. We investigated the effect of a diet recommended by Health Councils on AMD. DESIGN Prospective population-based cohort study. METHODS Four thousand two hundred and two participants from the Rotterdam Study ≥55 years of age who were free of AMD at baseline were included and followed up for 9.1 ± 5.8 years. Incident AMD was graded on fundus photographs. Dietary data were collected using a validated 170-item food frequency questionnaire, and food intakes were categorized into food patterns based on guidelines from Health Councils. Associations with incident AMD were analyzed using Cox proportional hazards models that were adjusted for age, sex, total energy intake, smoking, body mass index, hypertension, education, and income. RESULTS Seven hundred fifty-four people developed incident AMD. Intake of the recommended amounts of vegetables (≥200 g/day), fruit (2×/day), and fish (2×/week) were 30.6%, 54.9%, and 12.5%, respectively. In particular, the intake of fish (2×/week) decreased the risk of incident AMD (hazard ratio 0.76 [95% confidence interval 0.60-0.97]). Intake of the recommended amounts of all 3 food groups was only 3.7%, but adherence to this pattern showed a further reduction of the risk of incident AMD (hazard ratio 0.58 [95% confidence interval 0.36-0.93]). Younger age, higher income, and not smoking were associated with this food pattern, but the risk-lowering effects remained significant after additional adjustment for these factors. CONCLUSION A diet of 200 grams per day of vegetables, fruit two times per day, and fish two times per week is associated with a significantly reduced risk of AMD.
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27
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Milne RL, Fletcher AS, MacInnis RJ, Hodge AM, Hopkins AH, Bassett JK, Bruinsma FJ, Lynch BM, Dugué PA, Jayasekara H, Brinkman MT, Popowski LV, Baglietto L, Severi G, O'Dea K, Hopper JL, Southey MC, English DR, Giles GG. Cohort Profile: The Melbourne Collaborative Cohort Study (Health 2020). Int J Epidemiol 2018. [PMID: 28641380 DOI: 10.1093/ije/dyx085] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R L Milne
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia
| | - A S Fletcher
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - R J MacInnis
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia
| | - A M Hodge
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - A H Hopkins
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - J K Bassett
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - F J Bruinsma
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - B M Lynch
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia.,Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - P A Dugué
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia
| | - H Jayasekara
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia
| | - M T Brinkman
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - L V Popowski
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - L Baglietto
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia.,Centre de Recherche en Épidémiologie et Santé des Populations, Université Paris-Saclay, Villejuif, France.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - G Severi
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia.,Centre de Recherche en Épidémiologie et Santé des Populations, Université Paris-Saclay, Villejuif, France.,Human Genetics Foundation (HuGeF), Turin, Italy
| | - K O'Dea
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre of Population Health Research, University of South Australia, Adelaide, SA, Australia
| | - J L Hopper
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia
| | - M C Southey
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Genetic Epidemiology Laboratory, University of Melbourne, Parkville, VIC, Australia
| | - D R English
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia
| | - G G Giles
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia
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28
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Raimundo M, Mira F, Cachulo MDL, Barreto P, Ribeiro L, Farinha C, Laíns I, Nunes S, Alves D, Figueira J, Merle BMJ, Delcourt C, Santos L, Silva R. Adherence to a Mediterranean diet, lifestyle and age-related macular degeneration: the Coimbra Eye Study - report 3. Acta Ophthalmol 2018; 96:e926-e932. [PMID: 30218481 DOI: 10.1111/aos.13775] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 03/06/2018] [Indexed: 12/29/2022]
Abstract
PURPOSE To characterize the lifestyle and nutritional risk profile associated with the Mediterranean diet in a Portuguese population with and without age-related macular degeneration (AMD). METHODS Nested case-control study (n = 883) within the Coimbra Eye Study, including 434 subjects with AMD and 449 age- and sex-matched subjects without AMD. All enrolled subjects underwent a full risk assessment, including lifestyle-related risk factors and a thorough food frequency questionnaire. This allowed us to build an adherence score to the Mediterranean diet (mediSCORE, range 0-9) constructed from individual food intakes. Food intake was also further analysed by conversion to micronutrient consumption. RESULTS Our results suggest that physical activity has a protective role in AMD [p = 0.018 after multivariate adjustment, OR: 0.69 (0.51-0.93)]. High (mediSCORE ≥6) was also found to be protective [p = 0.041, OR: 0.62 (95% CI: 0.38-0.97)]. Food group analysis unveiled a specific protective role for increased fruits consumption (p = 0.029). Finally, micronutrient analysis revealed a protective role associated with increased consumption of caffeine, fibres, beta-carotene, vitamin C and vitamin E (p < 0.05). CONCLUSION High mediSCORE appears to confer protection against the development of AMD in a Mediterranean population. This effect is driven by increased consumption of fruits and some antioxidant micronutrients, which emerged as statistically significant protective factors. Further studies are required to establish dietary recommendations with clinical application.
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Affiliation(s)
- Miguel Raimundo
- Ophthalmology Department; Coimbra University Hospital Centre (CHUC); Coimbra Portugal
| | - Filipe Mira
- Faculty of Medicine; Institute for Biomedical Imaging and Life Sciences; University of Coimbra (FMUC-IBILI); Coimbra Portugal
| | - Maria da Luz Cachulo
- Ophthalmology Department; Coimbra University Hospital Centre (CHUC); Coimbra Portugal
- Faculty of Medicine; Institute for Biomedical Imaging and Life Sciences; University of Coimbra (FMUC-IBILI); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Patrícia Barreto
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Luísa Ribeiro
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Cláudia Farinha
- Ophthalmology Department; Coimbra University Hospital Centre (CHUC); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Inês Laíns
- Ophthalmology Department; Coimbra University Hospital Centre (CHUC); Coimbra Portugal
- Massachusetts Eye and Ear Infirmary; Harvard Medical School; Boston MA USA
| | - Sandrina Nunes
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Dalila Alves
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - João Figueira
- Ophthalmology Department; Coimbra University Hospital Centre (CHUC); Coimbra Portugal
- Faculty of Medicine; Institute for Biomedical Imaging and Life Sciences; University of Coimbra (FMUC-IBILI); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Bénédicte MJ Merle
- Inserm, Bordeaux Population Health Research Center; Team LEHA; UMR 1219; University of Bordeaux; Bordeaux France
| | - Cécile Delcourt
- Inserm, Bordeaux Population Health Research Center; Team LEHA; UMR 1219; University of Bordeaux; Bordeaux France
| | - Lèlita Santos
- Faculty of Medicine; Institute for Biomedical Imaging and Life Sciences; University of Coimbra (FMUC-IBILI); Coimbra Portugal
- Internal Medicine; Coimbra University Hospital Centre; Coimbra Portugal
| | - Rufino Silva
- Ophthalmology Department; Coimbra University Hospital Centre (CHUC); Coimbra Portugal
- Faculty of Medicine; Institute for Biomedical Imaging and Life Sciences; University of Coimbra (FMUC-IBILI); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
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29
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McCarter RV, Neville CE, Silvestri G, Montgomery S, Moore E, Silvestri V, Cardwell CR, Hogg RE, Woodside JV, McKay GJ. Dietary patterns were not associated with age-related macular degeneration: a cross-sectional analysis in the Irish Nun Eye Study. Ir J Med Sci 2018; 188:1005-1012. [PMID: 30467806 DOI: 10.1007/s11845-018-1932-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 11/13/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Analysing dietary patterns (DP) evaluates overall dietary intake, taking account of its complexity, quality, variance and the interaction between different foods, providing an alternative approach for the evaluation of nutritional influences on age-related macular degeneration (AMD) risk. AIMS To evaluate the relationship between DP and AMD in an older female population. METHODS Data was analysed from the cross-sectional Irish Nun Eye Study involving 1233 older women with a restricted lifestyle (mean age 76.3 years [range, 56-100 years). The Wisconsin Age-related Maculopathy Grading System was used to classify digital colour macular fundus images and dietary intake was assessed using a food frequency questionnaire (n = 1033). A posteriori DP were derived using principal component analysis. Logistic regression models examined associations between DP and AMD risk with adjustment for confounders. RESULTS Two DP were identified: a 'healthy' pattern characterised by a high intake of oily fish, wholegrains, vegetables and fruit; and an 'unhealthy' pattern characterised by high-fat dairy products, sugar, sweets and chips. Of the participants included within the analysis, AMD status were categorised as controls (n = 818, 86.9%), early AMD (n = 83, 8.8%) and late AMD (n = 21, 2.2%). Regression analysis failed to identify any significant associations between healthy or unhealthy DP and AMD risk, in unadjusted and adjusted models. CONCLUSION No evidence of an association between the DP identified and AMD risk was detected in this well-characterised population. Further research is required to determine the overall dietary influences on AMD risk in general population cohorts.
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Affiliation(s)
| | | | - Giuliana Silvestri
- Department of Ophthalmology, Belfast Health & Social Care Trust, Belfast, UK
| | | | - Evelyn Moore
- Department of Ophthalmology, Belfast Health & Social Care Trust, Belfast, UK
| | - Vittorio Silvestri
- Department of Ophthalmology, Belfast Health & Social Care Trust, Belfast, UK
| | | | - Ruth E Hogg
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Jayne V Woodside
- Centre for Public Health, Queen's University Belfast, Belfast, UK.,UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Gareth J McKay
- Centre for Public Health, Queen's University Belfast, Belfast, UK.
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30
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Chapman NA, Jacobs RJ, Braakhuis AJ. Role of diet and food intake in age-related macular degeneration: a systematic review. Clin Exp Ophthalmol 2018; 47:106-127. [PMID: 29927057 DOI: 10.1111/ceo.13343] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 06/13/2018] [Indexed: 01/05/2023]
Abstract
A systematic literature review was conducted to evaluate the role of diet and food intake in age-related macular degeneration (AMD). Eighteen high-quality studies were identified. Adherence to a Mediterranean diet had decreased risk of AMD progression. An Oriental diet pattern had decreased association with AMD prevalence, whereas a Western diet pattern had increased association with AMD prevalence. High consumption of vegetables rich in carotenoids and fatty fish containing omega-3 fatty acids was beneficial for those at risk of AMD. Vegetable oils and animal fats containing omega-6 fatty acids, and red/processed meat should be consumed minimally to reduce the risk of AMD progression. High glycaemic index diets and alcohol consumption of greater than two drinks a day had increased association with AMD. As the quality of diet and food intake had a vital role in AMD, the provision of appropriate nutritional advice to those at risk of AMD is recommended.
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Affiliation(s)
- Naoko A Chapman
- School of Optometry and Vision Science, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Robert J Jacobs
- School of Optometry and Vision Science, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Andrea J Braakhuis
- Department of Nutrition, School of Medical Science, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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31
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Food groups and risk of age-related macular degeneration: a systematic review with meta-analysis. Eur J Nutr 2018; 58:2123-2143. [DOI: 10.1007/s00394-018-1771-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/28/2018] [Indexed: 01/10/2023]
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32
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Nunes S, Alves D, Barreto P, Raimundo M, da Luz Cachulo M, Farinha C, Laíns I, Rodrigues J, Almeida C, Ribeiro L, Figueira J, Santos L, Silva R. Adherence to a Mediterranean diet and its association with age-related macular degeneration. The Coimbra Eye Study-Report 4. Nutrition 2018; 51-52:6-12. [PMID: 29547735 DOI: 10.1016/j.nut.2017.12.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 12/19/2017] [Accepted: 12/29/2017] [Indexed: 12/25/2022]
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.
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Affiliation(s)
- Sandrina Nunes
- Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.
| | - Dalila Alves
- Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Patrícia Barreto
- Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Miguel Raimundo
- Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Maria da Luz Cachulo
- 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
| | - Cláudia Farinha
- Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal; Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Inês Laíns
- Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - João Rodrigues
- Primary Health Care Unit of Lousã, Unidade de Saúde Familiar da Serra da Lousã e Trevim Sol, Coimbra, Portugal
| | | | - Luísa Ribeiro
- Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - João Figueira
- 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
| | - Lelita Santos
- 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
| | - Rufino Silva
- 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
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Kim EK, Kim H, Vijayakumar A, Kwon O, Chang N. Associations between fruit and vegetable, and antioxidant nutrient intake and age-related macular degeneration by smoking status in elderly Korean men. Nutr J 2017; 16:77. [PMID: 29202844 PMCID: PMC5715512 DOI: 10.1186/s12937-017-0301-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 11/27/2017] [Indexed: 01/12/2023] Open
Abstract
Background Age-related macular degeneration (AMD) is one of the major causes of irreversible blindness. The objective of this study was to determine whether there is any relationship between dietary intake of fruits and vegetables (F&V) and antioxidant nutrients including carotenoids and AMD according to smoking status in elderly men. Methods We performed a cross-sectional analysis using nationally representative samples of elderly aged ≥ 65 years (n = 1414) from the Korea National Health and Nutrition Examination Survey (KNHANES, 2010–2012). Results The current smokers consumed less food in total, and, in particular, less cereals/potatoes/sugar products, fruits and vegetables than the nonsmokers and former smokers (p < 0.05). Intake of energy, thiamin, vitamin C, vitamin A, and β-carotene were significantly lower in the current smokers than in the nonsmokers and the former smokers. For current smokers, the ORs of the highest tertile compared with the lowest tertile were 0.36 (95% CI: 0.14–0.96, p for trend = 0.0576) for F&V, 0.32 (95% CI: 0.12–0.85, p for trend = 0.0561) for vitamin C, 0.23 (95% CI: 0.08–0.67, p for trend = 0.0038) for α-carotene, 0.13 (95% CI: 0.04–0.46, p for trend = 0.0003) for β-carotene after adjusting for confounding factors. In contrast, there was no association between antioxidant nutrient intake and AMD among the nonsmokers and former smokers. Conclusions These results suggest that increased consumption of fruits and vegetables containing antioxidant components such as vitamin C, α-carotene, and β-carotene may have a protective effect on AMD. These effects may be more evident among current smokers.
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Affiliation(s)
- Eun-Kyung Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, 120-750, Republic of Korea
| | - Hyesook Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, 120-750, Republic of Korea
| | - Aswathy Vijayakumar
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, 120-750, Republic of Korea
| | - Oran Kwon
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, 120-750, Republic of Korea
| | - Namsoo Chang
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, 120-750, Republic of Korea.
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McNeill SH, Belk KE, Campbell WW, Gifford CL. Coming to terms: meat's role in a healthful diet. Anim Front 2017. [DOI: 10.2527/af.2017.0441] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S. H. McNeill
- National Cattlemen's Beef Association, Human Nutrition Research, Centennial, CO 80112
| | - K. E. Belk
- Colorado State University, Department of Animal Science, Fort Collins, CO 80523
| | - W. W. Campbell
- Purdue University, Department of Nutrition Science, West Lafayette, IN 47907
| | - C. L. Gifford
- Colorado State University, Department of Animal Science, Fort Collins, CO 80523
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Kim EK, Kim H, Kwon O, Chang N. Associations between fruits, vegetables, vitamin A, β-carotene and flavonol dietary intake, and age-related macular degeneration in elderly women in Korea: the Fifth Korea National Health and Nutrition Examination Survey. Eur J Clin Nutr 2017; 72:161-167. [DOI: 10.1038/ejcn.2017.152] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 07/18/2017] [Accepted: 07/19/2017] [Indexed: 12/25/2022]
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Combined influence of poor health behaviours on the prevalence and 15-year incidence of age-related macular degeneration. Sci Rep 2017; 7:4359. [PMID: 28659620 PMCID: PMC5489492 DOI: 10.1038/s41598-017-04697-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 05/18/2017] [Indexed: 01/03/2023] Open
Abstract
We aimed to establish the collective influence of four lifestyle practices (physical activity, diet, smoking and alcohol consumption) on the prevalence and incidence of AMD. At baseline, 2428 participants aged 49+ with complete lifestyle and AMD data were examined, and of these, 1903 participants were re-examined 15 years later. AMD was assessed from retinal photographs. A health behaviour score was calculated, allocating 1 point for each poor behaviour: current smoking; fruits and vegetables consumed <4 serves daily; <3 episodes of physical activity per week; and >2 alcoholic drinks per day. Cross-sectional analysis showed that participants who engaged in all 4 poor health behaviours (n = 29) versus those who did not engage in unhealthy behaviours (reference group; n = 677) had greater odds of any and late AMD: multivariable-adjusted OR, 5.14 (95% CI, 1.04–25.45) and OR 29.53 (95% CI 2.72–321.16), respectively. A marginally non-significant association was observed between increasing number of poor health behaviours and 15-year incidence of early AMD (multivariable-adjusted P-trend = 0.08). Our data suggests that motivating patients with AMD to eat better, exercise more, limit alcohol intake and avoid smoking seems advisable to decelerate the development or worsening of existing AMD.
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Chiu CJ, Chang ML, Li T, Gensler G, Taylor A. Visualization of Dietary Patterns and Their Associations With Age-Related Macular Degeneration. Invest Ophthalmol Vis Sci 2017; 58:1404-1410. [PMID: 28253403 PMCID: PMC5361454 DOI: 10.1167/iovs.16-20454] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Purpose We aimed to visualize the relationship of predominant dietary patterns and their associations with AMD. Methods A total of 8103 eyes from 4088 participants in the baseline Age-Related Eye Disease Study (AREDS) were classified into three groups: control (n = 2739), early AMD (n = 4599), and advanced AMD (n = 765). Using principle component analysis, two major dietary patterns and eight minor dietary patterns were characterized. Applying logistic regression in our analysis, we related dietary patterns to the prevalence of AMD. Qualitative comparative analysis by operating Boolean algebra and drawing Venn diagrams was used to visualize our findings. Results In general, the eight minor patterns were subsets or extensions of either one of the two major dietary patterns (Oriental and Western patterns) and consisted of fewer characteristic foods than the two major dietary patterns. Unlike the two major patterns, which were more strongly associated with both early and advanced AMD, none of the eight minors were associated with early AMD and only four minor patterns, including the Steak pattern (odds ratio comparing the highest to lowest quintile of the pattern score = 1.73 [95% confidence interval: 1.24 to 2.41; Ptrend = 0.02]), the Breakfast pattern (0.60 [0.44 to 0.82]; Ptrend = 0.004]), the Caribbean pattern (0.64 [0.47 to 0.89; Ptrend = 0.009]), and the Peanut pattern (0.64 [0.46 to 0.89; Ptrend = 0.03]), were significantly associated with advanced AMD. Our data also suggested several potential beneficial (peanuts, pizza, coffee, and tea) and harmful (salad dressing) foods for AMD. Conclusions Our data indicate that a diet of various healthy foods may be optimal for reducing AMD risk. The effects of some specific foods in the context of overall diet warrant further study.
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Affiliation(s)
- Chung-Jung Chiu
- Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, United States 2Department of Ophthalmology, School of Medicine, Tufts University, Boston, Massachusetts, United States
| | - Min-Lee Chang
- Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, United States
| | - Tricia Li
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Gary Gensler
- Age-Related Eye Disease Study Coordinating Center, The Emmes Corporation, Rockville, Maryland, United States
| | - Allen Taylor
- Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, United States 2Department of Ophthalmology, School of Medicine, Tufts University, Boston, Massachusetts, United States
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McGuinness MB, Karahalios A, Kasza J, Guymer RH, Finger RP, Simpson JA. Survival Bias When Assessing Risk Factors for Age-Related Macular Degeneration: A Tutorial with Application to the Exposure of Smoking. Ophthalmic Epidemiol 2017; 24:229-238. [PMID: 28287849 DOI: 10.1080/09286586.2016.1276934] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE We illustrate the effect of survival bias when investigating risk factors for eye disease in elderly populations for whom death is a competing risk. Our investigation focuses on the relationship between smoking and late age-related macular degeneration (AMD) in an observational study impacted by censoring due to death. METHODS Statistical methodology to calculate the survivor average causal effect (SACE) as a sensitivity analysis is described, including example statistical computing code for Stata and R. To demonstrate this method, we examine the causal effect of smoking history at baseline (1990-1994) on the presence of late AMD at the third study wave (2003-2007) using data from the Melbourne Collaborative Cohort Study. RESULTS Of the 40,506 participants eligible for inclusion, 38,092 (94%) survived until the start of the third study wave, 20,752 (51%) were graded for AMD (60% female, aged 47-85 years, mean 65 ± 8.7 years). Late AMD was detected in 122 participants. Logistic regression showed strong evidence of an increased risk of late AMD for current smokers compared to non-smokers (adjusted naïve odds ratio 2.99, 95% confidence interval, CI, 1.74-5.13). Among participants expected to be alive at the start of follow-up regardless of their smoking status, the estimated SACE odds ratio comparing current smokers to non-smokers was at least 3.42 (95% CI 1.57-5.15). CONCLUSIONS Survival bias can attenuate associations between harmful exposures and diseases of aging. Estimation of the SACE using a sensitivity analysis approach should be considered when conducting epidemiological research within elderly populations.
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Affiliation(s)
- Myra B McGuinness
- a Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital , Melbourne , Australia.,b Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health , University of Melbourne , Melbourne , Australia.,c Ophthalmology, Department of Surgery , University of Melbourne , Melbourne , Australia
| | - Amalia Karahalios
- b Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health , University of Melbourne , Melbourne , Australia
| | - Jessica Kasza
- d Department of Epidemiology and Preventive Medicine , Monash University , Melbourne , Australia
| | - Robyn H Guymer
- a Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital , Melbourne , Australia.,c Ophthalmology, Department of Surgery , University of Melbourne , Melbourne , Australia
| | - Robert P Finger
- a Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital , Melbourne , Australia.,c Ophthalmology, Department of Surgery , University of Melbourne , Melbourne , Australia.,e Department of Ophthalmology , University of Bonn , Bonn , Germany
| | - Julie A Simpson
- b Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health , University of Melbourne , Melbourne , Australia.,f Cancer Epidemiology Centre, Cancer Council Victoria , Melbourne , Australia
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McGuinness MB, Karahalios A, Finger RP, Guymer RH, Simpson JA. Age-Related Macular Degeneration and Mortality: A Systematic Review and Meta-Analysis. Ophthalmic Epidemiol 2017; 24:141-152. [DOI: 10.1080/09286586.2016.1259422] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Myra B. McGuinness
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
- Department of Ophthalmology, University of Melbourne, East Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Amalia Karahalios
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Robert P. Finger
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
- Department of Ophthalmology, University of Melbourne, East Melbourne, Australia
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Robyn H. Guymer
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
- Department of Ophthalmology, University of Melbourne, East Melbourne, Australia
| | - Julie A. Simpson
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Rajaram S, Valls-Pedret C, Cofán M, Sabaté J, Serra-Mir M, Pérez-Heras AM, Arechiga A, Casaroli-Marano RP, Alforja S, Sala-Vila A, Doménech M, Roth I, Freitas-Simoes TM, Calvo C, López-Illamola A, Haddad E, Bitok E, Kazzi N, Huey L, Fan J, Ros E. The Walnuts and Healthy Aging Study (WAHA): Protocol for a Nutritional Intervention Trial with Walnuts on Brain Aging. Front Aging Neurosci 2017; 8:333. [PMID: 28119602 PMCID: PMC5222811 DOI: 10.3389/fnagi.2016.00333] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 12/22/2016] [Indexed: 12/14/2022] Open
Abstract
Introduction: An unwanted consequence of population aging is the growing number of elderly at risk of neurodegenerative disorders, including dementia and macular degeneration. As nutritional and behavioral changes can delay disease progression, we designed the Walnuts and Healthy Aging (WAHA) study, a two-center, randomized, 2-year clinical trial conducted in free-living, cognitively healthy elderly men and women. Our interest in exploring the role of walnuts in maintaining cognitive and retinal health is based on extensive evidence supporting their cardio-protective and vascular health effects, which are linked to bioactive components, such as n-3 fatty acids and polyphenols. Methods: The primary aim of WAHA is to examine the effects of ingesting walnuts daily for 2 years on cognitive function and retinal health, assessed with a battery of neuropsychological tests and optical coherence tomography, respectively. All participants followed their habitual diet, adding walnuts at 15% of energy (≈30-60 g/day) (walnut group) or abstaining from walnuts (control group). Secondary outcomes include changes in adiposity, blood pressure, and serum and urinary biomarkers in all participants and brain magnetic resonance imaging in a subset. Results: From May 2012 to May 2014, 708 participants (mean age 69 years, 68% women) were randomized. The study ended in May 2016 with a 90% retention rate. Discussion: The results of WAHA might provide high-level evidence of the benefit of regular walnut consumption in delaying the onset of age-related cognitive impairment and retinal pathology. The findings should translate into public health policy and sound recommendations to the general population (ClinicalTrials.gov identifier NCT01634841).
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Affiliation(s)
- Sujatha Rajaram
- Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda CA, USA
| | - Cinta Valls-Pedret
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i SunyerBarcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos IIIMadrid, Spain
| | - Montserrat Cofán
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i SunyerBarcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos IIIMadrid, Spain
| | - Joan Sabaté
- Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda CA, USA
| | - Mercè Serra-Mir
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i SunyerBarcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos IIIMadrid, Spain
| | - Ana M Pérez-Heras
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i SunyerBarcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos IIIMadrid, Spain
| | - Adam Arechiga
- Department of Psychology, School of Behavioral Health, Loma Linda University, Loma Linda CA, USA
| | - Ricardo P Casaroli-Marano
- Ophthalmology Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer Barcelona, Spain
| | - Socorro Alforja
- Ophthalmology Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer Barcelona, Spain
| | - Aleix Sala-Vila
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i SunyerBarcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos IIIMadrid, Spain
| | - Mónica Doménech
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i SunyerBarcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos IIIMadrid, Spain
| | - Irene Roth
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i SunyerBarcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos IIIMadrid, Spain
| | - Tania M Freitas-Simoes
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer Barcelona, Spain
| | - Carlos Calvo
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i SunyerBarcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos IIIMadrid, Spain
| | - Anna López-Illamola
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i SunyerBarcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos IIIMadrid, Spain
| | - Ella Haddad
- Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda CA, USA
| | - Edward Bitok
- Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda CA, USA
| | - Natalie Kazzi
- Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda CA, USA
| | - Lynnley Huey
- Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda CA, USA
| | - Joseph Fan
- Department of Ophthalmology, School of Medicine, Loma Linda University, Loma Linda CA, USA
| | - Emilio Ros
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i SunyerBarcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos IIIMadrid, Spain
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Nutritional and Lifestyle Interventions for Age-Related Macular Degeneration: A Review. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:6469138. [PMID: 28154734 PMCID: PMC5244028 DOI: 10.1155/2017/6469138] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 11/02/2016] [Accepted: 12/14/2016] [Indexed: 12/16/2022]
Abstract
Age-related macular degeneration (AMD) is the leading cause of blindness in the developed world. In this narrative review, we will summarize the nutritional interventions evaluated in numerous observational studies and a few randomized clinical trials. The AREDS and AREDS2 studies demonstrated that supplements including vitamins C and E, beta-carotene, and zinc may reduce the progression to advanced AMD, in some patients, by 25% in five years. This is one of the few nutritional supplements known to have beneficial effects in any eye disease. Lutein/zeaxanthin supplementation may have beneficial effects in some individuals whereas omega-3 fatty acids supplementation needs to be further investigated and supported by more evidence. Genetic factors may explain the different patterns of response and explain differences found among individuals. More importantly, a combination of lifestyle behaviors such as the avoidance of smoking, physical activity, and the adoption of a healthy dietary pattern like the Mediterranean diet was associated with a lower prevalence of AMD. The adoption of these lifestyles may reduce the prevalence of the early stages of AMD and decrease the number of individuals who develop advanced AMD and consequently the onerous and climbing costs associated with the treatment of this disease.
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Zhang M, Baird PN. A decade of age-related macular degeneration risk models: What have we learned from them and where are we going? Ophthalmic Genet 2016; 38:301-307. [PMID: 27901647 DOI: 10.1080/13816810.2016.1227451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The genomic revolution has revealed the complexity of multifactorial diseases, making the development of effective diagnostics extremely challenging. In turn, the prospect of precision medicine as applied through targeted therapeutic treatments continues to remain largely elusive. Age-related macular degeneration (AMD) as a complex disease falls under this category, despite it being one of the most well characterized multifactorial diseases. This reflects both the extent of identified genetic components and known environmental risk factors. Additional considerations in dissecting out the roles played by genetic and non-genetic risk factors arise through the rapid increase in prevalence of AMD with age and the varying time periods over which disease progression can occur, complicating efforts to discriminate between "progressors" and non-"progressors." As a consequence, extensive research into the aetiology of AMD is yet to realize a clinically acceptable predictive test. This review covers the current climate of risk models in late AMD but will focus mainly on genetic risk factors as well as the types of models that have currently been employed in the AMD modelling literature.
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Affiliation(s)
- Michael Zhang
- a Centre for Eye Research Australia, University of Melbourne , East Melbourne , Victoria , Australia
| | - Paul N Baird
- a Centre for Eye Research Australia, University of Melbourne , East Melbourne , Victoria , Australia
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Gopinath B, Liew G, Russell J, Cosatto V, Burlutsky G, Mitchell P. Intake of key micronutrients and food groups in patients with late-stage age-related macular degeneration compared with age–sex-matched controls. Br J Ophthalmol 2016; 101:1027-1031. [DOI: 10.1136/bjophthalmol-2016-309490] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/14/2016] [Accepted: 11/16/2016] [Indexed: 11/04/2022]
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Mediterranean Diet Score and Its Association with Age-Related Macular Degeneration: The European Eye Study. Ophthalmology 2016; 124:82-89. [PMID: 27825655 DOI: 10.1016/j.ophtha.2016.09.019] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 09/05/2016] [Accepted: 09/13/2016] [Indexed: 01/01/2023] Open
Abstract
PURPOSE To examine associations between adherence to a Mediterranean diet and prevalence of age-related macular degeneration (AMD) in countries ranging from Southern to Northern Europe. DESIGN Cross-sectional, population-based epidemiologic study. PARTICIPANTS Of 5060 randomly sampled people aged 65 years or older from 7 study centers across Europe (Norway, Estonia, United Kingdom, France, Italy, Greece, and Spain), full dietary data were available in 4753. The mean age of participants was 73.2 years (standard deviation, 5.6), and 55% were women. METHODS Participants underwent an eye examination and digital retinal color photography. The images were graded at a single center. Dietary intake during the previous 12 months was assessed by using a semiquantitative food-frequency questionnaire (FFQ). A previously published Mediterranean Diet Score (MDS) was used to classify participants according to their responses on the FFQ. Multivariable logistic regression was used to investigate the association of the MDS score and AMD, taking account of potential confounders and the multicenter study design. MAIN OUTCOME MEASURES Images were graded according to the International Classification System for age-related maculopathy and stratified using the Rotterdam staging system into 5 exclusive stages (AMD 0-4) and a separate category of large drusen (≥125 μm). Age-related macular degeneration 4 included neovascular AMD (nvAMD) and geographic atrophy (GA). RESULTS Increasing MDS was associated with reduced odds of nvAMD in unadjusted and confounder-adjusted analysis. Compared with the lowest MDS adherence (≤4 score), those in the highest category MDS adherence (>6 score) showed lower odds of nvAMD (odds ratio, 0.53; 0.27-1.04; P trend = 0.01). The association with MDS did not differ by Y204H risk allele (P = 0.89). For all early AMD (grade 1-3), there was no relationship with MDS (P trend = 0.9). There was a weak trend (P = 0.1) between MDS and large drusen; those in the highest category of MDS had 20% reduced odds compared with those in the lowest (P = 0.05). CONCLUSIONS This study adds to the limited evidence of the protective effect of adherence to a Mediterranean dietary pattern in those with late AMD, although it does not support previous reports of a relationship with genetic susceptibility. Interventions to encourage the adoption of the Mediterranean diet should be developed, and methods by which such behavior change can be achieved and maintained investigated.
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Cachulo MDL, Laíns I, Lobo C, Figueira J, Ribeiro L, Marques JP, Costa J, Vieira A, Rodrigues J, Alves D, Nunes S, Costa M, Rodrigues V, Cunha-Vaz J, Delcourt C, Silva R. Age-related macular degeneration in Portugal: prevalence and risk factors in a coastal and an inland town. The Coimbra Eye Study - Report 2. Acta Ophthalmol 2016; 94:e442-53. [PMID: 26806024 DOI: 10.1111/aos.12950] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 11/05/2015] [Indexed: 01/22/2023]
Abstract
PURPOSE To determine the age- and sex-specific prevalence of early and late age-related macular degeneration (AMD) in two Portuguese population-based samples and to identify its risk factors. POPULATION A population of 6023 adults aged ≥55 years was recruited from two Portuguese primary healthcare units in the central region of Portugal - one from a coastal (n = 3000) and another from an inland town (n = 3023). METHODS Cross-sectional population-based study. Participants were enrolled in the two locations between August 2009 and October 2013. Responders underwent standardized interviews and ophthalmologic examination, including digital fundus imaging. All fundus photographs were graded according to an International Classification and Grading System. The main outcome measures consisted of age- and sex-adjusted prevalence of early and late AMD. Potential epidemiologic risk factors were also evaluated using logistic regression analysis. RESULTS Of the 6023 subjects enrolled, 5996 had gradable fundus images and were included in the analysis. The crude prevalence of early and late AMD was 6.99 and 0.67%, respectively, for the coastal town and 15.39 and 1.29% for the inland town. Age- and sex-adjusted prevalence of any AMD for the Portuguese population was 12.48% (95% CI: 11.61-13.33) with late AMD accounting for 1.16% (95% CI: 0.85-1.46). Neovascular AMD (NV-AMD) and geographic atrophy (GA) accounted for 0.55% (95% CI: 0.36-0.75) and 0.61% (95% CI: 0.37-0.84) of individuals, respectively. After adjusting for possible confounding factors, prevalence of early and late AMD increased with increasing age (OR = 1.35; 95% CI: 1.23-1.49 for early and OR = 3.01; 95% CI: 2.22-4.08 for late AMD, per each decade of age increase, p < 0.001). After adjustment for age, sex, family history, smoking history, hypertension, diabetes and BMI, subjects from the inland town presented a significantly higher OR of early and late AMD than subjects from the coastal town (OR = 2.57, 95% CI: 2.12-3.12, p < 0.001 for early and OR = 2.06, 95% CI: 1.07-3.95, p = 0.029 for late AMD). CONCLUSIONS The prevalence of early and late AMD in this Portuguese population was similar to other large-scale population-based cohorts. After controlling for confounders, age and study site of inclusion were significant independent predictors for both early and late forms of the disease. Further analysis will be needed to completely unravel the underlying reasons for this difference regarding geographic location.
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Affiliation(s)
- Maria da Luz Cachulo
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
| | - Inês Laíns
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
| | - Conceição Lobo
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
| | - João Figueira
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
| | - Luísa Ribeiro
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
| | - João P. Marques
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
| | - José Costa
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
| | | | - João Rodrigues
- Primary Health Care Unit of Lousã; Unidade de Saúde Familiar da Serra da Lousã e Trevim Sol; Coimbra Portugal
| | - Dalila Alves
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Sandrina Nunes
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Miguel Costa
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Victor Rodrigues
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
- Instituto de Higiene e Medicina Social of the Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
| | - José Cunha-Vaz
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | | | - Rufino Silva
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
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Cougnard-Grégoire A, Merle BMJ, Korobelnik JF, Rougier MB, Delyfer MN, Le Goff M, Samieri C, Dartigues JF, Delcourt C. Olive Oil Consumption and Age-Related Macular Degeneration: The Alienor Study. PLoS One 2016; 11:e0160240. [PMID: 27467382 PMCID: PMC4965131 DOI: 10.1371/journal.pone.0160240] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 07/15/2016] [Indexed: 12/03/2022] Open
Abstract
Background Olive oil provides a mixture of lipids and antioxidant nutrients which may help preventing age-related diseases such as age-related macular degeneration (AMD). However, little is known about the associations between olive oil consumption and the risk of AMD. Objective To examine associations between olive oil use and AMD prevalence in elderly subjects. Methods Alienor (Antioxydants, Lipides Essentiels, Nutrition et maladies OculaiRes) is a population-based study on eye diseases performed in elderly residents of Bordeaux (France). In 1999–2000, frequencies of consumption of main categories of dietary fats used were collected. In 2006–2088, AMD was graded from non mydriatic retinal photographs into three exclusive stages: no AMD, early AMD, and late AMD. Two categories of preferred dietary fat used (olive oil, n-3 rich oils, n-6 rich oils, mixed oils, butter and margarine) were defined: “no use” and “regular use” (using fat for spreading and/or cooking and/or dressing). Associations of AMD with each fat use were estimated using Generalized Estimating Equation logistic regressions models. Results Our study included 654 subjects (1269 eyes) with complete data (n = 268 eyes with early AMD and n = 56 with late AMD). After adjustment for potential confounders, regular use of olive oil was significantly associated with a decreased risk of late AMD (odds ratio [OR] = 0.44, 95% confidence interval [CI]: 0.21;0.91). In contrast, regular use of olive oil was not significantly associated with early AMD (OR = 0.84, 95%CI: 0.59;1.21). No associations were found between regular consumption of n-3 rich oils, n-6 rich oils, mixed oils, butter and margarine and AMD, whatever the stage. Conclusions This study suggests a protective effect of olive oil consumption for late AMD in this elderly community-dwelling population. Characterization of the mediating nutrients deserves further research.
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Affiliation(s)
- Audrey Cougnard-Grégoire
- Univ Bordeaux, ISPED, F-33000 Bordeaux, France
- Inserm U1219 –Bordeaux Population Health Research Center, F-33000 Bordeaux, France
- * E-mail:
| | - Bénédicte M. J. Merle
- Univ Bordeaux, ISPED, F-33000 Bordeaux, France
- Inserm U1219 –Bordeaux Population Health Research Center, F-33000 Bordeaux, France
| | - Jean-François Korobelnik
- Univ Bordeaux, ISPED, F-33000 Bordeaux, France
- Inserm U1219 –Bordeaux Population Health Research Center, F-33000 Bordeaux, France
- CHU de Bordeaux, Service d’Ophtalmologie, Bordeaux, F-33000, France
| | - Marie-Bénédicte Rougier
- Univ Bordeaux, ISPED, F-33000 Bordeaux, France
- Inserm U1219 –Bordeaux Population Health Research Center, F-33000 Bordeaux, France
- CHU de Bordeaux, Service d’Ophtalmologie, Bordeaux, F-33000, France
| | - Marie-Noëlle Delyfer
- Univ Bordeaux, ISPED, F-33000 Bordeaux, France
- Inserm U1219 –Bordeaux Population Health Research Center, F-33000 Bordeaux, France
- CHU de Bordeaux, Service d’Ophtalmologie, Bordeaux, F-33000, France
| | - Mélanie Le Goff
- Univ Bordeaux, ISPED, F-33000 Bordeaux, France
- Inserm U1219 –Bordeaux Population Health Research Center, F-33000 Bordeaux, France
| | - Cécilia Samieri
- Univ Bordeaux, ISPED, F-33000 Bordeaux, France
- Inserm U1219 –Bordeaux Population Health Research Center, F-33000 Bordeaux, France
| | - Jean-François Dartigues
- Univ Bordeaux, ISPED, F-33000 Bordeaux, France
- Inserm U1219 –Bordeaux Population Health Research Center, F-33000 Bordeaux, France
| | - Cécile Delcourt
- Univ Bordeaux, ISPED, F-33000 Bordeaux, France
- Inserm U1219 –Bordeaux Population Health Research Center, F-33000 Bordeaux, France
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McGuinness MB, Karahalios A, Simpson JA, Guymer RH, Robman LD, Hodge AM, Cerin E, Giles GG, Finger RP. Past physical activity and age-related macular degeneration: the Melbourne Collaborative Cohort Study. Br J Ophthalmol 2016; 100:1353-8. [DOI: 10.1136/bjophthalmol-2015-307663] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 12/24/2015] [Indexed: 11/04/2022]
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Meyers KJ, Liu Z, Millen AE, Iyengar SK, Blodi BA, Johnson E, Snodderly DM, Klein ML, Gehrs KM, Tinker L, Sarto GE, Robinson J, Wallace RB, Mares JA. Joint Associations of Diet, Lifestyle, and Genes with Age-Related Macular Degeneration. Ophthalmology 2015; 122:2286-94. [PMID: 26354764 PMCID: PMC4714866 DOI: 10.1016/j.ophtha.2015.07.029] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 07/23/2015] [Accepted: 07/27/2015] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Unhealthy lifestyles have been associated with increased odds for age-related macular degeneration (AMD). Whether this association is modified by genetic risk for AMD is unknown and was investigated. DESIGN Interactions between healthy lifestyles AMD risk genotypes were studied in relation to the prevalence of AMD, assessed 6 years later. PARTICIPANTS Women 50 to 79 years of age in the Carotenoids in Age-Related Eye Disease Study with exposure and AMD data (n=1663). METHODS Healthy lifestyle scores (0-6 points) were assigned based on Healthy Eating Index scores, physical activity (metabolic equivalent of task hours/week), and smoking pack years assessed in 1994 and 1998. Genetic risk was based on Y402H in complement factor H (CFH) and A69S in age-related maculopathy susceptibility locus 2 (ARMS2). Additive and multiplicative interactions in odds ratios were assessed using the synergy index and a multiplicative interaction term, respectively. MAIN OUTCOME MEASURES AMD presence and severity were assessed from grading of stereoscopic fundus photographs taken in 2001-2004. AMD was present in 337 women, 91% of whom had early AMD. RESULTS The odds of AMD were 3.3 times greater (95% confidence interval [CI], 1.8-6.1) in women with both low healthy lifestyle score (0-2) and high-risk CFH genotype (CC), relative to those who had low genetic risk (TT) and high healthy lifestyle scores (4-6). There were no significant additive (synergy index [SI], 1.08; 95% CI, 0.70-1.67) or multiplicative (Pinteraction=0.94) interactions in the full sample. However, when limiting the sample to women with stable diets before AMD assessment (n=728) the odds for AMD associated with low healthy lifestyle scores and high-risk CFH genotype were strengthened (odds ratio, 4.6; 95% CI, 1.8-11.6) and the synergy index was significant (SI, 1.34; 95% CI, 1.05-1.70). Adjusting for dietary lutein and zeaxanthin attenuated, and therefore partially explained, the joint association. There were no significant additive or multiplicative interactions for ARMS2 and lifestyle score. CONCLUSIONS Having unhealthy lifestyles and 2 CFH risk alleles increased AMD risk (primarily in the early stages), in an or additive or greater (synergistic) manner. However, unhealthy lifestyles increased AMD risk regardless of AMD risk genotype.
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Affiliation(s)
- Kristin J Meyers
- Department of Ophthalmology and Visual Sciences, McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Zhe Liu
- Department of Ophthalmology and Visual Sciences, McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Amy E Millen
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York
| | - Sudha K Iyengar
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
| | - Barbara A Blodi
- Department of Ophthalmology and Visual Sciences, McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Elizabeth Johnson
- Jean Mayer USDA Human Nutrition, Research Center on Aging, Tufts University, Boston, Massachusetts
| | - D Max Snodderly
- Department of Neuroscience, University of Texas, Austin, Texas
| | - Michael L Klein
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
| | - Karen M Gehrs
- Department of Ophthalmology & Visual Sciences, University of Iowa Hospital & Clinics, Iowa City, Iowa
| | - Lesley Tinker
- Department of Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Gloria E Sarto
- Department of Obstetrics & Gynecology, School of Medicine & Public Health, University of Wisconsin, Madison, Wisconsin
| | - Jennifer Robinson
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
| | - Robert B Wallace
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
| | - Julie A Mares
- Department of Ophthalmology and Visual Sciences, McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
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Merle BMJ, Silver RE, Rosner B, Seddon JM. Adherence to a Mediterranean diet, genetic susceptibility, and progression to advanced macular degeneration: a prospective cohort study. Am J Clin Nutr 2015; 102:1196-206. [PMID: 26490493 PMCID: PMC4625588 DOI: 10.3945/ajcn.115.111047] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 08/27/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Adherence to a Mediterranean-type diet is linked to a lower risk of mortality and chronic disease, but the association with the progression of age-related macular degeneration (AMD) and genetic susceptibility is unknown. OBJECTIVE We examined the association of adherence to the Mediterranean diet and genetic susceptibility with progression to advanced AMD. DESIGN Among 2525 subjects in the AREDS (Age-Related Eye Disease Study), 1028 eyes progressed to advanced AMD over 13 y. Baseline data for demographic and behavioral covariates were collected by using questionnaires. Dietary data were collected from food-frequency questionnaires. The alternate Mediterranean diet (aMeDi) score (range: 0-9) was constructed from individual intakes of vegetables, fruit, legumes, whole grains, nuts, fish, red and processed meats, alcohol, and the ratio of monounsaturated to saturated fats. Ten genetic loci in 7 genes [complement factor H (CFH), age-related maculopathy susceptibility 2/high-temperature requirement A serine peptidase 1 (ARMS2/HTRA1), complement component 2 (C2), complement factor B (CFB), complement component 3 (C3), collagen type VIII α 1 (COL8A1), and RAD51 paralog B (RAD51B)] were examined. Survival analysis was used to assess individual eyes for associations between incident AMD and aMeDi score, as well as interaction effects between aMeDi score and genetic variation on risk of AMD. RESULTS A high aMeDi score (score of 6-9) was significantly associated with a reduced risk of progression to advanced AMD after adjustment for demographic, behavioral, ocular, and genetic covariates (HR: 0.74; 95% CI: 0.61, 0.91; P-trend = 0.007). The aMeDi score was significantly associated with a lower risk of incident advanced AMD among subjects carrying the CFH Y402H nonrisk (T) allele (P-trend = 0.0004, P-interaction = 0.04). The aMeDi score was not associated with AMD among subjects who were homozygous for the risk (C) allele. CONCLUSION Higher adherence to a Mediterranean diet was associated with reduced risk of progression to advanced AMD, which may be modified by genetic susceptibility. This trial was registered at clinicaltrials.gov as NCT00594672.
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Affiliation(s)
- Bénédicte M J Merle
- Ophthalmic Epidemiology and Genetics Service, New England Eye Center, Tufts Medical Center, Boston, MA
| | - Rachel E Silver
- Ophthalmic Epidemiology and Genetics Service, New England Eye Center, Tufts Medical Center, Boston, MA
| | - Bernard Rosner
- Channing Division of Network Medicine, Harvard Medical School, Harvard University, Boston, MA
| | - Johanna M Seddon
- Ophthalmic Epidemiology and Genetics Service, New England Eye Center, Tufts Medical Center, Boston, MA;
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Nutritional risk factors for age-related macular degeneration. BIOMED RESEARCH INTERNATIONAL 2014; 2014:413150. [PMID: 25101280 PMCID: PMC4101976 DOI: 10.1155/2014/413150] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 06/16/2014] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the role of nutritional factors, serum lipids, and lipoproteins in late age-related macular degeneration (late AMD). METHODS Intake of red meat, fruit, fish, vegetables, and alcohol, smoking status, and body mass index (BMI) were ascertained questionnaire-based in 1147 late AMD cases and 1773 controls from the European Genetic Database. Serum levels of lipids and lipoproteins were determined. The relationship between nutritional factors and late AMD was assessed using logistic regression. Based on multivariate analysis, area-under-the-curve (AUC) was calculated by receiver-operating-characteristics (ROC). RESULTS In a multivariate analysis, besides age and smoking, obesity (odds ratio (OR): 1.44, P = 0.014) and red meat intake (daily: OR: 2.34, P = 8.22 × 10(-6); 2-6x/week: OR: 1.67, P = 7.98 × 10(-5)) were identified as risk factors for developing late AMD. Fruit intake showed a protective effect (daily: OR: 0.52, P = 0.005; 2-6x/week: OR: 0.58, P = 0.035). Serum lipid and lipoprotein levels showed no significant association with late AMD. ROC for nutritional factors, smoking, age, and BMI revealed an AUC of 0.781. CONCLUSION Red meat intake and obesity were independently associated with increased risk for late AMD, whereas fruit intake was protective. A better understanding of nutritional risk factors is necessary for the prevention of AMD.
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