Adherence to Mediterranean diet may decrease risk for AMD progression
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A high intake of specific nutrients, antioxidant supplementation and adherence to the Mediterranean diet may decrease the progression of age-related macular degeneration, according to a review in Acta Ophthalmologica.
“The pathogenesis of AMD is multifactorial with many different pathways implicated in its pathophysiology,” Els M. Pameijer, of the department of ophthalmology at University Medical Center Utrecht in the Netherlands, and colleagues wrote. “As AMD still is an incurable eye disease, strategies for primary and secondary prevention are of paramount importance.”
They continued, “A vast number of studies have investigated the association between dietary components, food groups, antioxidants and vitamin or mineral supplementation and the development or the progression of AMD.”
Pameijer and colleagues searched several electronic databases for systemic reviews, randomized controlled trials and other studies published between January 2015 and May 2021 to summarize evidence on the link between nutrition — including supplementation with antioxidants, vitamins and minerals — and the development or progression of AMD. They identified 27 relevant reviews or studies.
Using the Grading of Recommendations, Assessment, Development and Evaluations methodology to assess certainty of evidence, researchers reported that a high intake of beta-carotene, lutein and zeaxanthin, copper, folate, magnesium, vitamin A, niacin, vitamin B6, vitamin C, docosahexaenoic acid and eicosapentaenoic acid was associated with a lower risk for progression of early to late AMD.
In addition, use of antioxidant supplements and adherence to the Mediterranean diet, which encourages high consumption of vegetables, whole grains and nuts, were associated with decreased risk for developing AMD, as was a high intake of calcium or lycopene.
Conversely, increased alcohol consumption was linked with a higher risk for developing AMD. Researchers reported no association between a high dietary intake of fatty acids, saturated fatty acids, monosaturated fatty acids, polyunsaturated fatty acids or alpha-linolenic acids and AMD development.
“AMD is a multifactorial disorder with multiple genetic and environmental risk factors, of which diet is an important modifiable component,” Pameijer and colleagues wrote. “Future research should therefore focus on personalized therapeutic and preventive approaches, for example on the association between nutrition and immunological parameters.”
Perspective
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The nutrition and supplement industry is one of the largest and most rapidly growing industries in the world. With heightened emphasis on health and well-being, it is imperative we as optometrists recognize the correct amalgamation of nutrients our patients consume for managing their ocular health. AMD is one of the most common causes of vision loss, especially in the aging population, that is also strongly influenced by one’s diet. Looking back over the past 35 years, research has shown that intake of specific vitamins and supplements, along with proper diet control, is critical in managing progression of the disease.
One takeaway from the study is associated with alcohol consumption, such that a low intake is recommended for people without the disease; however a high intake is associated with higher risk of developing AMD. To practicing optometrists, being able to access a reference where risks and benefits of vitamins and supplements beyond AREDS can be summarized serves as a valuable tool for clinical practice as we play our part in this growing industry while incorporating evidence-based medicine.
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