Age–Related Macular Degeneration (ARMD): Nutritional Considerations

Dietary factors appear to play an important role. In epidemiologic studies, the following factors are associated with reduced risk of onset or progression of the disease:

• Maintenance of ideal weight: Studies have found a higher risk for macular degeneration in patients who are overweight, particularly those with abdominal obesity. In contrast, regular exercise is associated with lower risk.
• Low fat intake: Studies have found associations between high intakes of saturated fat and cholesterol and macular degeneration. Other studies have implicated vegetable fat and total fat intake.
  
  Regular consumption of processed baked goods doubled the risk compared with those who did not regularly consume these foods, possibly by causing increased blood cholesterol or inflammation.
• High consumption of fruits and vegetables: The carotenoids lutein and zeaxanthin are essential molecules in the macula. They are abundant in dark–green, leafy vegetables and appear to play an important role in the prevention of macular degeneration.
  
  Several studies have found that people with high intake of fruits and vegetables had a significantly lower risk compared with those who have low intakes. The Eye Disease Case Control Study found that individuals who had the highest intake of carotenoids had a more than 40 percent lower risk compared with those who consumed the least. Intakes of collard greens and spinach, both rich in lutein, were found to be the most protective. Further, two large studies, the Health Professionals Follow–Up Study and the Nurses’ Health Study, found that those who consumed the most fruit (three or more servings per day) had a lower risk.
• Antioxidant supplements: In the Age–Related Eye Disease Study, individuals with moderate or advanced macular degeneration who received 500 milligrams of vitamin C, 400 International Unites of vitamin E, 15 milligrams of beta carotene, and 80 milligrams of zinc had significantly reduced progression of their disease, compared with subjects receiving a placebo. However, caution is advised considering that other studies have shown that beta–carotene supplementation may increase lung cancer risk among smokers, and that high doses of vitamin E may increase cardiovascular risk.
  
  In the Lutein Antioxidant Supplementation Trial, a 10–milligram supplement of lutein taken daily, alone or with a vitamin supplement, improved vision when compared with a placebo. Lutein supplementation also improved vision in other controlled trials.