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Dietary lutein, zeaxanthin, and fats and the progression of age-related macular degeneration.
Can J Ophthalmol 2007; 42(5):720-6CJ

Abstract

BACKGROUND

To estimate the effect of dietary intake of lutein and zeaxanthin (L/Z) and fats on the progression of age-related macular degeneration (AMD).

METHODS

Two hundred and fifty-four subjects identified with early age-related macular degeneration (AMD) were re-examined to determine 7-year AMD progression. Intakes of L/Z and fatty acids were estimated from food frequency questionnaires. Progression was defined by 3 different definitions, 2 quantitative and 1 qualitative, which varied in the stringency of the change required for the AMD to be deemed to have progressed. Covariates included age, smoking, AMD family history, source study, and follow-up duration.

RESULTS

Energy-adjusted L/Z intake as a continuous variable was associated with AMD progression in the worse affected eye when defined by the most stringent criterion (odds ratio [OR] = 2.65, 95% confidence interval [CI] 1.13-6.22, p = 0.02). Similar associations were observed for the 2 other progression definitions (p = 0.18 and p = 0.13). Energy-adjusted omega-3 fatty acid intake modelled as a quintile median was associated with AMD progression only in the side-by-side assessment (OR = 2.56, 95% CI 1.11-5.91, p = 0.03), with borderline significance in the other 2 definitions (p = 0.05 and p = 0.08). No association of AMD progression was observed with the intake of either total fat or other subgroups: saturated, polyunsaturated, or monounsaturated fats; trans fatty acids; or omega-6 fatty acids.

INTERPRETATION

The findings of the study are counterintuitive, suggesting that increased intakes of dietary L/Z and omega-3 fatty acids are associated with progression of AMD. These results may indicate that too much of a good thing might be harmful. It is possible that in this study participants adopted a more healthy diet, having been aware of their AMD status at the beginning of the study. This healthy diet was then reflected in the dietary questionnaire completed at the end of study. However, this explanation may not adequately explain why those whose AMD had progressed, on the basis of fundus signs and not symptoms such as visual acuity decline, adopted a healthier lifestyle more aggressively than those without progression.

Authors+Show Affiliations

Centre for Eye Research Australia, University of Melbourne. liubov@unimelb.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17724493

Citation

Robman, Luba, et al. "Dietary Lutein, Zeaxanthin, and Fats and the Progression of Age-related Macular Degeneration." Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie, vol. 42, no. 5, 2007, pp. 720-6.
Robman L, Vu H, Hodge A, et al. Dietary lutein, zeaxanthin, and fats and the progression of age-related macular degeneration. Can J Ophthalmol. 2007;42(5):720-6.
Robman, L., Vu, H., Hodge, A., Tikellis, G., Dimitrov, P., McCarty, C., & Guymer, R. (2007). Dietary lutein, zeaxanthin, and fats and the progression of age-related macular degeneration. Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie, 42(5), pp. 720-6.
Robman L, et al. Dietary Lutein, Zeaxanthin, and Fats and the Progression of Age-related Macular Degeneration. Can J Ophthalmol. 2007;42(5):720-6. PubMed PMID: 17724493.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary lutein, zeaxanthin, and fats and the progression of age-related macular degeneration. AU - Robman,Luba, AU - Vu,Hien, AU - Hodge,Allison, AU - Tikellis,Gabriella, AU - Dimitrov,Peter, AU - McCarty,Catherine, AU - Guymer,Robyn, PY - 2007/8/29/pubmed PY - 2007/12/19/medline PY - 2007/8/29/entrez SP - 720 EP - 6 JF - Canadian journal of ophthalmology. Journal canadien d'ophtalmologie JO - Can. J. Ophthalmol. VL - 42 IS - 5 N2 - BACKGROUND: To estimate the effect of dietary intake of lutein and zeaxanthin (L/Z) and fats on the progression of age-related macular degeneration (AMD). METHODS: Two hundred and fifty-four subjects identified with early age-related macular degeneration (AMD) were re-examined to determine 7-year AMD progression. Intakes of L/Z and fatty acids were estimated from food frequency questionnaires. Progression was defined by 3 different definitions, 2 quantitative and 1 qualitative, which varied in the stringency of the change required for the AMD to be deemed to have progressed. Covariates included age, smoking, AMD family history, source study, and follow-up duration. RESULTS: Energy-adjusted L/Z intake as a continuous variable was associated with AMD progression in the worse affected eye when defined by the most stringent criterion (odds ratio [OR] = 2.65, 95% confidence interval [CI] 1.13-6.22, p = 0.02). Similar associations were observed for the 2 other progression definitions (p = 0.18 and p = 0.13). Energy-adjusted omega-3 fatty acid intake modelled as a quintile median was associated with AMD progression only in the side-by-side assessment (OR = 2.56, 95% CI 1.11-5.91, p = 0.03), with borderline significance in the other 2 definitions (p = 0.05 and p = 0.08). No association of AMD progression was observed with the intake of either total fat or other subgroups: saturated, polyunsaturated, or monounsaturated fats; trans fatty acids; or omega-6 fatty acids. INTERPRETATION: The findings of the study are counterintuitive, suggesting that increased intakes of dietary L/Z and omega-3 fatty acids are associated with progression of AMD. These results may indicate that too much of a good thing might be harmful. It is possible that in this study participants adopted a more healthy diet, having been aware of their AMD status at the beginning of the study. This healthy diet was then reflected in the dietary questionnaire completed at the end of study. However, this explanation may not adequately explain why those whose AMD had progressed, on the basis of fundus signs and not symptoms such as visual acuity decline, adopted a healthier lifestyle more aggressively than those without progression. SN - 0008-4182 UR - https://www.unboundmedicine.com/medline/citation/17724493/Dietary_lutein_zeaxanthin_and_fats_and_the_progression_of_age_related_macular_degeneration_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0008-4182(07)80014-7 DB - PRIME DP - Unbound Medicine ER -