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Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group.

Abstract

OBJECTIVE

--To evaluate the relationships between dietary intake of carotenoids and vitamins A, C, and E and the risk of neovascular age-related macular degeneration (AMD), the leading cause of irreversible blindness among adults. DESIGN--The multicenter Eye Disease Case-Control Study. SETTING--Five ophthalmology centers in the United States. PATIENTS--A total of 356 case subjects who were diagnosed with the advanced stage of AMD within 1 year prior to their enrollment, aged 55 to 80 years, and residing near a participating clinical center. The 520 control subjects were from the same geographic areas as case subjects, had other ocular diseases, and were frequency-matched to cases according to age and sex. MAIN OUTCOME MEASURES--The relative risk for AMD was estimated according to dietary indicators of antioxidant status, controlling for smoking and other risk factors, by using multiple logistic-regression analyses.

RESULTS

--A higher dietary intake of carotenoids was associated with a lower risk for AMD. Adjusting for other risk factors for AMD, we found that those in the highest quintile of carotenoid intake had a 43% lower risk for AMD compared with those in the lowest quintile (odds ratio, 0.57; 95% confidence interval, 0.35 to 0.92; P for trend = .02). Among the specific carotenoids, lutein and zeaxanthin, which are primarily obtained from dark green, leafy vegetables, were most strongly associated with a reduced risk for AMD (P for trend = .001). Several food items rich in carotenoids were inversely associated with AMD. In particular, a higher frequency of intake of spinach or collard greens was associated with a substantially lower risk for AMD (P for trend < .001). The intake of preformed vitamin A (retinol) was not appreciably related to AMD. Neither vitamin E nor total vitamin C consumption was associated with a statistically significant reduced risk for AMD, although a possibly lower risk for AMD was suggested among those with higher intake of vitamin C, particularly from foods. CONCLUSION--Increasing the consumption of foods rich in certain carotenoids, in particular dark green, leafy vegetables, may decrease the risk of developing advanced or exudative AMD, the most visually disabling form of macular degeneration among older people. These findings support the need for further studies of this relationship.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Epidemiology Unit, Massachusetts Eye and Ear Infirmary, Boston 02114.

    , , , , , , , ,

    Source

    JAMA 272:18 1994 Nov 09 pg 1413-20

    MeSH

    Aged
    Aged, 80 and over
    Aging
    Antioxidants
    Ascorbic Acid
    Blindness
    Carotenoids
    Case-Control Studies
    Data Collection
    Diet
    Eating
    Female
    Humans
    Logistic Models
    Macular Degeneration
    Male
    Middle Aged
    Nutritional Physiological Phenomena
    Risk Factors
    Smoking
    Vitamin A
    Vitamin E

    Pub Type(s)

    Journal Article
    Multicenter Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    7933422

    Citation

    Seddon, J M., et al. "Dietary Carotenoids, Vitamins A, C, and E, and Advanced Age-related Macular Degeneration. Eye Disease Case-Control Study Group." JAMA, vol. 272, no. 18, 1994, pp. 1413-20.
    Seddon JM, Ajani UA, Sperduto RD, et al. Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group. JAMA. 1994;272(18):1413-20.
    Seddon, J. M., Ajani, U. A., Sperduto, R. D., Hiller, R., Blair, N., Burton, T. C., ... Miller, D. T. (1994). Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group. JAMA, 272(18), pp. 1413-20.
    Seddon JM, et al. Dietary Carotenoids, Vitamins A, C, and E, and Advanced Age-related Macular Degeneration. Eye Disease Case-Control Study Group. JAMA. 1994 Nov 9;272(18):1413-20. PubMed PMID: 7933422.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group. A1 - Seddon,J M, AU - Ajani,U A, AU - Sperduto,R D, AU - Hiller,R, AU - Blair,N, AU - Burton,T C, AU - Farber,M D, AU - Gragoudas,E S, AU - Haller,J, AU - Miller,D T, PY - 1994/11/9/pubmed PY - 1994/11/9/medline PY - 1994/11/9/entrez SP - 1413 EP - 20 JF - JAMA JO - JAMA VL - 272 IS - 18 N2 - OBJECTIVE--To evaluate the relationships between dietary intake of carotenoids and vitamins A, C, and E and the risk of neovascular age-related macular degeneration (AMD), the leading cause of irreversible blindness among adults. DESIGN--The multicenter Eye Disease Case-Control Study. SETTING--Five ophthalmology centers in the United States. PATIENTS--A total of 356 case subjects who were diagnosed with the advanced stage of AMD within 1 year prior to their enrollment, aged 55 to 80 years, and residing near a participating clinical center. The 520 control subjects were from the same geographic areas as case subjects, had other ocular diseases, and were frequency-matched to cases according to age and sex. MAIN OUTCOME MEASURES--The relative risk for AMD was estimated according to dietary indicators of antioxidant status, controlling for smoking and other risk factors, by using multiple logistic-regression analyses. RESULTS--A higher dietary intake of carotenoids was associated with a lower risk for AMD. Adjusting for other risk factors for AMD, we found that those in the highest quintile of carotenoid intake had a 43% lower risk for AMD compared with those in the lowest quintile (odds ratio, 0.57; 95% confidence interval, 0.35 to 0.92; P for trend = .02). Among the specific carotenoids, lutein and zeaxanthin, which are primarily obtained from dark green, leafy vegetables, were most strongly associated with a reduced risk for AMD (P for trend = .001). Several food items rich in carotenoids were inversely associated with AMD. In particular, a higher frequency of intake of spinach or collard greens was associated with a substantially lower risk for AMD (P for trend < .001). The intake of preformed vitamin A (retinol) was not appreciably related to AMD. Neither vitamin E nor total vitamin C consumption was associated with a statistically significant reduced risk for AMD, although a possibly lower risk for AMD was suggested among those with higher intake of vitamin C, particularly from foods. CONCLUSION--Increasing the consumption of foods rich in certain carotenoids, in particular dark green, leafy vegetables, may decrease the risk of developing advanced or exudative AMD, the most visually disabling form of macular degeneration among older people. These findings support the need for further studies of this relationship. SN - 0098-7484 UR - https://www.unboundmedicine.com/medline/citation/7933422/Dietary_carotenoids_vitamins_A_C_and_E_and_advanced_age_related_macular_degeneration__Eye_Disease_Case_Control_Study_Group_ L2 - https://jamanetwork.com/journals/jama/fullarticle/vol/272/pg/1413 DB - PRIME DP - Unbound Medicine ER -