Multiple nutrients intake halts progression to late AMD

High dietary intake of nutrients, such as carotenoids, vitamins, and minerals, can help reduce the risk of progression to late age-related macular degeneration (AMD), with stronger associations seen for geographic atrophy (GA) than for neovascular AMD, a study has found. In addition, the same nutrients appear protective against large drusen development.

“Strong genetic interactions exist for some nutrient–genotype combinations, particularly omega-3 fatty acids and CFH,” the authors said.

A posthoc analysis of two controlled clinical trial cohorts (Age-Related Eye Disease Study [AREDS] and AREDS2) was conducted, which included 14,135 eyes with no late AMD at baseline among participants of AREDS (n=4,504) and AREDS2 (n=3,738). Mean age of patients was 71.0 years, and 56.5 percent were women. The authors collected fundus photographs at annual study visits and graded these centrally for late AMD. They also calculated dietary intake of multiple nutrients from food frequency questionnaires.

Of the 14,135 eyes, 32.7 percent progressed to late AMD over a median follow-up of 10.2 years. Compared to the lowest quintile, intake quintiles 4 or 5 for nine nutrients (vitamin A, vitamin B6, vitamin C, folate, β-carotene, lutein and zeaxanthin, magnesium, copper, and alcohol) significantly correlated with a lower risk of late AMD (p≤0.0005).

For three nutrients (saturated fatty acid, monounsaturated fatty acid, and oleic acid), quintiles 4 or 5 significantly correlated with an increased risk relative to quintile 1. Similar results were observed for GA.

Nine nutrients (vitamin A, vitamin B6, β-carotene, lutein and zeaxanthin, magnesium, copper, docosahexaenoic acid, omega-3 fatty acid, and alcohol) also correlated nominally with a reduced risk of neovascular AMD, while three nutrients (saturated fatty acid, monounsaturated fatty acid, and oleic acid) correlated with an increased risk.

Separate analyses (n=5,399 eyes of 3,164 AREDS participants) revealed the nominal association of 12 nutrients with a decreased risk of large drusen.

“These data may justify further research into underlying mechanisms and randomized trials of supplementation,” the authors said.