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Nutrition, Vitamins & Supplements for Seniors
Omega-3 Fatty Acids, Fish, Vitamin D Fight
Age-Related Macular Degeneration
No known way to prevent this major cause of blindness
in senior citizens
May 14, 2007 - Individuals who have higher dietary
intake of foods with omega-3 fatty acids and higher fish consumption
have a reduced risk of advanced age-related macular degeneration, while
those with higher serum levels of vitamin D may have a reduced risk of
the early stages of the disease, according to two reports in the May
issue of Archives of Ophthalmology, one of the JAMA/Archives journals.
Age-related macular degeneration (AMD) occurs when
the macula, the area at the back of the retina that produces the
sharpest vision, deteriorates over time.
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It is the most common cause of blindness among
older adults in the United States, affecting more than 7 million
individuals older than 40 years, according to background information in
the articles.
The prevalence of AMD is likely to increase as the
population ages. There is currently no known way to prevent the
condition, but research has begun to identify potentially modifiable
risk factors and nutrient-based treatments.
The Age-Related Eye Disease Study Research Group
assessed 4,519 individuals who were age 60 to 80 when they enrolled in
1992 through 1998. At that time, photographs were taken of their retinas
to determine if they had AMD, and if so, to which of four stages the
condition had progressed. The participants also completed a food
frequency questionnaire that measured how often they consumed foods rich
in certain vitamins, minerals and other nutrients, such as omega-3 fatty
acids commonly found in tuna, salmon and other fish.
A total of 1,115 participants did not have any
symptoms of AMD at the beginning of the study, and were compared with
those who did, including 658 individuals with neovascular (severe) AMD.
“Dietary total omega-3 long-chain polyunsaturated fatty acid intake was
inversely associated with neovascular AMD, as was docosahexaenoic acid,”
or DHA, a fatty acid that previous evidence suggests affects the retina,
the authors write. “Higher fish consumption, both total and
broiled/baked, was also inversely associated with neovascular AMD.”
Eating more than two medium (4-ounce) servings of fish per week or more
than one medium serving of broiled or baked fish was associated with the
lowest risk for advanced AMD.
Omega-3 fatty acids may influence processes
involved in the development of blood vessel– and nerve-related diseases
of the retina, the authors write. For instance, DHA may protect the
retina by influencing which genes turn on and off, while fatty acids
overall may eventually form compounds that promote cell survival and
proper blood vessel function, reduce inflammation and maintain energy
balance.
“These results and those from other observational
analytic investigations suggest that modifying diet to include more
foods rich in omega-3 long-chain polyunsaturated fatty acids could
result in a reduction in the risk of having neovascular AMD,” the
authors conclude. Clinical trials would provide further information
about whether diet changes or supplements could prevent the development
of advanced AMD.
In a related study, Niyati Parekh, Ph.D., R.D., of
the University of the Medicine and Dentistry of New Jersey, New
Brunswick, and the University of Wisconsin–Madison, and colleagues
analyzed data from 7,752 individuals (including 11 percent with AMD) who
were part of the National Health and Nutrition Examination Survey, a
large study designed to represent the entire U.S. population.
Participants were enrolled in the study between 1988 and 1994. They had
physical examinations that included blood and urine samples, photographs
of the retinas, and interviews and questionnaires regarding sociodemographics, lifestyle habits and food intake.
“Levels of serum vitamin D were inversely
associated with early AMD but not advanced AMD,” the authors write. When
participants were split into five groups based on level of vitamin D in
the blood, those in the highest group had a 40 percent lower risk of
early AMD than those in the lowest group. “Milk intake was inversely
associated with early AMD. Fish intake was inversely associated with
advanced AMD.”
Vitamin D may reduce the risk of AMD by reducing
inflammation or by preventing the growth of new blood vessels in the
retina, which contributes to some forms of AMD, the authors speculate.
“This study provides evidence that vitamin D may protect against AMD,”
the authors conclude. “However, at this time there is insufficient
epidemiologic evidence of the relationship between vitamin D level and
AMD to make recommendations regarding optimum serum vitamin D levels or
milk and fish intake to protect against AMD or its progression. The
results of the present research warrant further investigation for
confirmation of the vitamin D-AMD association in other population
studies.”
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