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Sheila Backus, Gabrielle HS Buitendijk, Jessica C. Kiefte-de Jong, Albert Hofman, Oscar H. Franco, Johannes R Vingerling, Cees Lucas, Caroline C W Klaver; . Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3762.
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Many studies have shown a protective effect of individual nutrients against age-related macular degeneration (AMD). However, the composition of the ‘AMD diet’ is not clear. We investigated whether the dietary guidelines from the Dutch Health Council can reduce the risk of AMD. These guidelines include vegetable intake >200gr/day; 2x fruit/day, and 2x fatty fish per week.
We included 4797 participants aged 55+ yrs of the population-based Rotterdam Study I in this analysis; follow up time was up to 20 years (mean 9.1 yrs (SD 5.8)). Data on food consumption and dietary habits were collected by a validated 170-item food frequency questionnaire, and were categorized into major food groups. Incident AMD was diagnosed on fundus photographs and stratified in Early and Late AMD. We studied the frequency and the risk of AMD for persons whose intake matched the advice of the guidelines using Cox-proportional hazards models, adjusting for sex and age. Additionally, we adjusted for smoking and total energy intake.
A total of 681 developed Early AMD, and 73 developed Late AMD. 29.7% of the participants consumed the suggested portion of vegetables (>200gr/day), 54.2% consumed 2 portions of fruits day) and 12.5% consumed 2x fatty fish per week. The combination of these 3 food groups was consumed by 3.5%, and the complete guidelines were followed by only 0.1%. Of the individual food groups, intake of fatty fish (2x/week) had the most prominent effect on incident Early or Late AMD (HR: 0.74 [95%CI 0.59-0.94]). Intake of the advised combination of vegetables, fruits and fish decreased AMD risk to HR 0.56 (95% 0.35-0.89, adjusted for age and sex). This association remained significant after additional adjustment for smoking and total energy intake (HR 0.55 [95% CI 0.35-0.88]).
Our results showed that not many people follow national dietary guidelines. However, the advised diet of 200 gr vegetables/day, 2x fruits/day and 2x fatty fish/week offers considerable protection against AMD. These guidelines should therefore be recommended by ophthalmologists and other eye care providers, particularly in persons at risk of AMD.
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