Current Recommended Diet Patterns and Their Relationship to the Prevalence of Intermediate Age-Related Macular Degeneration (AMD) in the Carotenoids in Age-Related Eye Diseases Study (CAREDS), an Ancillary Study of the Women’s Health Initiative Observational Study (WHIOS)

Abstract

Purpose: : We examined the association between adherence at WHIOS baseline (1994-8) to the current (2005) US Dietary Guidelines and the Alternative Mediterranean Diet Patterns, which are rich in nutrients and other bioactive components potentially protective against AMD, and the prevalence of intermediate AMD in 2001-2004.

Methods: : Women, ages 50-79 years, who participated in the WHIOS cohorts in Portland, OR, Iowa City, IA, and Madison, WI were invited to participate in the CAREDS if their food frequency questionnaire (FFQ) responses indicated them to be above the 78th or below the 28th percentile for lutein and zeaxanthin (n=2,005). Responses to FFQs were used to score diets for adherence to US 2005 Dietary Guidelines, as estimated by Healthy Eating Index (HEI) and for adherence to the Alternative Mediterranean Diet (AMed) Pattern. AMD was assessed by fundus photography. Women with complete photographic and risk factor data were included (n=1,787).

Results: : Higher scores for both healthy diet patterns were generally associated with higher intakes of a wide range of nutrients that are suspected to protect against AMD. Direct associations of HEI score and AMed score to AMD were observed in women >75 years and inverse associations in women <75 years of age (P-value for age interaction <0.001). In women < 75 years of age (n=1313 without AMD; 190 with intermediate AMD) reduced risk of intermediate AMD was associated with a one-standard deviation (SD) increase in healthy diet scores: Age-adjusted odds ratio [OR] (95% Confidence Interval [CI]) = 0.9 (0.7-1.0); P-trend = 0.05 for 2005 HEI score and = 0.8 (0.7-1.0); P-trend = 0.03 for AMed score. After further adjustment for smoking, hormone replacement therapy, eye color, diabetes, heart disease, and family history of AMD a 35-40 % reduction in risk for AMD was associated with being in high vs. low quintiles for 2005 HEI score (P-trend = 0.08) or having an AMed score of 5-9, compared with 0-2 (P-trend = 0.046).

Conclusions: : Adherence to either recommended diet pattern was associated with a similar reduction in prevalence of intermediate AMD in women <75 years.

Keywords: age-related macular degeneration • nutritional factors • clinical (human) or epidemiologic studies: risk factor assessment