Dietary Omega 3 Fatty Acids, Antioxidants and the Risk for Age-Related Maculopathy: The Alienor Study

Abstract

Purpose: : Previous studies have suggested a lower risk for age-related maculopathy (ARM) in subjects with high dietary intake of omega 3 fatty acids and antioxidants. We report the associations of ARM with past dietary intakes of fats and antioxidants in French elderly subjects.

Methods: : The Alienor Study is a population-based epidemiological study on nutrition and age-related eye diseases. 963 subjects had an eye examination from September 2006 to May 2008 in Bordeaux (France). Dietary intakes of fatty acids and antioxidants were estimated from a 24 hour dietary recall performed at home by dieticians in 2001-2002. Of 963 subjects, 84 (8.8 %) were excluded from the statistical analyses because of ungradable photographs in both eyes and 160 (16.6 %) because of missing data for confounders (age, gender, educational level, monthly income, smoking, HDL-Cholesterol, body mass index, diabetes and gene polymorphisms ApoE4, ApoE2 and CFH Y402H). ARM was classified in five exclusive stages: neovascular ARM (stage 4 n= 20); geographic atrophy (stage 3 n=20); large soft indistinct drusen and/or reticular drusen and/or large distinct drusen with pigment abnormalities (stage 2 n=72); large soft distinct drusen alone or pigment abnormalities alone (stage 1 n=133); stage 0 (n=474). Associations were estimated using polytomous logistic regression, stage 0 being the reference in all analyses. Odds-ratios were estimated for 1-SD increase in the energy-adjusted nutrients.

Results: : After multivariate adjustment, subjects with high dietary omega 3 intakes were at lower risk of neovascular ARM (OR= 0.55, 95% confidence interval (CI): 0.05-0.97, p= 0.045) and ARM stage 1 (OR= 0.77 95% CI: 0.60-1.00 p=0.05). Globally, late ARM (stages 3 and 4) was significantly associated with dietary omega 3 (OR=0.55 95% CI 0.32-0.97 p=0.04). Subjects with high dietary zinc intake were at higher risk of ARM stage 1 (OR=1.25 95% CI 1.02-1.52 p=0.03). Other antioxidants (retinol, vitamin C, E) were not significantly associated with any stage of ARM.

Conclusions: : Our results add to the existing literature showing a decreased risk for ARM in subjects with high omega 3 fatty acids intake. By contrast, we found no association of ARM with antioxidants, except for an increased risk of stage 1 ARM in subjects with high dietary zinc intake.

Keywords: age-related macular degeneration • nutritional factors • lipids