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S. Kaushik, J. J. Wang, V. Flood, E. Rochtchina, J. S. L. Tan, J. Brand-Miller, A. Barclay, P. Mitchell, Blue Mountains Eye Study; Glycaemic Index and 10-Year Incidence of Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1148.
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Glycaemic index (0 to 100) ranks carbohydrate foods based on the blood glucose response to that food compared to 50 grams of glucose. Low glycaemic index foods (<55) are thought to provide cardiovascular protection. We investigated the relationship between average dietary glycaemic index and the 10-year incidence of age-related macular degeneration (AMD) in the Blue Mountains Eye Study cohort.
Of 3654 baseline participants aged 49+years (1992-4); 2335 (75.1% of survivors) were re-examined after 5 (1997-9) and 1952 (75.6% of survivors) after 10 years (2002-4). At each visit retinal photographs were taken and participants completed a detailed food frequency questionnaire. Glycaemic index was calculated from an Australian database. AMD was assessed from retinal photos using the Wisconsin Grading System, and the incidence was confirmed using a side-by-side grading method. Incident early AMD was defined in subjects without early or late AMD, and incident late AMD was defined in subjects without late AMD, in either eye at baseline.
Mean glycaemic index of foods consumed in the baseline population was 57 (standard deviation 5), comparable to U.S. studies. Over 10 years, 72 of 2395 at risk subjects developed late AMD, and 266 of 2255 developed early AMD. After controlling for age, gender, smoking, history of heart disease, white cell count and consumption of fish, anti-oxidants and either carbohydrates or fats, participants within the highest quartile of energy-adjusted glycaemic index (compared to the lowest quartile) had an increased risk of incident early AMD (risk ratio, RR, 1.69, 95% confidence interval, CI, 1.05-2.72), or indistinct soft or reticular drusen (RR, 1.65 CI, 1.01-2.80). Participants consuming the highest quartile of breads and cereals (predominantly low glycaemic index foods like oatmeal and wholemeal/grain breads) had a lower risk of incident early AMD (HR, 0.86, CI, 0.75-0.98). Glycaemic index was not associated with incident late AMD. Excluding persons with diabetes did not alter results.
Eating higher glycaemic index foods predicted the development of early AMD, independent of other AMD risk factors, whereas eating lower glycaemic index foods was protective against early AMD. The glycaemic index of foods provides another potential area for dietary advice for patients at risk of AMD.
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