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J.P. SanGiovanni, E.Y. Chew, E. Agron, T.E. Clemons, J.M. Seddon, F.L. Ferris, AREDS Research Group; Dietary Lipid Intake and Vision Loss in the Age–Related Eye Disease Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2193.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the association of dietary lipid intake with vision loss.
Our findings are based on a multicenter clinic–based 8 year follow–up study of 2381 AREDS participants who had early or intermediate AMD in at least one eye at enrollment, best visual acuity of 20/32 or better in both eyes, and no history of cataract extraction. We applied repeated measures logistic regression to examine likelihood of progression to a >10 letter acuity loss (0.2 logMAR change) during follow–up. We estimated baseline lipid intake with a validated food frequency questionnaire; the lowest quintile of intake represented the referent group for other quintiles. Certified examiners measured best–corrected acuity with the AREDS protocol using ETDRS logMAR charts. Standardized questionnaires yielded demographic, lifestyle, medical, and ocular data. Annual fundus and lens photographs provided AMD and cataract data.
Likelihood of vision loss was lower among people reporting highest intake of docosahexaenoic acid (DHA, OR=0.72; 95%CI 0.58–0.90) and eicosapentaenoic acid (EPA, OR=0.66; 95%CI 0.54–0.82) in sex–, age–, race–, and calorie–adjusted models. Likelihood of vision loss was greater among those reporting highest monounsaturated fatty acid intake (OR=1.51; 95%CI 1.22–1.88). Adding lifestyle, medical, and environmental covariates in the second stage of modeling did not appreciably alter ORs for these lipids. Adjusting for lens opacity status or advanced AMD status (neovascular (NV) AMD and central geographic atrophy (CGA)) at the time of the visual acuity measurement did not appreciably alter ORs (no change for lens status, but adjusted for advanced AMD, DHA (OR=0.80; 95%CI 0.65–0.99) and EPA (OR=0.75; 95%CI 0.60–0.93). No significant associations were found with saturated fat, total cholesterol, arachidonic acid, linoleic acid, or α–linolenic acid in multivariable models including NV AMD and CGA. Analyses stratified by presence of advanced AMD revealed statistically significant EPA–acuity relationships only among people without advanced AMD (OR=0.7; 95%CI 0.6–0.9). The OR for people with CGA remained in the direction of benefit (0.6; 95%CI 0.3–1.2); for NV AMD it did not (1.0; 95%CI 0.5–1.9).
People reporting highest levels of dietary DHA and EPA were respectively 20% and 25% less likely to progress to vision loss in multivariable models, even after controlling for likely risk factors, including baseline and follow–up lens opacity and AMD status.
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