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B.E. Chua, V. Flood, E. Rochtchina, J.J. Wang, W. Smith, P. Mitchell, Blue Mountains Eye Study; Dietary Mono– and Poly–Unsaturated Fatty Acids and 5–Year Incidence of Age Related Maculopathy . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2381.
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Purpose:Several prospective studies have found increased risk of age related maculopathy (ARM) in participants with high intakes of dietary fat, including monounsaturated and polyunsaturated fats. We aimed to examine the effect of differential components of unsaturated dietary fatty acids on the incidence of ARM from a population–based cohort study. Methods: 3654 persons aged 49 years or older participated in the Blue Mountains Eye Study (BMES I, 1992–4), and 2335 (75.1% of survivors from BMES I) were re–examined after 5 years (BMES II, 1997–9). ARM was graded from stereoscopic fundus photographs following the Wisconsin ARM Grading System. Incidence of early and late ARM was determined after side–by–side grading of baseline and follow–up photographs. Participants completed a validated food frequency questionnaire at baseline, and dietary fat intake and its sub–types were calculated, using Australian nutrient databases for fatty acids and expressed as percent contribution of total energy. Logistic regression models were adjusted for age, sex and current smoking status. Results: Compared to participants in the middle three quintiles of fat intake, those with the lowest quintile of dietary monounsaturated fat intake had a 70% increased likelihood of incident early ARM (adjusted odds ratio, OR 1.7; 95% confidence interval, CI 1.0–3.1), and those with the lowest quintile of omega–3 polyunsaturated fat had 50% increased likelihood of incident early ARM (OR 1.5, CI 1.0–3.1). Participants with the highest quintile of omega–3 polyunsaturated fat intake had lower risk of incident early ARM when compared to participants in the lowest quintile (OR 0.4, CI 0.2–0.8). Supporting this, we also found a 40% risk reduction of incident early ARM in those consuming fish at least once /week (OR 0.6, CI 0.4–0.9), while the risk reduction of incident late ARM occurred with fish consumption at least 3 times /week (OR 0.3, CI 0.1–1.0). Conclusions: Our findings suggest that a diet high in omega–3 polyunsaturated fat, especially from fish, is protective against both early and late ARM. However, there was an apparent increased risk of incident early ARM with low intakes of monounsaturated and omega–3 polyunsaturated fat, contrary to data from some recent studies.
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