Determinants of Macular Pigment Density in the Carotenoids in Age–Related Eye Disease Study (CAREDS) an Ancillary Study of the Women's Health Initiative

Abstract

Abstract: : Purpose: The diet, lifestyle, medical and ocular factors that influence macular pigment are inconsistent across study samples to date, many of which have been small. We evaluated the determinants of macular pigment density in a large epidemiologic study. Methods: We measured macular pigment density using heterochromatic flicker photometry in a preliminary sample of 1,425 participants of CAREDS selected from Observational Study Cohorts of the Women's Health Initiative in Portland, Iowa City and Madison (ages 53–86 years) on the basis of dietary lutein and zeaxanthin intake in 1994–97 being above the 78th percentile or below the 23rd percentile. Results: Mean (SD) macular pigment optical density (MPOD) 0.5 degrees from the foveal center was 0.37 (0.21). The strongest predictors of MPOD in one–way analysis of variance, among demographic, diet, lifestyle, ocular and medical factors were: dietary lutein, body mass index, waist to hip ratio (an indicator of abdominal adiposity) and diabetes. In analysis of variance containing these variables together, MPOD in the first (median intake 677 mcg/day), second, third, fourth and fifth (median intake 4796 mcg/day) quintiles for dietary lutein were 0.31, 0.34, 0.39, 0.39, and 0.40. Adjusted means for MPOD were 0.31 in obese women (BMI >35 kg/m2) and 0.39 in lean women (BMI <22.5), 0.36 vs 0.32 in women in the lowest and highest quartiles for waist to hip ratio and 0.27 vs 0.37 in women with diabetes compared to without diabetes. Conclusions: In this sample of middle–aged and older women, the strongest independent predictors of macular pigment density were diet lutein, body fatness, abdominal adiposity and diabetes.

Keywords: macular pigment • carotenoids/carotenoid binding proteins • clinical (human) or epidemiologic studies: risk factor assessment