Relationship Between Dietary Patterns and Age–Related Maculopathy in the Carotenoids in Age–Related Eye Disease Study (CAREDS), an ancillary study of the Women's Health Initiative

Abstract

Abstract: : Purpose: To examine the relationship between overall dietary patterns and prevalence of age–related maculopathies (ARM) in older women. Methods: Women’s Health Initiative Observational Study participants aged 50 y+, at 3 sites, who reported high or low intakes of lutein and zeaxanthin on their baseline food frequency questionnaire (1994–1998) were recruited approximately 5 years later (2001–2003) to participate in the Carotenoids in Age–Related Eye Disease Study (n=1512). Stereo fundus photographs were obtained and graded using the Wisconsin Age–Related Maculopathy Grading System. Cluster analysis was used to identify the predominant dietary patterns in these women. Results: Seven dietary pattern groups were identified, with comparatively high intakes of: 1) alcohol (13% of energy); 2) low–fat dairy (18% of energy); 3) refined grains (18%); 4) whole grains (16%); 5) red meat (15%); 6) fruit and vegetables (31%); and 7) desserts and sweets (23%). After adjusting for age and energy intake, the fruit and vegetables group had significantly higher intakes of carotenoids, including lutein and zeaxanthin, than the other groups. The lowest intakes of carotenoids and micronutrients, and the highest fat intakes, were seen in the red meat and desserts groups. There was some suggestion of a difference in the prevalence odds of early ARM between the pattern groups (p=0.09), with the fruit and vegetables group appearing the least protective. After excluding women with a prior diagnosis of AMD (n=110), this association no longer approached significance (p=0.20). Diet patterns were not associated with any specific lesions of early ARM or late ARM. Further adjustment for smoking, family history, high dose antioxidant supplement use, hormone replacement therapy, waist–to–hip ratio, or history of cardiovascular disease (late ARM only) did not significantly alter the odds ratios. Conclusion: The self–selected dietary patterns of older women five years in the past do not appear to be strongly associated with prevalence of ARM. Further work is needed to determine if dietary intakes further in the past, or specifically prescribed diets, may be related to ARM.

Keywords: nutritional factors • age–related macular degeneration • clinical (human) or epidemiologic studies: risk factor assessment