Mediterranean diet and incidence of advanced AMD: The EYE-RISK CONSORTIUM

Abstract

Purpose : Higher adherence to Mediterranean diet (MeDi) is linked to a lower risk of mortality and chronic diseases and has been recently inversely associated with AMD, mostly in cross-sectional studies. The only prospective study resulted from a post-hoc analysis of a randomized clinical trial which limits its generalizability. We therefore investigated the associations between adherence to the Mediterranean diet and incidence of advanced AMD in a large sample from two population-based prospective studies.

Methods : Among the EYE-RISK Consortium database, 4 446 participants aged 55+ years from the Rotterdam study (RS) and 550 aged 73+ years from the Alienor study have been included. Subjects without advanced AMD at baseline were evaluated for the incidence of advanced AMD. Dietary data were collected from food frequency questionnaires at baseline. The MeDi Score (range 0-9) was constructed assigning points to more than median intakes of vegetables, fruits, legumes, cereals, fish, moderate alcohol consumption and the ratio of monounsaturated to saturated fats and to lower than median intakes of meats and dairy products. Data on age, gender, education, body mass index, smoking, supplement use, diabetes, hypertension and hypercholesterolemia were collected at baseline. Cox models were used to assess associations between incident AMD and MeDi score.

Results : In the studied sample, 155 participants developed incident advanced AMD (117 from the RS and 38 from Alienor study). After adjustment for age, sex, AMD grade at baseline, total energy intake, education, body mass index, smoking, supplement use, diabetes, hypertension and hypercholesterolemia, a high MeDi score (6-9) was significantly associated with a lower risk for incident advanced AMD (HR, 0.61 (95% CI: 0.51-0.73), p-trend<0.0001).
Regarding associations with specific components of the MeDi score, participants with consumption above the median for fruits, legumes and fish, with MUFAs to SFAs ratio above the median and with a mild to moderate consumption of alcohol had a reduced risk for incident advanced AMD.
Interactions between either CFH Y402H or ARMS2 and MeDi score were not statistically significant.

Conclusions : Higher adherence to the Mediterranean diet was associated with a 39% reduced risk of developing advanced AMD. These results highlight that eating a healthy diet, such as a Mediterranean-type diet, may help to limit progression to advanced AMD.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.