Dietary antioxidants and the long-term incidence of age-related macular degeneration: the Blue Mountains Eye Study.

Abstract

PURPOSE:

To assess the relationship between baseline dietary and supplement intakes of antioxidants and the long-term risk of incident age-related macular degeneration (AMD).

DESIGN:

Australian population-based cohort study.

PARTICIPANTS:

Of 3654 baseline (1992-1994) participants initially 49 years of older, 2454 were reexamined after 5 years, 10 years, or both.

METHODS:

Stereoscopic retinal photographs were graded using the Wisconsin Grading System. Data on potential risk factors were collected. Energy-adjusted intakes of alpha-carotene; beta-carotene; beta-cryptoxanthin; lutein and zeaxanthin; lycopene; vitamins A, C, and E; and iron and zinc were the study factors. Discrete logistic models assessed AMD risk. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated after adjusting for age, gender, smoking, and other risk factors.

MAIN OUTCOME MEASURES:

Incident early, late, and any AMD.

RESULTS:

For dietary lutein and zeaxanthin, participants in the top tertile of intake had a reduced risk of incident neovascular AMD (RR, 0.35; 95% CI, 0.13-0.92), and those with above median intakes had a reduced risk of indistinct soft or reticular drusen (RR, 0.66; 95% CI, 0.48-0.92). For total zinc intake the RR comparing the top decile intake with the remaining population was 0.56 (95% CI, 0.32-0.97) for any AMD and 0.54 (95% CI, 0.30-0.97) for early AMD. The highest compared with the lowest tertile of total beta-carotene intake predicted incident neovascular AMD (RR, 2.68; 95% CI, 1.03-6.96; P = 0.029, for trend). Similarly, beta-carotene intake from diet alone predicted neovascular AMD (RR comparing tertile 3 with tertile 1, 2.40; 95% CI, 0.98-5.91; P = 0.027, for trend). This association was evident in both ever and never smokers. Higher intakes of total vitamin E predicted late AMD (RR compared with the lowest tertile, 2.83; 95% CI, 1.28-6.23; and RR, 2.55; 95% CI, 1.14-5.70 for the middle and highest tertiles, respectively; P = 0.22, for trend).

CONCLUSIONS:

In this population-based cohort study, higher dietary lutein and zeaxanthin intake reduced the risk of long-term incident AMD. This study confirmed the Age-Related Eye Disease Study finding of protective influences from zinc against AMD. Higher beta-carotene intake was associated with an increased risk of AMD.

• Authors: Jennifer S L Tan, Jie Jin Wang, Victoria Flood, Elena Rochtchina, Wayne Smith, Paul Mitchell
• Journal: Ophthalmology (Ophthalmology) Vol. 115 Issue 2 Pg. 334-41 (Feb 2008) ISSN: 1549-4713 [Electronic] United States
• PMID: 17664009 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antioxidants
• beta Carotene
• Vitamin E
• Zinc
• Ascorbic Acid

Topics

• Aged
• Antioxidants (administration & dosage)
• Ascorbic Acid (administration & dosage)
• Choroidal Neovascularization (epidemiology)
• Cohort Studies
• Dietary Supplements
• Feeding Behavior
• Female
• Follow-Up Studies
• Humans
• Incidence
• Macular Degeneration (epidemiology)
• Male
• Middle Aged
• New South Wales (epidemiology)
• Risk Factors
• Vitamin E (administration & dosage)
• Zinc (administration & dosage)
• beta Carotene (administration & dosage)