Progression of Age-Related Macular Degeneration: Association With Dietary Fat, Transunsaturated Fat, Nuts, and Fish Intake | Cardiology | JAMA Ophthalmology | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 34.239.177.24. Please contact the publisher to request reinstatement.
1.
National Advisory Eye Council, Vision Research—A National Plan: 1999-2003, Vol. 1. A Report of the National Advisory Eye Council. Bethesda, Md National Institutes of Health1999;NIH publication 98-4120.
2.
Klein  RKlein  BEKLinton  KLP Prevalence of age-related maculopathy.  Ophthalmology. 1992;99933- 943PubMedGoogle ScholarCrossref
3.
Thylefors  B A global initiative for the elimination of avoidable blindness.  Am J Ophthalmol. 1998;12590- 93PubMedGoogle ScholarCrossref
4.
Seddon  JMHankinson  SSpeizer  FWillett  WC A prospective study of cigarette smoking and age-related macular degeneration in women.  JAMA. 1996;2761141- 1146PubMedGoogle ScholarCrossref
5.
Delcourt  CDiaz  JPonton-Sanchez  APapoz  L Smoking and age-related macular degeneration: the POLA Study.  Arch Ophthalmol. 1998;1161031- 1035PubMedGoogle ScholarCrossref
6.
Mitchell  PWang  JJSmith  WLeeder  S Smoking and the 5-year incidence of age-related maculopathy.  Arch Ophthalmol. 2002;1201357- 1363PubMedGoogle ScholarCrossref
7.
Age-Related Eye Disease Study Research Group, A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss.  Arch Ophthalmol. 2001;1191417- 1436PubMedGoogle ScholarCrossref
8.
Seddon  JMAjani  UASperduto  RD  et al.  Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration.  JAMA. 1994;2721413- 1420PubMedGoogle ScholarCrossref
9.
Seddon  JMCote  JDavis  NRosner  B Progression of age-related macular degeneration: association with body mass index, waist circumference, and waist-hip ratio.  Arch Ophthalmol. 2003;121785- 792PubMedGoogle ScholarCrossref
10.
Snow  KSeddon  J Do age-related macular degeneration and cardiovascular disease share common antecedents?  Ophthalmic Epidemiol. 1999;6125- 143PubMedGoogle ScholarCrossref
11.
Hu  FBStampfer  MJManson  JE  et al.  Dietary fat intake and the risk of coronary heart disease in women.  N Engl J Med. 1997;3371491- 1499PubMedGoogle ScholarCrossref
12.
Ascherio  ARimm  EBGiovannucci  ELSpiegelman  DStampfer  MWillett  WC Dietary fat and risk of coronary heart disease in men: cohort follow-up study in the United States.  BMJ. 1996;31384- 90PubMedGoogle ScholarCrossref
13.
Mares-Perlman  JABrady  WEKlein  RVander Langenberg  GMKlein  BEKPalta  M Dietary fat and age-related maculopathy.  Arch Ophthalmol. 1995;113743- 748PubMedGoogle ScholarCrossref
14.
Smith  WMitchell  PLeeder  S Dietary fat and fish intake and age-related maculopathy.  Arch Ophthalmol. 2000;118401- 404PubMedGoogle ScholarCrossref
15.
Seddon  JMRosner  BSperduto  RD  et al.  Dietary fat and risk for advanced age-related macular degeneration.  Arch Ophthalmol. 2001;1191191- 1199PubMedGoogle ScholarCrossref
16.
Cho  EHung  SWillett  W  et al.  Prospective study of dietary fat and the risk of age-related macular degeneration.  Am J Clin Nutr. 2001;73209- 218PubMedGoogle Scholar
17.
Heuberger  RAMares-Perlman  JAKlein  RKlein  BEKMillen  AEPalta  M Relationship of dietary fat to age-related maculopathy in the Third National Health and Nutrition Examination Survey.  Arch Ophthalmol. 2001;1191833- 1838PubMedGoogle ScholarCrossref
18.
Willett  WCSampson  LStampfer  MJ  et al.  Reproducibility and validity of a semi-quantitative food frequency questionnaire.  Am J Epidemiol. 1985;12251- 65PubMedGoogle Scholar
19.
Ajani  UWillett  WSeddon  Jthe Eye Disease Case-Control Study Group, Reproducibility of a food frequency questionnaire for use in ocular research.  Invest Ophthalmol Vis Sci. 1994;352725- 2733PubMedGoogle Scholar
20.
Willett  W Nutritional Epidemiology.  New York, NY Oxford University Press1990;
21.
Baik  IAscherio  ARimm  EB  et al.  Adiposity and mortality in men.  Am J Epidemiol. 2000;152264- 271PubMedGoogle ScholarCrossref
22.
Ferris  FL  IIIKassoff  ABresnick  GHBailey  I New visual acuity charts for clinical research.  Am J Ophthalmol. 1982;9491- 96PubMedGoogle Scholar
23.
Seddon  JSahagian  CGlynn  RSperduto  RDEGragoudas  Ethe Eye Disorders Case-Control Study Group, An iris color classification system.  Invest Ophthalmol Vis Sci. 1990;311592- 1598PubMedGoogle Scholar
24.
Chylack  LTLeske  MLMcCarthy  DKhu  PKashiwagi  TSperduto  R Lens Opacities Classification System II (LOCS II).  Arch Ophthalmol. 1989;107991- 997PubMedGoogle ScholarCrossref
25.
Age-Related Eye Disease Study Group, Age-Related Eye Disease Study (AREDS) Phase II Manual of Operations.  Potomac, Md EMMES Corp1992;
26.
Cohen  J Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit.  Psychol Bull. 1968;70213- 220Google ScholarCrossref
27.
Sunness  JSGonzalez-Baron  JBressler  NMHawkins  BApplegate  CA The development of choroidal neovascularization in eyes with the geographic atrophy form of age-related macular degeneration.  Ophthalmology. 1999;106910- 919PubMedGoogle ScholarCrossref
28.
Albert  CMHennekens  CHO'Donnell  CJ  et al.  Fish consumption and risk of sudden cardiac death.  JAMA. 1998;27923- 28PubMedGoogle ScholarCrossref
29.
Hu  FBStamfer  MJManson  JE  et al.  Frequent nut consumption and risk of coronary heart disease in women: prospective cohort study.  BMJ. 1998;3171341- 1345PubMedGoogle ScholarCrossref
30.
Albert  CMGaziano  JMWillett  WCManson  JE Nut consumption and decreased risk of sudden cardiac death in the Physicians' Health Study.  Arch Intern Med. 2002;1621382- 1387PubMedGoogle ScholarCrossref
31.
Feldman  EB The scientific evidence for a beneficial health relationship between walnuts and coronary heart disease.  J Nutr. 2002;1321062S- 1101SPubMedGoogle Scholar
32.
Jiang  RManson  JEStampfer  MJLiu  SWillett  WCHu  FB Nut and peanut butter consumption and risk of type 2 diabetes in women.  JAMA. 2002;2882554- 2560PubMedGoogle ScholarCrossref
33.
Kris-Etherton  PMHecker  KDBonanome  A  et al.  Bioactive compounds in foods: their role in the prevention of cardiovascular disease and cancer.  Am J Med. 2002;113 ((suppl 9B)) 71S- 88SPubMedGoogle ScholarCrossref
34.
Dreher  MLMaher  CV The traditional and emerging role of nuts in healthful diets.  Nutr Rev. 1996;54241- 245PubMedGoogle ScholarCrossref
35.
Mensink  RPMKatan  MB Effect of dietary trans fatty acids on high-density and low-density lipoprotein cholesterol levels in healthy subjects.  N Engl J Med. 1990;323439- 445PubMedGoogle ScholarCrossref
36.
Willett  WCAscherio  A Trans fatty acids: are the effects only marginal?  Am J Public Health. 1994;84722- 724PubMedGoogle ScholarCrossref
37.
National Institutes of Health National Eye Institute and Prevent Blindness America, Vision Problems in the US: Prevalence of Adult Vision Impairment and Age-Related Eye Disease in America.  Schaumburg, Ill Prevent Blindness America2002;
Clinical Sciences
December 2003

Progression of Age-Related Macular Degeneration: Association With Dietary Fat, Transunsaturated Fat, Nuts, and Fish Intake

Author Affiliations

From the Massachusetts Eye and Ear Infirmary, Epidemiology Unit (Dr Seddon and Ms Cote); the Departments of Ophthalmology (Dr Seddon) and Medicine, Biostatistics (Dr Rosner), Harvard Medical School; and the Departments of Epidemiology (Dr Seddon) and Biostatistics (Dr Rosner), Harvard School of Public Health; Boston, Mass. The authors have no relevant financial interest in this article.

Arch Ophthalmol. 2003;121(12):1728-1737. doi:10.1001/archopht.121.12.1728
Abstract

Background  Individuals with early or intermediate stages of age-related macular degeneration (AMD) make up a large, growing segment of the elderly population. Evidence is sparse regarding modifiable factors that may decrease the risk of progression to the advanced forms of AMD.

Objective  To advise patients with a high risk for advanced forms of AMD about preventive measures through our evaluation of the relationship between dietary fat intake and the progression of early or intermediate AMD to the advanced stages of the disease associated with visual loss.

Design  A prospective cohort study with an average follow-up time of 4.6 years.

Setting  A hospital-based clinical retinal practice specializing in macular degeneration.

Patients  The 261 participants were aged 60 years and older and had some sign of nonexudative AMD and visual acuity of 20/200 or better in at least 1 eye.

Main Outcome Measure  Progression to advanced AMD, which was defined as having geographic atrophy or neovascular disease.

Results  Higher total fat intake increased the risk of progression to the advanced forms of AMD, with a relative risk (RR) of 2.90 (95% confidence interval, 1.15-7.32) for the highest fat-intake quartile relative to the lowest fat-intake quartile, after controlling for other factors (P trend= .01). Animal fat intake was associated with a 2-fold increased risk of progression(RR, 2.29 for the highest quartile compared with the lowest quartile; 95% confidence interval, 0.91-5.72), although the trend for increasing risk with higher animal fat intake was not significant (P=.09). Higher vegetable fat intake had a stronger relationship with increased risk of AMD progression with an RR of 3.82 (95% confidence interval, 1.58-9.28) for the highest quartile compared with the lowest quartile (P trend = .003). Saturated, monounsaturated, polyunsaturated, and transunsaturated fats increased the likelihood of progression (RR, 2.09 and P trend = .08; RR, 2.21 and P trend = .04; RR, 2.28 and P trend = .04; RR, 2.39 and P trend = .008, respectively). Higher fish intake was associated with a lower risk of AMD progression among subjects with lower linoleic acid intake. Processed baked goods, which are higher in some of these fats, increased the rate of AMD progression approximately 2-fold, and nuts were protective.

Conclusions  Among individuals with the early or intermediate stages of AMD, total and specific types of fat intake, as well as some fat-containing food groups, modified the risk of progression to advanced AMD. Fish intake and nuts reduced risk. Since advanced AMD is associated with visual loss and reduced quality of life, these preventive measures deserve additional research and greater emphasis.

×