The relationship of dietary carotenoid and vitamin A, E, and C intake with age-related macular degeneration in a case-control study: AREDS Report No. 22.
OBJECTIVE
To evaluate the relationship of dietary carotenoids, vitamin A, alpha-tocopherol, and vitamin C with prevalent age-related macular degeneration (AMD) in the Age-Related Eye Disease Study (AREDS).


METHODS
Demographic, lifestyle, and medical characteristics were ascertained on 4519 AREDS participants aged 60 to 80 years at enrollment. Stereoscopic color fundus photographs were used to categorize participants into 4 AMD severity groups and a control group (participants with < 15 small drusen). Nutrient intake was estimated from a self-administered semiquantitative food frequency questionnaire at enrollment. Intake values were energy adjusted and classified by quintiles. The relationship between diet and AMD status was assessed using logistic regression analyses.


RESULTS
Dietary lutein/zeaxanthin intake was inversely associated with neovascular AMD (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.45-0.93), geographic atrophy (OR, 0.45; 95% CI, 0.24-0.86), and large or extensive intermediate drusen (OR, 0.73; 95% CI, 0.56-0.96), comparing the highest vs lowest quintiles of intake, after adjustment for total energy intake and nonnutrient-based covariates. Other nutrients were not independently related to AMD.


CONCLUSIONS
Higher dietary intake of lutein/zeaxanthin was independently associated with decreased likelihood of having neovascular AMD, geographic atrophy, and large or extensive intermediate drusen.
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SanGiovanni
John Paul
JP
Chew
Emily Y
EY
Clemons
Traci E
TE
Ferris
Frederick L
FL
Gensler
Gary
G
Lindblad
Anne S
AS
Milton
Roy C
RC
Seddon
Johanna M
JM
Sperduto
Robert D
RD
D000368:Aged; D000369:Aged, 80 and over; D001205:Ascorbic Acid / Q000008:administration & dosage*; D002338:Carotenoids / Q000008:administration & dosage*; D016022:Case-Control Studies; D020256:Choroidal Neovascularization / Q000453:epidemiology / Q000517:prevention & control; D004032:Diet; D004435:Eating; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D014975:Lutein / Q000008:administration & dosage; D008268:Macular Degeneration / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D014801:Vitamin A / Q000008:administration & dosage*; D014810:Vitamin E / Q000008:administration & dosage*; D024341:Xanthophylls / Q000008:administration & dosage; D065146:Zeaxanthins
D024341:Xanthophylls; D065146:Zeaxanthins; D014801:Vitamin A; D014810:Vitamin E; D002338:Carotenoids; D001205:Ascorbic Acid; D014975:Lutein