The relationship of dietary omega-3 long-chain polyunsaturated fatty acid intake with incident age-related macular degeneration: AREDS report no. 23.
OBJECTIVE
To examine the association of dietary omega-3 long-chain polyunsaturated fatty acid and fish intake with incident neovascular age-related macular degeneration (AMD) and central geographic atrophy (CGA).


METHODS
Multicenter clinic-based prospective cohort study from a clinical trial including Age-Related Eye Disease Study (AREDS) participants with bilateral drusen at enrollment. Main outcome measures were incident neovascular AMD and CGA, ascertained from annual stereoscopic color fundus photographs (median follow-up, 6.3 years). We estimated nutrient and food intake from a validated food frequency questionnaire (FFQ) at baseline, with intake of docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), combined EPA and DHA, and fish as primary exposures.


RESULTS
After controlling for known covariates, we observed a reduced likelihood of progression from bilateral drusen to CGA among people who reported the highest levels of EPA (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.23-0.87) and EPA+DHA (OR, 0.45; 95% CI, 0.23-0.90) consumption. Levels of DHA were associated with CGA in age-, sex-, and calorie-adjusted models (OR, 0.51; 95% CI, 0.26-1.00); however, this statistical relationship did not persist in multivariable models.


CONCLUSIONS
Dietary lipid intake is a modifiable factor that may influence the likelihood of developing sight-threatening forms of AMD. Our findings suggest that dietary omega-3 long-chain polyunsaturated fatty acid intake is associated with a decreased risk of progression from bilateral drusen to CGA.
SanGiovanni
John Paul
JP
National Eye Institute, Bethesda, Maryland, USA.
Chew
Emily Y
EY
Agrón
Elvira
E
Clemons
Traci E
TE
Ferris
Frederick L
FL
Gensler
Gary
G
Lindblad
Anne S
AS
Milton
Roy C
RC
Seddon
Johanna M
JM
Klein
Ronald
R
Sperduto
Robert D
RD
D000368:Aged; D001284:Atrophy / Q000517:prevention & control; D020256:Choroidal Neovascularization / Q000453:epidemiology* / Q000517:prevention & control; D004034:Diet Surveys; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage*; D018450:Disease Progression; D004281:Docosahexaenoic Acids / Q000008:administration & dosage; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage; D002149:Energy Intake; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D015994:Incidence; D008268:Macular Degeneration / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D016017:Odds Ratio; D010857:Pigment Epithelium of Eye / Q000473:pathology; D011446:Prospective Studies; D015593:Retinal Drusen / Q000517:prevention & control; D017747:Seafood; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D004042:Dietary Fats, Unsaturated; D015525:Fatty Acids, Omega-3; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid
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