Does eating particular diets alter the risk of age-related macular degeneration in users of the Age-Related Eye Disease Study supplements?
BACKGROUND
Recent information suggests that the Age-Related Eye Disease Study (AREDS) supplement, enhanced intake of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), and reducing dietary glycaemic index (dGI) are protective against advanced age-related macular degeneration (AMD).


METHODS
Dietary information was collected at baseline, and fundus photograph grades were obtained during the 8-year trial period from 2924 eligible AREDS AMD trial participants. Using the eye as the unit of analysis and multifailure Cox proportional-hazards regression, the risk of AMD progression was related to dietary intake in the four arms of the trial.


RESULTS
Independent of AREDS supplementation, higher intakes of DHA (> or =64.0 vs <26.0 mg/day) (hazard ratio (HR) = 0.73, 95% confidence interval (CI), 0.57 to 0.94), EPA (> or =42.3 vs <12.7 mg/day) (HR = 0.74, 95% CI 0.59 to 0.94), and lower dGI (dGI, <75.2 vs > or =81.5) (HR = 0.76, 95% CI 0.60 to 0.96) were associated with a lower risk for progression to advanced AMD. Participants consuming a lower dGI and higher DHA or EPA had the lowest risk (p value for synergistic interaction <0.001). Only participants in the "placebo" (p value for antagonistic interaction = 0.006) benefited from a higher DHA intake against early AMD progression (HR = 0.58, 95% CI 0.37 to 0.92; P(trend) = 0.01).


CONCLUSIONS
The findings show an association of consuming a diet rich in DHA with a lower progression of early AMD. In addition to the AREDS supplement, a lower dGI with higher intakes of DHA and EPA was associated with a reduced progression to advanced AMD.


BACKGROUND
NCT00000145.
Chiu
C-J
CJ
Laboratory for Nutrition and Vision Research, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA 02111, USA. cj.chiu@tufts.edu
Klein
R
R
Milton
R C
RC
Gensler
G
G
Taylor
A
A
D000368:Aged; D004038:Diet, Reducing; D019587:Dietary Supplements; D018450:Disease Progression; D004281:Docosahexaenoic Acids / Q000627:therapeutic use*; D015118:Eicosapentaenoic Acid / Q000627:therapeutic use*; D005260:Female; D038321:Glycemic Index; D006801:Humans; D008268:Macular Degeneration / Q000178:diet therapy / Q000517:prevention & control*; D008297:Male; D012307:Risk Factors
D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid