Dietary Carotenoids, Vitamins A, C, and E, and Advanced Age-Related Macular Degeneration

Abstract

OBJECTIVE--To evaluate the relationships between dietary intake of carotenoids and vitamins A, C, and E and the risk of neovascular age-related macular degeneration (AMD), the leading cause of irreversible blindness among adults. DESIGN--The multicenter Eye Disease Case-Control Study. SETTING--Five ophthalmology centers in the United States. PATIENTS--A total of 356 case subjects who were diagnosed with the advanced stage of AMD within 1 year prior to their enrollment, aged 55 to 80 years, and residing near a participating clinical center. The 520 control subjects were from the same geographic areas as case subjects, had other ocular diseases, and were frequency-matched to cases according to age and sex. MAIN OUTCOME MEASURES--The relative risk for AMD was estimated according to dietary indicators of antioxidant status, controlling for smoking and other risk factors, by using multiple logistic-regression analyses. RESULTS--A higher dietary intake of carotenoids was associated with a lower risk for AMD. Adjusting for other risk factors for AMD, we found that those in the highest quintile of carotenoid intake had a 43% lower risk for AMD compared with those in the lowest quintile (odds ratio, 0.57; 95% confidence interval, 0.35 to 0.92; P for trend = .02). Among the specific carotenoids, lutein and zeaxanthin, which are primarily obtained from dark green, leafy vegetables, were most strongly associated with a reduced risk for AMD (P for trend = .001). Several food items rich in carotenoids were inversely associated with AMD. In particular, a higher frequency of intake of spinach or collard greens was associated with a substantially lower risk for AMD (P for trend < .001). The intake of preformed vitamin A (retinol) was not appreciably related to AMD. Neither vitamin E nor total vitamin C consumption was associated with a statistically significant reduced risk for AMD, although a possibly lower risk for AMD was suggested among those with higher intake of vitamin C, particularly from foods. CONCLUSION--Increasing the consumption of foods rich in certain carotenoids, in particular dark green, leafy vegetables, may decrease the risk of developing advanced or exudative AMD, the most visually disabling form of macular degeneration among older people. These findings support the need for further studies of this relationship.

Resonance Raman measurement of macular carotenoids in normal subjects and in age-related macular degeneration patients

“…None of these normal subjects consumed lutein supplements in excess of 0.275 mg/day, a level much lower than the usual daily dietary intake of lutein and zeaxanthin by the American population (1-3 mg/day). 3,13 Increasing subject age is associated significantly with declining carotenoid Raman intensity (P < 0.001, one-way ANOVA), and the population values are best fit with an exponential curve (R = 0.664; Fig 5). Only a small number of young subjects had macular pigment readings beyond the detector's linear response range (>1500 counts).…”

“…Zeaxanthin supplements, however, were not commercially available in the United States until recently except as a minor component of lutein prepared from marigold flowers, and it has been suggested that dietary lutein may serve as a precursor for the very high concentrations of zeaxanthin found in the primate fovea. 11 A major epidemiologic study found that high dietary intakes and blood levels of these xanthophyll carotenoids are correlated with a significantly lower risk of AMD, 12,13 but another study did not reach the same conclusion. 14 These inconsistent findings derive in part from the fact that blood levels and dietary intakes of lutein and zeaxanthin are relatively poor markers of the actual amounts present in the macula.…”

Effect of Phenolic Acid on Antioxidant Activity of Wine and Inhibition of Pectin Methyl Esterase

“…High intake of antioxidant food is found to lower the risk of incidental lifestyle-related diseases 12,29 . More and more evidence is accumulating that the consumption of grape and grape extracts and/or grape products rich in polyphenols, such as those found in red wine, is beneficial for the prevention of chronic degenerative diseases such as, cardiovascular disease 22 .…”

Transference of lutein during cheese making, color stability, and sensory acceptance of prato cheese

“…One of the deficiencies resulting from advancing age, age-related macular degeneration (ARMD), affects 25% of the population over 75 years old in Brazil and is the leading cause of irreversible blindness in the elderly in Western countries (FINE et al, 2000). The ingestion of 6 mg per day of lutein leads to a 43% lower risk for ARMD (SEDDON et al, 1994). Lutein may also contribute to a significant reduction in oxidative stress and DNA damage, which can affect the development of cancer cells in the human body (SERPELONI et al, 2010).…”