Dietary Intakes of Eicosapentaenoic Acid and Docosahexaenoic Acid and Risk of Age-Related Macular Degeneration

Abstract

Objectives To evaluate the associations between intakes of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and the intermediate and advanced stages of age-related macular degeneration (AMD). Design Prospective cohort study. Participants We followed 75,889 women from the Nurses’ Health Study and 38,961 men from the Health Professionals Follow-Up Study who were at least 50 years old from 1984 to 2012 and 1986 to 2010, respectively. Cohort participants are mostly white (≥ 95%). Methods We assessed dietary intake by a validated food frequency questionnaire (FFQ) at baseline and every four years. We calculated cumulative average intakes of EPA and DHA from FFQs and also computed predicted erythrocyte and plasma scores directly from food intake using regression models. Cox proportional hazards models were used to compute the associations with AMD outcomes. Main Outcome Measures We confirmed 1,589 incident intermediate and 1,356 advanced AMD cases (primarily neovascular AMD) with a visual acuity of 20/30 or worse due primarily to AMD by medical record review. Results For intermediate AMD, the pooled hazard ratio (HR) between the two cohorts for DHA comparing the extreme quintiles of intake was 0.78 (95% CI, 0.66 – 0.92; p trend, 0.008) and for EPA + DHA was 0.83 (95% CI, 0.71 – 0.98; p trend, 0.03). The pooled HR for fatty fish comparing ≥ 5 servings/week to almost never was 0.61 (95% CI, 0.46 – 0.81; p trend, < 0.001). For advanced AMD, the pooled HR for DHA was 1.01 (95% CI, 0.84 – 1.21; p trend, 0.75) and for fatty fish was 0.80 (95% CI, 0.59 – 1.08; p trend, 0.11). Secondary analyses using predicted erythrocyte and plasma scores of EPA and DHA yielded slightly stronger inverse associations for intermediate AMD and similar results for advanced AMD. Conclusions Higher intakes of EPA and DHA may prevent or delay the occurrence of visually significant intermediate AMD. However, the totality of current evidence for EPA and DHA and advanced AMD is discordant, though there was no association with advanced AMD in the present study.

Docosahexaenoic acid, 22:6n‐3: Its roles in the structure and function of the brain

“…The data from intervention trials have been mixed, although the delayed progression of an intermediate type of age-related macular degeneration was reported earlier (Huang et al, 2008). The later studies did not find any positive effect on the agerelated macular after supplementation with n-3 LCPUFAs (Souied et al, 2015;Wu et al, 2017). The X-linked retinitis pigmentosa was shown to be improved with DHA supplementation (Hoffman et al, 2004).…”

Dietary intake of α-linolenic acid and risk of age-related macular degeneration ,

“…Correspondingly, intakes of EPA and DHA were also associated only with intermediate AMD but in the opposite direction (41). The reasons for the differential associations have been described (41). Briefly, we speculate that advanced AMD and a subset of intermediate AMD are 2 different disease processes, not just a continuum of progression, given the diverse clinical manifestations and underlying genetic profiles of AMD.…”

“…Correspondingly, intakes of EPA and DHA were also associated only with intermediate AMD but in the opposite direction (41). The reasons for the differential associations have been described (41).…”

Role of diet and food intake in age‐related macular degeneration: a systematic review

“…They also investigated the association of other dietary fats with AMD. Other studies such as Wu et al 17 and Christen et al 19 only looked at fewer omega-3 fatty acids (DHA + EPA) but included omega-6 fatty acids. They also found an increased risk of developing late AMD with a high consumption of trans-fats.…”

“…38 Hence, the consumption of vegetable oil products containing trans-fats should be kept to a minimum. Other studies such as Wu et al 17 and Christen et al 19 only looked at fewer omega-3 fatty acids (DHA + EPA) but included omega-6 fatty acids. Associations with AMD were also found.…”