Dietary n-3 Fatty Acid, α-Tocopherol, Zinc, vitamin D, vitamin C and β-carotene are Associated with Age-Related Macular Degeneration in Japan

Abstract

This case-control study reports the association between nutrient intake and neovascular age-related macular degeneration (AMD) in Japan. The nutrient intake of 161 neovascular AMD cases from two university hospitals and 369 population-based control subjects from a cohort study was assessed using a brief-type self-administered questionnaire on diet history, which required respondent recall of the usual intake of 58 foods during the preceding month. Energy-adjusted nutrient intake values were compared between the groups. Logistic regression analysis was used to estimate odds ratios (ORs) and 95% CIs adjusted for smoking history, age, sex, chronic disease history, supplement use, and alcohol consumption. Logistic regression analysis demonstrated that low intakes of n-3 fatty acid, α-tocopherol, zinc, vitamin D, vitamin C, and β-carotene were associated with neovascular AMD (Trend P < 0.0001 for n-3 fatty acid, Trend P < 0.0001 for α-tocopherol, Trend P < 0.0001 for zinc, Trend P = 0.002 for vitamin D, Trend P = 0.04 for vitamin C, Trend P = 0.0004 for β-carotene). There was no association with retinol or cryptoxanthin intake and neovascular AMD (P = 0.67, 0.06).

Intake of key micronutrients and food groups in patients with late-stage age-related macular degeneration compared with age–sex-matched controls

“…Our findings that AMD cases had lower intakes of vitamins C and E and beta-carotene concur with a recent Japanese case–control study,21 which also showed significant differences in dietary intake of vitamins C and E and beta-carotene between patients with AMD and healthy controls. AREDS demonstrated that intake of high doses of vitamins C and E and beta-carotene alone was not sufficient, but rather required the addition of zinc to reduce the risk of neovascular AMD,5 and the high dose of vitamin E (400 IU) recommended by AREDS is likely to be only achieved by vitamin E supplementation 21.…”

“…AREDS demonstrated that intake of high doses of vitamins C and E and beta-carotene alone was not sufficient, but rather required the addition of zinc to reduce the risk of neovascular AMD,5 and the high dose of vitamin E (400 IU) recommended by AREDS is likely to be only achieved by vitamin E supplementation 21. Our results therefore reinforce the importance of all the micronutrients and antioxidants in the AREDS formulation in reducing rates of progression of late AMD.…”

“…A high dose of zinc (80 mg) alone, which can again only be obtained by supplementation was found to be sufficient to reduce the risk of progression to neovascular AMD in the AREDS cohort 5 21. AREDS2 tested a lower dose of zinc (25 mg daily) and the results showed no impact on safety and an observed, non-significant, higher progression rate and therefore the investigators recommended retaining the 80 mg dose in the formulation 7.…”

Nutritional and Lifestyle Interventions for Age‐Related Macular Degeneration: A Review

“…Zinc is a cofactor of many active ocular enzymes, including superoxide dismutase and catalase [8, 72]. Zinc also binds complement factor H, inducing large multimeric forms that loose complement 3b inhibitory activity [73].…”

“…For example, in Japan, the prevalence of neovascular AMD has changed drastically. AMD was not registered in 1994 and now is the fourth-leading cause of visual disability [8], although it remains relatively low compared with Western countries [8]. …”