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TalkingNutrition

Providing perspectives on recent research into vitamins and nutritionals

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Hey Baby Boomers! Two Suggestions to Protect Your Vision

By Michael McBurney

According to the pundits, many elected leaders are lacking vision. TalkingNutrition cannot verify these observations but we can talk about nutrition and age-related vision loss. Visual impairment is defined as a reduction in clarity with which a person sees objects.The estimated total annual cost of visual impairment (and blindness) among Americans ≥40 years of age is $5.5 billion. The personal consequences are even greater.

Chou and colleagues analyzed nationally representative data (NHANES) collected from 5,222 Americans ≥40y.  The overall age-standardized prevalence of visual impairment in US adults was 7.5%. The highest incidence was found in people ≥80y (26.3%), followed by 70-79y (10.1%), 60-69y (6.7%), 50-59y (4.4%) and 40-49y (5.0%).  So age affects vision. 75% of American adults with impaired vision would benefit from new eyeglasses, contact lenses, or refractive surgery.  The remaining 2.2 million people in the US had poor vision because of age-related macular degeneration (AMD), glaucoma or diabetic retinopathy. Let’s focus on AMD, a leading cause of visual loss.

In the Rotterdam Study, Ho and colleagues reported that high dietary intakes of antioxidants (beta-carotene, lutein, zeaxanthin, zinc, etc) and omega-3 fatty acids (EPA and DHA) reduces the risk of early AMD in people with genetic risk.  The National Eye institute found that individuals, at varying stages of AMD, can reduce their risk of developing advanced AMD by ≈25% by using the AREDS dietary formulation (500mg vitamin C, 400IU vitamin E, 15mg beta-carotene, 80mg zinc as zinc oxide and 2 mg copper as copper oxide).  After 10 years of follow up, Chew and colleagues reported a 34% lower risk (Odds Ratio) of developing advanced AMD in individuals continuing with the AREDS formulation.

The AREDS2 study tested the impact of tweaking the carotenoid and omega-3 content of the AREDS formulation. The tweaks did not statistically affect primary outcomes (progression to advanced AMD relative to standard care treatment with AREDS formulation. Secondary analyses found benefits of taking 10mg lutein and 2mg zeaxanthin daily among those with low dietary intakes of lutein and zeaxanthin.

In their analysis of the population data, Chou and associates  write that the prevalence of visual impairment not due to refractive error is significantly higher among people with AMD (2.2%) than those without AMD (0.8%).  The odds ratio is >4 times higher.  They recommend better screening of older people to help identify and manage those at risk of losing their vision.

Here are our 2 recommendations: 1. Eat more fruit and vegetables. 2. Supplement wisely.  If you live in the US, there are two excellent resources to find foods (USDA National Nutrient Database )and supplements (Dietary Supplements Label Database) that are rich in the AREDS nutrients.-mm-

Citations

Chou C-F, Cotch MF, Vitale S, Zhang Z, Klein R, Friedman DS, Klein BEK, Saaddine JB. Age-related eye diseases and visual impairment among US adults. 2013 Am J Prevent Meddoi:10.116/j.amepre.2013.02.018

Ho L, van Leeuwen R, Witteman JCM, van Duijn CM, Uitterlinden AG, Hofman A, de Jong PTVM, Vingerling JR, Klaver CCW. Reducing the genetic risk of age-related macular degeneration with dietary antioxidants, zinc and w-3 fatty acids.  Arch Ophthalmol. 2011;129(6):758-766. doi:10.1001/archophthalmol.2011.141

Chew EY, Clemons TE, Agron E, Sperduto RD, SanGiovanni P, Kurinij N, Davis MD, Age-Related Eye Disease Study Group. Long-term effects of vitamins C and E, β-carotene, and zinc on age-related macular degeneration: AREDS Report No 35. 2013 J Opthalmol doi:10.1016/j.ophtha.2013.01.021

The Age-Related Eye Disease Study 2 (AREDS2) Research Group. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: The Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. 2013 JAMA doi:10.1001/jama.2013.4997


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