Valentine’s Day and AREDS2: Perceptions and Reality
According to Arnie Seipel and National Public Radio, Valentine’s Day has a rather muddled history. Present day perceptions of Valentine’s Day with love, chocolates, flowers, jewelry and cards diverge from historical reality. In the world of 2014, today’s blog reflects on this quote from Stephen Colbert, “It used to be, everyone was entitled to their own opinion, but not their own facts. But that’s not the case anymore. Facts matter not at all. Perception is everything.”
Our perceptions are based upon experiences. Stories we read. Things we hear from the news and our friends. Perceptions can be fed, growing like cancer, until they overwhelm facts. Perceptions can seem like reality. Even in science. In 2014, unlike decades ago, a single scientific study can receive media attention when it is first presented at a scientific meeting, when it is released on line as a pre-publication, and when it is disseminated in final, printed form. The same research, warts and all, can be retold multiple times, shaping and feeding perception, even when the facts remain the same:
Too many people don’t eat enough of the right foods to obtain micronutrients nutrients essential for health, including the health of the eye. Choosing fortified and enriched foods can help fill ‘nutrient shortfalls’ (Dwyer et al, 2014)
Multivitamins are the most common supplement used. Multivitamins contribute to nutrient adequacy. People who don’t use dietary supplements need them the most (Bailey et al, 2011).
Participants using the AREDS formulation consisting of vitamin C, vitamin E, beta carotene, and zinc had a 25% reduced risk of developing late age-related macular degeneration (AMD) during the trial (AREDS, 2001)and the benefit persisted 5 years after the clinical trial ended (Chew et al, 2013).
AREDS2 found no significant effect, positively or harmfully, of adding lutein/zeaxanthin, omega-3 long-chain polyunsaturated fatty acids, or the combination to the original formula containing vitamins C, E, beta carotene and zinc (AREDS2, 2014). The primary outcome, progression to late AMD, was the same with the AREDS2 and AREDS formulations.
Returning to the construct of separating perception from reality. Regardless of the number of times the same study may be presented for media attention, the facts remain unchanged:
- The AREDS formulation with vitamin C, vitamin E, beta-carotene and zinc reduced AMD risk by 25%.
- Tweaking the AREDS formulation with the addition of lutein/zeaxanthin, omega-3 fatty acids, and the combination did not affect the primary outcome – progression to late AMD.
Dwyer JT, Woteki C, Bailey R, Britten P, Carriquiry A, Gaine PC, Miller D, Moshfegh A, Murphy MM, Smith Edge M. Fortification: new finds and implications. 2014 Nutr Rev doi: 10.1111/nure.12086
Bailey RL, Fulgoni VL, Keast DR, Dwyer JT. Dietary supplement use is associated with higher intakes of minerals from food sources. 2011 Am J Clin Nutr doi: 10.3945/ajcn.111.020289
Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss. AREDS report no 8, 2001 Arch Opthalmal doi: 10.1001/archopht.119.10.1417
Chew EY, Clemons TE, Agron E, SanGiovanni JP, Kurinij N, Davis MD, . Age-Related Eye Disease Study Research Group. The relationship of dietary carotenoids, vitamin E, and vitamin C with age-related macular degeneration in a case-control study: AREDS report no 22. 2013 Arch Opthalmol doi: 10.1016/j.optha.2013.01.021
Age-related Eye Disease Study 2 (AREDS2) Research Group. Secondary analyses of the effects of lutein/zeaxanthin on age-related macular degeneration progression. 2014 JAMA Opthalmol doi: 10.1001/jamaopthalmol.2013.7376