Age-Related Macular Degeneration Risk is Influenced by Vitamin D Status
Age-related macular degeneration (AMD) is the leading cause of visual impairment and blindness as people age. Two large RCTs (AREDS and AREDS2) have demonstrated that increased consumption of antioxidant nutrients (vitamins C, E, zinc, copper, beta-carotene, lutein, zeaxanthin) can significantly decrease the progression of AMD by ~27%.
The CARED study measured pigment density (MPOD) of lutein and zeaxanthin in the macula of the retina of 1,803 individuals. Dietary lutein and zeaxanthin intake, serum concentrations and MPOD were measured. MPOD were correlated with food frequency intake but serum concentrations were a much stronger predictor of MPOD.
Because vitamin D plays a role in inflammation and immune function, Millen and associates examined the relationship between vitamin D status (serum 25(OH)D3 concentrations), polymorphisms in vitamin D genes, and AMD risk in a subset (913) of CARED participants. 10% and 30% were vitamin D deficient or suboptimal with serum concentrations <30 nmol/L or between 20 and 50 nmol/L, respectively. Having deficient or suboptimal vitamin D concentrations, increased the odds of AMD by 2.6 and 1.5 fold. The greatest risk was in vitamin D deficient women with 2 high-risk alleles (CFH or CFI).
Low serum concentrations of antioxidant nutrients have previously been associated with increased risk of AMD. This study confirms that vitamin D status and genetics may also influence AMD risk. Without measurements of MPOD or vitamin status, one can only guess if their dietary habits are optimized for longterm health.
Millen AE, Meyers KJ, Liu Z, Engelman CD, Wallace RB, LeBlanc ES, Tinker LF, Lyengar SK, Robinson JG, Sarto GE, Mares JA. Association between vitamin D status and age-related macular degeneration by genetic risk. 2015 JAMA Opthalmol doi: 10.1001/jamaopthalmol.2015.2715
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 Opthalmol doi: 10.1001/archopht.119.10.1417
AREDS2 Research Group. Secondary analyses of the effects of lutein/zeaxanthin on age-related macular degeneration progression: AREDS2 Report No. 3. 2014 JAMA doi: 10.1001/jamaopthalmol.2013.7376
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