Dietary Approaches to Prevent Age Related Macular Degeneration:A Review

Abstract

Age Related Macular Degeneration (ARMD) is the leading cause of irreversible blindness in older adults which has no cure and limited therapeutic options. ARMD may become an increasing concern in the developing countries like India as a result of socio-economic and dietary changes that accompany the economic development1. Diet is potentially one of the most cost effective strategies to prevent the development of end stage condition of ARMD. This review describes the current literature on the role of quality of diet and nutritional supplementation in prevention of advanced ARMD. Various researchers have explored the association between diet, nutrient intake and advanced ARMD. In the Age Related Eye Disease Study (AREDS), use of a daily antioxidant supplementation reduced the rate of progression from intermediate to advanced ARMD by 25% over a period of 5 years and resulted in a 19% reduction in the risk of moderate visual loss<sup>2</sup>. A high dietary fat intake was reported to be associated with a higher incidence of late ARMD whereas higher intakes of fish or n-3 fatty acids were associated with lower incidence of ARMD<sup>3</sup>. Chiu et al. reported that quality of dietary carbohydrates influences the risk of ARMD<sup>4</sup>. But at present, research shows insufficient evidence to recommend dietary modifications and nutritional supplementation in ARMD. Therefore to summarize, the temporal relationship of the diet to advanced ARMD, is a function of the quality of diet. Observational studies suggest that increased dietary intake of omega-3 fatty acids, macular carotenoids, antioxidants and oriental dietary pattern reduces the risk of ARMD whereas, poor dietary carbohydrates quality (as defined by dietary glycemic index) and western dietary pattern may increase the risk of ARMD.