Abstract
The role of diet and circulatory carotenoids and docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are implicated in age-related macular degeneration (AMD) but not well studied in Chinese. However, other fatty acids were not comprehensively evaluated if it had additional consequence on AMD. This study investigated the relationship among dietary habits, fatty acids levels, carotenoids and AMD in Hong Kong Chinese adults. In this cross-sectional case-controlled study, plasma fatty acids including, saturated fatty acids (SFA), monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA), and carotenoids levels were quantified between patients with neovascular AMD (n = 99) and age-gender-matched controls (n = 198). A food frequency questionnaire was also conducted. Low blood carotenoid levels and omega-3 PUFAs namely DHA, EPA and α-linolenic acid increased the odds ratio of developing neovascular AMD. High blood omega-6 PUFAs specifically arachidonic acid and eicosadienoic acid, oleic acid (a MUFA) and SFA levels increased the odds ratio of having neovascular AMD. Neovascular AMD group had significantly less omega-3 PUFA rich food (vegetables, nuts, seafood) intake and higher SFA (meat) intake than controls. In short, neovascular AMD was associated with lower circulatory levels of carotenoids and omega-3 PUFAs, and higher level of omega-6 PUFAs, oleic acid and SFAs in the Hong Kong Chinese population. These findings enhance the understandings of dietary impacts on neovascular AMD and provide a context for future nutritional intervention studies.
Highlights
Age-related macular degeneration (AMD) is a leading cause of blindness in the developed world and mainly affects people over 50 years of age
The role of specific dietary nutrients, such as, polyunsaturated fatty acids (PUFA), and carotenoids plus vitamins C and E, zinc and copper are effective in reducing the risk of development and progression from preclinical age-related macular degeneration (AMD) to a more advanced form of AMD owing to their antioxidant and photo-protective
There are very few studies looking at the relationship of circulatory levels of fatty acids and carotenoids, and AMD, especially in the Asian population where dietary intake of lipids is different compared to Western populations
Summary
Age-related macular degeneration (AMD) is a leading cause of blindness in the developed world and mainly affects people over 50 years of age. The role of specific dietary nutrients, such as, polyunsaturated fatty acids (PUFA), and carotenoids (lutein, zeaxanthin and beta-carotene) plus vitamins C and E, zinc and copper are effective in reducing the risk of development and progression from preclinical AMD to a more advanced form of AMD owing to their antioxidant and photo-protective. The most important PUFA in humans are the omega-3 PUFA, which include α-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). ALA is a precursor of EPA, which is a precursor of DHA in the omega-3 PUFA metabolism. EPA and DHA have anti-inflammatory properties, and a reduced level is implicated in AMD [4]. Carotenoids (i.e., lutein, zeaxanthin and beta-carotene) are important antioxidants, and being fat-soluble, they interact with PUFA metabolism
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