AMD FACTS (1)
- Age-related macular degeneration (AMD) is the leading cause of irreversible visual impairment in developed countries.
- 50% of blindness in the United States is attributed to AMD.
- The prevalence of AMD is expected to double over the next 20 years without effective strategies for prevention and treatment to slow progression.
RISK FACTOR S FOR AMD (1 – 3)
- Genetic predisposition
- Genetics affecting response to nutrients related to eye health
- Suboptimal levels of nutrients, particularly lutein and zeaxanthin
- Elevated cholesterol, particularly HDL cholesterol
- Exposure to UV light and blue light
NUTRITION FOR AMD
Balanced Blood Sugar
The glycemic index measures the ability of a food to raise blood sugar levels. Studies show that consumption of high glycemic foods is associated with a greater risk for AMD and AMD progression.4 Low glycemic diets in combination with DHA (a type of essential omega-3 fatty acid) consumption may be even more impactful for slowing AMD progression in patients with the condition.4 Intermittent fasting and other methods of balancing blood sugar may also be beneficial.
Choose clean proteins, healthy fats, organic vegetables and fiber-rich foods.
“PERSONS AT RISK FOR AMD OR HAVE INTERMEDIATE AMD OR WORSE SHOULD CONSIDER A DIET REPLETE WITH FISH AND GREEN LEAFY VEGETABLES.”5
Green Leafy Vegetables
Greens are excellent sources of key nutrients for AMD: the macular pigments lutein and zeaxanthin, and vitamin C, which can limit damage by protecting against cellular injury and oxidative stress.
Choose organic dark leafy greens like arugula, spinach, kale, chard, collards, and dandelion greens.
DHA is needed for the integrity of the retinal cells, and has been shown to promote retinal development and repair by regulating gene expression and modulating immune and inflammatory processeses.6 Observational studies suggest that consuming fish may reduce the risk of AMD, however fish oil supplementation did not affect disease progression in those who already had evidence of AMD.5
Choose wild fish high in DHA such as salmon, sardines, mackerel and herring.
A variety of carotenoids (yellow-orange pigments in the vitamin A family) have been studied with regard to AMD. 10 mg of lutein and 2 mg of zeaxanthin per day have strong data for improving vision and preventing, reversing, or slowing AMD progression.2,7 4 mg of astaxanthin may also be helpful in combination with the above,4 and the carotenoids in saffron may be supportive as well.8 These carotenoids are considered a safe and more effective alternative to beta-carotene, particularly for those who have a history of smoking.5
Sources of carotenoids include green leafy vegetables, and yellow-orange foods such as eggs, peppers, melons, carrots, oranges and squash.
Vitamin C & Vitamin E
500 mg of vitamin C and 400 mg of vitamin E in combination with lutein and zeaxanthin have been shown to slow the progression of AMD by about 25%.5 Vitamin C is abundant in leafy greens, cruciferous vegetables and citrus fruits.
Vitamin E can be found in nuts, seeds and leafy greens.
40 mg to 80 mg daily has been shown to slow AMD progression in those with intermediate or advanced AMD.7 Genetics play a role in whether zinc is a beneficial nutrient for AMD in certain individuals.1
Zinc is abundant in nuts and seeds, as well as animal proteins, fish and legumes.
Preliminary research suggests that curcumin, found in turmeric, may be a supportive compound, as it has been shown to reduce oxidation in retinal cells of those with AMD as well as gene expression of oxidative biomarkers.9, 10
1.Downie LE, Keller PR. Nutrition and age-related macular degeneration: research evidence in practice. Optom Vis Sci. 2014;91(8):821-831.
2.Behm VAY. Supplemental Use of the Carotenoids Lutein and Zeaxanthin. Jacobs Journal of Food and Nutrition. 2015.
3. Fan Q, Maranville JC, Fritsche L, et al. HDL-cholesterol levels and risk of age-related macular degeneration: a multiethnic genetic study using Mendelian randomization. Int J Epidemiol. 2017;46(6):1891-1902.
4.Schleicher M, Weikel K, Garber C, Taylor A. Diminishing risk for age-related macular degeneration with nutrition: a current view. Nutrients. 2013;5(7):2405-2456.
5.Chew EY. Nutrition, Genes, and Age-Related Macular Degeneration: What Have We Learned from the Trials? Ophthalmologica. 2017;238(1-2):1-5.
6.Chew EY, Clemons T, SanGiovanni JP, et al. The Age-Related Eye Disease Study 2 (AREDS2): study design and baseline characteristics (AREDS2 report number 1). Ophthalmology. 2012;119(11):2282-2289.
7. Macular degeneration. AOA.org. https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/macular-degeneration?sso=y. Accessed October 1, 2021.
8.Heitmar R, Brown J, Kyrou I. Saffron (Crocus sativus L.) in Ocular Diseases: A Narrative Review of the Existing Evidence from Clinical Studies. Nutrients. 2019;11(3):649.
9.Chang Y-C, Chang W-C, Hung K-H, et al. The generation of induced pluripotent stem cells for macular degeneration as a drug screening platform: identification of curcumin as a protective agent for retinal pigment epithelial cells against oxidative stress. Front Aging Neurosci. 2014;6:191-191.
10.Zhu W, Wu Y, Meng YF, et al. Effect of curcumin on aging retinal pigment epithelial cells. Drug Des Devel Ther. 2015;9:5337-5344. Published 2015 Sep 25. doi:10.2147/DDDT.S84979