Update from ARVO 200

ARVO is the acronym for the Association for Research in Vision and Ophthalmology. Most of the world’s best researchers in eye disease attend the annual ARVO meeting which was recently held in Fort Lauderdale, Florida. There were a number of reports that dealt with diet and the risk of AMD. Most of us had thought that omega-6 fatty acids (linoleic acidor LA) was bad for AMD and that omega-3 (linolenic or ALA) fatty acids might reduce the risk of AMD (see blogs 8/4,8/12, 8/22-3 and 11/9). Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are the omega-3 acids that are normally found in the body. AREDS II is testing whether one gram a day of DHA retards the rate of progression of AMD. ARED II is also testing whether supplementation with lutein and zeaxanthin reduces the progression of AMD.

Here is the latest from ARVO:

1. Fletcher and associates found that higher levels of either LA (supposedly the bad one) or ALA were associated with less risk of AMD. They basically found no association with DHA or EPA.




2. SanGiovanni and associates found that AMD patients with the highest dietary intake of DHA and EPA were 20-25% less likely to progress to severe AMD.




3. Robman and associates found that higher dietary intake of omega-3 fatty acids or lutein/zexanthin actually increased the rate of AMD progression.




4. Hodge and associates reviewed published studies and found the results concerning the protective effect of omega-3 fatty acids varied greatly. The effect varied from being protective to neutral to actually harmful in preventing AMD.




5. Souied and colleagues found that patients with wet AMD had low serum of DHA.




6. Chong and associates found no association between late AMD and dietary intake of LA, ALA, lutein or zexanthin. They found that fried fish increased the risk of late AMD but steamed, grilled, or baked fish decreased the risk. They also found that olive oil decreased the risk.




7. Rosenthal and associates found that high dietary intake of lutein/zeaxanthin reduced the risk of wet AMD.

As you can see the results of the studies were varied. These studies point to the need of a randomized controlled trial testing whether supplementation with DHA and or lutein/zexanthin reduces the risk of progression to severe AMD. That is exactly what AREDS II will do and recruitment into the trial will start soon.
So what should you do? I would participate in the AREDS II if possible. If you cannot I would take the vitamins recommend from the AREDS trial (see blog June 29, 2006). I would also limit my intake of animal fat and I would eat baked, steamed, or grilled fish at least once a week. I would also use olive oil instead of other oils such as soy, sunflower, peanut, and corn oils all of which have a high content of LA and little ALA. And of course, eat colorful fruits and vegetables.
You can also purchase our book if you wish which, among many other things, discusses diet, vitamins, and other supplements in detail.

References

1. Fletcher AE, et al. Omega Fatty Acids and Age-Related Macular Degeneration in the Eureye Study. Invest Ophthalmol Vis Sci 2006; ARVO E-Abstract 1132. [Available from http://www.arvo.org/eweb/DynamicPage.aspx?site=am&WebCode=AbstractSearch]
2. SanGiovanni JP, et a;. Dietary Lipid Intake and Vision Loss in the Age-Related Eye Disease Study. Invest Ophthalmol Vis Sci 2006; ARVO E-Abstract 2193/B772. [Available from http://www.arvo.org/eweb/DynamicPage.aspx?site=am&WebCode=AbstractSearch]
3. Robman L, et al. The Role of Carotenoids and Fats in the progression of Age-Related Macular Degeneration. Invest Ophthalmol Vis Sci 2006; ARVO E-Abstract 2198/B777. [Available from http://www.arvo.org/eweb/DynamicPage.aspx?site=am&WebCode=AbstractSearch]
4. Hodge WG, et al. The Efficacy of Omega-3 Fatty Acids in Preventing Age Related Macular Degeneration – A Systemic Review. Invest Ophthalmol Vis Sci 2006; ARVO E-Abstract 2174/B853. [Available from http://www.arvo.org/eweb/DynamicPage.aspx?site=am&WebCode=AbstractSearch]
5. Souied EH, et al. NAT-2. Report #1 : High HDL and Low PUFAs Levels in Exudative AMD Patients. Invest Ophthalmol Vis Sci 2006; ARVO E-Abstract 2181/B760. [Available from http://www.arvo.org/eweb/DynamicPage.aspx?site=am&WebCode=AbstractSearch]
6. Chong EW, et al. The Associations of Dietary Lutein, Zeaxanthin and Fats with Age-Related Macular Degeneration : The Melbourne Collaborative Cohort Study. Invest Ophthalmol Vis Sci 2006; ARVO E-Abstract 1133. [Available from http://www.arvo.org/eweb/DynamicPage.aspx?site=am&WebCode=AbstractSearch]
7. Rosenthal JM, et al. A Dietary Antioxidant Index and Risk for Advanced Age-Related Macular Degeneration in the Age-Related Eye Disease Study. Invest Ophthalmol Vis Sci 2006; ARVO E-Abstract 1134. [Available from http://www.arvo.org/eweb/DynamicPage.aspx?site=am&WebCode=AbstractSearch]