Nutrition and Macular Degeneration

The Age Related Eye Disease Study (AREDS) was a large clinical trial, which took place at eleven medical centers across the United States to learn more about the role of nutrition in preventing vision loss. It was funded and organized by the National Eye Institute, one of the National Institutes of Health. This study was to determine if antioxidant vitamins and/or zinc could slow the progression of cataracts and ARMD.  It was found that cataracts were not influenced by high dose supplementation of antioxidant vitamins and zinc.  For those patients, the study showed a modest risk reduction of 10%. Patients with minimal ARMD did not show benefit.  Patients with severe visual loss already probably do not benefit.  Certainly, vitamin supplementation does not bring back lost vision.

The 3,640 participants in AREDS who benefited the most took Vitamin A in the form of beta carotene, (15 mg.), Vitamin C (500 mg.), Vitamin E (400 IU), Zinc oxide (80 mg.) and Copper (in the form of cupric oxide, 2 mg.). Those of you who are already knowledgeable about eye health supplements may wonder why the carotenoids naturally found in the macula — Lutein and Zeaxanthin, were not included.  These products were not available at the time the study began.  AREDS investigators admitted that Lutein and Zeaxanthin are probably quite important and that they would have been included in the study had they been available at the time.  They also have stated that the amount of zinc used in AREDS was probably significantly more than was needed.  Copper was included only because high amounts of zinc tend to deplete the body of copper.  It should also be noted that beta carotene has been shown to increase the risk of lung cancer in people who smoke.  Vitamin A in the form of Vitamin A Palmitate is not recommended.

An alternative to taking supplements is to consume these nutrients in foods.  The best way to accomplish this is to eat a diet high in fruits and vegetables.  The foods highest in Lutein are dark green, leafy vegetables, such as spinach.  Those who take Coumadin or other “blood thinners” may not want to consume too much spinach, however, because it is also high in Vitamin K, which can impair the actions of these medications.

A study at Harvard Medical School showed an increased risk of ARMD in people who eat a lot of the fats found in potato chips, snack foods, french fries, margarine and vegetable shortening.   Many of these oils become oxidized (rancid) very quickly and are then more damaging to cellular tissues.  Oils become oxidized by heat, light and air.  You should never use cooking oils that have become darkened in color or have a disagreeable odor.  Try to use cooking oils such as olive oil or canola oil as they do not become oxidized as quickly.  Try to purchase them as fresh and light in color as possible.

Always store cooking oils in airtight containers and keep them as cool as possible (refrigerator is best even if you have to run the container under hot water to soften it for use).

On the other hand, those who ate two or more servings of fish each week, which contains a different type of fat, had a decreased risk for ARMD. This could also be accomplished by taking Flaxseed Oil.

By food selection and/or vitamin supplements consume the following nutrients:

Vitamin A (beta carotene) — 4 mg. to 16 mg. per day (2,000 to 9,000 IU).  If you smoke, you should not take beta carotene as there is some concern that it can cause an increase in lung cancer in smokers.

Vitamin C — 200 mg. to 500 mg. per day

Vitamin E — 150 IU to 400 IU per day

Zinc Oxide — 30 mg. to 50 mg. per day

Copper — about 2 mg. per day

Lutein — 4 mg. to 12 mg. per day

Zeaxanthin — .5 mg. to 2 mg. per day

Bilberry extract also seems to be helpful for macular degeneration.  Bilberry is a European form of blueberry.  It is grown primarily for the purple pigment which seems to be the effective component.  We do not yet have a recommended dosage.

Since these supplements exceed the Recommended Daily Allowances (RDA’s), you should inform your physician before you begin to take them.  Higher doses (or prices) don’t necessarily mean the product is better.

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