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Ophthalmology. 2018 Aug 13. pii: S0161-6420(18)30721-8. doi: 10.1016/j.ophtha.2018.08.006. [Epub ahead of print]

Mediterranean Diet and Incidence of Advanced Age-Related Macular Degeneration: The EYE-RISK Consortium.

Author information

1
Team LEHA, Bordeaux Population Health Research Center, Inserm, Université de Bordeaux, Bordeaux, France. Electronic address: benedicte.merle@u-bordeaux.fr.
2
Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
3
Team LEHA, Bordeaux Population Health Research Center, Inserm, Université de Bordeaux, Bordeaux, France.
4
Team LEHA, Bordeaux Population Health Research Center, Inserm, Université de Bordeaux, Bordeaux, France; Service d'Ophtalmologie, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France.
5
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
6
Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands.
7
Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team LEHA, UMR 1219, F-33000 Bordeaux, France.
8
Centre for Ophthalmology, Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, University Clinic Tuebingen, Tuebingen, Germany.
9
Assay Development, AYOXXA Biosystems GmbH, Cologne, Germany.
10
Department of Regeneration and Cell Therapy, Andalusian Molecular Biology and Regenerative Medicine Centre (CABIMER), Seville, Spain.
11
Barcelona Macula Foundation, Barcelona, Spain.
12
Business Development, AYOXXA Biosystems GmbH, Cologne, Germany.
13
Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands.
14
Department of Ophthalmology, Radboud university medical center, Nijmegen, the Netherlands.
15
Department of Ophthalmology, Radboud university medical center, Nijmegen, the Netherlands; Department of Human Genetics, Radboud university medical center, Nijmegen, the Netherlands.
16
Centre for Experimental Medicine, Queen's University Belfast, Belfast, United Kingdom.
17
Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Ophthalmology, Radboud university medical center, Nijmegen, the Netherlands.
18
Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland.
19
Institute of Ophthalmology, University College London, London, United Kingdom.
20
Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.
21
Ocular biology, UCL Institute of Opthalmology, London, United Kingdom.
22
Centre for Ophthalmology, Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, University Clinic Tuebingen, Tuebingen, Germany; Department of Ophthalmology, University Medical Centre Tübingen, Tuebingen, Germany.
23
Research and & Development, AYOXXA Biosystems GmbH, Cologne, Germany.

Abstract

PURPOSE:

To investigate associations of adherence to the Mediterranean diet (MeDi) with incidence of advanced age-related macular degeneration (AMD; the symptomatic form of AMD) in 2 European population-based prospective cohorts.

DESIGN:

Prospective cohort study of the Rotterdam Study I (RS-I) and the Antioxydants, Lipides Essentiels, Nutrition et Maladies Oculaires (Alienor) Study populations.

PARTICIPANTS:

Four thousand four hundred forty-six participants 55 years of age or older from the RS-I (The Netherlands) and 550 French adults 73 years of age or older from the Alienor Study with complete ophthalmologic and dietary data were included in the present study.

METHODS:

Examinations were performed approximately every 5 years over a 21-year period (1990-2011) in RS-I and every 2 years over a 4-year period (2006-2012) in the Alienor Study. Adherence to the MeDi was evaluated using a 9-component score based on intake of vegetables, fruits, legumes, cereals, fish, meat, dairy products, alcohol, and the monounsaturated-to-saturated fatty acids ratio. Associations of incidence of AMD with MeDi were estimated using multivariate Cox proportional hazard models.

MAIN OUTCOMES MEASURES:

Incidence of advanced AMD based on retinal fundus photographs.

RESULTS:

Among the 4996 included participants, 155 demonstrated advanced incident AMD (117 from the RS-I and 38 from the Alienor Study). The mean follow-up time was 9.9 years (range, 0.6-21.7 years) in the RS-I and 4.1 years (range, 2.5-5.0 years) in the Alienor Study. Pooling data for both the RS-I and Alienor Study, participants with a high (range, 6-9) MeDi score showed a significantly reduced risk for incident advanced AMD compared with participants with a low (range, 0-3) MeDi score in the fully adjusted Cox model (hazard ratio, 0.59; 95% confidence interval, 0.37-0.95; P = 0.04 for trend).

CONCLUSIONS:

Pooling data from the RS-I and Alienor Study, higher adherence to the MeDi was associated with a 41% reduced risk of incident advanced AMD. These findings support the role of a diet rich in healthful nutrient-rich foods such as fruits, vegetables, legumes, and fish in the prevention of AMD.

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