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Intake of Vegetables, Fruit, and Fish is Beneficial for Age-Related Macular Degeneration

  • Alexandra P.M. de Koning-Backus
    Affiliations
    Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands

    Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands

    Department of Clinical Epidemiology, University of Amsterdam, Academic Medical Center, Amsterdam, The Netherlands
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  • Gabriëlle H.S. Buitendijk
    Affiliations
    Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands

    Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
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  • Jessica C. Kiefte-de Jong
    Affiliations
    Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands

    Leiden University College The Hague, The Hague, The Netherlands
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  • Johanna M. Colijn
    Affiliations
    Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands

    Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
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  • Albert Hofman
    Affiliations
    Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands

    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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  • Johannes R. Vingerling
    Affiliations
    Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands

    Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
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  • Elizabeth B. Haverkort
    Affiliations
    Department of Clinical Epidemiology, University of Amsterdam, Academic Medical Center, Amsterdam, The Netherlands

    Research Group Innovation in Preventive Care, Research Centre for Innovations in Health Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands
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  • Oscar H. Franco
    Affiliations
    Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
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  • Caroline C.W. Klaver
    Correspondence
    Inquiries to Caroline C.W. Klaver, Department of Ophthalmology, Department of Epidemiology, Erasmus Medical Centre, P.O. Box 2040, NL-3000 CA, Rotterdam, The Netherlands
    Affiliations
    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
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Published:October 09, 2018DOI:https://doi.org/10.1016/j.ajo.2018.09.036

      Purpose

      What patients should eat to reduce their risk of age-related macular degeneration (AMD) is still unclear. We investigated the effect of a diet recommended by Health Councils on AMD.

      Design

      Prospective population-based cohort study.

      Methods

      Four thousand two hundred and two participants from the Rotterdam Study ≥55 years of age who were free of AMD at baseline were included and followed up for 9.1 ± 5.8 years. Incident AMD was graded on fundus photographs. Dietary data were collected using a validated 170-item food frequency questionnaire, and food intakes were categorized into food patterns based on guidelines from Health Councils. Associations with incident AMD were analyzed using Cox proportional hazards models that were adjusted for age, sex, total energy intake, smoking, body mass index, hypertension, education, and income.

      Results

      Seven hundred fifty-four people developed incident AMD. Intake of the recommended amounts of vegetables (≥200 g/day), fruit (2×/day), and fish (2×/week) were 30.6%, 54.9%, and 12.5%, respectively. In particular, the intake of fish (2×/week) decreased the risk of incident AMD (hazard ratio 0.76 [95% confidence interval 0.60-0.97]). Intake of the recommended amounts of all 3 food groups was only 3.7%, but adherence to this pattern showed a further reduction of the risk of incident AMD (hazard ratio 0.58 [95% confidence interval 0.36-0.93]). Younger age, higher income, and not smoking were associated with this food pattern, but the risk-lowering effects remained significant after additional adjustment for these factors.

      Conclusion

      A diet of 200 grams per day of vegetables, fruit two times per day, and fish two times per week is associated with a significantly reduced risk of AMD.
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