Fat Intake Modifies Progression of Age-Related Macular Degeneration

Laurie Barclay, MD

December 08, 2003

Dec. 8, 2003 — Most types of dietary fat are associated with increased risk of progression to advanced age-related macular degeneration (AMD), whereas nuts and fish are protective, according to the results of a prospective cohort study published in the December issue of the Archives of Ophthalmology.

"We found that higher levels of dietary fat intake were associated with the progression of AMD to the advanced stages associated with visual loss," write Johanna M. Seddon, MD, ScM, from the Massachusetts Eye and Ear Infirmary in Boston, Massachusetts, and colleagues. "Specifically, higher intake of vegetable fat, and to a lesser extent animal fat, increased rates of progression."

The 261 patients in this study were at least 60 years of age and had some sign of nonexudative AMD and visual acuity of 20/200 or better in at least one eye. Average follow-up was 4.6 years.

Based on food frequency questionnaires reflecting dietary patterns in the previous week, consumption of dietary fats and fat-containing food groups increased the risk of progression to advanced AMD, defined as having geographic atrophy or neovascular disease. Fish and nut consumption reduced the risk.

Relative risk for progression to advanced AMD with higher fat intakes was 2.90 for total fat (95% confidence interval [CI], 1.15 - 7.32), 2.29 for animal fat (95% CI, 0.91 - 5.72), 3.82 for vegetable fat (95% CI, 1.58 - 9.28), 2.09 for saturated fat (95% CI, 0.83 - 5.28), 2.21 for monounsaturated fat (95% CI, 0.90 - 5.47), 2.28 for polyunsaturated fat (95% CI, 1.04 - 4.99), and 2.39 for transunsaturated fat (95% CI, 1.10 - 5.17).

"Saturated, monounsaturated, polyunsaturated, and transunsaturated fats were also related to progression. Food groups with higher levels of these fats, particularly processed baked goods, were also associated with a higher rate of progression of AMD, except for nuts, which were protective," the authors write. "Thus, dietary intake of fat, including specific types of fat as well as fat-containing foods, is a potentially important behavior that can modify the outcome for patients who already have the early or intermediate forms of AMD."

The Foundation Fighting Blindness, Inc.; the Massachusetts Lions Eye Research Fund, Inc.; Research to Prevent Blindness, Inc.; the Epidemiology Unit Research Fund, Massachusetts Eye and Ear Infirmary; and a Lew R. Wasserman Merit Award from Research to Prevent Blindness to Dr. Seddon supported this study.

Arch Ophthalmol. 2003;121:1728-1737

Reviewed by Gary D. Vogin, MD

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