%T Mediterranean Diet and Incidence of Advanced Age-Related Macular Degeneration: The EYE-RISK Consortium
%P 381-390
%D 2019
%V 126
%A BMJ Merle
%A JM Colijn
%A A Cougnard-Grégoire
%A APM de Koning-Backus
%A MN Delyfer
%A JC Kiefte-de Jong
%A M Meester-Smoor
%A C Féart
%A T Verzijden
%A C Samieri
%A OH Franco
%A JF Korobelnik
%A CCW Klaver
%A C Delcourt
%A S Ajana
%A B Arango-Gonzalez
%A A Armento
%A V Arndt
%A V Bhatia
%A SS Bhattacharya
%A M Biarnés
%A A Borrell
%A S Bühren
%A SM Calado
%A JM Colijn
%A A Cougnard-Grégoire
%A S Dammeier
%A EK de Jong
%A B De la Cerda
%A C Delcourt
%A AI den Hollander
%A FJ Diaz-Corrales
%A S Diether
%A E Emri
%A T Endermann
%A LL Ferraro
%A M Garcia
%A TJ Heesterbeek
%A S Honisch
%A CB Hoyng
%A E Kersten
%A E Kilger
%A CCW Klaver
%A H Langen
%A I Lengyel
%A P Luthert
%A C Maugeais
%A M Meester-Smoor
%A BMJ Merle
%A J Monés
%A E Nogoceke
%A T Peto
%A FM Pool
%A E Rodríguez
%A M Ueffing
%A KU Ulrich Bartz-Schmidt
%A EM van Leeuwen
%A T Verzijden
%A M Zumbansen
%A V Vasiliev
%L discovery10063769
%N 3
%K AMD, age-related macular degeneration, Alienor, Antioxydants, Lipides Essentiels, Nutrition et Maladies Oculaires, AREDS, Age-Related Eye Disease Study, ARMS2, Age-Related Maculopathy Susceptibly 2, CAREDS, Carotenoids in Age-Related Eye Disease Study, CFH, complement factor H, CI, confidence interval, FFQ, food frequency questionnaire, HR, hazard ratio, MeDi, Mediterranean diet, MUFA, monounsaturated fatty acid, PREDIMED, Prevención con Dieta Mediterránea, RS-I, Rotterdam Study I, SFA, saturated fatty acid, TEI, total energy intake
%J Ophthalmology
%X 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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