Using data from 2 large, population-based prospective studies, researchers investigated the association between a Mediterranean diet and incidence of advanced AMD.

Study design

Investigators included 4,996 patients aged 55 years or older were who were enrolled in the Rotterdam Study I and the Alienor Study from France in this analysis. Patients in the Rotterdam study were examined and completed food questionnaires every 5 years over a 21-year period, while patients in the Alienor Study were seen every 2 years over a 4-year period. Participants were followed for an average of 10 years (range 1 to 20 years) and graded on their adherence to a Mediterranean diet.

Researchers quantified daily intake of vegetables, fruits, legumes, cereals, fish, meat, dairy, alcohol, and the ratio of monounsaturated-to-saturated fatty acids.

Outcomes

Patients with a high Mediterranean diet score (6 to 9 points on a scale of 0 to 9) had an approximately 40% reduced probability in developing advanced AMD compared with patients with a low adherence to this diet (0 to 3 points).

Limitations

While this cohort study was well designed, only 155 developed AMD during the course of the study. These populations were fairly homogenous and may not be representative of other populations from other communities.

Clinical significance

In this study, the authors found that each individual food category did not offer any significant protective effects. However, adhering to a Mediterranean diet more comprehensively reduced the risk of developing advanced AMD.

Ophthalmologists have an opportunity to engage both patients with macular degeneration as well as their concerned friends and family in a discussion about the importance of lifestyle changes that may reduce the risk of developing vision loss. Numerous studies, including this one, suggests that eating “real” food primarily focused on fruits and vegetables seems to be helpful. Limiting dairy and meat is also beneficial. If patients remain unconvinced, a glass of wine gets them as much credit as a serving of broccoli. That diet is one that many people can get behind.