The relationship of major American dietary patterns to age-related macular degeneration

Abstract

Purpose: We hypothesized that major American dietary patterns are associated with risk for age-related macular degeneration (AMD).

Design: Cross-sectional study.

Methods: We classified 8103 eyes in 4088 eligible participants in the baseline Age-Related Eye Disease Study (AREDS). They were classified into control (n = 2739), early AMD (n = 4599), and advanced AMD (n = 765) by the AREDS AMD Classification System. Food consumption data were collected by using a 90-item food frequency questionnaire.

Results: Two major dietary patterns were identified by factor (principal component) analysis based on 37 food groups and named Oriental and Western patterns. The Oriental pattern was characterized by higher intake of vegetables, legumes, fruit, whole grains, tomatoes, and seafood. The Western pattern was characterized by higher intake of red meat, processed meat, high-fat dairy products, French fries, refined grains, and eggs. We ranked our participants according to how closely their diets line up with the 2 patterns by calculating the 2 factor scores for each participant. For early AMD, multivariate-adjusted odds ratio (OR) from generalized estimating equation logistic analysis comparing the highest to lowest quintile of the Oriental pattern score was ORE5O = 0.74 (95% confidence interval (CI): 0.59-0.91; Ptrend =0.01), and the OR comparing the highest to lowest quintile of the Western pattern score was ORE5W = 1.56 (1.18-2.06; Ptrend = 0.01). For advanced AMD, the ORA5O was 0.38 (0.27-0.54; Ptrend < 0.0001), and the ORA5W was 3.70 (2.31-5.92; Ptrend < 0.0001).

Conclusions: Our data indicate that overall diet is significantly associated with the odds of AMD and that dietary management as an AMD prevention strategy warrants further study.

Copyright © 2014 Elsevier Inc. All rights reserved.

Figures

FIGURE 1

Odds ratios (95% confidence intervals) of age-related macular degeneration according to quintile groups of two major American dietary pattern scores. Abbreviation: OR, odds ratio; CI, confidence interval; AMD, age-related macular degeneration. Participants were divided into quintile categories according to their dietary pattern score and those in the lowest 20% of the distribution comprised the referent category. The multivariate-adjusted logistic models using Group 1 (n = 2,739) as control were adjusted for age, sex, race, education, smoking status, alcohol intake, calorie intake, multivitamin use, body mass index, sunlight exposure, hypertension history, lens opacity, and refractive error. The analysis used 4,599 early AMD eyes (1,801 eyes with intermediate drusen plus 2,798 eyes with large drusen, i.e., Group 2 plus Group 3) and 765 advanced AMD eyes (164 eyes with geographic atrophy plus 601 eyes with choroidal neovascularization, i.e., Group 4 plus Group 5). See AMD grading procedures in METHODS section for the five (Groups 1~5) AMD grouping criteria.