Cited by 1,031Retinal Diseases and TreatmentsAntioxidant Activity and Oxidative StressRetinal Imaging and Analysis

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Dietary Carotenoids, Vitamins A, C, and E, and Advanced Age-Related Macular Degeneration

Seddon, Johanna M.·1994·JAMA: The Journal of the American Medical Association

DOI 10.1001/jama.1994.03520180037032

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Abstract

Objective. —To evaluate the relationships between dietary intake of carotenoids and vitamins A, C, and E and the risk of neovascular age-related macular degeneration (AMD), the leading cause of irreversible blindness among adults. Design. —The multicenter Eye Disease Case-Control Study. Setting. —Five ophthalmology centers in the United States. Patients. —A total of 356 case subjects who were diagnosed with the advanced stage of AMD within 1 year prior to their enrollment, aged 55 to 80 years, and residing near a participating clinical center. The 520 control subjects were from the same geographic areas as case subjects, had other ocular diseases, and were frequency-matched to cases according to age and sex. Main Outcome Measures. —The relative risk for AMD was estimated according to dietary indicators of antioxidant status, controlling for smoking and other risk factors, by using multiple logistic-regression analyses. Results. —A higher dietary intake of carotenoids was associated with a lower risk for AMD. Adjusting for other risk factors for AMD, we found that those in the highest quintile of carotenoid intake had a 43% lower risk for AMD compared with those in the lowest quintile (odds ratio, 0.57; 95% confidence interval, 0.35 to 0.92;Pfor trend=.02). Among the specific carotenoids, lutein and zeaxanthin, which are primarily obtained from dark green, leafy vegetables, were most strongly associated with a reduced risk for AMD (Pfor trend=.001). Several food items rich in carotenoids were inversely associated with AMD. In particular, a higher frequency of intake of spinach or collard greens was associated with a substantially lower risk for AMD (Pfor trend<.001). The intake of preformed vitamin A (retinol) was not appreciably related to AMD. Neither vitamin E nor total vitamin C consumption was associated with a statistically significant reduced risk for AMD, although a possibly lower risk for AMD was suggested among those with higher intake of vitamin C, particularly from foods. Conclusion. —Increasing the consumption of foods rich in certain carotenoids, in particular dark green, leafy vegetables, may decrease the risk of developing advanced or exudative AMD, the most visually disabling form of macular degeneration among older people. These findings support the need for further studies of this relationship. (JAMA. 1994;272:1413-1420)

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“…age, cigarette smoking, higher body mass index, arterial hypertension and nutritional factors, have been identified (Age-Related Eye Disease Study Research Group 2000, 2001, 2005; Eye Disease Case-Control Study Group 1992; Seddon et al. 1994, 1996, 2003a; Smith et al. 2001; Tomany et al. 2004).”
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A Systematic Review of Carotenoids in the Management of Age-Related Macular Degeneration
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“An increased intake of 6 mg lutein per day has been shown to reduce the risk of AMD (Krinsky, Landrum, & Bone, 2003; Seddon et al., 1994).”
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“During the design of the trial, 6 mg daily intake of lutein had been reported to be associated with a reduced risk of AMD (57% lower risk for the highest quintile of lutein intake, 6 mg/day, relative to the lowest quintile, 0.5 mg/day) (Seddon et al., 1994).”
BackgroundMethodInfluential
Multivitamin-multimineral supplements and eye disease: age-related macular degeneration and cataract.
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“The most consistent evidence relates to lutein and zeaxanthin (7, 8, 43) as well as dietary n 3 fatty acids (44-47).”
BackgroundResultInfluentialSelf-citation

Authors: Seddon, J. M.
Corresponding author: Seddon, Johanna M.
ORCID: Seddon, Johanna M.
Venue: JAMA: The Journal of the American Medical Association
Publisher: American Medical Association (AMA)
Published: 1994-11-09
Volume: 272
Issue: 18
Pages: 1413
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.1994.03520180037032
OpenAlex: W4296976934
Cited by: 993
References: 0
Citations by year: 2026: 10 · 2025: 17 · 2024: 48 · 2023: 27 · 2022: 30 · 2021: 30 · 2020: 39 · 2019: 44 · 2018: 35 · 2017: 35 · 2016: 37 · 2015: 41 · 2014: 38 · 2013: 41 · 2012: 56
FWCI: 21.40
Type: journal article
Language: en
Open access: closed
Locations: JAMA (publishedVersion)
Funders: National Eye Institute (EY09972)
Topics: Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
Health Sciences › Medicine › Biochemistry (medical) › Antioxidant Activity and Oxidative Stress
Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
Keywords: neovascular age-related macular degeneration, dietary carotenoids, lutein, zeaxanthin, vitamin A, vitamin C, vitamin E, antioxidant intake, dark green leafy vegetables, spinach, collard greens, AMD risk factors, dietary intake, older adults, blindness prevention, retinol, dietary supplements

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Dietary Carotenoids, Vitamins A, C, and E, and Advanced Age-Related Macular Degeneration

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