Dietary intake of antioxidants and risk of age-related macular degeneration
Abstract
CONTEXT: Age-related macular degeneration (AMD) is the most prevalent cause of irreversible blindness in developed countries. Recently, high-dose supplementation with beta carotene, vitamins C and E, and zinc was shown to slow the progression of AMD. OBJECTIVE: To investigate whether regular dietary intake of antioxidants is associated with a lower risk of incident AMD. DESIGN: Dietary intake was assessed at baseline in the Rotterdam Study (1990-1993) using a semiquantitative food frequency questionnaire. Incident AMD until final follow-up in 2004 was determined by grading fundus color transparencies in a masked way according to the International Classification and Grading System. SETTING: Population-based cohort of all inhabitants aged 55 years or older in a middle-class suburb of Rotterdam, the Netherlands. PARTICIPANTS: Of 5836 persons at risk of AMD at baseline, 4765 had reliable dietary data and 4170 participated in the follow-up. MAIN OUTCOME MEASURE: Incident AMD, defined as soft distinct drusen with pigment alterations, indistinct or reticular drusen, geographic atrophy, or choroidal neovascularization. RESULTS: Incident AMD occurred in 560 participants after a mean follow-up of 8.0 years (range, 0.3-13.9 years). Dietary intake of both vitamin E and zinc was inversely associated with incident AMD. The hazard ratio (HR) per standard deviation increase of intake for vitamin E was 0.92 (95% confidence interval [CI], 0.84-1.00) and for zinc was 0.91 (95% CI, 0.83-0.98). An above-median intake of all 4 nutrients, beta carotene, vitamin C, vitamin E, and zinc, was associated with a 35% reduced risk (HR, 0.65; 95% CI, 0.46-0.92) of AMD. Exclusion of supplement users did not affect the results. CONCLUSION: In this study, a high dietary intake of beta carotene, vitamins C and E, and zinc was associated with a substantially reduced risk of AMD in elderly persons.
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In the Rotterdam Study, a high dietary intake of beta-carotene, vitamins C and E, and zinc was associated with a substantially reduced risk of age-related macular degeneration in elderly individuals.
“In the Rotterdam Study, a high dietary intake of beta-carotene, vitamins C and E, and zinc was associated with a substantially reduced risk of age-related macular degeneration in elderly individuals.96”
From Age-related macular degeneration (2008) · cites this paper as [96]
Population-based studies have shown inconsistent associations of dietary levels of lutein and zeaxanthin with age-related macular degeneration.
“Population-based studies have shown in consistent associations of dietary levels of these compounds with age-related macular degeneration.94,96,102,103”
From Age-related macular degeneration (2008) · cites this paper as [96]
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- Authors
- van Leeuwen, R.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2005-12-28
- Volume
- 294
- Issue
- 24
- Pages
- 3101
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2120882408
- Cited by
- 345
- References
- 25
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 6 · 2023: 4 · 2022: 10 · 2021: 10 · 2020: 13 · 2019: 17 · 2018: 9 · 2017: 10 · 2016: 11 · 2015: 25 · 2014: 15 · 2013: 20 · 2012: 31
- FWCI
- 24.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
- Keywords
- age-related macular degeneration, dietary antioxidants, vitamin E, zinc, beta-carotene, vitamin C, drusen, geographic atrophy, choroidal neovascularization, dietary intake, older adults, Rotterdam Study
- MeSH terms
- Aged, Antioxidants, Ascorbic Acid, Diet, Diet Surveys, Female, Humans, Macular Degeneration, Male, Middle Aged, Netherlands, Risk, Vitamin E, Zinc, Cohort Studies, beta Carotene
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