Purpose: What patients should eat to reduce their risk of age-related macular degeneration (AMD) is still unclear. We investigated the effect of a diet recommended by Health Councils on AMD. Design: Prospective population-based cohort study. Methods: Four thousand two hundred and two participants from the Rotterdam Study ≥55 years of age who were free of AMD at baseline were included and followed up for 9.1 ± 5.8 years. Incident AMD was graded on fundus photographs. Dietary data were collected using a validated 170-item food frequency questionnaire, and food intakes were categorized into food patterns based on guidelines from Health Councils. Associations with incident AMD were analyzed using Cox proportional hazards models that were adjusted for age, sex, total energy intake, smoking, body mass index, hypertension, education, and income. Results: Seven hundred fifty-four people developed incident AMD. Intake of the recommended amounts of vegetables (≥200 g/day), fruit (2×/day), and fish (2×/week) were 30.6%, 54.9%, and 12.5%, respectively. In particular, the intake of fish (2×/week) decreased the risk of incident AMD (hazard ratio 0.76 [95% confidence interval 0.60-0.97]). Intake of the recommended amounts of all 3 food groups was only 3.7%, but adherence to this pattern showed a further reduction of the risk of incident AMD (hazard ratio 0.58 [95% confidence interval 0.36-0.93]). Younger age, higher income, and not smoking were associated with this food pattern, but the risk-lowering effects remained significant after additional adjustment for these factors. Conclusion: A diet of 200 grams per day of vegetables, fruit two times per day, and fish two times per week is associated with a significantly reduced risk of AMD.

Additional Metadata
Persistent URL dx.doi.org/10.1016/j.ajo.2018.09.036, hdl.handle.net/1765/112285
Journal American Journal of Ophthalmology
Citation
de Koning-Backus, A.P.M. (Alexandra P.M.), Buitendijk, G.H.S, Kiefte-de Jong, J.C, Colijn, J.M, Hofman, A. (Albert), Vingerling, J.R, … Klaver, C.C.W. (2019). Intake of Vegetables, Fruit, and Fish is Beneficial for Age-Related Macular Degeneration. American Journal of Ophthalmology, 198, 70–79. doi:10.1016/j.ajo.2018.09.036