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    Mediterranean Diet Reduces Risk of Advanced AMD

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    The Mediterranean Diet has been found to lower the risk of cardiovascular disease and cognitive decline, but relatively few studies have examined its impact on age-related macular degeneration (AMD).

    Now, a consortium of European researchers has found that the diet decreases an individual’s risk of developing advanced AMD, particularly the dry form of the disease.1 “We found that participants (55 years of age or older) who have a high adherence to the Med­iterranean Diet have a 41% reduced risk of developing AMD,” said lead author Bénédicte M.J. Merle, PhD, at the Université de Bordeaux in Bordeaux, France.

    Rationale. The Mediterranean Diet provides an abun­dance of omega-3 fatty acids, lutein, and zeaxanthin, all of which have been found to contribute to retinal health, Dr. Merle pointed out. “The Mediterranean Diet is replete in healthful nutrient-rich foods, such as plant foods and fish. It also limits the consumption of un­healthful foods, such as red and processed meats and savory and salty industrialized products. So, we wanted to assess if patients who adhere to this diet have a reduced risk of developing advanced AMD.”

    In addition, she said, “We wanted to go further [than previous studies] by focusing on global nutrition rather than isolated nutrients.”

    Study specifics. Researchers with the EYE-RISK project ( investigated the associations between diet and incidence of advanced AMD in a large sample from two European population-based prospective studies, the Alienor Study and the Rotter­dam Study 1 (RS-1). Participants in the Alienor Study (n = 550) were 73 years of age or older, and those in RS-1 (n = 4,446) were 55 or older; all were free of ad­vanced AMD at baseline.

    Dietary components. The researchers evaluated participants’ adherence to the full Mediterranean Diet, using a nine-component score that assessed consump­tion of plant foods (fruits, vegetables, legumes, and cereals), fish, meat, dairy products, alcohol, and the ratio of monounsaturated-to-saturated fatty acids.

    Outcomes. All told, 155 of the 4,996 participants developed advanced AMD during a mean follow-up of 9.9 years in RS-1 (range, 0.6-21.7 years) and 4.1 years in Alienor (range, 2.5-5.0 years). Those who hewed more closely to the Mediterranean Diet were less likely to develop AMD, despite any regional variations. (For in­stance, those in RS-1 were more likely to consume dairy, while those in the Alienor Study were more likely to eat vegetables, cereals, and fish.) “Participants from the Alienor and the RS-1 studies had slightly different diets, but the association with AMD incidence was similar [between the two cohorts],” Dr. Merle said.

    The big picture. Of note, none of the individual food categories was associated with AMD incidence, which highlights the need to assess overall dietary patterns rather than individual components, the researchers said. Additional studies are planned, Dr. Merle said.

    —Jean Shaw


    1 Merle BMJ et al, for the EYE-RISK Consortium. Ophthalmolo­gy. Published online Aug. 13, 2018.


    Relevant financial disclosures—Dr. Merle: Bausch + Lomb: C; Laboratoires Théa: S.


    1 Jaffe GJ et al. Ophthalmology. Published online Oct. 24, 2018.

    2 Jaffe GJ et al. Ophthalmology. 2016;123(9):1940-1948.


    Relevant financial disclosures—Dr. Jaffe: Eye­Point Pharmaceuticals: C. This study was funded by EyePoint Pharmaceuticals; the sponsor partic­ipated in the design of the study, study conduct, data collection, data management, data analysis and interpretation, and preparation and review of the manuscript.

    For full disclosures and the disclosure key, see below.

    Full Financial Disclosures

    Dr. Jaffe AbbVie: C; Alcon: C; EyePoint Pharmaceuticals: C; Heidelberg Engineering: C; Neurotech USA: C; Novartis: C.

    Dr. Jain None.

    Dr. Merle Bausch + Lomb: C; Laboratoires Théa: S.

    Dr. Mollan None.

    Dr. Pearce None.

    Disclosure Category



    Consultant/Advisor C Consultant fee, paid advisory boards, or fees for attending a meeting.
    Employee E Employed by a commercial company.
    Speakers bureau L Lecture fees or honoraria, travel fees or reimbursements when speaking at the invitation of a commercial company.
    Equity owner O Equity ownership/stock options in publicly or privately traded firms, excluding mutual funds.
    Patents/Royalty P Patents and/or royalties for intellectual property.
    Grant support S Grant support or other financial support to the investigator from all sources, including research support from government agencies (e.g., NIH), foundations, device manufacturers, and/or pharmaceutical companies.


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