• Mediterranean Diet Score and AMD: The European Eye Study

    Written By: Marianne Doran and selected by George B. Bartley, MD

    Journal Highlights

    Ophthalmology, January 2017

    Download PDF


    Hogg et al.
    performed a population- based epidemiologic study to examine associations between adherence to a Mediterranean diet and the prevalence of age-related macular degeneration (AMD) in 7 European countries. They found that participants with the highest Mediterra­nean Diet Score (MDS) had the lowest levels of advanced neovascular AMD.

    Participants included 5,060 individuals aged 65 years or older (mean age, 73.2; 55% women) who were randomly selected from study centers in Norway, Estonia, United Kingdom, France, Italy, Greece, and Spain. Full dietary data were available for 4,753. Participants underwent eye examination and digital retinal color photography. Images were graded at a single center, according to the International Classification System for age-related maculopathy, and were stratified according to the Rotterdam staging system into 5 exclusive stages (AMD 0-4) and a separate category of large drusen (≥125 μm). AMD 4 included neovascular AMD (nvAMD) and geographic atrophy.

    Dietary intake during the previ­ous 12 months was assessed with a semi-quantitative food-frequency ques­tionnaire, from which the MDS (on a scale of 0-9) was determined. Multi­variable logistic regression was used to investigate the association between the MDS score and AMD. Among other factors, the researchers also looked for possible links between the MDS and the Y204H risk allele in AMD.

    The researchers found that a higher MDS was associ­ated with reduced odds of nvAMD in both unadjust­ed and confound­er-adjusted anal­ysis. Compared with participants with the lowest MDS adherence (≤4 score), those in the highest category of MDS (>6 score) showed lower odds of nvAMD (odds ratio, 0.53). No signifi­cant association was found with MDS for AMD grades 1-3. The researchers noted a weak trend between MDS and large drusen, with those in the highest category of MDS having 20% reduced odds compared with those in the lowest category. In this study, the association with MDS was not modified by the Y204H risk allele for any AMD stage.

    In conclusion, this study adds to the limited evidence of the protective effect of adherence to a Mediterranean diet among those with late AMD, but it does not support earlier reports of a relationship with genetic susceptibility.

    The original article can be found here.