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The Blue Mountains Eye Study

Jennifer S. L. Tan, MBBS, BE; Jie Jin Wang, MMed, PhD; Victoria Flood, MPH, PhD; Paul Mitchell, MD, PhD

Arch Ophthalmol. 2009;127(5):656-665.

Objective  To assess the relationship between baseline dietary fatty acids and 10-year incident age-related macular degeneration (AMD).

Methods  In an elderly Australian cohort, 3654 participants were examined at baseline and 2454 were examined 5 and/or 10 years later. We assessed AMD from retinal photographs. Participants completed a semiquantitative food frequency questionnaire.

Results  After adjusting for age, sex, and smoking, 1 serving of fish per week was associated with reduced risk of incident early AMD (relative risk, 0.69 [95% confidence interval, 0.49-0.98]), primarily among participants with less than the median linoleic acid consumption (0.57 [0.36-0.89]). Findings were similar for intake of long-chain -3 polyunsaturated fatty acids. One to 2 servings of nuts per week was associated with reduced risk of incident early AMD (relative risk, 0.65 [95% confidence interval, 0.47-0.91]). Protective associations between the intake of nuts and reduced risk of pigmentary abnormalities were seen among nonsmokers, participants with less than the median ratio of serum total to high-density lipoprotein cholesterol, and those with beta carotene intake greater than the median level.

Conclusions  This study provides evidence of protection against early AMD from regularly eating fish, greater consumption of -3 polyunsaturated fatty acids, and low intakes of foods rich in linoleic acid. Regular consumption of nuts may also reduce AMD risk. Joint effects from multiple factors are suggested.

Author Affiliations: Centre for Vision Research, Department of Ophthalmology, Westmead Millennium Institute, Westmead Hospital (Drs Tan, Wang, Flood, and Mitchell), and Human Nutrition Unit, Department of Molecular and Microbial Biosciences (Dr Flood), University of Sydney, Sydney, Australia.

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