Category: Nutrition

Vitamin & Diet Recommendations for ARMD

Post author By Randall Wong, M.D.
Post date May 24, 2013
4 Comments on Vitamin & Diet Recommendations for ARMD

With the AREDS 2 study recently published, the recommendations for vitamin supplements have not changed.

AREDS 2 did not change any of the recommendations for changing diet or adding supplements. While it didn’t lead to any discoveries, it did validate the original AREDS study.

Take the AREDS Formulation!

The original AREDS formulation contains;

Vitamin C, 500 milligrams
Vitamin E, 400 IU
Beta-Carotene, 15 milligrams
Zinc Oxide, 80 milligrams
Cupric Oxide, 2 milligrams

Note that there is no lutein in the formulation.

Some popular brands containing the AREDS formulation;

There are others made by other vitamin companies but they also sell products for which their is no scientific data on efficacy. In general, look for the AREDS formulation. Compare to the ingredient list above.

AREDS and Multivitamins

AREDS vitamins and multivitamins are different. One is not a substitute for the other. There are elements found in the AREDS formulation not found in the multivitamin.

Consult your physician if your are considering stopping or starting either vitamin.

You do not need vitamins based upon the AREDS 2 formulation.

What Does this Mean?

The new study confirmed the AREDS study released in 2006.

1. Take AREDS vitamins, but only if you have intermediate or high risk for developing ARMD. You’ll have to ask your doctor if you meet the criteria.

2. Lutein is not necessary.

3. The vitamins do NOT improve or prevent the development of macular degeneration. They may, when indicated, prevent severe vision loss from the wet form of the disease.

4. Omega 3 Fatty Acids have no direct effect on macular degeneration.

Randy

Randall V. Wong, M.D.
Retina Specialist
Fairfax, Virginia
www.RetinaEyeDoctor.com

Tags AREDS, AREDS 2, ARMD, lutein, omega 3

Macular Degeneration Nutrition

AREDS 2 Vitamin Study for Macular Degeneration

Post author By Randall Wong, M.D.
Post date May 16, 2013
5 Comments on AREDS 2 Vitamin Study for Macular Degeneration

The original AREDS study (Age-Related Eye Disease Study) was published in 2001 and concluded that a combination of vitamins and supplements, the “AREDS Formula,” consisting of vitamin C, vitamin E, B-Carotene, zinc and copper could reduce the risk of developing advanced ARMD.

The “AREDS Formula” has been recommended for patients with intermediate or high risk ARMD. The AREDS study found that in these patients, the eye vitamins reduced the chance of severe vision loss by 25%.
The eye vitamins do not improve the vision or stage of the disease, but do prevent those at high risk from getting worse. Unless, there is evidence of macular degeneration showing these risk factors…there is no need for taking the AREDS vitamins.
Lutein and zeaxanthin (pigmented anti-oxidants) were never studied directly. Both were associated with improvements in macular degeneration, but neither were ever proven to improve macular degeneration.
Omega-3 fatty acids were suspected to retard macular degeneration, but never proven.
B-Carotene increases the chance of lung cancer in smokers.

AREDS Formula (2001)

Vitamin C
Vitamin E
B-Carotene
Zinc
Copper

AREDS 2 Study Tested

In 2006, AREDS II was initiated to determine if improvements could be made on the AREDS formula. Specifically questions asked

Do omega-3 fatty acids (DHA/EPA) reduce AMD or cataract?
Do antioxidants, lutein/zeaxanthin, reduce AMD or cataract?
What is the role of zinc?
What is the role of B-Carotene?

AREDS 2 Study Results

Omega-3 fatty acids had no effect on reducing macular degeneration nor cataract formation.
Antioxidants, lutein/zeaxanthin, did not retard the progression of macular degeneration.
Reducing the amount of zinc did not change the effectiveness of the AREDS formulation.
B-Carotene did increase the rate of lung cancer in former smokers (active smokers were not given B-carotene), but there may be advantages to substituting lutein/zeaxanthin for the B-carotene in smokers.

What Does this Mean?

Though it seems that little new information was produced from the AREDS 2 study, in fact, the study was very positive.

The results of the AREDS study were validated. Patients who have high risk or intermediate risk factors for AMD should be recommended to take the AREDS formula vitamins. Those who do not have these risk factors, including “normal” people, do not need to take these vitamins.

B-carotene should not be taken by smokers or former smokers. This was suspected, but now has been validated. There are AREDS formulations available for smokers (no B-Carotene).

Unfortunately, omega- 3 fatty acids (e.g. fish oils) and antioxidants also have no role in preventing macular degeneration. This also means, those products touting the importance of lutein…are unfounded.

Randy

Randall V. Wong, M.D.
Retina Specialist
Fairfax, Virginia
www.RetinaEyeDoctor.com

Tags AREDS, AREDS 2, vitamins

Macular Degeneration Nutrition

Eating Fish and Omega-3's Lower ARMD Risk in Women

Post author By Randall Wong, M.D.
Post date March 23, 2011
5 Comments on Eating Fish and Omega-3's Lower ARMD Risk in Women

Eating fish and other sources of omega-3 fatty acids may lower the risk of developing macular degeneration in women. A new study reports a lower incidence of AMD in those eating one serving of fish per week compared to those who did not.

Omega 3 May Reduce Eye Disease

The study was to evaluate the potential benefits of eating fish and certain fatty acids with the development of the disease in women. The analysis was performed on the data collected from the Women’s Health Study. This study included almost 40,000 women all of whom were health professionals.

The participants all completed a questionnaire regarding dietary habits and then followed for about 10 years looking to see who might develop the disease. The initial screening involved self-reporting.

One Serving of Fish Per Week May Reduce Eye Disease

The results indicate that eating just one serving of fish per week decreases the chances of developing ARMD compared to those who do not. There was a bias to those eating canned tuna fish and dark-meat fish.

What Does This Mean? This is great circumstantial evidence that omega-3 fatty acids may prevent macular degeneration…at least in women. While not proven, it does support other similar studies indicating a possible association omega-3 FA’s and fish consumption.

Foods containing these fatty acids include “cold water” fish and nuts.

AREDS 2 is presently underway and should conclusively answer if omega-3 FA’s prevent macular degeneration. The study concludes in a few years. This is a prospective and randomized study. The study is also specifically designed to examine the benefits of omega-3’s.

In contrast, this study reported in the Archives of Ophthalmology is really more the result of a questionnaire, was not truly random (all participants were women and also health professionals) and was retrospective. While there is some value to these sorts of studies, the strongest evidence is taken from studies designed like AREDS2.

Tags age related eye disease study, AMD, fish, Macular Degeneration, Omega-3 fatty acid, tuna, Women's Health Study

Macular Degeneration Nutrition

Was Jack LaLanne Right?

What can we learn from Jack LaLanne and how we prevent macular degeneration?

Jack LaLanne, the pioneer of diet and exercise died this week. He was 96 years old. He was a chiropractor, fitness and diet expert, bodybuilder, weightlifter and was best known for his fitness television show aired from 1951 to 1985.

Eating Healthy and Staying Fit

Jack was an exercise fanatic, working out 2 hours every morning, followed by a rather regimented two meals a day consisting of hard-boiled egg whites, broth, oatmeal, soy and fruit. He ate lots of fish and did not drink coffee.

Long before diet and exercise were popular, LaLanne promoted the benefits of leading a healthy life and did so by leading by example.

Jack LaLanne’s European Health Spas eventually became Bally Total Fitness. He is responsible for the “power of juice” coined to promote what is now the Power Juicer.

What Does This Mean? You can’t help but associate Jack LaLanne with exercise, nutrition and longevity.

Was it the exercise, good nutrition or both that led to his longevity? You might be right if you think so.

But we don’t really know that.

It could be that the LaLanne family has a great “longevity” gene and that Jack might have lived just as long had he never exercised, smoked and drank. We don’t really know that either. (It seems as though his mother did live to near 90 and his brother lived to be 97.)

As in Mr. LaLanne’s case, there are many variables that could have caused his longevity.

The same is true with diet and eyesight…particularly macular degeneration. We don’t really know if diet, or vitamins, really have an impact on our vision. There are too many variables for us to know for sure.

Part of the job of good science is to create a hypothesis. Does variable ‘x’ cause a particular result? For instance, does lutein help macular degeneration? Will Omega-3 fatty acids save our sight?

Testing the hypothesis is even harder. Ideally you want to keep all variables the same, except for the one variation that you are testing. In a perfect world, you’d be doing all your testing on clones. All have the same exact DNA and the only variable would be the change in diet…feeding them only fatty acids or lutein.

For now, the best we can do is to perform our testing on huge numbers of people. As with the LaLanne family, there are too many variables that could effect the same outcome.

The AREDS II study will be completed in a few years. It is a large study designed to determine if certain supplements such as lutein and omega 3 fatty acids are beneficial to our health and sight.

For now, you have to make your own choices based upon little credible evidence. Read carefully, there is lots of misleading stuff out there. As with Mr. LaLanne, don’t get swayed by emotion. Your doctors can give you some guidance, but look for proof.

In the end, you have you have to make up your own mind. For me, I do believe diet and exercise are beneficial and will only help you maximize your genetic potential.