Which nutrients might help prevent the most common cause of blindness in the elderly?

Macular degeneration is the most common cause of blindness in the elderly. And sufferers of this condition in England had some welcome news this week when the barring from use of a drug used to treat this condition (Lucentis) by National Health Service (NHS) doctors was reversed. This means that doctors in the state medical system in England can now prescribe this drug to individuals suffering from one of the two main forms of this condition known as ‘wet’ macular degeneration.

This story reminded me that there are certain nutritional approaches that may have merit in the prevention or treatment of age-related macular degeneration (AMD). One nutritional factor that has caught the eye of scientists in this respect are the omeg-3 fats found in oily fish such as salmon, trout, sardine, mackerel and herring. In a recent study [1], eating oily fish one a week was found to be associated about half the risk of AMD compared to individuals eating less than this. The researchers also looked at the relationship between the intakes of the two main types of omega-3 fat in fish (DHA and EPA) and their relationship with AMD risk. They found:

Those eating the highest amounts DHA were at a 68 per cent reduced risk of AMD

Those eating the highest amounts EPA were at a 71 per cent reduced risk of AMD

Quite recently, a group of scientists reviewed the available evidence regarding the relationship between omega-3 fats and AMD [2]. Their analysis found that a high dietary intake of omega-3 fatty acids was associated with a 38% reduction in the risk of AMD accoutring later in life rather than earlier (late AMD).

Now, even a stack of studies of this nature a mile high would tell us whether omeg-3 fats actually prevent AMD. However, it should be borne in mind that there are a number of mechanisms through which omega-3 fats may have benefit here.

To begin with, a gumming up of the arteries (atherosclerosis) that supply blood to the retina at the back of the eye is thought to contribute to AMD, and the great likelihood is that omega-3 fats help to protect against this process. Also, DHA levels of very high in the retina, and there is some evidence which suggests this nutrient has a key role in the visual process. EPA, through its conversion into substances called eicosanoids may have the ability to combat other eicosanoids of other kinds that have been implicated in the development of AMD through their ability to, say, cause inflammation and leakiness of blood vessels.

Another process that has been implicated in the development of AMD are damaging, destructive molecules known as ‘free radicals’. This has led some to consider whether combating free radicals with nutrients that have antioxidant action might help to prevent or retard AMD. By far the biggest study to test this concept is the Age-Related Eye Disease Study (AREDS) which was published in 2001 [3].

Here, literally thousands of individuals deemed to be at high risk of AMD were treated for an average of more than 6 years with one of the following:

1. The antioxidants vitamin C (500 mg per day), vitamin E (400 IU per day), and beta carotene (15 mg per day)

2. Zinc oxide (80 mg per day) with copper (cupric oxide at a dose of 2 mg per day)

3. The antioxidants plus zinc

4. Placebo

The results were:

The antioxidant combination reduced the risk of developing advanced AMD by 20 per cent.

The antioxidant and zinc combination reduced risk by 28 per cent.

Zinc alone reduced risk by 25 per cent.

Now, the group responsible for this research have embarked on a new study to test the effectiveness of other nutritional approaches in eye disease (AREDS II). They will be testing the effects of two so-called ‘carotenoid’ nutrients ” lutein and zeaxanthin ” that studies have found to be linked with a reduced risk of AMD. The lutein and zeaxanthin are to be combined with another promising nutrient in the prevention of AMD ” you guessed it: omega-3 oils.


1. Augood C, et al. Oily fish consumption, dietary docosahexaenoic acid and eicosapentaenoic acid intakes, and associations with neovascular age-related macular degeneration. Am J Clin Nutr. 2008;88(2):398-406

2. Chong EW, et al. Dietary omega-3 fatty acid and fish intake in the primary prevention of age-related macular degeneration: a systematic review and meta-analysis. Arch Ophthalmol. 2008;126(6):826-33

3. Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. 8. Arch Ophthalmol. 2001;119(10):1417-36.

7 Responses to Which nutrients might help prevent the most common cause of blindness in the elderly?

  1. Daisy 31 August 2008 at 5:59 pm #

    My 87 year old father suffers from this disease, and his sight is still deteriorating. He has been told that nothing can be done for him, and, indeed, nothing ever could.
    Is this a heridit

  2. Daisy 31 August 2008 at 6:04 pm #

    sorry – got cut off…as I was saying, a hereditary disease, and should I at nearly 50 be thinking about taking these supplements? Thanks for your advice

  3. helen 31 August 2008 at 9:24 pm #

    Not only should you take the suppliments but also cut out the use of polyunsaturated oils & sugar as these have also been linked to Deterioration of the blood vessels that supply the eye. and it is probably only hereditary in the sense that you probably have a similar diet to your father so change the diet & add the supplements & skip the disease.

  4. Hilda 31 August 2008 at 10:25 pm #

    There is research which suggests that macular degeneration can bre helped with diet and supplements. Luein and zeanthin from the yellow pigments in foods can help prevent this and I did hear on the radio that some studies have shown that it can be helped also. Why not do some reasearch on it.

  5. Daisy 1 September 2008 at 7:25 pm #

    Similar diet to my Dad! Perish the thought! Biut what are safe oils to use in cooking now? I’ve heard that neither olive oil nor colza should be heated

  6. Paul Anderson 2 September 2008 at 7:24 pm #

    How about a little butter or macadami oil? I would still suggest that a little olive oil won’t cause too many problems. Its probably a good idea to fry on as low a heat as possible.

    I recall that some research has suggested that eating a diet rich in spinach can stop and even reverse wet macular degeneration. The BBC had a programme on superfoods a while back, testing a few superfoods.

    Walnut oil is good for salads, tasty, and a source of omega 3 as well.

    Their somewhat limited trials showed improvement in most participants over a relatively short period of time. In any case spinach is a pretty health food, in my opinion and quite a versatile food.

    Paul Anderson.

  7. Daisy 3 September 2008 at 11:06 am #

    Thank you, this is good news, I eat a lot of spinach! I’ve never used macadamia oil, but I’ll certainly try it; apparently it’s “an excellent frying oil due to its high heat capacity”. Just what I’m looking for!

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