Reducing the genetic risk of age-related macular degeneration with dietary antioxidants, zinc, and ω-3 fatty acids: The Rotterdam Study

Lintje Ho, Redmer Van Leeuwen, Jacqueline C.M. Witteman, Cornelia M. Van Duijn, André G. Uitterlinden, Albert Hofman, Paulus T.V.M. De Jong, Johannes R. Vingerling, Caroline C.W. Klaver*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

176 Citations (Scopus)

Abstract

Objective: To investigate whether dietary nutrients can reduce the genetic risk of early age-related macular degeneration (AMD) conferred by the genetic variants CFH Y402H and LOC387715 A69S in a nested case-control study. Methods: For 2167 individuals (≥55 years) from the population-based Rotterdam Study at risk of AMD, dietary intake was assessed at baseline using a semiquantitative food frequency questionnaire and genetic variants were determined using TaqMan assay. Incident early AMD was determined on fundus photographs at 3 follow-up visits (median follow-up, 8.6 years). The synergy index was used to evaluate biological interaction between risk factors; hazard ratios were calculated to estimate risk of early AMD in strata of nutrient intake and genotypes. Results: Five hundred seventeen participants developed early AMD. Significant synergy indices supported the possibility of biological interaction between CFH Y402H and zinc, β-carotene, lutein/zeaxanthin, and eicosapentaenoic/ docosahexaenoic acid (EPA/DHA) and between LOC387715 A69S and zinc and EPA/DHA (all P < .05). Homozygotes of CFH Y402H with dietary intake of zinc in the highest tertile reduced their hazard ratio of early AMD from 2.25 to 1.27. For intakes of β-carotene, lutein/zeaxanthin, and EPA/DHA, these risk reductions were from 2.54 to 1.47, 2.63 to 1.72, and 1.97 to 1.30, respectively. Carriers of LOC387715 A69S with the highest intake of zinc and EPA/DHA reduced their risk from 1.70 to 1.17 and 1.59 to 0.95, respectively (all P trends <.05). Conclusions: High dietary intake of nutrients with antioxidant properties reduces the risk of early AMD in those at high genetic risk. Therefore, clinicians should provide dietary advice to young susceptible individuals to postpone or prevent the vision-disabling consequences of AMD.

Original languageEnglish
Pages (from-to)758-766
Number of pages9
JournalArchives of Ophthalmology
Volume129
Issue number6
DOIs
Publication statusPublished - 13 Jun 2011

Bibliographical note

Funding/Support: This study was supported by the Netherlands Organization for Scientific Research, the Hague;
Optimix, Amsterdam, the Netherlands; Neyenburgh, Bunnik, the Netherlands; Physico Therapeutic Institute, Rotterdam, the Netherlands; Swart van Essen, Rotterdam;
Blindenpenning, Amsterdam; Sint Laurens Institute, Rotterdam; Bevordering van Volkskracht, Rotterdam; Blindenhulp, the Hague; Rotterdamse Blindenbelangen Association, Rotterdam; OOG, the Hague; kfHein, Utrecht,
the Netherlands; Prins Bernhard Cultuurfonds, Amsterdam; Van Leeuwen Van Lignac, Rotterdam; Algemene
Nederlandse Vereniging ter Voorkoming van Blindheid, Doorn, the Netherlands; Oogfonds Nederland,
Utrecht; MD Fonds, Utrecht; and Lijf en Leven, Krimpen aan de Ijssel, the Netherlands. An unrestricted grant was
obtained from Topcon Europe BV, Capelle aan de Ijsse,
the Netherlands.
Role of the Sponsors: The funding organizations had no
role in the design and conduct of the study; the collection,
management, analysis, and interpretation of the data; or
the preparation, review, or approval of the manuscript.

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