Healthy eating, healthy eyes.

This May, for Macula Month, Macular Disease Foundation Australia (MDFA) has launched updated Nutrition Guidelines for age-related macular degeneration. 

Patients often ask their treatment professionals what foods they should eat to manage their condition. When it comes to age-related macular degeneration (AMD), a survey of optometrists found that two-thirds of practitioners regularly discuss the impact of diet on eye diseases, and 91% routinely recommend nutritional supplements to patients. Since AMD affects about 1.5 million people, making it Australia’s leading cause of vision loss, that’s a lot of diet talk.

At present, there are no official guidelines for nutritional advice. But this May, for Macula Month, Macular Disease Foundation Australia (MDFA) is launching updated Nutrition Guidelines for AMD. These recommendations are based on the first systematic review of all the published systematic reviews – the highest level of evidence to inform clinical and public health decisions – investigating dietary patterns, food, nutrition supplements and AMD. Systematic reviews gather, combine and evaluate findings from relevant studies, finding the best, the most appropriate and the findings with the most evidence behind them. MDFA has recently conducted a systematic review evaluating the strength of evidence for dietary patterns, foods, nutrients and supplements to prevent AMD and/or slow its progression.

What this review, performed in partnership with the University of Sydney, found contained some surprises. There has long been plenty of evidence for certain foods being protective against AMD. Yet while eating large amounts of fish to get your omega-3 polyunsaturated fatty acids is a great idea, it may not be as important as your eating patterns. It seems that it’s not what you eat, but how you eat.

A new finding for MDFA was that sticking closely to the Mediterranean diet or an Asian-style diet was likely associated with lower risk of early AMD and delaying progression to late AMD.

A new finding for MDFA was that sticking closely to the Mediterranean diet was likely associated with lower risk of early AMD and delaying progression to late AMD. Similarly, an Asian-style eating pattern (defined as a high intake of vegetables, fish and plant-based proteins in the diet pattern traditional in Japan and south-east Asia) likely reduces the risk of developing late AMD and might reduce the risk of developing early AMD.

This focus on an eating pattern is novel. Most previous advice has centred around specific foods and single nutrients. People often focus on improving their diets by consuming individual nutrient supplements or so-called super-foods; in reality nutrition concerns the long-term, overall diet. The concept of ‘food synergy’, the concerted action of food constituents on overall health, is an important message to highlight, and the importance of overall eating patterns has been stressed in MDFA’s nutrition recommendations.

When it comes to individual foods, the winners are those rich in lutein and zeaxanthin, found in dark leafy vegetables foods were likely associated with reduced risk of developing late AMD or progressing to late AMD.

Multi-antioxidant supplements were associated with delaying progression of AMD, but not preventing early AMD.

Not everything was good news. Some new evidence uncovered by MDFA was that more than ~1 standard drink was likely associated with higher risk of developing early AMD.

High meat consumption (especially red and processed meat) was also associated with a greater risk for developing early AMD.

Research has shown that inflammation plays a role in the development of AMD: ocular tissues are vulnerable to oxidative stress. A Mediterranean diet has been linked to lower levels of oxidative stress biomarkers in the blood. This may be due to antioxidant and anti-inflammatory properties in fruit, vegetables and fish.

It’s all very painless really. And your eyes might be grateful.