Skip to main content
ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #208925
Title: DIETARY CARBOHYDRATE AND PROGRESSION OF AGE-RELATED MACULAR DEGENERATION, A PROSPECTIVE STUDY FROM THE AGE-RELATED EYE DISEASE STUDY

Author
item CHIU, CHUNG-JUNG - TUFTS/HNRCA
item MILTON, ROY - THE EMMES CORP.
item KLEIN, RONALD - UNIV. OF WISCONSON
item GENSLER, GARY - THE EMMES CORP.
item Taylor, Allen

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/6/2007
Publication Date: 10/1/2007
Citation: Chiu, C., Milton, R.C., Klein, R., Gensler, G., Taylor, A. 2007. Dietary carbohydrate and progression of age-related macular degeneration, a prospective study from the age-related eye disease study. American Journal of Clinical Nutrition. 86(4):1210-8.

Interpretive Summary: According to cross-sectional studies, diets that provide a higher dietary glycemic index (dGI) may be associated with the increased risk of age-related macular degeneration (AMD), which past studies have not addressed. Among 3977 participants between ages 55-80 in the Age-Related Eye Disease Study, the dGI was calculated as the weighted average of GIs from foods and was evaluated as being above or below the gender median. 7232 eligible eyes without advanced AMD were classified into one of three different AMD categories. Maximal progression was then timed to evaluate the relationship between dGI and AMD risk using the multifailure Cox proportional-hazards regression model. Results indicate that the risk of progression over 8 years of follow-up was higher in the high dGI as opposed to the low dGI group. The increased risk of progression for Groups 1, 2, and 3 were 5%, 8%, and 17%. The study also suggests that 7.8% of new advanced AMD cases can be prevented in 5 years if participants consumed the low dGI diet. Overall, data indicates that it is beneficial to consume less refined carbohydrates for a person who is at risk for AMD, namely those at the highest risk for advanced AMD.

Technical Abstract: Background Cross-sectional studies indicate that diets that provide a higher dietary glycemic index (dGI) are associated with increased risk of age-related macular degeneration (AMD). No prospective studies have addressed this issue. Methods dGI was calculated as the weighted average of GIs from foods and evaluated as being above or below the gender median (female = 77.9, male = 79.3) for 3977 participants aged 55 - 80 y (58% female) in the Age-Related Eye Disease Study (AREDS). The 7232 eligible eyes without advanced AMD were classified into one of three AMD categories: Group 1 (nonextensive small drusen), 2 (intermediate drusen/extensive small drusen/pigmentary abnormalities), and 3 (large drusen/extensive intermediate drusen). Using multifailure Cox proportional-hazards regression we modeled the time to the maximal progression to evaluate the relationship between dGI and risk for AMD. Results Overall, the multivariate-adjusted risk of progression over 8 years of follow-up (mean = 5.4 y) was significantly higher (risk ratio = 1.10; 95% confidence interval, 1.00, 1.20; P = 0.047) in the high dGI vs. the low dGI group. The increased risk of progression for Group 1, 2, and 3 eyes was 5%, 8%, and 17%, respectively (P value for trend < 0.001). The latter gives an estimate that 7.8% of new advanced AMD cases would be prevented in 5 years if people consumed the low dGI diet. Conclusions These data suggest that there is a benefit of consuming less refined carbohydrates in persons at risk of AMD progression, especially for those at high risk for advanced AMD.