In the news: Refresher: How to Reduce AMD Risk

AMD Risk Factors We Can Address

A recent overview(1) of risk factors and strategies for slowing AMD offers a good reminder of what we can be doing to help protect our eyesight, as well as a peek into possible future risk-reduction steps.

AMD is influenced by genetic, lifestyle, nutritional and health conditions that contribute to oxidative stress and chronic inflammation in the eye’s retina. Oxidative stress can trigger inflammation and inflammation can also prompt oxidative stress – both leading to retinal injury.

Nutrition—Diet plays a central role in protecting against or contributing to AMD. The main connection linking diet to AMD is oxidative stress and foods that can promote or help prevent it. The retina has a high demand for oxygen which makes it particularly vulnerable to oxidative stress, leading to protein damage and damage to the retinal pigment epithelial cells in the retina’s outer layer.

Healthy Carbs--Multiple studies suggest a link between a diet high in simple and refined carbs and an increased risk and progression of AMD. Highly processed and/or sugary carbs cause rapid, high rises in blood sugar which promotes inflammation and oxidative stress, and can contribute to the formation of advanced glycation end products which damage eye tissues. Choose whole grains, high fiber fruits & veggies

Mediterranean (Med) Diet—Staying Healthy readers are probably aware of the many positive health effects of the Med diet. Studies have also shown that following this way of eating lowers the risk of both early and late AMD. Focus on veggies, fruits, legumes (e.g. beans), whole grains, nuts and fish.

AREDS2 Supplements—Evidence from the large AREDS trial—and later from the and AREDS2 trial- demonstrated that supplemental antioxidants (vitamins C, E, minerals zinc, copper and the carotenoids lutein and zeaxanthin) are a useful strategy to reduce the risk of AMD progressing in those who already have the condition. Recent analyses of AREDS and AREDS2 showed that the supplements also appear to slow the advance of central geographic atrophy toward the macula’s center – a finding not seen in the original trials.

Tobacco Smoking--There’s an abundance of evidence linking smoking to a significantly increased risk for AMD. Smoking releases toxic substances – e.g. nicotine, heavy metals and tar – that generate free radicals which concentrate in the retina and lead to oxidative stress. Oxidative stress is an imbalance between free radicals (reactive oxygen species) and the antioxidants that neutralize or remove them. Take Home: Don’t smoke and stop if you do.

Physical Activity—Studies suggest that people with lower levels of physical activity have a higher likelihood of developing both early and late-stage AMD. Regular exercise increases the activity of antioxidant enzymes and ups resistance to oxidative stress. Find activities you like and stick with them.

Sunlight Exposure—Excessive sunlight exposure is strongly suspected to play role in the development of AMD, even though only a few studies have shown an association between AMD and sunlight exposure. However, UV light leads to oxidative stress, and many eye care professionals recommend UV-protective lenses. Ask your eye doctor about photo-protection.

Overall Health Status—While more research is needed to confirm these observations – diabetes, heart disease, hypertension and obesity have been linked to developing AMD or its progression. Both diabetes and obesity cause retinal inflammation and oxidative stress. Damage to blood vessels can also compromise the delivery of protective carotenoids like lutein and zeaxanthin to the retina’s macula. Strive to maintain healthy weight; get regular check-ups and treat chronic conditions.

Emerging Research Areas—Scientists are exploring the effects of the Microbiome on AMD risk which involves the relationship between diet, gut bacteria and gene expression. Another preliminary area of exploration is that of sleep quality, with too little sleep linked to higher risk of AMD. Research has shown that an interplay between diet and gene modification (epigenetics) also affects AMD risk and progression.

References

1. Saigal K, et al. Modifiable lifestyle risk factors and strategies for slowing the progression of age-related macular degeneration. Vision. 9.16, 2025.