In the news: Good News from AREDS Reports Nos. 28 & 29!

Benefit of AREDS2 Formula Confirmed for Slowing AMD: AREDS Report No. 28

The results of a new report analyzing 10 years of AREDS2 data shows that the AREDS2 formula “is not only safer, but actually better at slowing AMD progression” according to lead author of the study report Emily Chew MD(1).

In AREDS2, the beta-carotene formulation was compared to one containing lutein/zeaxanthin. The beta-carotene-containing formula was only given to participants who had never smoked or who had quit smoking.

At the end of the 5-year AREDS2 study period, the research group concluded that lutein/ zeaxanthin did not increase lung cancer risk, and that the new AREDS2 formulation could reduce the risk of AMD progression by about 26%.

The new analysis(2) collected information from 3,883 of the original 4,203 AREDS2 participants on whether they had developed lung cancer and whether their AMD had progressed to late disease (validated with medical records) over the next 5 years of post-AREDS2 follow-up.

Even though all participants had switched to the lutein/zeaxanthin-containing formula at the end of the AREDS2 study, the follow-up continued to show that beta carotene nearly doubled lung cancer risk among former smokers. In contrast, there was no increased risk for lung cancer in those receiving lutein/zeaxanthin.

Importantly, after 10 years, those assigned to receive lutein/zeaxanthin had an additional 20% lower risk for progression to late AMD compared to those assigned to receive beta-carotene.

The follow-up also confirmed that receiving fish oil (omega-3 fatty acid) conferred no additional benefit beyond the AREDS supplement, and that there was no apparent difference between higher (80 mg) vs. lower (25 mg) in terms of developing late AMD However, the NEI continues to recommend an 80mg dose of zinc in the AREDS2 formula. That is because AREDS2 did not include a placebo control, and results from AREDS, a placebo-controlled trial, are still considered the gold standard.

Components of Med Diet May Impact Dry AMD Progression: AREDs Report No. 29

Researchers from the National Eye Institute and the University of Wisconsin School of Medicine and Public Health teamed to investigate how adherence to the Mediterranean diet affected the rate of geographic atrophy (GA) enlargement among a subset of 850 participants (1,155 eyes) in the AREDS2 study population(3).

Geographic atrophy area was measured from color fundus photographs at annual visits. An alternative Mediterranean Diet index (aMedi) was calculated for each participant by food frequency questionnaire.

Over a mean follow-up of 3.1 years, GA enlargement was significantly slower in those with higher aMedi scores (0.256, 0.290, and 0.298 mm/year, P = 0.008 for aMedi tertiles 3, 2, and 1, respectively).

Of the 9 aMedi components considered separately, significant differences in enlargement rate were seen for four of them. Enlargement was slower in those with higher whole fruit, lower red meat, moderate alcohol, and higher monounsaturated fatty acid: saturated fatty acid intake (P = 0.0004, P = 0.0002, P = 0.006, and P =0.040), respectively). No association was observed with fish intake.

The authors conclude that a Mediterranean-type diet is associated with slower GA enlargement. Diet patterns like this may therefore lead to clinically meaningful delays in vision loss. The good news is that diet can make a difference, even for those with GA.

References

1. National Institutes of Health. NIH study confirms benefit of supplements for slowing age-related macular degeneration. NIH news release, June 2, 2022.
2. Chew EY, et al for the AREDS2 Research group. Long-term outcomes of adding lutein/zeaxanthin and omega-3 fatty acids to the AREDS supplements on age-related macular degeneration. Report #28. JAMA Ophthalmol. Online ahead of print, June 2, 2022.
3. Agron E, et al. Adherence to a Mediterranean diet and geographic atrophy enlargement rate: Age-Related Eye Disease Study 2 Report 29. Ophthalmol Retina. Online ahead of print, Apr. 4, 2022.