Specific guidelines to optimise your macular health

The Age Related Eye Disease Study (AREDS) and the subsequent (AREDS2) were 2 major clinical trials conducted by the National Eye Institute in the USA. These studies identified a specific formula of antioxidants that was effective in slowing the progression of age related macular degeneration (MD). To date, these are the only studies for which there is good, long-term evidence for the effects of high dose nutrients for people who are diagnosed with MD.

The study showed that taking the AREDS formula every day significantly reduced the relative risk of progression of MD and delayed visual loss. The results in a nutshell;

•        Those with intermediate stage MD reduced their risk by approximately 25%.

•        Those with late stage MD in one eye reduced their risk by approximately 20%.

•        Beta-carotene  and omega 3 supplements showed no effect in reducing MD risk

•        Lutein and Zeaxanthin intake has a clear link with reduced MD risk

Based on these results we at Eyes of Howick recommend the AREDS2 formula to our patients with intermediate or late stage MD.

AREDS2 FORMULA

·         Vitamin C 500mg

·         Vitamin E 400 iu

·         Lutein 10mg

·         Zeaxanthin 2mg

·         Zinc 80mg

·         Copper 2mg

While there are several brands of supplements available which align with the AREDS2 formula, it is important to note that a supplement is not a cure for MD, nor does it stop or reverse damage caused by MD. It is important to read the label to understand how many tablets need to be taken to match the AREDS formula.

One of the key differences between the AREDS and AREDS2 formula is the omission of beta-carotene from the later study due to concerns about it increasing the risk of cancer in smokers. People who smoke or have smoked or who have asbestosis should not take a supplement that contains beta-carotene. Furthermore, if beta-carotene and lutein is taken concurrently, the absorption of lutein is lowered.

While the AREDS2 study found no link between supplementary omega 3 fatty acids and reduced risk of MD, it is still advised to eat fish 2-3 times per week. It should be noted that there are other benefits of taking an Omega 3 supplement if your fish intake is low such as to help with dry eye and reduce risk of glaucoma.

For those patients who have a risk factor for MD such as family history, over 50 years of age, early macula changes and if their diet is poor in dark green leafy vegetables, a daily lutein supplement of 6-10mg  is appropriate.

And if you want to ensure your diet is the best it can be to optimise your eye health here are some guidelines to get you started.

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*Recommended Daily Intake (RDI) per National Health and Medical Research Council (NHMRC). The RDI refers to the amount of a specific nutrient (vitamins, minerals, energy or protein) considered adequate to meet the nutritional requirements of healthy people. The RDI was formulated as a way to help prevent nutritional deficiency diseases in healthy people, and does not address theextraordinary needs of people who smoke, suffer from ill health or are on medication

 ‡ There is no standard daily intake for lutein. 6 mg is the accepted amount in lutein supplements.

# The measure mcg is a microgram. 1 mg = 1000 mcg.

Please note that Kale and some other green vegetables are high sources of Vitamin K which can interfere with the anticoagulant effect of medications such as warfarin. Always consult your healthcare professional if undertaking a major dietary change.