Is Macular Degeneration Avoidable?

Remember...peanuts aren't nuts, they're legumes

Remember…peanuts aren’t nuts, they’re legumes

I saw an optometrist earlier this year for a new eyeglass prescription and mentioned that age-related macular degeneration (ARMD or AMD) runs in my family. ARMD is the leading cause of adult blindness in the West. Thank God, I don’t have it….yet.

The optometrist suggested I start taking eye vitamins to help prevent ARMD. Popular eye vitamin preparations in Arizona are Ocuvite and I-Caps. He said a multivitamin like Centrum might be just as effective.

UpToDate.com, a source I trust, says that supplements for prevention probably don’t work and are not recommended. Which means Centrum would be just as effective: i.e., none of them work.

Instead, UpToDate recommends regular exercise, not smoking, and relatively high consumption of leafy green vegetables, fruits, fish and nuts. Although they didn’t mention it by name, the traditional Mediterranean diet provides all of those.

On the other hand, if you already have macular degeneration (wet or dry), UpToDate recommends these supplements (probably based on the AREDS-2 study):

  • vitamin C 500 mg/day
  • vitamin E 400 mg/day
  • lutein 10 mg/day
  • zeaxanthin 1 mg/day
  • zinc 80 mg/day (as zinc oxide)
  • copper 2 mg/day (as cupric oxide)

A reasonable alternative for non-smokers and never-smokers is the standard AREDS formula. It’s the same as above except it substitutes beta carotene for lutein or zeaxanthin. You can buy both formulations over-the-counter in the U.S. pre-mixed so you don’t have to swallow a handful of pills, just one.

The last time I checked the supermarket price, Bausch and Lomb’s AREDS-2 formula was about $10/month.

Steve Parker, M.D.

6 Comments

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6 responses to “Is Macular Degeneration Avoidable?

  1. Jan

    I don’t get this idea of supplements when real food can provide.. The Mediterranean diet seems to have all that is required.

    ~Vitamin C in tomatoes, citrus, colorful fruit and veggies.
    ~Vitamin E is provided by seeds, nuts, and spinach.
    ~Leafy greens are good sources of lutein and zeacanthin.
    ~Red meat, poultry, seeds and nuts are good sources of zinc, seeds and mushrooms are good sources of copper.

    All of these are common in Mediterranean cuisines.

    We don’t even know all the micronutrients provided by real food–a supplement can never fully compete. I sure wouldn’t wait until the macular degeneration has made itself known to start eating this way!

  2. Danae

    I too have a family history of ARMD, so I’ve been thinking about the same questions on vitamins for prevention. It does seem likely that a good Mediterranean diet would cover the vitamins C and E, and the carotenoids. My big questions has been regarding the zinc. The 80 mg of zinc in the ARED formula is a large dose (the RDA is 8-11 mg/day), and taking too much zinc can mess up your zinc/copper balance. But maybe it would be useful for prevention purposes to know if one is low in zinc, so one could supplement at a more modest level. Do you know if there are reliable blood tests for zinc and copper? Are those tests commonly used, or is my doctor going to give me one of “those looks” if I raise the question?

  3. Jim Jozwiak

    We all have legitimate concerns that we are predisposed to conditions our relatives have suffered. The only approach that makes sense to me is to adopt some nutrition standard such as a recommended daily allowance and determine that one’s diet meets that standard for all essential nutrients, then:
    1) experimentally supplement the individual essential nutrients (carotenoids are not “essential nutrients”) one at a time to discover if some essential nutrient is too low in the standard, and if so determine the optimal level.
    2) determine the optimal grams each of carbohydrate and protein and the optimal calorie level and eat that way.
    Is this a complicated undertaking? Yes, but if you are concerned but not concerned enough to actually figure out your diet, then accept that you are not really all that concerned.

  4. Cathy

    It seems that the “epidemic” of macular degeneration coincided with the demonization of foods containing saturated fat and especially eggs. The lutein found in egg yolks helps keep one’s eyes healthy.