Visualization of dietary patterns and their associations with age-related macular degeneration

Authors: CHIU, CHUNG-JUNG - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; CHANG, MIN-LEE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; LI, TRICIA - Harvard University; GENSLER, GARY - Emmes Corporation; TAYLOR, ALLEN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University

Submitted to: Investigative Ophthalmology and Visual Science
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/24/2017
Publication Date: 3/1/2017
Citation: Chiu, C., Chang, M., Li, T., Gensler, G., Taylor, A. 2017. Visualization of dietary patterns and their associations with age-related macular degeneration. Investigative Ophthalmology and Visual Science. doi: 10.1167/iovs.16-20454.

Interpretive Summary: Prevention of disease is preferred to treatment and remediation. This is especially true of age-related macular degeneration (AMD.) Advanced AMD is the major cause of incurable blindness in persons aged 65 years or older in developed countries. Vision impairment due to advanced AMD significantly reduces quality of life and consumes a large portion of the Medicare budget. Most importantly, current treatments for AMD are costly and can only arrest the neovascular type of advanced AMD without preventing progression of visual loss. The purpose of this study was to find out if certain dietary patterns provide more protection than others against AMD. We collected data from an elderly American cohort of 4,088 people and analyzed the participants' dietary patterns and how their dietary patterns related to AMD risk. To facilitate our analysis, we used simple diagrams to visualize the results. In doing so, we were able to gain insight into what had been missed before. Our findings suggest that a diet consisting of various healthy foods, including previously unidentified beneficial foods, may be optimal for reducing AMD risk and that the effects of combinations of specific foods in the overall diet warrant further study.

Technical Abstract: PURPOSE: We aimed to visualize the relationship of predominant dietary patterns and their associations with AMD. METHODS: A total of 8103 eyes from 4088 participants in the baseline Age-Related Eye Disease Study (AREDS) were classified into three groups: control (n=2739), early AMD (n=4599), and advanced AMD (n=765). Using principle component analysis, two major dietary patterns and eight minor dietary patterns were characterized. Applying logistic regression in our analysis, we related dietary patterns to the prevalence of AMD. Qualitative comparative analysis by operating Boolean algebra and drawing Venn diagrams was used to visualize our findings. RESULTS: In general, the eight minor patterns were subsets or extensions of either one of the two major dietary patterns (Oriental and Western patterns) and consisted of fewer characteristic foods than the two major dietary patterns. Unlike the two major patterns, which were more strongly associated with both early and advanced AMD, none of the eight minors were associated with early AMD and only four minor patterns, including the Steak pattern (odds ratio comparing the highest to lowest quintile of the pattern score =1.73 [95% confidence interval: 1.24 to 2.41; Ptrend=0.02]), the Breakfast pattern (0.60 [0.44 to 0.82]; Ptrend=0.004]), the Caribbean pattern (0.64 [0.47 to 0.89; Ptrend=0.009]), and the Peanut pattern (0.64 [0.46 to 0.89; Ptrend=0.03]), were significantly associated with advanced AMD. Our data also suggested several potential beneficial (peanuts, pizza, coffee, and tea) and harmful (salad dressing) foods for AMD. CONCLUSIONS: Our data indicate that a diet of various healthy foods may be optimal for reducing AMD risk. The effects of some specific foods in the context of overall diet warrant further study.