Agrón Elvira, Vance Emily, Domalpally Amitha, Chew Emily Y, Keenan Tiarnán D L
Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA.
Department of Ophthalmology and Visual Sciences, Madison School of Medicine and Public Health, University of Wisconsin, Madison, WI 53726, USA.
Nutrients. 2025 Feb 22;17(5):771. doi: 10.3390/nu17050771.
: The objective of this study was to analyze the relationships between diet and geographic atrophy (GA) progression, both area-based and proximity-based, for dietary pattern, components, and micronutrients. : In the Age-Related Eye Diseases Study (AREDS) and AREDS2, an Alternative Mediterranean Diet Index (aMedi), its nine components, and individual micronutrient intakes were calculated. Mixed-model regression was performed for square root GA area, GA foveal proximity, and acuity. : The study populations comprised 657 (AREDS) and 1179 eyes (AREDS2). For area-based progression, a higher aMedi was associated with slower progression in AREDS2 and (in analyses excluding MUFA:SFA) AREDS. A higher intake was associated with slower progression for seven components (including vegetables and fruit at Bonferroni) and four components (including fruit and less red meat at Bonferroni), and seven and 15 nutrients, in AREDS1/2, respectively. For proximity-based progression, a higher aMedi was associated with slower progression in AREDS. A higher intake was associated with slower progression for three components (including vegetables at Bonferroni) and two components, and 10 and 8 nutrients, in AREDS1/2, respectively. With increasing oral supplementation, associations between proximity-based progression and aMedi/components/nutrients were weaker. In AREDS2 eyes with non-central GA, higher aMedi was associated with a slower acuity decline. : A Mediterranean-type diet is associated with slower GA area-based progression and slower progression to the fovea, accompanied by a slower decline in acuity. The most important components and micronutrients for incidence, area-based progression, and foveal progression overlap only partially. For the latter two, they include vegetables, fruit, and less red meat. These findings suggest the benefits of targeted nutritional and supplementation strategies.
本研究的目的是分析饮食模式、成分和微量营养素在基于面积和基于距离的情况下与地理性萎缩（GA）进展之间的关系。在年龄相关性眼病研究（AREDS）和AREDS2中，计算了替代地中海饮食指数（aMedi）、其九个组成部分以及个体微量营养素摄入量。对GA面积的平方根、GA中心凹距离和视力进行了混合模型回归分析。研究人群包括657只眼睛（AREDS）和1179只眼睛（AREDS2）。对于基于面积的进展，在AREDS2以及（在排除单不饱和脂肪酸：饱和脂肪酸的分析中）AREDS中，较高的aMedi与较慢的进展相关。在AREDS1/2中，分别有七种成分（在Bonferroni校正下包括蔬菜和水果）、四种成分（在Bonferroni校正下包括水果和较少的红肉）以及七种和十五种营养素，较高的摄入量与较慢的进展相关。对于基于距离的进展，在AREDS中，较高的aMedi与较慢的进展相关。在AREDS1/2中，分别有三种成分（在Bonferroni校正下包括蔬菜）、两种成分以及十种和八种营养素，较高的摄入量与较慢的进展相关。随着口服补充剂的增加，基于距离的进展与aMedi/成分/营养素之间的关联减弱。在非中心性GA的AREDS2眼睛中，较高的aMedi与较慢的视力下降相关。地中海式饮食与基于GA面积的较慢进展、向中心凹的较慢进展以及较慢的视力下降相关。对于发病率、基于面积的进展和向中心凹的进展而言，最重要的成分和微量营养素仅部分重叠。对于后两者，它们包括蔬菜、水果和较少的红肉。这些发现表明了针对性营养和补充策略的益处。
