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Intake of key micronutrients and food groups in patients with late-stage age-related macular degeneration compared with age–sex-matched controls
  1. Bamini Gopinath1,
  2. Gerald Liew1,
  3. Joanna Russell2,
  4. Victoria Cosatto1,
  5. George Burlutsky1,
  6. Paul Mitchell1
  1. 1Centre for Vision Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
  2. 2Faculty of Social Sciences, School of Health and Society, University of Wollongong, Sydney, New South Wales, Australia
  1. Correspondence to Dr Bamini Gopinath, Centre for Vision Research, The Westmead Institute for Medical Research, The University of Sydney, Westmead Hospital, Hawkesbury Rd, Westmead, NSW 2145, Australia; bamini.gopinath{at}


Background Knowledge of the risk factor profile of patients presenting with late-stage age-related macular degeneration (AMD) could help identify the most frequent modifiable AMD precursors among people who are referred for treatment. We aimed to assess dietary behaviours by comparing adjusted mean intakes of micronutrients and major food groups (fruits, vegetables, fish) among patients with AMD and a sample of age–sex-matched controls.

Methods Cross-sectional analysis of 480 late AMD cases and 518 population-based age–sex-matched controls with no AMD signs. AMD cases (aged 60+ years) were those presenting for treatment to a hospital eye clinic in Sydney, Australia, during 2012–2015. The comparator group were obtained from a cohort study (Blue Mountains Eye Study; Sydney, Australia) during 2002–2009. Dietary intake was assessed using a semiquantitative food-frequency questionnaire. AMD lesions were assessed from retinal photographs.

Results After multivariable adjustment, patients with late-stage AMD compared with controls had significantly lower intakes of vitamin E (7.4 vs 9.8 mg/day; p<0.0001), beta-carotene (6232 vs 7738 μg/day; p<0.0001), vitamin C (161 vs 184 mg/day; p=0.0002) and folate (498.3 vs 602 μg/day; p<0.0001); but had higher intakes of zinc (13.0 vs 11.9 mg/day; p<0.0001). A significantly lower proportion of patients with late AMD met the recommended intake of vegetables than controls: 52.9% versus 64.5%; p=0.0002.

Conclusions This study showed significant differences in intakes of vitamins C and E, beta-carotene, folate and vegetables between patients with late-stage AMD and healthy controls, and thus has provided a better understanding of the nutritional intake of patients presenting with advanced AMD.

  • Epidemiology
  • Macula
  • Public health

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  • Contributors The authors' responsibilities were as follows—BG and PM: study concept and design; PM, VC: acquisition of data; GB: analysis of data; BG, JR, GL and PM: interpretation of data; BG: drafting of the manuscript; BG, JR, GL, VC and PM: critical revision of the manuscript.

  • Funding This study is funded by the Macular Disease Foundation Australia. The Blue Mountains Eye and Hearing Studies were supported by the Australian National Health and Medical Research Council (Grant Nos 974159, 991407, 211069, 262120). BG is supported by a Blackmores and Macular Disease Foundation Australia Dr Paul Beaumont Fellowship.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval The University of Sydney and the Western Sydney Area human ethics committees approved the study. The study protocol was reviewed and approved by the Western Sydney Local Health District human research ethics committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All relevant data are within the paper.

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