A combination of two European population-based prospective cohorts has carried out the investigation on the adherence to a Mediterranean diet (“MeDi”). The adherence to the MeDi was evaluated using a 9-component score, based on intake of (i) vegetables, (ii) fruits, (iii) legumes, (iv) cereals, (v) fish, (vi) meat, (vii) dairy products, (viii) alcohol, and (ix) the monounsaturated-to-saturated fatty acids ratio. The results of the 21-year study showed that 4,996 participants associated with a 41% reduced risk of incident in advanced AMD with a higher adherence to the MeDi. The researchers support the role of a diet rich in healthful nutrient-rich foods such as fruits, vegetables, legumes, and fish in the prevention of AMD.
The report of the two studies focused on the analysis of the Rotterdam Study I (RS-I) and the Antioxydants, Lipides Essentiels, Nutrition et Maladies Oculaires (Alienor) Study populations, based in Rotterdam and Bordeaux, respectively. In it, researchers commented that “a prospective design is more accurate and less biased than a cross-sectional or case-control design to evaluate the association between diet and AMD”. Among the 4996 included participants, 155 demonstrated advanced incident AMD (117 from the RS-I and 38 from the Alienor Study). The mean follow-up time was 9.9 years (range, 0.6–21.7 years) in the RS-I and 4.1 years (range, 2.5–5.0 years) in the Alienor Study. Pooling data for both the RS-I and Alienor Study, participants with a high (range, 6–9) MeDi score showed a significantly reduced risk for incident advanced AMD compared with participants with a low (range, 0–3) MeDi score in the fully adjusted Cox model (hazard ratio, 0.59; 95% confidence interval, 0.37–0.95; P = 0.04 for trend).
According to the study, it is estimated that 196 million people worldwide will be affected by AMD in 2020, increasing to 288 million affected people in 2040. As the risk of AMD is developing jointly on the basis of age, individual genetic background, and lifestyle, the only current modifiable risk here is diet. Consequently, health and diet may be clearly useful as a public health policy tool that can significantly benefit across populations. In the conclusion of the paper, the researchers commented that “studies suggest that adopting an energy-unrestricted diet rich in healthful nutrient-rich foods such as fruits, vegetables, legumes, and fish and reducing the unhealthful foods such as red and processed meats and savory and salty industrialized products” are likely to support the prevention of AMD.