Smoking, Antioxidant Supplementation and Dietary Intakes among Older Adults with Age-Related Macular Degeneration over 10 Years

<div><p>We aimed to compare the micronutrient usage and other lifestyle behaviors over 10 years among those with and without age-related macular degeneration (AMD). 1612 participants aged 49+ years at baseline were re-examined over 10 years, west of Sydney, Australia. AMD was assessed from retinal photographs. Dietary data were collected using a semi-quantitative food frequency questionnaire. Smoking status was self-reported. 56 participants had any AMD at baseline, of these 25% quit smoking at 5 years and were still not smoking at 10-year follow-up. Among participants who had below the recommended intake of vitamins A, C or E supplements at baseline, those who did compared to those who did not develop late AMD over 10 years were more likely to report vitamins A (total), C or E supplement intake above the recommended intake at 10-year follow-up: multivariable-adjusted OR 4.21 (95% CI 1.65-10.73); OR 6.52 (95% CI 2.76-15.41); and OR 5.71 (95% CI 2.42-13.51), respectively. Participants with compared to without AMD did not appreciably increase fish, fruit and vegetable consumption and overall diet quality. Adherence to smoking and dietary recommendations was poor among older adults with AMD. However, uptake of antioxidant supplements increased significantly among those with late AMD.</p></div

Association between cumulative cases of AMD and increase in consumption of fruits, vegetables (in g/day), and fish over 10 years in the Blue Mountains Eye Study.

<p>^a At or above recommended vegetable intake at BMES-3 defined as ≥375 g/day (five 75 gram serves per day) and lower intake at BMES-1 as <375 g/day</p><p>^b At or above recommended fruit intake at BMES-3 defined as ≥300 g (two 150 gram serves per day) and low intake at BMES-1 as <300 g</p><p>^c At or above recommended fish consumption at BMES-3 defined as ≥28.5 g/day (two 100 gram serves per day) and low consumption at BMES-1 as <28.5 g/day</p><p>Association between cumulative cases of AMD and increase in consumption of fruits, vegetables (in g/day), and fish over 10 years in the Blue Mountains Eye Study.</p

Association between cumulative AMD and incident antioxidant supplement usage over 10 years ^a in the Blue Mountains Eye Study, presented as adjusted odds ratio (OR) and 95% confidence intervals (CI).

<p>^a Analyses included participants who were below the recommended daily intake for vitamins A, C, or E or β-carotene, and/or zinc at baseline.</p><p>^b Adjusted for age, sex, smoking, education, BMI, and receipt of pension</p><p>^c Total Vitamin A in μg retinol equivalents = retinol micrograms + (beta-carotene μg / 6)</p><p>^d Cumulative cases of early or late AMD over the 10-year follow-up</p><p>Association between cumulative AMD and incident antioxidant supplement usage over 10 years <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0122548#t002fn001" target="_blank">^a</a> in the Blue Mountains Eye Study, presented as adjusted odds ratio (OR) and 95% confidence intervals (CI).</p

Study characteristics of participants stratified by AMD status at baseline who were followed up at the 10-year follow up in 2007–9 Blue Mountains Eye Study.

<p>Data are presented as n (%) or mean (SD)</p><p>Study characteristics of participants stratified by AMD status at baseline who were followed up at the 10-year follow up in 2007–9 Blue Mountains Eye Study.</p

Included and excluded participants.

<p>Numbers are means (standard deviations) or %.</p

Measurement of retinal arterioles (red lines) and venules (blue lines) passing through a region between ½ to 1 disc diameters from the optic disc margin.

<p>Measurement of retinal arterioles (red lines) and venules (blue lines) passing through a region between ½ to 1 disc diameters from the optic disc margin.</p

Multivariable adjusted arteriolar and venular calibers.

<p>Model 1 is adjusted for age and sex; Model 2 adjusted for variables in Model 1 and systolic blood pressure, diabetes, smoking; Model 3 adjusted for variables in model 2 and either venular or arteriolar caliber.</p><p>P values are for trend.</p><p>* per quintile increase in blood count component.</p><p>** for blood count component in the given model.</p

Blood components and unadjusted retinal arteriolar and venular calibers.

<p>M refers to Men, W refers to Women. Q1–5 refers to quintiles. SD to standard deviation.</p

Association between head injury and concussion with retinal vessel caliber

<div><p>The adverse long-term consequences following traumatic brain injury are poorly understood, particularly on the cerebral microvasculature. Retinal vessels are a surrogate marker of cerebral vascular changes. We therefore aimed to examine the cross-sectional association between serious head injury or being knocked unconscious, and/or concussion and retinal microvascular signs, specifically, mean retinal arteriolar and venular calibre, in older adults after accounting for potential confounders. This cohort study involved 2,624 adults with mean age of 66.9 (±9.1) years who self-reported head injury and concussion parameters, and had gradable retinal photographs. Face-to-face interviews with trained interviewers allowed participants to report prior serious head injury or being knocked unconscious, and/or a previous diagnosis of concussion by a medical professional. Fundus photographs were taken and retinal vascular calibre measured using computer-assisted techniques and summarized. There were 25.9%, 15.3% and 10.1% who reported a prior serious head injury or being “knocked unconscious”, concussion, and both, respectively. Participants in the first group compared to non-injured participants had significantly wider (~2 μm) mean retinal venular calibre (p = 0.02), after adjusting for age, sex, smoking, body mass index, mean arterial blood pressure, type 2 diabetes and fellow vessel calibre. No significant associations were observed in people reporting medically diagnosed concussion or with mean retinal arteriolar calibre. Our exploratory study suggests that head injury is independently associated with wider retinal venular caliber. These findings warrant further investigation in longitudinal cohort studies.</p></div

Energy-adjusted dietary intakes of long chain omega-3 polyunsaturated fatty acids (LCn-3 PUFA) at age 12 and 17 years among participants of the Sydney Childhood Eye Study during 2004–5 to 2009–11.

<p>Energy-adjusted dietary intakes of long chain omega-3 polyunsaturated fatty acids (LCn-3 PUFA) at age 12 and 17 years among participants of the Sydney Childhood Eye Study during 2004–5 to 2009–11.</p