How AMD develops

Your macula is part of your retina – the area in the back of your eye that turns images into signals which go to your brain. It lets you see small details clearly. When the macula starts to break down, you begin to have difficulty seeing detail.
As the disease gets worse, you lose your central vision. That makes it a problem to drive, read or make out faces clearly.
There are two forms of Macular Degeneration – dry and wet. Most people (over 85%) have what is called “dry” macular degeneration, which develops slowly.

Dry AMD

Dry AMD develops through lack of nutrients and the development of what are called drusen in your retina. These are small white or yellow fatty deposits largely consisting of cholesterol.  They cause the retina to begin to break down.

There is a genetic component, but anyone can succumb because inflammation and oxidative (free radical) damage to tissues, nerves and photoreceptor cells are the ultimate drivers of dry AMD.

Wet AMD

With the “wet” version, abnormal leaky blood vessels damage your macula and change the shape of your retina. While it’s less common, the wet type of macular degeneration is the cause of 90% of all vision loss leading to legal blindness. Often the ‘wet’ type follows the development of the ‘dry’ type.

Risk factors for AMD

A 2014 Lancet article estimates the risk of AMD is about 2% if you are under the age of 50, but this rises to almost 20% for people over the age of 75. About 65% of AMD cases occur in women and 35% in men but this is partly as women live longer.

According to the National Eye Institute, risk factors include smoking, a poor highly processed diet, lack of exercise, high blood pressure, a low intake of anti-oxidants and overweight or obesity.

The Lancet adds fluctuating blood sugar levels and high levels of inflammation and oxidative (free radical) damage as risk factors. Cardiovascular disease and diabetes are frequently co-existing diseases – which is logical because the driver behind these illnesses is also inflammation and free radical damage.

The AREDS studies confirm AMD risk can be cut with supplements

Two studies confirm that the risk of AMD can be cut substantially through taking food supplements. They are called AREDS 1 and AREDs 2. ARED stands for Age Related Eye Disease Study. Both studies were conducted by the National Eye Institute – a part of the US Government’s National Institutes of Health.

AREDS1 reported in 2001 and since the results were good, it was followed by AREDS2 which started in 2006 and ran 5 years. Its purpose was to see if an improved nutritional formula would work even better.

The supplements the studies used were both designed as high anti-oxidant formulae. They include the carotenoids lutein, beta carotene and zeaxanthin, plus high dose vitamin C and a small number of selected minerals.

The results of AREDS 2 showed long lasting benefits with a very significant – 32% – lower risk of advanced AMD.

Improving the results of supplementation even further

Can we even improve on these results? We can. The basis is a high anti-oxidant and a high anti-inflammatory diet and supplement. Here are 5 specific ways.

1. Boost fish oil consumption

   A study at the Massachusetts Eye and Ear Infirmary and another at the University of Sydney showed that men over 50 with the highest levels of oily fish consumption were 45 percent less likely to have AMD than those who ate the least amount of fish. High consumption was over two servings weekly; low consumption was less than one serving per week. So make salmon, herrings and sardines a frequent choice and/or add an Omega 3 supplement.

2. Eat nuts, green vegetables and fruit daily

   A 2004 study at Harvard Medical School showed that people who ate three or more servings of fruit daily had a substantially lower risk of wet or advanced AMD. Blueberries, bilberries, blackcurrants and cherries are especially beneficial since they contain what are called polyphenols. Polyphenols are a large class of anti-oxidant and anti-inflammatory compounds that fruits and vegetables have evolved to protect themselves – and when we eat those plants we get the same protective benefit too.

   In the case of berry fruits, the polyphenols are called anthocyanins – and anthocyanins give the berries their dark colouring and are powerful anti-oxidants.

   A further study from the Massachusetts Eye and Ear Infirmary reported that people who consumed the most vegetables rich in carotenoids (like lutein, lycopene and zeaxanthin) had a 43 percent lower risk of AMD than those who ate the least. Carotenoid-rich foods include spinach, kale and leafy green vegetables.

3. Limit your intake of sugar and refined carbohydrates

   Diets high in refined carbohydrates increase the risk of AMD, because they have a high glycemic index, causing a rapid increase in blood sugar and insulin release. In addition, sugars promote what is called glycation – where sugar molecules bond to proteins and cause ‘cross linking’ in body tissues. This cross linking is a little like wires becoming tangled and results in the general stiffening of tissues – including both small blood vessels and arteries.This not only damages eyes and the heart, but is a major cause of skin ageing.

4. Exercise regularly

   According to a study in the British Journal of Ophthalmology, which monitored 4,000 people for 15 years, people who led an active lifestyle were 70 percent less likely to have AMD develop during the follow-up period. ‘Active’ was defined as walking at least two miles a day for 3 days a week.

5. Wear sunglasses with UV and blue light protection

   A major recent study found that people who consumed too few antioxidants, and had overexposure to blue light, were four times more likely to develop advanced or wet AMD.

Other risk reduction actions

1. • Increase the font size and contrast on your computer, which reduces eye strain.
   • Keep hydrated. It helps clears any irritants out of your eyes.
   • A possible ‘off label’ drug treatment for AMD is Avastan. Avastan is a drug used in cancer therapy. It works by inhibiting the supply of new blood vessels feeding a tumour – essentially starving the cancer of the nutrients it needs to grow. Ophthalmologists can use Avastan to prevent the abnormal growth of cells involved in especially wet AMD. There is evidence that soy isoflavones too at a level of about 40mg a day can limit the supply of new blood vessels.

Protect your eyesight – but not in isolation from the rest of your body

If you are concerned that you are developing macular degeneration, or if you are trying to halt its progression, it’s natural to concentrate on solving this one problem.

But we now know that inflammation and free radical damage are the key drivers of this disease. And these twin threats don’t just damage your eyes. They are the central cause of almost all so-called ‘age related’ disease.

We say ‘so-called’ because it is not the simple advance of years – it is the accumulation of free radical damage and chronic inflammation that underlies loss of vision, alongside heart disease, stroke, diabetes, arthritis and even some cancers.

We have seen that official studies show that the AREDS supplements have a significant preventative effect on eye health – which, incidentally, gives a lie to those who say health supplements are a waste of money.

But we can go further. By adding some of the most powerful anti-oxidant and anti-inflammatory compounds identified in fruits and vegetables, plus Omega 3, we can create a supplement that helps protect – not just your vision – but your whole body.

Dr Paul Clayton, the former Chair of the Forum on Food and Health at the Royal Society of Medicine, proposed just such a supplement in his best-selling book Health Defence. It has been turned into an actual supplement called Nutrishield.

Below is the comparison between the AREDS formula and NutriShield. NutriShield adds a much wider range of anti-oxidant and anti-inflammatory nutrients, plus vitamins and minerals at what are judged to be optimum levels, rather than just RDA levels.

SUMMARY

Although there is no cure, as yet, for Age-related Macular Degeneration, there is very good evidence that its progression can be slowed and even halted.

The way is through improved diet and a supplement that is specifically designed to counteract oxidation and inflammation. Because these are the drivers, not only of AMD, but almost all other age-related illnesses.

NOTE: We created this article in response to a question from a customer. As a reader of this blog, if you have a health question, we are always pleased to try to help. Please CONTACT US or visit A-Z QUESTIONS page. 

Dr Paul Clayton designed NutriShield as a comprehensive health supplement with OPTIMUM levels of essential nutrients.