Dietary prevention of age-related macular degeneration.

S Pratt
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Abstract

Background: Age-related macular degeneration (ARMD) is the leading cause of blindness in people over the age of 65, and the prevalence of ARMD is expected to increase as the population ages. Although the incidence of ARMD increases sharply with age, recent studies indicate that prevention measures and dietary changes, implemented early in life, can reduce an individual's risk of ARMD.

Methods: Several dietary components have been proposed and studied with regard to their ability to protect against ARMD; these components include antioxidant vitamins and specific carotenoids. In particular, consumption of dark green, leafy vegetables has been shown in clinical studies to reduce the risk of ARMD.

Results: Biochemical studies of such vegetables have found that they contain several nutrients that may account for this effect, including high concentrations of the related carotenoids lutein and zeaxanthin. Structural and clinical studies have shown that these carotenoids are concentrated in the retinal macular pigment and that such accumulation is dependent on dietary intake. Further studies have indicated that the density of the macular pigment is related to preservation of visual sensitivity and (possibly) protection from ARMD.

Conclusions: Large-scale clinical trials will be necessary to demonstrate that specific agents can reduce the incidence of ARMD. Nevertheless, specific dietary components--particularly, the carotenoids found in dark green, leafy vegetables--have shown great promise. While lifestyle modifications such as smoking cessation, reduction of alcohol consumption, and the wearing of sunglasses may reduce the risk of ARMD, it is likely that consumption of specific dietary components can reduce the risk further.

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饮食预防老年性黄斑变性。
背景:年龄相关性黄斑变性(ARMD)是65岁以上人群致盲的主要原因,随着人口老龄化,ARMD的患病率预计会增加。尽管ARMD的发病率随着年龄的增长而急剧增加,但最近的研究表明,在生命早期实施的预防措施和饮食改变可以降低个体患ARMD的风险。方法:已经提出并研究了几种膳食成分对ARMD的保护能力;这些成分包括抗氧化维生素和特定的类胡萝卜素。特别是,临床研究表明,食用深绿色多叶蔬菜可以降低ARMD的风险。结果:对这类蔬菜的生化研究发现,它们含有几种可以解释这种效果的营养物质,包括高浓度的相关类胡萝卜素叶黄素和玉米黄质。结构和临床研究表明,这些类胡萝卜素集中在视网膜黄斑色素中,这种积累依赖于饮食摄入。进一步的研究表明,黄斑色素的密度与保持视觉敏感性和(可能)防止ARMD有关。结论:大规模的临床试验将是必要的,以证明特定的药物可以减少ARMD的发病率。然而,特定的饮食成分——尤其是深绿色绿叶蔬菜中的类胡萝卜素——显示出了巨大的希望。虽然生活方式的改变,如戒烟、减少饮酒和戴太阳镜可能会降低患ARMD的风险,但摄入特定的饮食成分可能会进一步降低风险。
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