Better Health. No Hassles. Nutrition & Eye Health Sponsored in part by a generous education grant...

Better Health. No Hassles.

Nutrition & Eye Health

Sponsored in part by a generous education grant from:


Age-Related Eye Diseases

• More than 30 million people age 40 and older suffer vision loss in the U.S.

• Age-Related Macular Degeneration (AMD)– Approximately 21 million Americans have AMD

– AMD cases have risen 25% since 2002, largest increase among major eye diseases

• Cataracts– More than 22 million Americans have cataracts

– 400,000 new cases of cataract occur each year in the U.S.

Prevent Blindness America/National Eye Institute 2008 “Vision Problems in the US”W. Reed Moran, Spotlight Health, With medical adviser Stephen A. Shoop, M.D., USA Today, Feb.

2001


Age-Related Eye Diseases

• Non-surgical treatments of AMD– Low Vision Rehabilitation

– Nutrition

−National Eye Institute (of the NIH) - Age-Related Eye Disease Study (AREDS)

−3640 patients in high risk AMD categories

−7 year supplementation: Beta-carotene, Vitamin C, Vitamin E & Zinc/Copper

(2001). "A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age- related macular degeneration and

vision loss: AREDS report no. 8." Arch Ophthalmol 119(10): 1417-36.


AREDS

• Daily supplement dosage– Beta-carotene – 15 mg

– Vitamin C – 500 mg

– Vitamin E – 400 IU

– Zinc – 80 mg/Copper – 2 mg

• Conclusions– AMD is a nutrition responsive disorder

– 29% decreased risk of progression of advanced AMD

– 21% reduction of visual acuity loss

(2001). "A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age- related macular degeneration and vision loss: AREDS report no. 8." Arch Ophthalmol 119(10): 1417-36.


Vitamin C

• Why is it important?– Body unable to synthesize

– Antioxidant capability

• How much do I need each day?– 75 – 90 mg/day (DRI)

– 500 mg/day (eye health)

• Where can I get it in my diet?– Citrus fruits and juices

Jacob, R. A. and G. Sotoudeh (2002). "Vitamin C function and status in chronic disease." Nutrition in clinical care 5(2): 66-74.(2001). "A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene,

and zinc for age- related macular degeneration and vision loss: AREDS report no. 8." Arch Ophthalmol 119(10): 1417-36.

Chiu, C. J. and A. Taylor (2007). "Nutritional antioxidants and age-related cataract and maculopathy." Experimental eye research 84(2): 229-45.

Chew, E. (2007). “Age-related eye disease study 2 protocol.” National Eye Institute Protocol 07-EI-0025.


Vitamin E

• Why is it important?– Body unable to synthesize

– Antioxidant capability

• How much do I need each day?– 22 IU/day (DRI)

– 400 IU/day (Eye Health)

• Where can I get it in my diet?– Nuts, fortified cereals, sweet potatoes

(2001). "A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age- related macular degeneration and vision loss: AREDS report no. 8." Arch Ophthalmol 119(10): 1417-36.

Chiu, C. J. and A. Taylor (2007). "Nutritional antioxidants and age-related cataract and maculopathy." Experimental eye research 84(2): 229-45.



Zinc

• Why is it important?– Essential trace element

• How much do I need each day?– 8-11 mg zinc/day (DRI)– 40 – 80 mg zinc/day (Eye Health)

• Where can I get it in my diet?– Red meat, poultry, mixed nuts

• Copper– High zinc may cause copper deficiency– 2 mg included in AREDS study

(2001). "A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age- related macular degeneration and vision loss: AREDS report no. 8." Arch Ophthalmol 119(10):

1417-36.Chew, E. (2007). “Age-related eye disease study 2 protocol.” National Eye Institute Protocol 07-EI-0025.

Grahn, B. H., P. G. Paterson, et al. (2001). "Zinc and the eye." Journal of the American College of Nutrition 20(2 Suppl): 106-18.


Emerging Science


AREDS2

• National Eye Institute (of the NIH)

• Follow-up to original AREDS

• 4000 patients in high risk AMD categories

• 5 year supplementation:– Carotenoids: lutein (10mg/day), zeaxanthin (2

mg/day) – Essential Fatty Acids: DHA (350 mg/day) and EPA

(650 mg/day)– Patients allowed to take the original AREDS formula

Age-Related Eye Disease study 2 Protocol.www.emmes.com/study/areds2


Lutein & Zeaxanthin

Lutein & Zeaxanthin

In nature

In human dietIn bloodIn retina

600

50

14

2

Ong and Tee, Methods in enzymology (1992) 213:142-167Krinsky NI, Russett MD, Handelman GJ, Snodderly DM, J Nutr. (1990) 120:1654-1662

Khachik F, Beecher GR, Goli MB, Lusby WR, Smith JC Jr., Anal Chem. (1992) 64: 2111-22


Why are they important?

• Body unable to synthesize

• Blue-light filter– Reduces exposure to the most damaging, high-

energy light

• Antioxidant – Neutralizes or quenches free radicals

Stahl and Sies (2005) Biochimica et Biophysica Acta. 1740:101-107.


Internal pair of sunglasses

The sun emits photo oxidizing (UV) rays that are harmful to the eyes

Sunglasses reduce free radicals

Carotenoids such as lutein and zeaxanthin filter blue light to block production of free radicals

Good nutrition helps reduce the risk of chronic eye diseases such as macular degeneration and may improve visual function


How much do I need each day?

• 10 mg/day lutein

• 2 mg/day zeaxanthin

• Dietary Guidelines for Americans*– Equivalent to 4 - 8 mg lutein &

zeaxanthin per day

– < 4% Americans meet guidelines

– U.S. average: 1 – 2.5 mg/day

*9 servings of fruits and vegetables every day; recommendation

based on the reference 2,000 calorie diet.

HHS/USDA. Dietary Guidelines for Americans 2005. http://www.healthierus.gov/dietaryguidelines/CDC. National Health and Nutrition Examination Survey Data 2001-2002. http://www.cdc.gov/nchs/about/major/nhanes/nhanes01-02.htm

Richer, S., W. Stiles, et al. (2004). "Double-masked, placebo-controlled, randomized trial of lutein and antioxidant supplementation in the intervention of atrophic age-related macular degeneration: the Veterans LAST study (Lutein Antioxidant Supplementation Trial)." Optometry 75(4): 216-30.

Stringham, J. M. and B. Hammond (2008). "Macular Pigment and Visual Performance Under Glare Conditions." Optometry & Vision Science 85(2): 82-88. Chew, E. (2007). “Age-related eye disease study 2 protocol.” National Eye Institute Protocol 07-EI-0025.


Where can I get these nutrients in my diet?

• Increase consumption of:

– Green, leafy vegetables– Eggs– Dietary supplements– Functional beverages

(a beverage that provides health benefits beyond energy and essential nutrients)

RomaineLettuce

Spinach

Eggs

Supplements

U.S. Department of Agriculture, Agricultural Research Service, USDA Nutrient Data Laboratory. USDA National Nutrient Database for Standard Reference, Release 20 (2007). Nutrient Data Laboratory Home Page,

http://www.nal.usda.gov/fnic/foodcomp


Where can I get these nutrients in my diet?

Food item mg lutein & zeaxanthin (per 100 g)

Kale, raw 39.6 Spinach, raw 12.2 Turnip greens, cooked 8.4 Collard, cooked 7.7 Green peas, cooked 2.6 Romaine lettuce, raw 2.3 Broccoli, raw 1.4 Corn, cooked 0.9 Green beans, cooked 0.7 Papaya (1 large) 0.3 Egg (1 large) 0.2

U.S. Department of Agriculture, Agricultural Research Service, USDA Nutrient Data Laboratory.

USDA National Nutrient Database for Standard Reference, Release 20 (2007). Nutrient Data Laboratory Home Page, http://www.nal.usda.gov/fnic/foodcomp


Essential Fatty Acids - DHA/EPA

• Why are they important?– Important role in many bodily organs/systems

especially the brain and retina (eye)

• How much do I need each day?– 350 mg DHA / 650 mg EPA per day

• Where can I get them in my diet?– Flax, fleshy fish like tuna or salmon

Fliesler, et al. Prog Lipid Res (1983) 22:79-131Connor, et al. Nutr Rev (1992) 50:21-29

Cho, et al. Am. J. Clin. Nutr. (2001) 73:209-218Birch, et al. Ped. Res. (1998) 42: 201-209.



Nutrients for Healthy Eyes

• 500 mg/day Vitamin C

• 400 IU/day Vitamin E

• 25 or 80 mg Zinc / 2 mg Copper per day

• 10 mg Lutein / 2 mg Zeaxanthin per day

• 350 mg DHA / 650 mg EPA per day


For More Nutrition Information

• www.aoa.com

• www.eatright.org

• www.luteininfo.com

Better Health. No Hassles. Nutrition & Eye Health Sponsored in part by a generous education grant...

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