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Nutrition, Macular Pigments and AMD  - New

Nutritional Intervention and Lifestyle May Help Macular Degeneration

How Can Changes in Diet, Vitamins and Lifestyle Modifications Help Macular Degeneration?

Lange Eye Care and Associates / Lange Eye Institute
Dr. Michael P. Lange O.D., C.N.S.  Board Certified Optometric Physician and Board Certified Nutritional Specialist  4-30-2009

Vitamin therapy and lifestyle modifications have proven to be extremely valuable at helping to stabilize Macular Degeneration.

Macular Degeneration is the leading cause of vision impairment for people over the age of 55 in the United States. Currently there are close to two million people living in our country that are vision impaired from Macular Degeneration. With our population living longer and longer it is estimated that over 3 million people by 2020 will have Age Related Macular Degeneration. By then each of us will know someone that has lost their vision from Macular Degeneration. 

Macular Degeneration is a medical condition that causes degeneration of the central part of the retina called the macula. There are two basic types of Age Related Macular Degeneration 

1. Wet ARMD or neovascular ARMD, which means abnormal growth of new blood vessels grow into the retina and leak causing edema and atrophy of the central retina. 

2. Dry ARMD or non-neovascular ARMD. The dry form of Macular Degeneration is the most common type with around 85%-90% of sufferers having the dry form. The wet form of Macular Degeneration is the most destructive and the onset can be fairly rapid. The dry form of ARMD can slowly steal a patients central vision until they become legally blind. 

An estimate of about 20% of Dry ARMD can turn into Wet ARMD. Some people may have an increased risk of developing Macular Degeneration because of their genetic makeup. However, most cases of Macular Degeneration are probably related to a combination of genetics, poor nutrition, sedimentary lifestyle and environmental factors. 

Significant research in the area of Macular Degeneration looks very promising. The evolving therapies Board Certified Optometrists and Ophthalmologists have, brings new hope for anyone diagnosed with ARMD. These new therapies may halt, improve or even cure forms of Macular Degeneration. Ongoing research in Macular Degeneration is constantly revealing new ways to help the Macular Degenerative patient and maintains a very high level of hope for the future care of ARMD. 

Ultimately we look forward to a future where macular degeneration no longer poses a threat to vision.

What can be done to decrease the risk of going blind from Macular Degeneration?

Nutritional intervention and lifestyle modifications may be beneficial at helping to stabilize Macular Degeneration. I have personally seen thousands of patients with Macular Degeneration in clinical practice for over 17 years.  I have seen the positive benefits that patients can realistically obtain through nutritional intervention and lifestyle modifications.  Many patients with Macular Degeneration are benefiting dramatically from visiting an eye care provider that is in tune with the latest in nutritional therapy.  Doctors from all over the world are using dietary modifications, addition of nutraceuticals and lifestyle changes to aid the patient with Macular Degeneration. These Doctors have seen some incredible improvements in vision as well as overall health in these patients. 

Optometrists and Ophthalmologists often times utilize intracellular and plasma blood testing along with advanced retinal imaging to help determine if a patient may have modifiable risk factors for Macular Degeneration.  Some of these modifiable risk factors include elevated c-reactive protein, elevated cholesterol, elevated triglycerides, elevated homocysteine, lipofuscin pigment accumulation and nutritional deficiencies.

The following is a list of 15 steps that can be utilized to decrease the risk of having progressive visual loss from macular degeneration. This list was compiled based on solid scientific evidence reported in related literature and from positive results we have seen clinically in a very large Macular Degeneration practices. This does not replace a comprehensive dilated eye examination by a board certified Optometrist or Ophthalmologist.

1.  Follow a low fat diet (decrease saturated fats and trans fatty acids) eat more turkey, chicken, cold water fish and soy products like Garden burgers (a popular vegetarian meat substitute), soy milk and tofu. 

Eat less red meat, whole milk and cheese. Eat the breast meat of chicken and turkey from free roaming organically raised sources (if possible), and prepare without deep frying; broiling, grilling, boiling or baking is healthier.

Be careful when eating fish because many large fish have toxic levels of mercury, lead and PCBs (PCBs are persistent organic pollutants, banned since 1977, that entered the environment through both original use and later disposal). Eat small fish like sardines, anchovies and herring. 

Try to avoid farm raised fish and eat wild fish especially wild Alaskan salmon (wild salmon are high in a super carotenoid  called astaxanthin that is proving to be a key nutrient in  the nutritional approach for macular degeneration. 

A lean organically raised GRASS FED steak in moderation is a good source of protein, Vitamin B complex, zinc, iron, folate, magnesium, selenium and omega three essential fatty acids. A good source of grass fed organic beef is grassisgood.com.

2.  Eat more dark green leafy vegetables like spinach, kale, collards and Swiss chard (preferably organically grown). Carefully boil, steam or simmer these in extra virgin olive oil. Gentle cooking helps to break down the cell wall releasing the bioavailability of the greens. 

Juicing is also a good way of getting these nutrients. Lutein is abundant in dark green leafy vegetables and has been shown to potentially help slow down the devastating properties of Macular Degeneration. 

If you are taking a blood thinner like Coumadin consult with your physician prior to eating more dark green leafy vegetables.

3.  Eat more orange bell peppers (preferably organically grown), gently cooked or raw. Orange bell peppers are very high in Zeaxanthin.  Scientists believe this nutrient when combined with Lutein helps filter out dangerous HEV light (blue light) and may help maintain macular health.  Sauté spinach and orange bell peppers together in extra virgin olive oil for good macular health.

4.  Eat more darkly pigmented berries (preferably organically grown).   Studies indicate that eating more dark berries like blueberries, blackberries and raspberries may help preserve macular health.  Some of the power fruits like Gogi berry, Acai berry and Mangosteen are powerful antioxidants that may prove to be beneficial for macular disease.  These are not easily found in your local grocery unless they are in a juice or powdered form.  If you are a diabetic consult with your physician prior to eating more fruits.

5.  Consume more omega 3 fatty acids by taking micro distilled triglyceride fish oil.  Stay away from the Ethyl Ester form of fish oil do to alcohol being attached to the molecule and poorer absorption rate when compared to triglyceride fish oil.  Due to the large amount of pollutants in fish, molecularly distilled triglyceride fish oil may be a better option than eating the fish.   Canned sardines are a good source of omega threes, protein, Co-Q10, Calcium and are fairly contaminant free!

6.  Eat less salt.  Research may indicate that decreasing salt intake may decrease deposition of waste products in the macula called drusen.   Reduction in salt intake may help decrease blood pressure and fluid retention.

7.  Wear blue blocking sunglasses especially if you have had cataract surgery.  There is science that indicates blocking the high energy visible spectrum (400nm-500nm), the “blue light”, may help prevent damage to the macula.  Yellow, amber and orange colored lenses are good at blocking the blue light.  Wear them anytime you are outdoors during daylight.  Wear polarized blue blockers while in the sun.  Non-polarized lenses are better while indoors, cloudy and overcast days and for certain sports like motorcycling, golf, road biking and mountain biking.

8.  NO SMOKING!  If you do smoke try to quit.  Smoking lowers your serum antioxidant levels in your blood and thus causes a nutritional deficiency at the cellular level.  Second hand smoke is just as bad.  Smokers increase their risk dramatically of developing the more advanced stages of Macular Degeneration.  

Smoking increases C-reactive protein (inflammatory marker in blood that is a risk factor for Macular Degeneration).   If you smoke be sure you do NOT take high levels of the supplement called beta carotene.  High dosages of Beta-Carotene my increase ones risk of lung cancer.  New science also indicates Beta-Carotene may interfere with the absorption of Lutein (a beneficial carotenoid for macular health), Beta-Carotene should not be in a vitamin formula especially if you have macular degeneration.  Vegans may want to supplement with Beta-Carotene since they aren't getting any vitamin A from animal sources, however most Americans that do eat some animal protein will not be deficient in Vitamin A and thus don't need any Beta- Carotene.

9.  Cardiovascular exercises 20-30 minutes 5 times a week (discuss this with your physician first).  Research indicates that patients that did cardiovascular exercise (treadmill, stationary bike, elliptical, walking, jogging, swimming etc.) were less likely to develop Macular Degeneration.

10.  If you are overweight, LOSE WEIGHT! Overweight people are twice as likely to develop Macular Degeneration.  Loosing weight will also reduce C-reactive protein and help to normalize cholesterol and triglycerides. Controlling C-Reactive, Cholesterol and triglycerides may benefit Macular Degeneration.

11.  Control systemic health problems such as Hypertension, Diabetes, elevated Cholesterol and elevated homocysteine.  Elevated Homocysteine has been linked to Macular Degeneration as well as Optic Neuropathies, certain types of Glaucoma, retinal occlusive  disease and diabetic retinopathy. 

12.  Drink red wine and green tea!  New research may indicate that drinking red wine in moderation, sipping green tea, eating more soy products and cooking with curry may have some positive impact on Macular Degeneration, cataracts and inflammatory diseases in the eye.  If drinking red wine, consume more Pinot Noir from New York, this wine has some of the highest resveratrol content.  Resveratrol is a powerful antioxidant proving to have many health benefits.  Walnuts are also a good source of resveratrol.  The latest research shows that soy, resveratrol, green tea and curcumin may all have the ability to inhibit new fragile blood vessel growth (anti veg-f), this may prove to be beneficial at decreasing the chance of the dry form or macular degeneration from turning into the wet form.

13.  Have a vitamin D blood test; 25 (OH) D done routinely, making sure you are not deficient in Vitamin D.  Recent research shows patients with low levels of serum Vitamin D may be more likely to develop Macular Degeneration.  Vitamin D is a potent steroid hormone and deficiencies are linked to cancer, cardiovascular disease, stroke, hypertension, diabetes, osteoathritis, osteoporosis, depression, multiple sclerosis, muscle wasting, schizophrenia and even the flu.  The sun is the best source of Vitamin D, 15 - 20 minutes of sun exposure during the peak hours in shorts and a tank top while wearing a good pair of blue blocking sunglasses and a wide brimmed hat may be beneficial, consult with your physician before too much sun exposure especially if history of skin cancers or melanoma.

14.  Dark Chocolate is high in polyphenols and antioxidants that may prove to be beneficial for Macular Degeneration.  The darker the chocolate the better.  Dark chocolate is proving to be good for for many health conditions including diabetes, hypertension, elevated cholesterol and may reduce the risk of blood clots, strokes and heart attacks.

15.  Take a good nutritional supplement based on the latest scientific data, preferably one that does not have any artificial dyes and synthetic nutrients.   Be careful of supplements that have only “window dressing” amounts of specific nutrients. Many vitamin companies will add tiny amounts of popular nutrients just to be able to put it on the label. These small amounts may have no nutritional value. 

Patients must also be extremely careful not to take too many supplements as well. Vitamins can build up toxic levels, especially the fat soluble forms. 

The leading company that takes all of the current science into consideration in the development of their nutraceuticals is Fortifeye® Vitamins. These products are all natural with no dyes. They provide therapeutic levels of nutrients and no window dressing. 

The Fortifeye Vitamins mission is stated as promoting proper vision and whole body health with the right ingredients at the right levels. I recommend to all of my patients the multivitamin Fortifeye™ Complete Plus which is a combination of vitamins, minerals, phytonutrients, enzymes, whole foods and omega 3 essential fatty acids designed to lay a strong foundation for eye an d total body health. 

If the patient has Macular Degeneration or smokes, I recommend Fortifeye Complete Macular Defense this is a nutritional system to help prevent any further vision loss from Macular Degeneration and gives the additional antioxidants necessary for smokers. 

I have seen many patients in clinical practice improve, some quite dramatically while taking these supplements.  Many doctors throughout the country are now recommending Fortifeye™ vitamins to their patients with Macular Degeneration.  Fortifeye stays abreast of the most current science in regards to nutritional supplementation for the eye and body.  Fortifeye vitamins for Macular Degeneration and total body health are constantly evolving. For more information go to www.fortifeye.com

You can see that many patients will require a total overhaul in their dietary habits and lifestyles. and others will have some minor adjustments.  If patients would only do these 15 things faithfully we would see much less vision loss from Macular Degeneration and have a much healthier society.   Remember there is no miracle cure for Macular Degeneration.  However if you implement the 15 steps outlined, you will decrease your risk of going blind from Macular Degeneration. 

Keep the faith! 

Dr. Mike