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Dietary -3 Fatty Acid and Fish Intake in the Primary Prevention of Age-Related Macular Degeneration

A Systematic Review and Meta-analysis

Elaine W-T. Chong, MBBS; Andreas J. Kreis, MD; Tien Y. Wong, MBBS, PhD, FRANZCO; Julie A. Simpson, PhD; Robyn H. Guymer, MBBS, PhD, FRANZCO

Arch Ophthalmol. 2008;126(6):826-833.

Objective  To systematically review the evidence on dietary -3 fatty acid and fish intake in the primary prevention of age-related macular degeneration (AMD).

Methods  Seven databases were systematically searched with no limits on publication year or language using standardized criteria. Randomized controlled trials and prospective cohort, case-control, and cross-sectional studies were included. Of 2754 abstracts identified, 3 prospective cohort, 3 case-control, and 3 cross-sectional studies met the criteria. Measures of associations were pooled quantitatively using meta-analytic methods.

Results  Nine studies provided data on a total sample of 88 974 people, including 3203 AMD cases. A high dietary intake of -3 fatty acids was associated with a 38% reduction in the risk of late AMD (pooled odds ratio [OR], 0.62; 95% confidence interval [CI], 0.48-0.82). Fish intake at least twice a week was associated with a reduced risk of both early AMD (pooled OR, 0.76; 95% CI, 0.64-0.90) and late AMD (pooled OR, 0.67; 95% CI, 0.53-0.85).

Conclusions  Although this meta-analysis suggests that consumption of fish and foods rich in -3 fatty acids may be associated with a lower risk of AMD, there is insufficient evidence from the current literature, with few prospective studies and no randomized clinical trials, to support their routine consumption for AMD prevention.

Author Affiliations: Centre for Eye Research Australia (Drs Chong, Kreis, Wong, and Guymer) and Centre for Molecular, Environmental, Genetic and Analytic Epidemiology (Dr Simpson), University of Melbourne, Melbourne; Singapore Eye Research Institute, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (Dr Wong); and Cancer Epidemiology Centre, Cancer Council of Victoria, Carlton, Australia (Dr Simpson).