Part I – A Growing Problem

Age-related macular degeneration (AMD) is the leading cause of blindness in persons over 50 in developed nations.  There is no known cure and only limited treatments for the end-stage condition. Macular degeneration currently affects more than 10 million Americans this is more than cataracts and glaucoma combined, and by 2020 approximately 3 million people are expected to suffer life-limiting vision loss as a result of AMD.


Macular degeneration is characterized by deterioration of the macula, located in the center of the retina at the back of the eye. This is where the rods and cones, the eye’s photoreceptors, are concentrated. The disease develops when abnormal blood cells grow and emit fluids that damage the retina, resulting in a loss of central vision. Legal blindness is a common outcome, and victims lose the ability to read or drive. AMD occurs most often after age 60, but it can happen earlier.

There are two forms of AMD, atrophic (dry) and exudative (wet). Dry AMD reduces vision, but it does not usually result in blindness. The wet form normally causes more serious loss and often creates blindness.

Risk Factors

The following influences one’s risk for macular degeneration:

  • Poor diet increases risk
  • Age (Most common in elderly persons)
  • Smoking doubles risk
  • Obesity increases risk
  • Race (Caucasians are more frequently diagnosed with AMD than African-Americans or Hispanics.)
  • Gender (More common in women than men.)
  • Family history (Genetic tendency can be inherited.)
  • Sedentary lifestyle increases risk
  • High blood pressure can increase a person’s AMD risk, especially if uncontrolled
  • High cholesterol that is not reduced by medication or other means can also increase a person’s AMD risk

Incidence and the Effect of Modern Agriculture

The number of victims nationwide is steadily rising and this has a lot to do with our changing American diet and the agricultural policies that underlie our food industry. Since the advent of commercialized agriculture and our modern food industry more than 70 years ago, the average American’s dietary consumption has altered towards an increasingly larger proportion of refined and processed foods at the sacrifice of natural, whole plant foods.

Here is a brief summation of how this change transpired. The U.S. Farm Bill provides subsidies to growers of wheat, soybeans and corn. These commodities form the basis of our fast food industries – meat (raised on corn and soy), oil, flour and sugar (high fructose corn syrup).

Consequently, it is now far more economical to purchase processed foods than fruits and vegetables, since produce farmers are not entitled to subsidies. This is evidenced by the U.S. Department of Commerce reports which reveal the cost of fresh produce has risen by 40 percent since 1980, whereas soda and processed food prices have dropped by 10 to 30 percent.

Given these indices, the higher percentages of chronic, degenerative diseases in the lower income sectors of our society are clearly understandable. Reduced resources and disproportionate food costs force many to subsist primarily on junk food which are convenient and calorically dense but nutrient poor

The Sugar Theory

A number of researchers believe that excessive consumption of refined carbohydrates may result in a rapid influx of glucose to sensitive eye cells and may increase risk for macular degeneration. Persons with some degree of glucose intolerance (pre-diabetes and diabetics) would be at greatest risk.

“High glycemic” refers to foods which can create spikes in blood glucose. When you eat refined carbs, consuming some protein and fiber at the same time can greatly modulate the glycemic effect as those two constituents significantly slow down glucose release from the digestive tract. Therefore, try to replace your sodas and other sweets with meals and nutritious snacks to avoid the sugar rush. (It’ll help you avoid dental problems too!)

High glycemic carbohydrates include:

  • White flour pasta
  • White potatoes
  • White bread
  • White rice
  • Sugar of all kinds (high fructose corn syrup, glucose, cane sugar, maltose,      dextrose, raw sugar, brown sugar, white sugar, syrups, etc.)

Part II – Avoiding Macular Degeneration

Tips for Prevention

  1. Eat whole grains such as rice(especially brown rice), whole wheat, oatmeal (not instant), quinoa, barley, millet and others.
  2. Use healthy fats like extra virgin olive oil and unrefined coconut oil which are rich in phytonutrients(healthful plant chemicals).
  3. Avoiding processed foods as much as possible will greatly reduce harmful fats, refined carbohydrates(white flour and sugars), and dietary sodium.
  4. Restrict red meat and limit intake of cheese and other high-fat dairy. Avoid processed meats like sausage and lunch meats altogether as meta-analyses reveal those are also linked to increasing risk for colorectal cancer. Choose fish,      chicken, legumes, nuts and low-fat dairy as healthiest protein sources.
  5. Make fruits and vegetables compose half your plate as our Dietary Guidelines for Americans 2015 recommends. Consuming a wide variety of whole plant foods in a rainbow of colors is important for good vision and healthy eyes as well as overall vitality and longevity.
  6. Maintain normal blood pressure and cholesterol, be physically active every day, and avoid smoking to keep your disease risk low.

If macular degeneration is detected early, dietary and lifestyle changes can often slow progression of the disease. Even better, the chances of avoiding it altogether are high for those who eat a healthy diet, exercise regularly and don’t use tobacco.

A Diet for Prevention

The Mediterranean diet will help defend against most of the chronic health problems that plague Western, industrialized nations. Along with reducing risk for cancer, diabetes, heart disease and many other largely preventable diseases, the Mediterranean diet has been demonstrated to lower risk for AMD as it is rich in the protective nutrients found in natural foods and olive oil. A study by the Centre for Eye Research Australiafound that people who consume two to three teaspoons of extra virgin olive oil each day are almost 50 percent less likely to develop macular degeneration than those who don’t include this antioxidant-rich oil in their diet.

Certain nutrients are especially important for minimizing our risk not only for AMD, but also many other forms of chronic, degenerative disease. The vitamin A precursors or corotenoids, lutein and zeaxanthin, are among the most important for reducing risk for AMD.

Foods rich in lutein and zeaxanthin:

  • Dark leafy greens
  • Corn
  • Nectarines and Peaches
  • Oranges
  • Papaya
  • Squash
  • Orange peppers
  • Grapes
  • Kiwi
  • Sweet potato
  • Egg yolk

These antioxidant nutrients add a yellow pigment to foods and are found in both the lens and the macular region of the retina. Lutein and zeaxanthin posses the amazing ability to filter out harmful blue light rays and prevent damage to sensitive eye tissues, effectively reducing risk for AMD.

Vitamin E and Zinc

These nutrients are also highly protective and important for prevention.

Good sources of vitamin E:

  • Eggs
  • Peanut butter
  • Sunflower seeds
  • Almonds
  • Wheat germ and wheat germ oil
  • Whole grains

 Best dietary sources for zinc:

  • Meat
  • Poultry
  • Fish
  • Whole grains
  • Dairy products

Vitamin D

The Sunshine Vitamin has recently been determined to be important in reducing risk for AMD, particularly in persons with a genetic predisposition to the disease. Scientists recommend supplementation for individuals who are not exposed to enough sunlight for adequate vitamin D manufacture by the skin. This consists of a minimum of 15 to 30 minutes a day of full sunlight exposure to at least 10 percent of body surface.

Dietary sources of vitamin D:

  • Fortified milk and orange juice
  • Fatty, coldwater fish such as salmon, herring, sardines, tuna, halibut and mackerel

Omega-3 Fats

According to the Age-Related Eye Disease Study, sponsored by the National Eye Institute, a diet which provides plenty of the essential omega-3 fatty acids found in coldwater fish will decrease risk for many of the vision problems that commonly occur in older adults, including AMD.


Our modern consumer shift towards convenience foods has resulted in a number of serious consequences. Most Americans concerned with eating healthy must make the effort to prepare a lot of their meals from scratch. This of course, requires much more time and effort than many are willing to invest, especially with the demands of a 40-hour work week.

In addition, cooking whole grains, vegetables and lean protein frequently adds up to larger dollar amounts than relying on fast fare created by our 540 billion dollar processed food industry. The U.S. Department of Commerce reports this is one of our largest manufacturing sectors and is experiencing growth at a steady pace.

The bitter pill responsible citizens are called to swallow amounts to the daily commitment and determination to invest in a rewarding future by prioritizing a healthy diet and lifestyle. Such proactive individuals enjoy a far greater likelihood of experiencing old age in good health, with sharp cognition, and the ability to choose among many opportunities for employment and recreation.

On the other hand, a large percentage of those who claim they “don’t have time” to exercise, cook or eat healthy enter retirement with serious health conditions. The majority of these conditions are derived from poor choices over decades. Plans for the enjoyment of work-free living can tragically shift as disease management takes its toll.

Daily compromises often result in premature morbidity. Thus we can optimize our chances of enjoying retirement years filled with peace, joy and deep satisfaction. Be wise and choose well, each and every day.

You may contact Haven Hospice’s Registered Dietitian, Verna Groger, with any questions regarding diet, cooking time savers and ideas on how to fit exercise into your life. She will be happy to help!

Click here for a list of sources.