Avoid vision loss after 50

Clinical trials support use of food supplements


To realise that you are beginning to lose your sight is a truly frightening experience.

A condition called macular degeneration is the leading cause of loss of vision. And because it occurs most often after the age of 60, it’s usually referred to as Age-related Macular Degeneration – or AMD.

But two peer-reviewed clinical trials on natural food supplements bring real hope. They show that the risks of developing AMD can be very substantially reduced and that the progress of the disease can be slowed or even halted.

How AMD develops

Your macula is part of your retina – the area in the back of your eye that turns images into signals which go to your brain. It lets you see small details clearly. When the macula starts to break down, you begin to have difficulty seeing detail.

As the disease gets worse, you lose your central vision. That makes it a problem to drive, read or make out faces clearly.

There are two forms of Macular Degeneration – dry and wet. Most people (over 85%) have what is called “dry” macular degeneration, which develops slowly.


Dry AMD develops through lack of nutrients and the development of what are called drusen in your retina. These are small white or yellow fatty deposits largely consisting of cholesterol.  They cause the retina to begin to break down.

There is a genetic component, but anyone can succumb because inflammation and oxidative (free radical) damage to tissues, nerves and photoreceptor cells are the ultimate drivers of dry AMD.


With the “wet” version, abnormal leaky blood vessels damage your macula and change the shape of your retina. While it’s less common, the wet type of macular degeneration is the cause of 90% of all vision loss leading to legal blindness. Often the ‘wet’ type follows the development of the ‘dry’ type.

Risk factors for AMD

A 2014 Lancet article estimates the risk of AMD is about 2% if you are under the age of 50, but this rises to almost 20% for people over the age of 75. About 65% of AMD cases occur in women and 35% in men but this is partly as women live longer.

According to the National Eye Institute, risk factors include smoking, a poor highly processed diet, lack of exercise, high blood pressure, a low intake of anti-oxidants and overweight or obesity.

The Lancet adds fluctuating blood sugar levels and high levels of inflammation and oxidative (free radical) damage as risk factors. Cardiovascular disease and diabetes are frequently co-existing diseases – which is logical because the driver behind these illnesses is also inflammation and free radical damage.

without macular degeneration

Without macular degeneration

with macular degeneration

With macular degeneration, central vision is compromised

The AREDS studies confirm AMD risk can be cut with supplements

Two studies confirm that the risk of AMD can be cut substantially through taking food supplements. They are called AREDS 1 and AREDs 2. ARED stands for Age Related Eye Disease Study. Both studies were conducted by the National Eye Institute – a part of the US Government’s National Institutes of Health.

AREDS1 reported in 2001 and since the results were good, it was followed by AREDS2 which started in 2006 and ran 5 years. Its purpose was to see if an improved nutritional formula would work even better.

The supplements the studies used were both designed as high anti-oxidant formulae. They include the carotenoids lutein, beta carotene and zeaxanthin, plus high dose vitamin C and a small number of selected minerals.

AREDS 1 Formula
Nutrient per day
Vitamin C 500mg
Vitamin E 400 IU
Zinc 80mg
Copper 2mg
Beta carotene 15mg
AREDS 2 Formula
Nutrient per day
Vitamin C 500mg
Vitamin E 400 IU
Zinc 80mg
Copper 2mg
Lutein 10mg
Zeaxanthin 2mg

The results of AREDS 2 showed long lasting benefits with a very significant – 32% – lower risk of advanced AMD.

Improving the results of supplementation even further

Can we even improve on these results? We can. The basis is a high anti-oxidant and a high anti-inflammatory diet and supplement. Here are 5 specific ways.

  1. Boost fish oil consumption

    A study at the Massachusetts Eye and Ear Infirmary and another at the University of Sydney showed that men over 50 with the highest levels of oily fish consumption were 45 percent less likely to have AMD than those who ate the least amount of fish. High consumption was over two servings weekly; low consumption was less than one serving per week. So make salmon, herrings and sardines a frequent choice and/or add an Omega 3 supplement.

  2. Eat nuts, green vegetables and fruit daily

    A 2004 study at Harvard Medical School showed that people who ate three or more servings of fruit daily had a substantially lower risk of wet or advanced AMD. Blueberries, bilberries, blackcurrants and cherries are especially beneficial since they contain what are called polyphenols. Polyphenols are a large class of anti-oxidant and anti-inflammatory compounds that fruits and vegetables have evolved to protect themselves – and when we eat those plants we get the same protective benefit too.

    In the case of berry fruits, the polyphenols are called anthocyanins – and anthocyanins give the berries their dark colouring and are powerful anti-oxidants.

    A further study from the Massachusetts Eye and Ear Infirmary reported that people who consumed the most vegetables rich in carotenoids (like lutein, lycopene and zeaxanthin) had a 43 percent lower risk of AMD than those who ate the least. Carotenoid-rich foods include spinach, kale and leafy green vegetables.

  3. Limit your intake of sugar and refined carbohydrates

    Diets high in refined carbohydrates increase the risk of AMD, because they have a high glycemic index, causing a rapid increase in blood sugar and insulin release. In addition, sugars promote what is called glycation – where sugar molecules bond to proteins and cause ‘cross linking’ in body tissues. This cross linking is a little like wires becoming tangled and results in the general stiffening of tissues – including both small blood vessels and arteries.This not only damages eyes and the heart, but is a major cause of skin ageing.

  4. Exercise regularly

    According to a study in the British Journal of Ophthalmology, which monitored 4,000 people for 15 years, people who led an active lifestyle were 70 percent less likely to have AMD develop during the follow-up period. ‘Active’ was defined as walking at least two miles a day for 3 days a week.

  5. Wear sunglasses with UV and blue light protection

    A major recent study found that people who consumed too few antioxidants, and had overexposure to blue light, were four times more likely to develop advanced or wet AMD.

Other risk reduction actions

  • Increase the font size and contrast on your computer, which reduces eye strain.
  • Keep hydrated. It helps clears any irritants out of your eyes.
  • A possible ‘off label’ drug treatment for AMD is Avastan. Avastan is a drug used in cancer therapy. It works by inhibiting the supply of new blood vessels feeding a tumour – essentially starving the cancer of the nutrients it needs to grow. Ophthalmologists can use Avastan to prevent the abnormal growth of cells involved in especially wet AMD. There is evidence that soy isoflavones too at a level of about 40mg a day can limit the supply of new blood vessels.

Protect your eyesight – but not in isolation from the rest of your body

If you are concerned that you are developing macular degeneration, or if you are trying to halt its progression, it’s natural to concentrate on solving this one problem.

But we now know that inflammation and free radical damage are the key drivers of this disease. And these twin threats don’t just damage your eyes. They are the central cause of almost all so-called ‘age related’ disease.

We say ‘so-called’ because it is not the simple advance of years – it is the accumulation of free radical damage and chronic inflammation that underlies loss of vision, alongside heart disease, stroke, diabetes, arthritis and even some cancers.

We have seen that official studies show that the AREDS supplements have a significant preventative effect on eye health – which, incidentally, gives a lie to those who say health supplements are a waste of money.

But we can go further. By adding some of the most powerful anti-oxidant and anti-inflammatory compounds identified in fruits and vegetables, plus Omega 3, we can create a supplement that helps protect – not just your vision – but your whole body.

Dr Paul Clayton, the former Chair of the Forum on Food and Health at the Royal Society of Medicine, proposed just such a supplement in his best-selling book Health Defence. It has been turned into an actual supplement called Nutrishield.

Below is the comparison between the AREDS formulae and NutriShield. NutriShield adds a much wider range of anti-oxidant and anti-inflammatory nutrients, plus vitamins and minerals at what are judged to be optimum levels, rather than just RDA levels.

Supplements against AMD

Nutrient AREDS1/2
Vitamin C (A1&A2) 500 mg 500 mg
Vitamin E (A1&A2) 400 IU 109 IU
Zinc (A1&A2) 80 mg 10 mg
Copper (A1&A2) 2 mg 1 mg
Beta carotene (A1) 15 mg 7 mg
Lutein (A2) 10 mg 6 mg
Zeaxanthin (A2) 2 mg 42 mcg
Lycopene 5 mg Anti-cancer carotenoid
Omega 3
fish oil
1,000 mg Anti-inflammatory
Green Tea 150 mg Anti-inflammatory
Grapeseed 50 mg Anti-inflammatory
Bilberry 2 mg Anti-oxidant
Curcumin 250 mg Anti-inflammatory
Ascophyllum nodosum
50 mg Improves omega-3 effects
Soy isoflavones 40 mg Anti-cancer
Betaine 450 mg Reduced heart disease risk
Co-Enzyme Q10 30 mg Helps heart health
Vitamin D3 800 IU Vital for immune function
All other vitamins and minerals at optimum levels VITAMINS A B1 B2 B3 B5 B6 B7 B9 B12 K1 K2
MINERALS Magnesium Calcium Selenium Chromium Manganese Iodine Molybdenum
Glucosamine 500 mg Cartilage builder but needs
vits D and K alongside
(black pepper)
2.5 mg Boosts curcumin absorption


Although there is no cure, as yet, for Age-related Macular Degeneration, there is very good evidence that its progression can be slowed and even halted.

The way is through improved diet and a supplement that is specifically designed to counteract oxidation and inflammation. Because these are the drivers, not only of AMD, but almost all other age-related illnesses.

You can find NutriShield at https://nutrishield.com/

NOTE: We created this article in response to a question from a customer. As a reader of this blog, if you have a health question, we are always pleased to try to help.

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Dr Paul Clayton designed NutriShield as a comprehensive healthbutton-2 supplement with OPTIMUM levels of essential nutrients. See more detail elsewhere on this site or click on the button.

Dr Paul Clayton’s best-selling book Health Defence is available from bookstores. Or read a summary report here FREE simply by registering your email address.


See online here for delicious recipes from the Health Defence Cookbook incorporating healthy foods featuring in a Mediterranean Diet. Combined 3 courses strip


AREDS2 Research Group. “Lutein/Zeaxanthin and Omega-3 Fatty Acids for Age-Related Macular Degeneration. The Age-Related Eye Disease Study 2 (AREDS2) Controlled Randomized Clinical Trial.” JAMA, published online May 5, 2013.

AREDS2 Research Group. “Lutein/Zeaxanthin for the Treatment of Age-Related Cataract.” JAMA Ophthalmology, published online May 5, 2013.

Chew et al. “Long-Term Effects of Vitamins C, E, Beta-Carotene and Zinc on Age-Related Macular Degeneration.” Ophthalmology, published online April 11, 2013.

Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Wan Ling Wong et al. Lancet Glob Health. 2014 Feb;2(2):e106-16.

Smoking and age related macular degeneration: the number of pack years of cigarette smoking is a major determinant of risk for both geographic atrophy and choroidal neovascularisation. J C Khan et al. Br J Ophthalmol 90(1); 2006 Jan

An Update on the Health Effects of Tomato Lycopene Erica N. Story, Rachel E. Kopec, Steven J. Schwartz and G. Keith Harris. Annu Rev Food Sci Technol. 2010; 1: 10.1146/annurev.food.102308.124120.



Nitrate-rich foods reduce blood pressure

Why NO is a big YES

NONitric Oxide – is a vital chemical messenger which relaxes otherwise constricted and stiff blood vessels, increasing both oxygen and blood flow. So it’s vital for reducing blood pressure and therefore heart health.

Improved blood and oxygen flow is also critical for better brain function as the brain uses 20% of our oxygen intake.

It’s also a way to help in cases of ED – erectile dysfunction. Drugs like sildenafil work in exactly this way – boosting nitric oxide signalling, relaxing arteries and increasing blood flow. And adequate Nitric Oxide is equally important for women, because unhindered blood flow helps sexual arousal in both men and women.

The inside of the arteries produces NO

The interior surface of your arteries is called the endothelium and it produces nitric oxide. When oxidised cholesterol (plaque) builds up there – the condition known as atherosclerosis – you reduce your capacity to produce nitric oxide and your arteries then become rigid, making blood flow more difficult. Your blood pressure rises and that significantly increases your risk of a heart attack, stroke or sexual dysfunction.

Preventing this chain of events is why physicians prescribe nitroglycerin for heart and stroke patients. But beetroot has a similar effect!

The free radical connection

The normal action of Nitric Oxide is impaired by excess free radicals.

Some free radical action is a normal part of metabolism – when food molecules are broken down in the presence of oxygen to create energy.

But there are occasions when oxygen in the body splits into single atoms with unpaired electrons. Electrons need to be in pairs, so these atoms, now called free radicals, scavenge the body to seek out other electrons so they can become a pair. This causes damage to cells, proteins and DNA.

As a consequence, free radical damage is linked to cancer, atherosclerosis, macular degeneration, Alzheimer’s disease, Parkinson’s disease and to ageing generally. Indeed, ageing has been defined as a gradual accumulation of free-radical damage.

Free radicals – and what is called oxidative stress – can be created when we consume high-temperature fried foods and alcohol, when we exercise to excess, or when we are exposed to tobacco smoke, residual pesticides and air pollutants.

A natural solution – anti-oxidants in food

If oxidative stress is the enemy of Nitric Oxide, anti-oxidants are the solution. You need to bathe your blood stream in anti-oxidants to neutralise excess free radicals.  This ensures that your endothelial cells can produce the Nitric Oxide that will, in turn, keep your arteries supple and your blood pressure normal.

You do that with anti-oxidant-rich foods like berry fruits, kale, broccoli and spinach, and nitrate-rich foods like beetroot and leafy green vegetables.

The nitrate in these plants is converted into nitric oxide in the body. Indeed researchers were able to show that drinking 250ml beetroot juice could drop blood pressure in a group of normal BP people by 10 points in just two hours.

Top nitrate foods include:
  • Rocket
  • Rhubarb
  • Lettuce
  • Coriander
  • Beetroot and beetroot greens
  • Spring greens
  • Basil
  • Chard
  • Whole grains

This suggests that a regular mixed salad with rocket, lettuce, coriander, basil and beetroot can be a top blood pressure lowering dish.

Nitrates for boosting athletic performance?

It also suggests that nitrate-rich foods might boost athletic performance. And this seems to be true. A study (referenced below) where cyclists were given beetroot juice before training showed that their energy production became 11% more efficient. For a top athlete that is a huge competitive advantage.

But since it’s an all-natural intervention, don’t expect newspaper headlines along the lines of: ‘Beetroot Doping Scandal Hits Tour de France!!’

Protect your NO

Eating nitrate-rich foods is one important way to lower blood pressure. Another way is to increase your consumption of foods containing the amino acid L-arginine, which can be found in nuts, fruits and dairy.

Nitric oxide only lasts a short time in the body, so the more antioxidant protection we provide it, the longer the effects will last. In fact, surgeons are even coating stents (the mesh tubes that prop open arteries after surgery) with drugs that produce nitric oxide.

You can protect your nitric oxide by consuming anti-oxidant rich foods as outlined above, and by supplementing with anti-oxidant nutrients including vitamins C and E, beta carotene, Co-Q10, lycopene, lutein and selenium.

Exercise for increased NO

When you exercise, your muscles need more oxygen, which is supplied by the blood. As the heart pumps, the lining of the arteries releases nitric oxide into the blood, which relaxes and widens the vessel wall, allowing for more blood to pass through.

As we get older, however, our blood vessels and nitric oxide system become less efficient due to free radical damage, causing our veins and arteries to become less elastic. So maintaining activity and exercise is important for Nitric Oxide health.

There’s a final heart/brain benefit to nitric oxide: in addition to relaxing or vasodilating blood vessels, nitric oxide also displays anti-platelet properties, which helps to prevent inappropriate blood clotting.


If you enjoyed this article, please share it with family and friends. You can follow us on Facebook or Twitter for daily headline health tweets.

Visit Us On TwitterVisit Us On FacebookVisit Us On Youtube

CTA Register NewsletterAnd register now for a free monthly e-newsletter on the latest in nutrition and health research.

Dr Paul Clayton designed NutriShield as a comprehensive healthbutton-2 supplement with OPTIMUM levels of essential nutrients. See more detail elsewhere on this site or click on the button.

Dr Paul Clayton’s best-selling book Health Defence is available from most good bookstores.

See the website www.healthdefence.com for excerpts and links to buy direct from the publisher.

See online here for delicious recipes from the Health Defence Cookbook incorporating healthy foods featuring in a Mediterranean Diet. Combined 3 courses strip


Beetroot juice and exercise: pharmacodynamic and dose-response relationships. Wylie LJ, Kelly J, Bailey SJ, Blackwell JR, Skiba PF, Winyard PG, Jeukendrup AE, Vanhatalo A, Jones AM. J Appl Physiol (1985). 2013 Aug 1;115(3):325-36. doi: 10.1152/japplphysiol.00372.2013. Epub 2013 May 2.

Nitric Oxide: a molecule of the millennium. Shinde UA, Mehta AA, Goyal RK. Indian J Exp Biol 2000 Mar;38(3):201-10.

Discovery concerning nitric oxide as a signaling molecule in the cardiovascular system. Furchgott RF, Ignarro LJ, Murad F. Nobel Prize in Medicine and Physiology 1998.

In vitro effects of a novel class of nitric oxide (NO) donating compounds on isolated human erectile tissue. Seidler M, Uckert S, Waldkirch E, Stief CG, Oelke M, Tsikas D, Sohn M, Jonas U. Eur Urol. 2002 Nov;42(5):523-8

Age-related reduction of NO availability and oxidative stress in humans. Taddei S, Virdis A, Ghiadoni L, Salvetti G, Bernini G, Magagna A, Salvetti A. Hypertension. 2001 Aug;38(2):274-9.

Arginine Metabolism: nitric oxide and beyond. Guoyao WU, Morris SM. Biochem J 1998; 336:1-17

Antioxidants and the bioactivity of endothelium-derived nitric oxide. Tomasian D, Keaney JF, Vita JA. Cardiovasc Res. 2000 Aug 18;47(3):426-35.

Free radicals, antioxidants and functional foods: Impact on human health. V Lobo, A Patil, A Phatak, N Chandra. Pharmacogn Rev. 2010 Jul-Dec; 4(8): 118–126. doi:  10.4103/0973-7847.70902