Avoid vision loss after 50

Clinical trials support use of food supplements

Eyes

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

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.

Wet 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
formula
daily
NutriShield
Premium
daily
Comments
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
POLYPHENOLS and FLAVONOIDS
Green Tea 150 mg Anti-inflammatory
Grapeseed 50 mg Anti-inflammatory
Bilberry 2 mg Anti-oxidant
Curcumin 250 mg Anti-inflammatory
Anti-oxidant
Seaweed
Ascophyllum nodosum
50 mg Improves omega-3 effects
MORE
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
Piperine
(black pepper)
2.5 mg Boosts curcumin absorption

SUMMARY

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.


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.

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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


References

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.

 

 

The healthiest fats and oils

Coconut oil? Olive oil? Avocado oil? Butter? What’s the healthiest?

Here’s the skinny on healthy fats. With such a range of oils and fats in the stores and conflicting advice – often from biased sources – choosing the healthiest is not easy.

Various fats and oils

The 3 main criteria for healthy oil or fat choice are:

  1. The ratio of Omega 3 to Omega 6 fatty acids
  2. The level of saturated fat
  3. A high flash or smoking point, if the oil is for cooking

Most of us understand that unsaturated fat is good, saturated fat is bad and trans-fats are ugly. But it’s more complicated than that.

The Omega 3:Omega 6 ratio of polyunsaturated fats (PUFAs)

The amount of Omega 3 in your diet compared with the amount of Omega 6 is important because Omega 3 oil is a powerful anti-inflammatory. This therefore decreases the risk of heart attacks, strokes, arthritis and even dementia, because inflammation in the brain has a role in Alzheimer’s.

The most important Omega 3 fatty acids are EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), with DHA playing a key role in maintaining good cognitive focus and memory.

In addition, the body uses fats in the diet to build cell membranes and a diet with a comparatively high Omega 3 to Omega 6 ratio builds cell walls that are more flexible and therefore healthier.

In contrast, excess Omega 6 in the diet is pro-inflammatory. The emphasis here is on excess, because Omega 6 oils are still needed for skin, bone and hair growth and reproductive health.

The problem arises when the ratio of Omega 6 to 3 becomes excessive.

Omega 6 intakes have become excessive as most of the Omega 6 oils are cheap and used extensively in fast foods and ready meals. They include sunflower, soya, corn and peanut oils.

A report in the US National Library of Medicine confirmed that:

“Excessive amounts of omega-6 polyunsaturated fatty acids and a high omega-6/omega-3 ratio (typically 15:1 or higher), as is found in today’s Western diets, promotes … many diseases, including cardiovascular disease, cancer and inflammatory and autoimmune diseases.

In contrast, the report continues:

“A ratio of 4:1 (omega-6 to omega-3) was associated with a 70% decrease in total mortality.

“A ratio of 2.5:1 reduced rectal cell proliferation in patients with colorectal cancer and a decreased risk of breast cancer in women.

“A ratio of between 2:1 and 3:1 suppressed inflammation in patients with rheumatoid arthritis, and had a beneficial effect on patients with asthma.”

So your ratio of Omega 6 to Omega 3 should be no more than 4:1 – ideally even lower.

Monounsaturated fats (MUFAs)

Monounsaturated fats – Omega 9 and Omega 7 – are also healthy.

Olive oil and avocado oil are the principal Omega 9 oils – these help lower cholesterol levels, boost the immune system and lower insulin resistance, which in turn lowers the risk of diabetes.

Saturated fats (SFAs)

Saturated fat in the diet does raise LDL cholesterol levels (the bad form of cholesterol) – and high LDL cholesterol raises heart and stroke risk. So it is wise to limit your intake of saturated fats.

Saturated fat from animal sources, such as butter and lard, mainly raises LDL cholesterol; some plant oils such as coconut oil contain a “healthier” saturated fat (lauric acid), which raises BOTH the bad LDL and the good HDL cholesterol.

And also more important – as always – is the big picture. 50% of people who die of a heart attack are found to have normal cholesterol levels.

Many of them, however, do have high levels of a special amino acid called homocysteine. The way to lower homocysteine levels is through a B vitamin rich diet including folic acid and betaine.

The importance of a high smoke or flash point for oils you fry with at high temperatures

If fat/oil is heated to the point that it begins to smoke, it starts to create toxins and harmful free radicals, which damage tissues in arteries and DNA – a potential trigger for cancer. So for high temperature cooking the best choices are oils that have a high flash point.

The healthiest fats/oils

Bearing in mind these three criteria: the ratio of Omega 6 to Omega 3, the level of saturated fat and the flash point, which are the healthiest oils?

The table below gives the answers.

Healthiest for salads

Fat/oil Omega
6 to 3
ratio
% PUFAs
poly-
unsat
% MUFAs
mono-
unsat
% SFAs
satur-
ated
Smoke or Flash Point
Flaxseed
=Linseed
=Flax
1:4 68% 18% 9% 107 C 225 F
Excellent for salads etc, but don’t cook with it
Extra virgin
olive
13:1 11% 73% 14% 207 C 405 F
Macadamia 3:1 2% 80% 16% 200 C 390 F
Not cheap but versatile
Hempseed 3:1 75% 13% 10% 165 C 330 F
Walnut 5:1 63% 23% 9% 160 C 320 F

Healthiest for cooking

Fat/oil Omega
6 to 3
ratio
% PUFAs
poly-
unsat
% MUFAs
mono-
unsat
% SFAs
satur-
ated
Smoke or Flash Point
Extra virgin
olive
13:1 11% 73% 14% 207 C 405 F
Choose best quality oil for higher flash point
Rapeseed
or unrefined Canola
2:1 28% 63% 7% 177 C 350 F
Canola was developed from rapeseed in Canada in 1970.
Avocado 13:1 13% 71% 12% 271 C 520 F
Ideal for all cooking including to highest temperatures.
Rice bran 20:1 35% 39% 20% 254 C 490 F
Preferred for highest temperatures if no avocado.

Use in moderation

Fat/oil Omega
6 to 3
ratio
% PUFAs
poly-
unsat
% MUFAs
mono-
unsat
% SFAs
satur-
ated
Smoke or Flash Point
Coconut NO omega 3 2% 6% 82%
medium-chain triglycerides
177 C 350 F
May be less heart-risky than other saturated fats.
Butter NO omega 3 4% 26% 63% 177 C 350 F
Limit consumption.
Sunflower
(high oleic acid)
19:1 4% 84% 10% 160 C 320 F
But avoid standard sunflower oil (see below)
Peanut
=Groundnut
NO omega 3 32% 46% 17% 232 C 450 F
Sesame NO omega 3 42% 40% 14% 210 C 410 F

AVOID!

Fat/oil Omega
6 to 3
ratio
% PUFAs
poly-
unsat
% MUFAs
mono-
unsat
% SFAs
satur-
ated
Smoke or Flash Point
Corn 46:1 55% 28% 13% 232 C 450 F
Soy
=Soybean
8:1 58% 23% 16%
and 0.5% trans
257 C 495 F
Safflower NO omega 3 75% 14% 6% 266 C 510 F
Sunflower
(standard)
NO omega 3 66% 19% 10% 225 C 437 F
Cottonseed NO omega 3 52% 18% 26% 216 C 420 F
Grapeseed NO omega 3 70% 16% 10% 216 C 420 F
Palm NO omega 3 9% 37% 49%
“bad” long-chain triglycerides
232 C 450 F
Also environmentally damaging farming
Lard NO omega 3 11% 45% 39% 190 C 374 F

Our conclusions

Extra virgin olive oil is the choice for salad oil and for all except really high-temperature cooking. Get the highest quality you can afford.

For example, cooking tomatoes in olive oil releases more of the lycopene, and lycopene is linked to both prostate health and lower breast cancer risk. It’s the foundation oil of the Mediterranean Diet.

Flaxseed and hempseed oils are excellent alternatives to olive oil for salads.

The ideal oil for high-temperature cooking is avocado oil – excellent for searing meats.

Rapeseed/canola oil is medium priced and a good general choice. But avoid canola which is high-temperature-modified.

What about coconut oil?

Coconut and coconut oilCoconut oil has got a lot of media attention lately, but it’s 90% saturated fat and, along with palm oil and butter fats, it does raise LDL cholesterol levels. Indeed gram for gram coconut oil has more saturated fat than butter, which is a reason that the American Heart Association (AHA) has recommended against coconut oil.

So how has coconut oil gained its healthy image? Initially it was pointed out that the Polynesian diet featured coconut oil and Polynesians have low heart disease rates.

True – but as always in nutrition you have to look at the big picture. Polynesians also eat a lot of fish – with heart healthy Omega 3; they eat fibre-rich and anti-inflammatory fruits and vegetables at most meals and are physically active.

That said, some coconut oil – especially for high temperature cooking – is not going to have a negative impact on your health. Indeed, some 50% of the fatty acids in coconut oil are lauric acid – a so-called medium-chain triglyceride, which has anti-microbial and anti-bacterial properties and which can counteract the yeast Candida albicans.

Inflammation is more worrying than cholesterol

Moreover, cholesterol is not the clear cut baddie that the press makes out.

Our bodies make cholesterol internally in the liver, because it is present and needed in every cell membrane. It’s essential for the integrity of cells and for normal body function. Indeed it makes up 25% of your brain cell membranes and nerve cells.

By far the most significant driver of heart disease is not so much cholesterol as long-term, ie. chronic inflammation and excess oxidation – free radical damage to arteries and tissues. It is these that are the key underlying risk factors in heart disease, Alzheimer’s and certain cancers.

The way to counteract these two key threats is via a Mediterranean type diet – a high proportion of fruits and vegetables, oily fish and olive oil.

Even so, as you get older and nutrient demands increase, I believe you should add  a comprehensive supplement featuring anti-inflammatory and anti-oxidant nutrients.

Choose fats and oils carefully – and add supplements

Olive oilUse extra-virgin olive oil as your baseline go-to oil, switching to avocado if you’re doing really high-temperature cooking.

By eating oily fish at least twice a week, taking a daily Omega 3 supplement, not consuming high levels of Omega 6s through other fats and oils, and adding, for instance, flax seeds to cereals, you can push your Omega 3-6 balance over to the Omega 3 side.

And if you like the taste of butter or other nut oils, including coconut, try to choose organic and sustainably farmed brands, and continue to enjoy them in moderation.

 


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 regular 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 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


References

Coronary heart disease: seven dietary factors. DAT Southgate. The Lancet 1991

Effects of coconut oil, butter, and safflower oil on lipids and lipoproteins in persons with moderately elevated cholesterol levels. C Cox, J Mann, W Sutherland, A Chisholm and M Skeaff. Journal of Lipid Research 2017

Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials; Ronald P Mensink, Peter L Zock, Arnold DM Kester and Martijn B Katan; American Journal of Clinical Nutrition; 2003

The importance of the ratio of omega-6/omega-3 essential fatty acids. Simopoulos AP. Biomed Pharmacother 2002 Oct;56(8):365-79.