A new study by the Journal of the American Medical Association shows that adding omega-3 fatty acids to the mix probably won’t help, but that replacing beta-carotene with two other nutrients might be a good idea.
Among key results:
• Simply adding omega-3s or lutein and zeaxanthin to the standard AREDS formula did not help or hurt.
• Taking away beta-carotene and reducing the zinc dose (meant to reduce side effects such as urinary tract problems) didn’t hurt.
• Using lutein and zeaxathin instead of beta-carotene produced somewhat better eye protection and no increased risk of lung cancer. Those supplements were especially effective for people whose diets were low in the nutrients.
The findings, though they sound complicated, will make counseling patients easier, says Julia Haller, ophthalmologist in chief at Wills Eye Institute, Philadelphia. She had patients in the study. The results suggest that all patients can take the same formula — dropping beta-carotene and adding lutein and zeaxathin — without worrying about smoking history, she and Chew say.
While the supplements don’t prevent advancement of AMD in all patients, Haller says, they are well worth taking.
“This is a disease largely driven by genetics and aging, and those are two things we can’t do anything about,” she says. “This is something patients can do to slow the progress, put the brakes on the train.”
There’s no evidence the supplements help the vision of healthy adults or people with earlier stages of AMD. The supplements also have not been shown to prevent cataracts, though an additional study published Sunday showed some possible protective effect from the lutein and zeaxathin formula in people with low levels of the nutrients in their diets.
But Chew says the best advice for most people is to “eat a good balanced diet with plenty of leafy greens and fish.” Such a diet is good for hearts, she says, “and it certainly can’t hurt your eyes.”
Abdhish Bhavsar, a retina surgeon in Minneapolis and a clinical spokesman for the American Academy of Ophthalmology, notes that smoking is a major risk factor for AMD progression. So for smokers with the disease, the most important advice is to stop smoking, he says: “What vitamin they take has a much smaller impact.”