How to Eat When You Have Wet AMD
The foods you eat can make a real difference in protecting your vision. Discover the best way to fill your plate.by Erin L. Boyle Health Writer
You are what you eat.
You’ve probably heard that expression hundreds of times and never given it much thought. But it turns out, those words ring true for anyone dealing with wet age-related macular degeneration (AMD)—and improving your diet just might be a game changer for your condition.
Researchers have found that eating healthy, nutrient-rich foods (think: low fat dairy, fresh fruit, cruciferous vegetables, whole grains, and carotene vegetables) improves eye health and reduces your risk of developing late-stage AMD (or advanced stages of wet AMD). Meanwhile, a diet heavy in processed and red meat, fried food, refined grains, high fat dairy, and sugar-sweetened beverages may be a risk factor for disease progression, according to studies.
Nutrition plays a big role in wet AMD, confirms retinal disease specialist Rishi P. Singh, M.D., a staff surgeon at the Cole Eye Institute and associate professor of ophthalmology at the Lerner College of Medicine in Cleveland, OH. “At this point, we know from many studies that nutrition is a really important topic for eye disease,” he says.
How Nutrition Affects Wet AMD
A diet rich in antioxidants does more than promote good health and a strong immune system—though it does that, too. “Oxidants, such as cigarette smoke and UV light, are known to cause damage to precious retinal cells,” says Lori Smolinski, O.D., a low-vision specialist at the Association for the Blind and Visually Impaired, a subsidiary of Mary Free Bed Rehabilitation Hospital in Grand Rapids, MI. “Consuming antioxidants through your diet helps to counteract those effects.”
What are antioxidants, exactly? These naturally occurring compounds in foods delay or prevent cellular damage from oxidants by removing harmful waste products in your cells. Eye-benefitting antioxidants include beta-carotene, vitamin C, and vitamin E (all found in kale and sweet potatoes, among others); carotenoids (served up in tomatoes and red bell peppers); and lutein and zeaxanthin (two types of carotenoids found in spinach, broccoli, and brussels sprouts).
In addition, research suggests that other foods may have positive effects on eyesight. For instance, a 2009 Australian study of more than 3,600 people found that one to two servings of nuts per week was associated with a reduced risk for early-stage AMD, as was eating fish regularly. And studies suggest that limiting foods high in linoleic acid (such as vegetable oils and meats) may have a protective effect against developing AMD.
Other investigations, like the 2019 EYE-RISK Consortium study, found that filling your plate with fruits, vegetables, legumes, and fish as part an overall Mediterranean style-diet reduced the risk of late-stage AMD by more than 40%. That jives with the classic Age-Related Eye Disease Study (AREDS), a two-part investigation that found supplementing with certain vitamins and minerals may reduce progression to advanced AMD by more than 25% over the course of five years for some patients.
The AREDS report has become an industry standard; in fact, AMD medication is largely based on its findings.
The evidence of food impacting vision is pretty clear, says Dr. Singh, and certainly more conclusive than the influence of diet on other types of diseases. “If you look across diseases, including cardiovascular disease and cancer, other than diabetes there’s no stronger predictor of condition status than what’s known about nutrition and AMD at this point in time,” he says.
Eat This, Skip That
So what should you eat to prevent eye-disease progression, even if you have late-stage, wet AMD? The simplest answer: Eat healthy. “I tell my patients to eat well,” says Timothy G. Murray, M.D., president of the American Society of Retina Specialists and a retina specialist in private practice in Miami. “I worry most about patients who are on some type of limited diet, so that they’re limiting their intake of the appropriate vegetables and food sources that may be beneficial.”
More specifically, these foods are full of the nutrients found to be beneficial to vision in the AREDS studies. While you can get these nutrients through supplements, they are also easy to incorporate into your daily meals.
Feel free to liberally season these foods with spices and herbs—it could raise their antioxidant powers even higher, says Kerry M. Gelb, O.D., an optometrist in Woodbridge, NJ, and a board member of the Ocular Nutrition Society. “Spices like cayenne pepper and paprika have lutein in them, so you can apply these on foods like eggs to supercharge them,” he says.
On the other hand, some foods can negatively impact your eye health, especially processed sugar and refined grains which cause inflammation in the blood vessels of the eye (contributing to leakage in wet AMD) and an increase in drusen, those floaty spots on your retina which indicate higher risk of central vision loss. In addition, processed meat and red meat may raise your risk for developing late-stage AMD, according to research in the British Journal of Ophthalmology.
To Supplement, or Not to Supplement?
You may have heard people say that if you follow a healthy diet, there’s no reason to supplement with additional vitamins and minerals. In theory, that’s true. But it’s tough for people to eat a broad range of foods at all times, says Dr. Murray, including in the winter when less fresh produce is available locally or during, say, a pandemic when canned goods take preference over fresh.
For these reasons, taking vitamins and minerals in supplement form can be beneficial. There’s a specific supplement for preventing AMD progression, known as AREDS2 formulation, that you can buy online or at your local pharmacy to help with your vision. It’s best taken only if you meet the criteria of having intermediate AMD in one or both eyes or wet AMD in one eye but not the other, Dr. Singh emphasizes.
With or without supplementation, a healthy and well-rounded diet is your friend for ensuring you take in as many eye-benefitting nutrients as possible through whole-food sources. “It takes effort,” Dr Singh acknowledges, but it’s one of the few tools you have to take control of your eye health.
To improve your daily diet, start by taking small steps, Dr. Gelb recommends. Make one new addition a week, like trying a recipe for wild salmon or adding bell peppers to a salad—even simple swaps can help decrease wet AMD progression by about 40%, he says. And don’t beat yourself up if you occasionally fall off the healthy-food wagon. You are still better off taking two steps forward and one step back than taking no steps at all.
Blue Mountains Eye Study: JAMA Ophthalmology. (2009). “Dietary Fatty Acids and the 10-Year Incidence of Age-Related Macular Degeneration The Blue Mountains Eye Study,” jamanetwork.com/journals/jamaophthalmology/fullarticle/423128
EYE-RISK Consortium: Ophthalmology. (2019). “Mediterranean Diet and Incidence of Advanced Age-Related Macular Degeneration,” aaojournal.org/article/S0161-6420(18)30721-8/fulltext
AREDS2: Ophthalmology. (2012). “The Age-Related Eye Disease Study 2 (AREDS2): study design and baseline characteristics (AREDS2 report number 1),” ncbi.nlm.nih.gov/pubmed/22840421
Western Diet Problems: British Journal of Ophthalmology. (2019). “Diet patterns and the incidence of age-related macular degeneration in the Atherosclerosis Risk in Communities (ARIC) study,” bjo.bmj.com/content/early/2019/12/06/bjophthalmol-2019-314813.full#ref-19
What to Eat: BrightFocus Foundation.(2020). "Healthy Livng." brightfocus.org/macular/diet-and-exercise
Details on AREDS: National Eye Institute. (2019). "For the Public: What the AREDS Means for You." nei.nih.gov/research/clinical-trials/age-related-eye-disease-study-2-areds2/public-what-areds-means-you