Risk Factors for Age-Related Macular Degeneration (AMD)

By Lylas G. Mogk, M.D.

To understand what the risk factors are and what we can do to lower our risk for age-related macular degeneration (AMD), it's helpful to understand how macular degeneration develops:

• First, advanced age and long-term environmental exposures together produce an increased number of free radicals: unstable molecules that damage the macula if they are not immediately neutralized by anti-oxidants.
• Next, this initial damage causes inflammation, then the inflammation causes more damage which results in more inflammation and the cycle continues, eventually scarring the macula and causing central vision loss.

To reduce the risk of age-related macular degeneration we need to decrease our exposure to toxins, neutralize the free radicals that are produced by exposure to toxins, and decrease our inflammatory response. We can do that by addressing the first six of the ten risk factors listed below. These are the ones we can control.

Top 10 Risk Factors for Developing Age-Related Macular Degeneration

The six we can control:

1. Smoking. Current smokers have a two-to-three times higher risk for developing age-related macular degeneration than people who never smoked. Thornton et al., 2005).

2. Environmental toxins: smoke, air pollution, herbicides, pesticides, and artificial food ingredients, including artificial fats. Usually labeled "partially-hydrogenated vegetable oils," these are pervasive in foods but in particular in low fat bakery goods. Low-fat foods are fine if they get to be low-fat just by removing the fat, as in skim milk or low fat cottage cheese. But low fat bakery goods are different; if you take all or half the fat out of a recipe for a cake, it won't turn into a cake. That means that when bakery goods are labeled low-fat or no-fat, it doesn't mean they used less fat but that they used artificial fat. These substitute fats are chemicals made in a laboratory; they are not food and our bodies can't metabolize them.

3. Sunlight. It is the blue wavelengths from the sun that damage the macula, not the UV rays. Macular Degeneration Support provides two online articles about this topic: Artificial Lighting and the Blue Light Hazard by Dan Roberts, founder of MDSupport, and Blue Light and Macular Degeneration by Dr. Mogk.

4. Diet high in packaged, processed food and low in fresh vegetables. Vegetable oils are added in the packaging process and they are rich in omega-6 fatty acids which promote inflammation.

5. Uncontrolled hypertension and high cholesterol. The National Eye Institute's Age-Related Eye Disease Study (AREDS) indicated that persons with hypertension were 1.5 times more likely to develop wet macular degeneration than persons without hypertension ("Facts About," 2009).

6. Obesity. Being overweight doubles the risk of developing advanced macular degeneration (van Leeuwen et al., 2003).

The four we can't control:

7. Advanced age. Studies indicate that your chances of developing age-related macular degeneration are 2.5 times higher if you have a parent, child, or sibling with macular degeneration (Fine, Berger, Maguire, & Ho, 2000).

8. Caucasian race. Whites are much more likely to lose vision from age-related macular degeneration than are Blacks or African-Americans ("Facts About," 2009).

9. A gene variant that regulates inflammation. While not all types of macular degeneration are hereditary, certain genes have been strongly associated with a person's risk of age-related macular degeneration, and genetic predisposition may account for half the cases of age-related macular degeneration in this country (Haines et al., 2005).

10. Family history of age-related macular degeneration. Individuals with a parent or sibling with age-related macular degeneration are at 3 to 4 times the risk of developing it. That makes it even more important to take the steps to reduce your risk!

To decrease your risk of developing age-related macular degeneration and if you have age-related macular degeneration, to decrease the rate of progression, here's what to do:

The "Don'ts":

1. Don't smoke. Avoid other toxins as much as possible.

2. Don't eat packaged, processed food, to the degree possible.

3. Don't eat artificial fats. Eat real bakery goods, made with real fat; just don't eat the whole box!

The "Do's":

1. Wear sunglasses, preferably with an amber, brown, or orange tint that blocks blue light.

2. Eat lots of dark green leafy vegetables. These vegetables—kale, spinach and collards, for example—contain lutein, a substance that neutralizes the free radicals that will otherwise cause damage the macula. If you are taking Coumadin and can't eat these vegetables because of the vitamin K in them, you can take a lutein supplement.

3. Eat lots of omega-3 fatty acids, which are found in fish, fish oil, flaxseeds, and some nuts. This is because Omega-3 fatty acids reduce inflammation.

4. Keep your blood pressure and cholesterol down.

5. Exercise regularly and keep your weight down.