Prospective study of intake of fruits, vegetables, vitamins, and carotenoids and risk of age-related maculopathy

Objective: To examine the intake of antioxidant vitamins and carotenoids as well as fruits and vegetables in relation to the development of age-related maculopathy (ARM). Methods: We conducted a prospective follow-up study of women in the Nurses' Health Study and men in the Health Professionals Follow-up Study. We followed 77 562 women and 40 866 men who were at least 50 years of age and had no diagnosis of ARM or cancer at baseline for up to 18 years for women and up to 12 years for men. Fruit and vegetable intakes were assessed with a validated semi-quantitative food-frequency questionnaire up to 5 times for women and up to 3 times for men during follow-up. Results: A total of 464 (329 women and 135 men) incident cases of early ARM and 316 (217 women and 99 men) cases of neovascular ARM, all with visual loss of 20/30 or worse due primarily to ARM, were diagnosed during follow-up. Fruit intake was inversely associated with the risk of neovascular ARM. Participants who consumed 3 or more servings per day of fruits had a pooled multivariate relative risk of 0.64 (95% confidence interval, 0.44-0.93; P value for trend = .004) compared with those who consumed less than 1.5 servings per day. The results were similar in women and men. However, intakes of vegetables, antioxidant vitamins, or carotenoids were not strongly related to either early or neovascular ARM. Conclusion: These data suggest a protective role for fruit intake on the risk of neovascular ARM.