Highlight: Do our choices or our genes impact the development & progression of AMD?

You may have gotten an email yesterday about this post which said it was password protected.  I keep forgetting that putting a password on a page while it’s being developed doesn’t work to stop an early email.  Sorry!

Facebook group member Vickie Hoecherl (a link to her new Guest Author page below) has gone through the December 2017 article from the award-winning lecture by well-respected and widely-published Dr. Johanna M. Seddon and has shared with the group members some of the researcher’s quotes.   Click here for the full article “Macular Degeneration Epidemiology: Nature-Nurture, Lifestyle Factors, Genetic Risk, and Gene-Environment Interactions – The Weisenfeld Award Lecture”.


Do our choices impact the progression of AMD?  How much of our future is written in our genetic code

Note: If you see (), we’ve left out statistics from Dr. Seddon’s article. You can see them in the full article. Also, we’ve added topic headings to the researcher’s quotes. 
Nature vs. nurture

“Our analyses showed that a high proportion of AMD was attributable to genetics, with heritability ranging from 46% to 71%, depending on the stage of the disease. More advanced disease, as well as larger drusen and greater drusen area measuring 175 μm or larger were highly heritable, with estimates of 71%. The environmental influence on this disease is also notable (19% to 37%). Therefore, both nature and nurture were important in the development of AMD.”

Stop smoking

“The leading modifiable risk factor is cigarette smoking.”

Eat your greens, know your fats

“. . . . a higher frequency of intake of spinach or collard greens was associated with a substantially lower risk for AMD. Results suggested an 88% lower risk with higher intake, defined as eating a one-half cup serving at least five times per week. Other foods that are high in lutein and zeaxanthin include dark green leafy vegetables, kale, turnip greens, and collard greens.”

“High total fat intake was associated with almost a three-fold higher risk of progression and saturated and trans-unsaturated fats conferred over a 2-fold higher rate of progression from nonadvanced to advanced stages of AMD. Higher intake of omega-3 fats, which are found in high levels in fish and some nuts, reduced risk of progression to advanced AMD by 25% to 40%, particularly among participants with lower linoleic acid intake.”

Supplements weigh in

“Supplements containing vitamin C, E, zinc, as well as lutein and zeaxanthin are now recommended for individuals with intermediate-level AMD”

Get out the tape measure

“We also evaluated modifiable anthropometric factors, including BMI, waist circumference, and waist-to-hip ratio, in our prospective cohort. A BMI defined as obese (≥30) was significantly associated with a higher risk of progression to advanced stages of AMD (), as was the overweight classification (). A significant trend was observed for higher risk with higher BMI (). The highest tertile of waist circumference significantly increased risk of progression () compared with the lowest tertile. A higher waist-to-hip ratio also increased risk of progression (). In contrast, higher levels of physical activity tended to reduce risk of progression. ”

Genes effect on occurrence and progression

“Genes conferring AMD risk are not only related to the occurrence of AMD as found in case-control studies, but we also found they are important in determining the rate of progression of disease over time, from early and intermediate stages to advanced clinical phenotypes.”

Genes and diet can interplay

“We found the highest quintile of omega-3 intake was associated with a lower risk of progression to geographic atrophy, when compared with the lowest intake, and this beneficial effect was noted particularly among individuals who carried the homozygous risk genotype for ARMS2 (). No protective effect was observed for the ARMS2 homozygous nonrisk genotype. ”

“Additional gene-diet differences were observed with regard to high adherence to a Mediterranean diet (). High adherence reduced the risk of progression to advanced AMD, and specifically among those individuals carrying at least one nonrisk allele at CFH Y402H (). There was no effect of the Mediterranean diet on risk of progressing to advanced AMD among individuals carrying the CFH homozygous risk genotype (CC).”

“In our diet-gene evaluation of dietary folate, high consumption of dietary folate was significantly associated with a lower risk of progression (). We found a protective effect of higher folate intake against progression to geographic atrophy, particularly among individuals carrying the C3 R102G homozygous nonrisk genotype (). The beneficial effect of folate was not observed for those carrying at least one risk allele (G) at this locus.”

“We also recently reported that participants with the highest quintile of dietary vitamin D intake had a significantly lower risk of progression to advanced stages of AMD, and especially NV. This effect also may vary according to genotype.”


Read about Vickie’s journey with AMD

 

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Looking for Answers

Lin gave me a preview of the page Nancy submitted as a guest writer. I am so glad Nancy took our invitation! Hoping that more of you do the same. [click here for Nancy’s page.]

Now, we all know I am a little ‘different’. Might as well embrace it. My immediate supervisor at school loves to tell me “You are such a psychologist!” She’s telling me I’m weird; right?

Anyway, even though I am not normal, I see parallels between Nancy’s experiences, my experiences and maybe even your experiences, too.

We are all “of a certain age”. At 64, I think of myself as a youngster with AMD but Lin tells me new Facebook members keep getting younger. What the hey is happening there?!?!? Anyway, this is not a disease of the young.

Most of us had parents or relatives with AMD. Nancy worried about developing it herself. I never did but Daddy was into his 80s when he lost his sight and his condition was never named for me. Since relatives were pretty few and far between on my father’s side, he was a sample of one for me. I never gave a thought to it being hereditary. Oops. Maybe you were not so obtuse and worried like Nancy.

Both Nancy and I have had the anxiety of waiting for things to go to hell in a proverbial handbag. One of the problems with a slowly developing condition is it lulls you into complacency and the next thing you know WHAM! No longer so complacent.

Many of us are facing limitations. These are limitations we don’t like and don’t want. Limitations that hit right at our independence and threaten who we are and how we interact with our worlds.

Then there are the attempts to combat this stuff. I went research and science. Fits me. Nancy went nutrition. Me? Not so much. Even though my ‘little’ nephew – 6’5” and possibly still growing – assures me food is the most important drug you can put in your body, I am not going there.

And in keeping with the season I just had a really excellent piece of pumpkin spice cake. What? Don’t give me grief; it was orange! Antioxidant color; right?

Back on track – but it was yummy cake! – we are all looking for answers. We are all hoping for the miracle cure. Is it coming? I truly believe so. Just don’t expect it by next Tuesday. In the age of great medical breakthroughs, you would think our little problem would be easy but it’s not. It is a frustration we all feel.

Then…the elephant in the room: depression. We have talked about it before and will talk about it again. We have all felt it. Some of us have the resources to help us bounce back. Some of us need help finding those resources. Lin said something about citing pages, etc. about depression so I am sure several of these words will be blue soon. [click here for an article about depression in people with AMD.]

What I learned from Nancy’s page? We are all having similar experiences. Nancy, probably you, me, too. So maybe I’m not so weird after all? Maybe?

written October 2nd, 2017 Continue reading “Looking for Answers”

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Highlight: Consistent checkups are important to eye health

March 25, 2016

This is a great article that points out that it is important to have your eyes checked regularly and that the timing depends on what’s going on with your eyes.  The article makes 2 especially important points about a diagnosis of AMD:

  •  Even though there is no cure yet for AMD,  it’s important to catch it early since there are some ways to slow down the disease.
  • If a person is diagnosed with AMD, it’s a good idea for them to alert their children about it since there is a hereditary component to it.

Click here to read the rest of the article

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