Food groups and risk of age-related macular degeneration: a systematic review with meta-analysis

Objective: To systematically review all the available evidence from prospective cohort studies that investigated the association between consumption of food groups and the occurrence of age-related macular degeneration (AMD). Methods: We conducted an electronic literature search through MedLine, Embase, Google Scholar, Web of Science, and bibliographies of retrieved articles up to January, 2018. Studies were included if they analysed prospectively the association between consumption of food groups and AMD. Results: At the end of the selection process, 26 articles were included in the meta-analysis, for a total of 211,676 subjects and 7154 cases of AMD. By comparing the highest vs. the lowest consumption, pooled analyses showed no significant association with AMD for vegetables, fruit, nuts, grains, dairy products, as well as dietary fats such as oils, butter and margarine. Fish determined a significant (p < 0.05) reduction of risk for total AMD (RR 0.82 95% CI 0.75–0.90), as well as for both early (RR 0.84 95% CI 0.73–0.97), and late (RR 0.79 95% CI 0.70–0.90) AMD. On the other hand, high meat consumption was associated with a significant increased risk of early (RR 1.17 95% CI 1.02–1.34), but not late AMD. Finally, a significant increased risk of AMD for the highest consumption of alcohol (RR 1.20 95% CI 1.04–1.39) was reported. Conclusions: The results of the present meta-analysis show a significant 18% reduced risk for fish and a 20% increased risk for alcohol consumption. In addition, an increased risk was observed for meat, but only in the subgroup of early AMD.