PURPOSE To investigate associations of adherence to the Mediterranean diet (MeDi) with incidence of advanced age-related macular degeneration (AMD; the symptomatic form of AMD) in 2 European population-based prospective cohorts. DESIGN Prospective cohort study of the Rotterdam Study I (RS-I) and the Antioxydants, Lipides Essentiels, Nutrition et Maladies Oculaires (Alienor) Study populations. PARTICIPANTS Four thousand four hundred forty-six participants 55 years of age or older from the RS-I (The Netherlands) and 550 French adults 73 years of age or older from the Alienor Study with complete ophthalmologic and dietary data were included in the present study. METHODS Examinations were performed approximately every 5 years over a 21-year period (1990-2011) in RS-I and every 2 years over a 4-year period (2006-2012) in the Alienor Study. Adherence to the MeDi was evaluated using a 9-component score based on intake of vegetables, fruits, legumes, cereals, fish, meat, dairy products, alcohol, and the monounsaturated-to-saturated fatty acids ratio. Associations of incidence of AMD with MeDi were estimated using multivariate Cox proportional hazard models. MAIN OUTCOMES MEASURES Incidence of advanced AMD based on retinal fundus photographs. RESULTS Among the 4996 included participants, 155 demonstrated advanced incident AMD (117 from the RS-I and 38 from the Alienor Study). The mean follow-up time was 9.9 years (range, 0.6-21.7 years) in the RS-I and 4.1 years (range, 2.5-5.0 years) in the Alienor Study. Pooling data for both the RS-I and Alienor Study, participants with a high (range, 6-9) MeDi score showed a significantly reduced risk for incident advanced AMD compared with participants with a low (range, 0-3) MeDi score in the fully adjusted Cox model (hazard ratio, 0.59; 95% confidence interval, 0.37-0.95; P = 0.04 for trend). CONCLUSIONS Pooling data from the RS-I and Alienor Study, higher adherence to the MeDi was associated with a 41% reduced risk of incident advanced AMD. These findings support the role of a diet rich in healthful nutrient-rich foods such as fruits, vegetables, legumes, and fish in the prevention of AMD.

中文翻译：

---

地中海饮食和与年龄相关的高级黄斑变性的发病率：眼-风险联盟。

目的探讨在两个欧洲人口为基础的前瞻性队列研究中，坚持地中海饮食（MeDi）与晚期老年性黄斑变性（AMD； AMD的症状形式）的发生率的相关性。设计对鹿特丹研究I（RS-1）和抗氧化剂，脂类香精，营养和疟疾眼病（Alienor）研究人群进行的前瞻性队列研究。参与者本研究包括来自RS-I（荷兰）的55岁或以上的404名参与者和来自Alienor研究的550岁73岁或以上的法国成年人，他们具有完整的眼科和饮食数据。方法在Alienor研究中，在RS-I的21年期间（1990-2011年）大约每5年进行一次检查，在4年期间（2006-2012年）每2年进行一次检查。使用基于蔬菜，水果，豆类，谷物，鱼，肉，乳制品，酒精和单不饱和脂肪酸与饱和脂肪酸之比的摄入量的9成分评分，评估对MeDi的粘附性。使用多变量Cox比例风险模型估算AMD与MeDi的发生率关联。主要指标：根据眼底照片对晚期AMD的发生率。结果在4996名参与者中，有155人表现出严重的AMD事件（来自RS-1的117人和来自Alienor研究的38例）。在RS-1中，平均随访时间为9.9年（0.6-21.7年），在Alienor研究中为4.1年（2.5-5.0年）。收集RS-I和Alienor研究的数据，参与者（范围，6-9）与在完全调整的Cox模型中MeDi得分低（范围为0-3）的参与者相比，MeDi得分显示发生晚期AMD的风险显着降低（风险比为0.59; 95％的置信区间为0.37-0.95 ；对于趋势，P = 0.04）。结论从RS-I和Alienor研究中收集的数据表明，对MeDi的更高依从性使发生晚期AMD的风险降低了41％。这些发现支持富含健康，营养丰富的食物（例如水果，蔬菜，豆类和鱼类）的饮食在预防AMD中的作用。