Aging of the lens and retina of the eye promote the development of cataract and macular degeneration (AMD), common causes of visual loss and health care expenditures in older Americans, particularly older women. The totality of scientific evidence from animal studies, clinical trials and observational studies suggests that nutrition is the most promising means to prevent or slow these conditions, aside from smoking cessation. Yet, there is a need to 1) understand some specific aspects of diet that may contribute to risk but which have not been well-studied and 2) evaluate the degree to which overall aspects of healthy eating reduces risk. We plan to conduct epidemiological investigations to evaluate these newly considered nutritional means of slowing age-related degenerative changes in the eye. This can be accomplished quickly and at low cost by extending the data and serum analyses from the Carotenoids in Age-Related Eye Disease Study, an ancillary study of the Women's Health Initiative (WHI). This sample of women (n=2005) from WHI observational study cohorts in Portland, OR, Iowa City, IA and Madison, Wl, ages 50-79 years, previously provided extensive nutritional, lifestyle and medical data since 1994-97 and additional data, including photography of the lens and retina in 2001-2004. Recent evidence suggests that poor vitamin D status is not only common among older Americans but may also slow age-related macular degeneration. This converges with new evidence that inflammation promotes AMD and that vitamin D has anti-inflammatory properties. We will investigate relationships of levels of vitamin D and a marker of systemic inflammation, C-reactive protein, in serum obtained in 1994-97, to the prevalence of AMD and cataract in 2001-04. We will also explore the possibility that overall healthy eating patterns which reflect national dietary guidelines may reduce the estimated risk for these conditions more than single nutrients, alone. We will examine relationships of a modified Healthy Eating Index (HEI) score of diets in 1994-97, and of specific aspects of this score, to cataract and AMD in 2001-2004. These studies are expected to enhance our ability to develop practical public health recommendations that integrate the many aspects of diet which may slow the development of age-related cataract and macular degeneration. ? ? ? ?
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