Despite popular interest in the possibility that the xanthophyll carotenoid lutein, and its structural isomer zeaxanthin, may protect against the onset or progression of age-related macular degeneration, data to support this relationship is insufficient. Data are also accumulating to support a possible protective affect of diet xanthophylls on nuclear cataract. Observational studies that reflect long term relationships of intake of these xanthophyll carotenoids to their accumulation in the retina and the occurrence of these conditions in human populations are needed. We plan to utilize the existing cohort of Women's Health Initiative participants to study the relationships of long term high vs. low dietary intake of xanthophylls to the accumulation of xanthophyll carotenoids in macular pigment and the prevalence of age-related maculopathy and nuclear cataract (the two major determinants of visual impairment in the older adult population). Participants in observational study cohorts of the Women's Health Initiative at these sites (Kaiser Center for Health Sciences in Portland, University of Iowa, Iowa City and University of Wisconsin-Madison) whose xanthophyll intake at study entry were in highest and lowest quintiles will be selected (n=2713). We will compare macular pigment density measured by newly advanced technology using heterochromatic flicker photometry in these groups and evaluate the lifestyle, physical, and diet factors that influence these comparisons. We will also compute odds ratios for age-related maculopathy and nuclear opacities in women with high and low xanthophyl intakes, after adjusting for other known diet, physical and lifestyle factors that may influence these relationships. Results will add to the body of evidence needed to make dietary recommendations regarding the benefit of eating diets rich in fruits and vegetables that are rich in xanthophylls. They will also provide information needed about these relationships to conduct sound clinical trials that evaluate the influence of supplements containing these xanthophylls on shorter term progression of age-related eye diseases.
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