Risk factors and Age-Related Macular Degeneration in a Mediterranean basin population, the PAMDI (Prevalence of ARMD in Italy) Study: Report 2.

Aim: To investigate the association of diet and other modifiable risk factors with the prevalence of Age Related Macular Degeneration (ARMD) within rural and urban communities of a Mediterranean population in the North-East of Italy. Methods: A cross-sectional population-based study was conducted among subjects over 60 years. A Frequency Food Questionnaire (FFQ) collected the assumption of different food categories: Protective (P), Risky (R), Lutein-rich (L) and Neutral (N). Smoking habits and alcohol intake were also examined. Macular pigment was measured by Raman spectroscopy. Results: P food intake reduced the risk of large drusen (ARM2) (OR=0.93, 95%CI: 0.89-0.96) within the rural community. In this subgroup, R foods resulted in a slight association with large drusen, though the R/P food ratio was highly correlated with ARM2 (OR=1.21, 95%CI: 1.12-1.31). Raman measures showed age-dependent decrease but did not correlate with lutein intake. Smoking habits showed a positive association with ARM2 among women (OR=2.40, 95%CI: 1.54-3.75) whereas alcohol consumption resulted in protective odds (OR=0.72, 95%CI: 0.60-0.86). Conclusion: FFQ analysis confirmed the role of P and R foods and the benefit of the Mediterranean diet on ARMD. Moderate alcohol consumption showed a beneficial effect, whereas the deleterious role of smoking habit was more evident in females.