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Omega 3 and vitamin D supplements don't prevent or delay macular degeneration: JAMA
The initial publication of results from the Age-Related Eye Disease Study (AREDS), showed that oral therapy with over-the-counter vitamins and zinc slowed the progression of age-related macular degeneration (AMD), in its early stages.
Also observational studies done in past suggest that higher intake or blood levels of vitamin D and marine Omega 3 fatty acids may be associated with lower risks of age-related macular degeneration (AMD). But evidence from randomized trials is limited
Recently researchers have found in an ancillary Study of the VITAL Randomized Clinical Trial that supplementation of vitamin D or omega-3 fatty acids does not lower the risk for age-related macular degeneration (AMD) or its progression,
The study has appeared in JAMA Ophthalmology .
They conducted a nationwide, placebo-controlled, randomized clinical trial to evaluate whether daily supplementation for approximately 4 to 6 years with vitamin D, marine Omega-3 fatty acids, or both vs placebo prevents the development or progression of age-related macular degeneration in initially healthy US adults.
In a prespecified ancillary study of the Vitamin D and Omega-3 Trial (VITAL) , the researchers randomised over 25,000 U.S. adults aged 50 and older to receive vitamin D supplementation (2000 IU/day) plus marine omega-3 fatty acids (1 g/day), vitamin D plus placebo, omega-3s plus placebo, or double placebo.Randomization was from November 2011 to March 2014, and study pill-taking ended as planned on December 31, 2017.
The primary end point was total age-related macular degeneration (AMD) events, a composite of incident cases of age-related macular degeneration (AMD) plus cases of progression to advanced AMD among participants with AMD at baseline, based on self-report confirmed by medical record review. Analyses were conducted using the intention-to-treat population.
The researchers found that for vitamin D3, there were 163 events in the treated group and 161 in the placebo group . For Omega -3 fatty acids, there were 157 events in the treated group and 167 in the placebo group . In analyses of individual components for the primary end point, HRs comparing vitamin D3 groups were 1.09 (95% CI, 0.86-1.37) for incident AMD and 0.63 (95% CI, 0.33-1.21) for AMD progression. For Omega-3 fatty acids, HRs were 0.93 (95% CI, 0.73-1.17) for incident AMD and 1.05 (95% CI, 0.56-1.97) for AMD progression.
During a median 5 years of treatment, 1.3% of participants experienced either incident AMD or worsening of preexisting AMD. Outcomes did not differ significantly regardless of whether participants received vitamin D, omega-3s, or placebo.
The researchers concluded that vitamin D3 or marine ω-3 fatty acid supplementation didn't have a significant overall effect on AMD incidence or progression.They note that prior observational studies suggested a potential benefit for vitamin D in age-related macular degeneration (AMD), but such studies could have been limited by residual confounding. , "These negative results of a large, well-designed, and well-conducted clinical trial, performed by highly experienced investigators, [are] discouraging."writes a commentator.
For further reference log on to:
JAMA Ophthalmol. Published online October 29, 2020. doi:10.1001/jamaophthalmol.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751