Can Changes in Diet , Vitamins and Lifestyle
Modifications Help Macular Degeneration?
Vitamin therapy and lifestyle
modifications have proven to be extremely
valuable at helping to stabilize Macular Degeneration.
Care and Associates / Lange Eye Institute
Dr, Michael P. Lange, Board Certified Optometric
Board Certified Nutritional Specialist
Macular Degeneration is the leading
cause of vision impairment for people over
the age of 55 in the United States.
Degeneration is the leading cause of legal
blindness in the United States in the over
55 age group. Currently there are close to
two million people living in our country that
are vision impaired from macular degeneration.
With our population living longer and longer
it is estimated that over 3 million people
by 2020 will have Age Related Macular Degeneration
(ARMD). By then each of us will know someone
that has lost their vision from macular degeneration.
Macular degeneration is a medical condition
that causes degeneration of the central part
of the retina called the macula. There are
two basic types of Age Related Macular Degeneration
1. Wet ARMD or neovascular
ARMD, which means abnormal growth of new blood
vessels which grow into the retina and leak
causing edema and atrophy of the central retina.
2. Dry ARMD or non-neovascular
ARMD. The dry form of macular degeneration
is the most common type with around 85%-90%
of sufferers having the dry form. The wet
form of macular degeneration is the most destructive
and the onset can be fairly rapid. The dry
form of ARMD can slowly steal a patients central
vision until they become legally blind. An
estimate of about 20% of dry ARMD can turn
into wet ARMD. Some people may have an increased
risk of developing macular degeneration because
of their genetic makeup. However, most cases
of macular degeneration are probably related
to a combination of genetics, poor nutrition,
sedimentary lifestyle and environmental factors.
Significant research in the area of macular
degeneration looks very promising. The evolving
therapies the Board Certified Optometrists
and Ophthalmologists have developed bring
new hope for anyone diagnosed with ARMD. These
new therapies may halt, improve or even cure
forms of macular degeneration. Ongoing research
in macular degeneration is constantly revealing
new ways to help the macular degenerative
patient and maintains a very high level of
hope for the future care of ARMD. Ultimately
we look forward to a future where macular
degeneration no longer poses a threat to vision.
What can be done to decrease the risk of going blind from Macular Degeneration?
intervention and lifestyle modifications
may be beneficial at helping to stabilize
macular degeneration. I have personally seen
thousands of patients with macular degeneration
in clinical practice for over 18 years. I
have seen the positive benefits that patients
can realistically obtain thru nutritional
intervention and lifestyle modifications.
Many patients with macular degeneration are
benefiting dramatically from visiting an eye
care provider that is in tune with the latest
in nutritional therapy. Doctors from all over
the world are using dietary modifications,
introduction of nutraceuticals and lifestyle
changes to aid the patient with macular degeneration.
These doctors have seen some incredible improvements
in vision as well as overall health in these
patients. Optometrists and ophthalmologists
often times utilize intracellular and plasma
blood testing along with advanced retinal
imaging to help determine if a patient may
have modifiable risk factors for macular degeneration.
Some of these modifiable risk factors include
elevated c-reactive protein, elevated cholesterol,
elevated triglycerides, elevated homocysteine,
lipofuscin pigment accumulation and nutritional
deficiencies. The following is a list of 17
steps that can be utilized to decrease the
risk of having progressive visual loss from
macular degeneration. This list was compiled
based on solid scientific evidence reported
in related literature and from positive results
we have seen clinically in several very large
macular degeneration practices. This does
not replace a comprehensive dilated
eye examination by a board certified optometrist
a low fat diet. Decrease saturated
fats and trans fatty acids. Eat more turkey,
chicken , cold water fish and soy products
like Garden Burgers (a popular vegetarian
meat substitute), soy milk and tofu. Eat less
corn fed beef, whole milk and cheese. Eat
the breast meat of chicken and turkey from
free roaming organically raised sources (if
possible), and prepare without deep frying.
Broiling, grilling, boiling or baking is healthier.
Eat more fish (omega-3) but be careful when
eating fish because many large fish have toxic
levels of mercury, lead and PCBs (PCBs are
persistent organic pollutants, banned since
1977, that entered the environment through
both original use and later disposal). Eat
cold water fish (sardines, tuna, mackerel,
lake trout, Atlantic halibut, herring and
wild—not farmed—salmon). Try to avoid farm
raised fish and instead eat wild fish especially
wild Alaskan salmon. Wild salmon are high
in a super carotenoid called astaxanthin that
is proving to be a key nutrient in the nutritional
approach for macular degeneration. A lean
organically raised GRASS FED steak in moderation
is a good source of protein, Vitamin B complex,
zinc, iron, folate, magnesium, selenium and
omega-3 essential fatty acids. A good source
of grass fed organic beef is www.alrosas.com.
Omega-6 fats predominate in commercially-raised
(corn-fed) meat, poultry, dairy and eggs;
and also in nuts, seeds, margarine, and vegetable
oils (such as corn, peanut, canola, safflower,
soybean, sunflower, and grape seed oils).
Omega-6 increases inflammation in the body!
Olive oil is an omega-9 and is beneficial;
it should be the primary bottled oil in the
kitchen for use in cooking and salad dressings.
The typical American diet provides 10-20 times
more omega-6 than omega-3, but a healthier
ratio is 3:1 or 4:1! Cut back on your omega-6
(choosing healthy omega-6 foods like nuts,
seeds, and avocado) and increase omega-3.
more dark green leafy vegetables
like spinach, kale, collards and swiss chard
(preferably organically grown). Carefully
boil, steam or simmer these in extra virgin
olive oil. Gentle cooking helps to break down
the cell wall releasing the bio-availability
of the greens. Juicing is also a good way
of getting these nutrients. Lutein is abundant
in dark green leafy vegetables and has been
shown to potentially help slow down the devastating
properties of macular degeneration. Lutein
and its related compound zeaxanthin are highly
concentrated in the macula, providing a yellow
color known as the macular pigment (MP).The
macular pigment acts like a built in sun screen
and protects the macula from the damaging
photo-oxidative effects of blue light. Eating
more foods that contain lutein and/or taking
a supplement with 10-30 mg of lutein daily
will help replenish the macula pigment density
that you are more prone to loose as you age
with macular degeneration. If you are taking
a blood thinner like Coumadin, consult with
your physician prior to eating more dark green
more orange bell peppers (preferably
organically grown), gently cooked or raw.
Orange bell peppers are very high in zeaxanthin.
Scientists believe this nutrient when combined
with lutein helps filter out dangerous HEV
light (blue light) and may help maintain macular
health. Sauté spinach and orange bell
peppers together in extra virgin olive oil
for good macular health. Goji berries are
also one of nature's most powerful antioxidants
that has a very high concentration of zeaxanthin.
Goji berry is one of the richest edible plant
sources known for zeaxanthin content. Up to
77% of total carotenoids present in goji berry
exist as zeaxanthin. Both goji berry and zeaxanthin
also may prove to be helpful in the irregular
blood vessel growth and leakage that occurs
in the wet form of macular degeneration due
to their potential anti-VEGF properties.
more darkly pigmented berries (preferably
organically grown). Studies indicate that
eating more dark berries like blueberries,
black berries and raspberries may help preserve
macular health. Some of the "super fruits"
like gogi berry, acai berry and mangosteen
are powerful antioxidants that may prove to
be beneficial for macular disease. These are
not easily found in your local grocery unless
they are in a juice or powdered form. If you
are a diabetic consult with your physician
prior to eating more fruits. Darkly pigmented
berries may also exhibit some anti-VEGF attributes.
5. Get more
omega 3 fatty acids by taking micro
distilled triglyceride fish oil. Stay away
from the ethyl ester form of fish
oil due to alcohol being attached to the molecule
and poorer absorption rate when compared to
triglyceride fish oil. Due
to the large amount of pollutants in fish,
molecularly distilled triglyceride fish oil
may be a better option than eating the fish.
Canned sardines are a good source of omega
threes, protein, Co-Q10 and calcium, and are
fairly contaminant free. Eat more cold-water
fish (sardines, tuna, mackerel, lake trout,
Atlantic halibut, herring and wild—not farmed—salmon).
Flax seed oil is not a good source of omega-3
essential fatty acids! I recommend Fortifeye
Super Omega since it is the more
natural concentrated triglyceride form of
omega-3 and goes through a triple molecular
distillation process to insure it is contaminant
free. This gel cap is also chewable with a
great taste for those patients that have difficulty
swallowing pills. Fortifeye Vitamins
phone number is 1-866-503-9746 or go to www.fortifeye.com.
6. Eat less
salt. Research may indicate that
decreasing salt intake may decrease deposition
of waste products in the macula called drusen.
Reduction in salt intake may help decrease
blood pressure and fluid retention.
7. Wear blue
blocking sunglasses especially if
you have had cataract surgery. There is science
that indicates blocking the high energy visible
spectrum (400nm-500nm, the “blue light”),
may help prevent damage to the macula. Yellow,
amber and orange colored lenses are good at
blocking the blue light. Wear them anytime
you are outdoors during daylight. Wear polarized
blue blockers while in the sun. Non-polarized
lenses are better while indoors, during cloudy
and overcast days and for certain sports like
motorcycling, golf, road biking and mountain
SMOKING! If you do smoke try to quit.
Smoking lowers your serum antioxidant levels
in your blood and thus causes a nutritional
deficiency at the cellular level. Second hand
smoke is just as bad. Smokers increase their
risk dramatically of developing the more advanced
stages of macular degeneration. Smoking increases
C-reactive protein (inflammatory marker in
blood that is a risk factor for macular degeneration).
If you smoke be sure you do NOT take high
levels of the supplement called beta-carotene.
High dosages of beta-carotene my increase
ones risk of lung cancer. New science also
indicates beta-carotene may interfere with
the absorption of lutein (a beneficial carotenoid
for macular health). Beta-carotene should
not be in a vitamin formula especially if
you have macular degeneration. Vegans may
want to supplement with beta-carotene since
they arent getting any vitamin A from animal
sources, however most Americans that do eat
some animal protein will not be deficient
in Vitamin A and thus dont need any beta-carotene.
Beta-carotene has shown some form of competitive
inhibition against lutein that may begin in
9. Do cardiovascular
exercises for 20-30 minutes 5 times
a week (discuss this with your physician first).
Research indicates that patients who did cardiovascular
exercise (treadmill, stationary bike, elliptical,
walking, jogging, swimming etc.) were less
likely to develop macular degeneration. These
forms of exercise may be beneficial for glaucoma
patients as well.
10. If you are
overweight, LOSE WEIGHT! Overweight
people are twice as likely to develop macular
degeneration. Losing weight will also reduce
C-reactive protein and help to normalize cholesterol
and triglycerides. Controlling C-reactive,
cholesterol and triglycerides may benefit
macular degeneration. Overweight patients
are also more likely to develop glaucoma and
cataracts at an earlier age. Reducing your
caloric intake and increasing your cardiovascular
exercise will aid in weight reduction. Patients
who are over weight with pre-existing health
conditions may want to seek help from a physician
supervised weight loss program.
systemic health problems such as
hypertension, diabetes, elevated C-reactive
protein and elevated homocysteine. Elevated
homocysteine has been linked to macular degeneration
as well as optic neuropathies, certain types
of glaucoma, retinal occlusive disease and
diabetic retinopathy. Patients who are overweight
can have a dramatic improvement in these systemic
health problems once they start a weight management
program and stick to it.
Drink red wine and green tea!
New research may indicate that drinking red
wine in moderation, sipping green tea, eating
more soy products and cooking with curry may
have some positive impact on macular degeneration,
cataracts and inflammatory diseases in the
eye. Consume more Pinot Noir from
the New York region, because this wine has
some of the highest resveratrol content. Resveratrol
is a powerful antioxidant proving to have
many health benefits. Walnuts are also a good
source of resveratrol. The latest research
shows that soy, resveratrol, green tea and
curcumin may all have the ability to inhibit
new fragile blood vessel growth (anti VEG-F).
This may prove to be beneficial at decreasing
the chance of the dry form of macular degeneration
from turning into the wet form. Some other
specific nutrients that may also exhibit effects
on VEGF are Vitamin D, rutin, zeaxanthin,
tocotrienols, super berries and even B vitamins.
Have a vitamin D blood test;
25 (OH) D done routinely, making sure you
are not deficient in Vitamin D. Recent research
shows patients with low levels of serum Vitamin
D may be more likely to develop macular degeneration.
Vitamin D is a potent steroid hormone and
deficiencies are linked to cancer, cardiovascular
disease, stroke, hypertension, diabetes, osteoathritis,
osteoporosis, depression, multiple sclerosis,
muscle wasting, schizophrenia and even the
flu. The sun is the best source of Vitamin
D. Just 15-20 minutes of sun exposure during
the peak hours in shorts and a tank top while
wearing a good pair of blue blocking sunglasses
and a wide brimmed hat may be beneficial.
Consult with your physician before too much
sun exposure especially if there is a history
of skin cancers or melanoma.
Dark Chocolate is high in polyphenols
and antioxidants that may prove to
be beneficial for macular degeneration. The
darker the chocolate the better. Dark chocolate
is proving to be good for for many health
conditions including diabetes, hypertension,
and elevated cholesterol and may reduce the
risk of blood clots, strokes and heart attacks.
Polyphenols from dark chocolate may also exhibit
some anti-VEGF properties and may prove to
be beneficial for macular degeneration. Try
to eat the dark chocolate with the highest
percent of cocoa and the least amount of sugar.
Do not take supplemental beta-carotene!
Many emerging studies are proving that supplemental
beta-carotene blocks the absorption of lutein.
Beta-carotene also increases the risk of lung
cancer among smokers. There is no beta-carotene
in the eye, however, there is a high percent
of lutein concentrated in the macula, so macular
degeneration patients do not want to block
this valuable carotenoid. Do not take Vitamin
A palmitate as studies now indicate that it
may increase the risk of macular degeneration
and it may also increase the risk of osteoparosis,
liver problems and neuro degenerative diseases.
If you are deficient in Vitamin A then a physician
needs to determine why and treat accordingly.
Get a good night's sleep.
More and more research is indicating that
sleep deprivation is a major risk factor for
many health problems. Sleep deprivation can
suppress the immune system, increase inflammation
in the body, lead to weight gain, high blood
pressure and possibly Alzheimer's disease.
Sleep deprivation may increase your risk of
optic nerve problems as well as macular degeneration.
The National Sleep Foundation recommends
7-9 hours of sleep a night for adults.
17. Take a good
nutritional supplement based on the
latest scientific data, preferably one that
does not have any artificial dyes and synthetic
nutrients. Be careful of supplements that
have only “window dressing” amounts of specific
nutrients. Many vitamin companies will add
tiny amounts of popular nutrients just to
be able to put it on the label. These small
amounts may have no nutritional value. Patients
must also be extremely careful not to take
too many supplements as well. Vitamins can
build up toxic levels, especially the fat
soluble forms. The leading company that takes
all of the current science into consideration
in the development of their nutraceuticals
Vitamins. The Fortifeye®
products are all natural with no dyes. They
provide therapeutic levels of nutrients and
no window dressing. The Fortifeye Vitamins
mission is stated as promoting proper vision
and whole body health with the right ingredients
at the right levels. I recommend to all of
my patients the multivitamin Fortifeye™
Complete Plus, which is a combination
of vitamins, minerals, phytonutrients, enzymes,
whole foods and omega-3 essential fatty acids
designed to lay a strong foundation for eye
and total body health. If the patient has
macular degeneration or is a smoker, I recommend
Complete Macular Defense which
is a nutritional system to help prevent any
further vision loss from macular degeneration
and gives the additional antioxidants necessary
for smokers. I have seen many patients in
clinical practice improve, some quite dramatically,
while taking these supplements. Many doctors
throughout the country are now recommending
Fortifeye™ Vitamins to their
patients with macular degeneration. Fortifeye
stays abreast of the most current science
in regards to nutritional supplementation
for the eye and body, and because of this,
their vitamins for macular degeneration and
total body health are constantly evolving.
for the latest information, or call toll free
Michael P. Lange
Board Certified Optometric Physician
and Board Certified Nutritional Specialist
You can see that many patients
will require a total overhaul in their dietary
habits and lifestyles, and others will have
some minor adjustments. If patients would
only do these 17 things faithfully we would
see much less vision loss from macular degeneration
and have a much healthier society. Remember
there is no miracle cure for macular degeneration.
However if you implement the 17 steps outlined,
you will decrease your risk of going blind
from macular degeneration. Keep the faith!
Dr. Michael P. Lange
Board Certified Optometric Physician
and Board Certified Nutritional Specialist
Lange Eye Care and Associates
The Lange Eye Institute
(Located in Central/North Central Florida)
Dec 27, 2009