@article {1304390,
	title = {Adherence to a mediterranean diet and its association with age-related macular degeneration. The Coimbra Eye Study-Report 4},
	journal = {Nutrition},
	volume = {51-52},
	year = {2018},
	month = {2018 Mar 13},
	pages = {6-12},
	abstract = {OBJECTIVES: This study aimed to characterize the association of lifestyle and nutritional risk profiles with age-related macular degeneration (AMD) in two subpopulations with differing AMD prevalence. METHODS: This case-control study (n = 1992) included 768 patients with AMD and 1224 age- and sex-matched participants without AMD with a single visit at a primary health care unit. Enrolled participants completed a validated lifestyle and food frequency questionnaire. A score to measure adherence to the Mediterranean diet (mediSCORE; Range, 0-9) was constructed from individual food intakes, which were further analyzed by conversion to nutrient consumption. RESULTS: Higher adherence to the Mediterranean diet (mediSCORE >=6) was significantly associated with no AMD (odds ratio [OR] = 0.73; P = 0.009). The subpopulation with lower AMD prevalence presented significantly higher adherence to the Mediterranean diet in relation to all individual food groups that comprised the mediSCORE (P \&lt; 0.014) with the exception of cereals. Food group analysis showed significant associations between the increased consumption of vegetables (OR = 0.63; P \&lt; 0.001) and fruit and nuts (OR = 0.78; P = 0.010) with no AMD. Nutrient analysis revealed that an increased ingestion of water, fibers, total fat, monounsaturated and polyunsaturated fatty acids, linoleic acid, vitamins A and C, carotene, alpha-tocopherol, folate, magnesium, iron, and zinc were significantly associated with no AMD (P \&lt; 0.0013). Finally, regular physical activity was associated with no AMD (P = 0.003). CONCLUSIONS: High adherence to a Mediterranean diet and regular physical activity seem to be protective factors for AMD in a Portuguese population. The effect of the diet is likely driven by the increased consumption of vegetables, fruits, and nuts.},
	issn = {1873-1244},
	doi = {10.1016/j.nut.2017.12.010},
	author = {Nunes, Sandrina and Alves, Dalila and Barreto, Patr{\'\i}cia and Raimundo, Miguel and da Luz Cachulo, Maria and Farinha, Cl{\'a}udia and La{\'\i}ns, In{\^e}s and Rodrigues, Jo{\~a}o and Almeida, Carlos and Ribeiro, Lu{\'\i}sa and Figueira, Jo{\~a}o and Santos, Lelita and Silva, Rufino}
}
