The Rising Challenge of AMD
Age-related macular degeneration (AMD) stands as a significant concern as the leading cause of blindness in the Western world. This condition deteriorates the central part of the visual field, leading to blurred vision or distortion, which severely impacts daily activities like reading or recognizing faces. In our era, where smartphones and the internet are integral to daily life, the ability to see clearly is more crucial than ever. With the rise of lifestyle changes and an aging population, the incidence of AMD in traditionally low-risk populations, such as Japan, is increasing. Recent epidemiological surveys indicate a doubling in AMD cases over nine years, highlighting an urgent need for effective prevention strategies.
The Constant Challenges Your Macula Faces
The macula, the central part of the retina responsible for clear vision, faces continuous stress and damage with age. As you view the world, light is constantly focused on your macula, bombarding it with oxygen and leading to the production of reactive oxygen species. This persistent oxidative stress is believed to be a key contributor to AMD’s development. Understanding how your macula is affected by light and oxidative stress is crucial in grasping how AMD progresses and what can be done to prevent it.
Understanding Reactive Oxygen Species and Oxidative Stress
Life on Earth fundamentally depends on oxygen for metabolic activities. However, a few percent of the oxygen we breathe is converted into reactive oxygen species (ROS). While these molecules have essential roles in antibacterial defense and cell signaling, an excess can lead to cell damage, manifesting in harmful oxidative stress reactions like DNA damage and lipid peroxidation. Our body’s antioxidant defense mechanisms work tirelessly to suppress ROS production and repair the damage they cause. But, modern lifestyle factors like UV radiation, pollution, and stress can disrupt this delicate balance, tipping it towards oxidation and tissue damage.
But, modern lifestyle factors like UV radiation, pollution, smoking, alcohol consumption, an imbalanced diet, excessive or insufficient exercise, and stress can disrupt this delicate balance, tipping it towards oxidation and tissue damage. These elements contribute significantly to the overall oxidative burden our bodies face, emphasizing the need for a conscious and proactive approach to our lifestyle choices
Learning from Risk Factors for Age-Related Macular Degeneration
To protect ourselves from AMD, understanding its risk factors is essential. Aging is the most significant and uncontrollable risk factor. Over time, the macula’s natural antioxidant defenses weaken, making it more susceptible to damage. However, not all older adults develop AMD, suggesting that other modifiable factors also play a role. These include dietary habits, smoking, and sunlight exposure. By focusing on what we can change, such as improving our diet and avoiding harmful habits, we can help protect our macular health.
Let’s return to the topic of age-related macular degeneration (AMD). If you don’t want to develop AMD, it’s necessary to understand the risk factors that make it more likely to occur. Below, we will look at the risk factors for AMD, and you’ll see how important it is to respond to oxidative stress.
Aging as the Primary Risk Factor
The macula, constantly exposed to reactive oxygen due to its function, is equipped with an advanced antioxidant defense mechanism. When young, your eyes can handle a lot of use and exposure to sunlight without issue. However, as you age, the power of this antioxidant defense mechanism diminishes, making it easier for oxidative stress to occur. Thus, aging is the most significant risk factor for AMD. However, not all older individuals develop AMD, indicating that factors other than age are at play. While you can’t change aging, it’s essential to focus on other risk factors that you can influence to prevent the deterioration of the macula.
Genetic Variability in Susceptibility to AMD
The rate at which the macula’s antioxidant defense mechanism degrades with age varies genetically. This is because several genes have been linked to the development of AMD. Currently, you can’t change your genes, so this isn’t something you can ‘work on’. However, if you have a family history or genetic predisposition to AMD, it’s crucial to be aware and make every effort to prevent it.
Beyond Aging and Genetic Individuality
What efforts can you make to prevent AMD, aside from the unavoidable factors of aging and genetics? Let’s look at other known risk factors for AMD to see where you can make changes.
- Diet (Nutrition) ➡ Reassess your diet + Use supplements
- Smoking ➡ Quit smoking
- Sunlight
- Sunlight Exposure ➡ Depending on your job and sports activities, avoid direct sunlight exposure to the eyes as much as possible
- Post-Cataract Surgery ➡ Nowadays, intraocular lenses that cut off UV and blue light are standard, so you can feel secure
- Hypertension ➡ Prevent through diet, exercise, early detection, and blood pressure management
- Cardiovascular Disease ➡ Prevent through diet, exercise, early detection, and treatment
- Obesity ➡ While genetics influence obesity, diet has a more significant impact, so reassess your diet
Among these factors, it’s clear that the daily efforts you can make include quitting smoking, improving your diet, reducing exposure to sunlight, and exercising.
Everyday Impact and Lifestyle Considerations
Our daily habits play a crucial role in the development of AMD. Diet, smoking, sunlight exposure, and exercise are not just lifestyle choices; they directly impact our macular health. By making conscious decisions about what we eat, how much we exercise, and how we protect our eyes, we can influence our long-term health. A proactive approach to lifestyle changes can significantly reduce the risk of AMD and enhance overall well-being.
Boosting Antioxidant Power: Diet and Exercise Key
The key to combating AMD lies in strengthening our body’s natural antioxidant defenses. A diet rich in vitamins, minerals, and other antioxidants can help protect the macula from oxidative damage. Similarly, regular exercise boosts overall health and helps maintain a robust antioxidant system. Together, a nutritious diet and an active lifestyle form a powerful defense against AMD and other age-related conditions.
Effective Nutrients for Preventing Age-Related Macular Degeneration
A balanced intake of specific nutrients is crucial in preventing AMD. Antioxidants like vitamins C and E, zinc, lutein, zeaxanthin, and omega-3 fatty acids (EPA and DHA) play significant roles in protecting the macula. Lutein and zeaxanthin, found in high concentrations in the macula and lens, are particularly effective in absorbing harmful blue light and combating oxidative stress. Ensuring a diet rich in these nutrients can significantly decrease the risk of developing AMD and maintain overall eye health.
Insights from Clinical Trials: The Power of Supplements
Clinical trials such as the AREDS and AREDS2 have provided valuable insights into how high-dose supplementation can slow AMD’s progression. These studies highlight the benefits of combining multiple antioxidant nutrients, suggesting that a comprehensive approach is more effective than focusing on a single nutrient. While these supplements are particularly beneficial for individuals at high risk of advanced AMD, maintaining a balanced diet is crucial for everyone looking to protect their eye health.
Preventive Effects Through Dietary Improvement
A study that followed over 4,202 individuals aged 55 and above, who were not suffering from AMD, for an average of more than nine years in the Rotterdam area of the Netherlands, found that 754 people (18%) developed AMD. However, those who consumed fish twice a week had a 25% reduced risk of developing AMD, and those who added at least 200g of vegetables and two servings of fruit daily, in addition to fish, had an astonishing 42% reduction in their risk. Specifically, the percentages of individuals who achieved the consumption levels of vegetables (≥200 g/day), fruit (2×/day), and fish (2×/week) were 30.6%, 54.9%, and 12.5%, respectively. Moreover, only 3.7% of the total group managed to meet the recommended intake for all three types of these foods.
This indicates that:
- A balanced and sufficient intake of vegetables, fruits, and fish significantly contributes to preventing AMD.
- Particularly, consuming fish has a high preventive effect.
- However, the number of people who eat fish is less compared to those who consume other food items.
Despite the proximity to the sea, the reality in Rotterdam and similar areas is that most people do not consume fish twice a week. Even when aware of its health benefits, people might not often include it in their diet due to regional food culture. This highlights the potential benefits of incorporating Japanese cuisine, known for its fish dishes, into one’s diet.
Why Japanese Cuisine is Good for AMD Prevention
Japan’s Rich Fish Culinary Culture
Japan, an island nation surrounded by the sea, has historically relied on fish as a primary source of protein. This led to the development of a variety of main dishes centered around fish. The Japanese have enjoyed fish in many ways: raw, as sushi, grilled, boiled, steamed, poached, pickled, dried, and fried. The diversity in types of fish, mirrored in the dozens of sushi toppings available, provides a wide range of flavors and textures. This variety far exceeds that of meat. Therefore, eating traditional Japanese food typically includes some form of fish dish. For instance, people in Rotterdam, by incorporating Japanese meals like sushi twice a week, can achieve twice-a-week fish consumption.
The Health Benefits of Fish Oil
It’s worth noting that one reason fish is considered effective in preventing AMD is due to the presence of omega-3 fatty acids such as EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) in fish oil, which are also common ingredients in supplements.
Decline in Fish Consumption in Japan and the Rise in AMD
Despite a long history of consuming Japanese cuisine rich in fish, Japan has seen a shift towards Western eating habits. According to surveys by the Fisheries Agency, fish consumption has halved over the past 20 years, and in 2011, it was even surpassed by meat consumption. While the direct correlation between this decline and the increase in AMD in Japan isn’t conclusively proven, a connection is plausible. Personally, even though I’m inclined towards meat dishes, I make sure to eat grilled salmon for breakfast at least three times a week.
Japanese Fish Dishes and Their Accompaniment with Alcohol – An Experience in Japanese Restaurants
In Japan, a wide variety of Japanese food establishments like sushi bars, izakayas, tempura bars, and traditional Japanese restaurants offer delicious fish dishes. Fish not only pairs well with beer and white wine but is also traditionally accompanied by sake. With the increasing number of Japanese restaurants abroad, why not try one near you for an authentic taste of Japanese fish cuisine? And of course, when you visit Japan, be sure to experience these culinary delights firsthand.
A Diet for AMD Prevention May Also Be Effective for Other Age-Related Diseases
The nutrients that combat oxidative stress are not limited to just preventing age-related macular degeneration (AMD). It’s believed that oxidative stress plays a role in a wide array of diseases, including cancer, myocardial infarction, arteriosclerosis, renal dysfunction, Parkinson’s disease, Alzheimer’s disease, autism, depression, and chronic fatigue syndrome. Oxidative stress is involved in the changes your body undergoes with aging, and your genetic makeup may predetermine which diseases you are most susceptible to and how various organs might be affected. Conversely, by maintaining a balanced intake of nutrients with antioxidant properties, you might be able to reduce the likelihood of these predisposed conditions manifesting as you age.
Japanese Cuisine as an Inspiration for Nutritional Awareness
I’m not asserting that Japanese cuisine is the only good diet, as there are various food cultures around the world that offer significant health benefits. I hope that by incorporating Japanese cuisine into your current diet, it will help advance your journey towards a healthier lifestyle.
Maintaining a stable and balanced diet is not easy, primarily because people don’t just eat for health. The palatability, preference, and comfort food brings are often prioritized. Hence, people tend to have ‘habitual’ eating patterns where they consume similar types of food daily. Showing interest and trying out different food cultures can be an opportunity to change your deeply ingrained dietary habits. I hope that your interest in Japanese food culture will serve as such an inspiration