Age-Reversal Diet and Lifestyle Plan May Slow AMD Development

Several studies have identified specific nutrients and healthy behaviors as effective in delaying the development and slowing the progression of age-related diseases like macular degeneration. It has been said that the best cure for age-related macular degeneration (AMD) is to simply stop growing older. Now a pilot study of 43 men ages 50 to 72 may give that suggestion some veracity. Through a program of diet, sleep, exercise, and relaxation techniques, combined with supplemental probiotics and phytonutrients, a team of international scientists have described a plan that may actually reverse aging and its resultant effect on disease. 

In their study, the diet and lifestyle treatment group decreased in biological age by 3.23 years compared to the control group. The data also showed that those in the treatment group decreased in biological age by 1.96 years over the eight weeks. These results were determined by chemical analyses of the subjects’ DNA, and biological age was calculated using the Horvath DNA Methylation Clock. Scientists, by the way, have determined that predictions of mortality and multiple morbidities are better using biological age rather than chronological age.

The researchers gave well-supported rationales for each intervention in the plan, but they stress that slowing the aging clock may or may not actually curtail risks of age-related diseases. Still, the interventions used in the study are worth considering as an expansion upon the current recommendations for good eye health found on this website and many others. For that reason, they are outlined below as they were followed by the subjects in the 8-week program. It is important to remember that the researchers made choices based upon their knowledge of nutritives and activities providing optimum benefit to this study, but that is not to say that other options are not as beneficial. According to the authors:

“The combination of interventions used in this study may yet be improved upon and may be more impactful when further personalized. Future iterations of the intervention in continued clinical trials will attempt to optimize the program for efficacy, efficiency, scalability and affordability. An ever-evolving understanding of personalized application of such dietary and lifestyle interventions will likely lead to refinements to this kind of intervention that may further extend indicators of biological age.”

Dietary Prescription

Guidance per week:
3 servings of liver
  •(1 serving = 3 oz)
  •Preferably organic

5-10 eggs
•Ideally free-range, organic, omega-3 enriched

Guidance per day:
2 cups of dark leafy greens
  •Measured raw, chopped, and packed
  •Including kale, Swiss chard, collards, spinach, dandelion, mustard greens
  •Does not include salad greens such as romaine, iceberg, Spring mix

2 cups cruciferous vegetables
  •Measured raw, chopped, and packed
  •Includes broccoli, cabbage, cauliflower, Brussels sprouts, bok choy,   arugula, kale, mustard greens, watercress, rutabaga, kohlrabi, radish, Swiss chard, turnip

3 additional cups colorful vegetables of your choosing (excluding white potatoes, sweetcorn)

1-2 medium beet 4 tbsp (1/4 cup) pumpkin seeds (or pumpkin seed butter)

4 tbsp (1/4 cup) sunflower seeds (or sunflower seed butter)

1+ serving methylation adaptogens, choose from:
  •1/2 cup berries (wild preferred)
  •1/2 tsp rosemary
  •1/2 tsp turmeric
  •2 medium cloves garlic
  •2 cups green tea (brewed 10 minutes)
  •3 cups oolong tea (brewed 10 minutes)

6 oz animal protein
  •Grass-fed, pastured, organic and hormone/antibiotic-free

2 servings of low glycemic fruit

General guidance:
Organic preferred over conventional
Stay hydrated
Don’t eat between 7pm and 7am
Include “healthy” oils
  •Balance types of fat
  •E.g. coconut, olive, flaxseed and pumpkin seed oil
Avoid added sugar/candy, dairy, grains, legumes/beans Minimize plastic food containers

Supplement Prescription
PhytoGanix® [or comparable product]*, a combination of organic vegetables, fruits, seeds, herbs, plant enzymes, prebiotics and probiotics.
UltraFlora® Intensive Care* [or comparable product], containing Lactobacillus plantarum 299v.

Exercise Prescription
Minimum of 30 minutes of exercise per day for at least 5 days per week, at an intensity of 60-80% of maximum perceived exertion.

Sleep Prescription
Average a minimum of 7 hours of sleep per night.

Stress Management Prescription 
Breathing exercise from Steps to Elicit the Relaxation Response developed by Herbert Benson MD, twice daily.

*PhytoGanix® and UltraFlora® Intensive Care are products of Metagenics, Inc., which supported this study with an unrestricted grant.

Author: Dan Roberts

SOURCE: Fitzgerald KN, et al. Potential reversal of epigenetic age using a diet and lifestyle intervention: a pilot randomized clinical trial. Aging (Albany NY). 2021; 13:9419-9432.

Vitamin D3 and Omega-3 Offer No Protection Against AMD

Observational studies have suggested 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). A recent large randomized trial (VITAL), however, has concluded that supplementation with vitamin D3 and marine omega-3 fatty acids actually had no significant overall effect on AMD incidence or progression.

25,871 adult US men and women, mean age 67.1, consumed daily supplementation with vitamin D3(2000 IU) and marine omega-3 fatty acids (1 g) for a median of 5.3 years. Randomization was from November 2011 to March 2014, and study pill-taking ended as planned on December 31, 2017. This the first randomized trial to examine vitamin D in AMD prevention. On the other hand, omega-3 has been studied in two past trials, most notably the AREDS2, but results have been uncertain.

In view of several minor limitations, the VITAL study has offered the most solid evidence to date that neither vitamin D3 nor omega-3 supplementation, while beneficial for other conditions, offer no specific prevention against AMD.


Effect of Vitamin D and ω-3 Fatty Acid Supplementation on Risk of Age-Related Macular Degeneration: An Ancillary Study of the VITAL Randomized Clinical Trial. William G. Christen, ScD1 (JAMA Ophthalmol. Published online October 29, 2020. doi:10.1001/jamaophthalmol.2020.4409)

Smoking Is At An All-Time Low

For over two decades, eye health organizations have worked diligently to increase awareness of the high risks of macular degeneration from tobacco smoking. Now, the recently-released 2020 Surgeon General’s report has revealed that the work of those organizations is paying off.

Americans are doing better at making good choices when it comes to smoking. According to latest research, the percentage of Americans who smoke has decreased to an all-time low of 14%, or 34 million people. More than three out of every five adults (61.7%) who were ever cigarette smokers have quit, with credit being given to better education, improved health care, availability of effective smoking cessation treatments, aggressive media campaigns, and encouragement of warning labels on tobacco products.

The SG report also found that persons who had smoking-related chronic diseases like macular degeneration were more likely to heed professional advice to quit than those without the disease. This may be because such persons have more contact with healthcare and patient support systems, or simply because they realize that quitting could improve, or avoid exacerbating, their eye condition and general health.

Whatever the reasons for quitting or never starting smoking, this news is good. Unfortunately, the research has shown that, with increasing age, attempts to give up tobacco tend to decrease. If only for that reason, awareness efforts and patient support need to continue as long as the temptation exists.

SOURCE: U.S. Department of Health and Human Services. Smoking Cessation. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2020.

“Bitterness Gene” May Explain Aversion To Vegetables

The first rule of nutrition for maintaining good retina health is, for some people, the most difficult to swallow. Consuming a diet rich in leafy green vegetables for their high antioxidant values is highly recommended by professional nutritionists and eye care specialists, and no one argues about its preventative value. So why is this rule so often broken?

The list of high-antioxidant vegetables includes kale, spinach, Brussels sprouts, alfalfa sprouts, broccoli, beets, red bell pepper, cauliflower, and eggplant. Opinions about the taste of these foods have been the cause of many dinner table arguments among family members, often ending in hurt feelings and unfortunate children going to bed without supper. Well, research now suggests that it may be the fault of a “bitterness gene”.

Researchers from the University of Kentucky School of Medicine report that 50% of consumers are normally sensitive to bitter foods. Another 25% are “non-tasters” who aren’t at all sensitive to bitterness, and 25% have extreme sensitivity to the bitterness some plants develop to keep animals from eating them.

It appears that a specific gene makes certain compounds taste bitter, which may make it harder for some people to include healthy vegetables in their diet. Everyone inherits two copies of a taste gene called TAS2R38, which has two variants (mutations) called AVI and PAV. People who inherit two copies of AVI aren’t sensitive to bitter tastes from certain chemicals. Those with one copy of AVI and one copy of PAV perceive bitter tastes of these chemicals. And then there are individuals with two copies of PAV, who find the same foods exceptionally and unpleasantly bitter.

Researchers analyzed food-frequency questionnaires from 175 people (average age 52, more than 70% female) and found that people with the PAV form of the gene were more than 2.5 times as likely to rank in the bottom half of participants on the number of vegetables eaten. These are people who are likely to be noncompliant with their nutritionists’ advice, not because they are being recalcitrant or childish, but, due to their genetic makeup, they simply cannot bear the taste.

So what can be done? One might use various cooking methods to mask the bitterness, such as including them in a casserole. Equally-nutritious substitute foods also may be found. Eggs, for example, are a rich source of the carotenoids lutein and zeaxanthin, which, like dark green leafy vegetables, are recommended for their high antioxidant value. Another example is collard greens, which are a less potent substitute for kale.

Thanks to empathetic food scientists, less bitter varieties of vegetables are being developed through cross-pollination, so even better options may be available in the future. All in hopes of keeping more people eye-healthy and keeping more children from being injudiciously sent to bed hungry.


  1. Rare haplotypes of the gene TAS2R38 confer bitter taste sensitivity in humans” by Emma E. Boxer and  Nicole L. Garneau (Published online 2015 Sep 17. doi: 10.1186/s40064-015-1277-z PMCID: PMC4574037PMID: 26405625
  2. Oral presentation to the American Heart Association’s Scientific Sessions 2019 by Jennifer Smith, RN (University of Kentucky School of Medicine), Nov 2019

Milk Chocolate vs. Dark Chocolate: Which Is Better?

We have known for more than a decade that chocolate is a good antioxidant and, therefore, healthy for the eyes.

A 2003 study by scientists at Cornell University in New York and Seoul National University in Korea showed that cocoa has almost twice the antioxidant power of wine, 2-3 times that of green tea, and 4-5 times that of black tea. Chang Yong Lee, who headed the study, suggested that a cup of hot chocolate in the morning, a cup of green tea in the afternoon, and a glass of red wine in the evening would satisfy our daily antioxidant requirement.

But which kind of chocolate is better? Milk or dark? A small 2018 study published in JAMA Ophthalmol helps to answer the question.

According to the authors, consumption of dark chocolate can improve blood flow, mood, and cognition in the short term, but until now, little has been known about the possible effects of dark chocolate on visual performance. To find out, they tested 30 young adults, all of whom were visually healthy. Within two hours of consuming milk chocolate and dark chocolate, their small-letter contrast sensitivity was significantly higher after consuming dark chocolate. Their large-letter contrast sensitivity was slightly higher after dark chocolate, and their visual acuity improved slightly.

The findings favored dark chocolate as better for the eyes, but the duration of that effect and how it influences real-world performance await further testing. And, of course, there is a point at which chocolate consumption may do more harm than good, considering its high caloric content (1 oz = approximately 155 calories).

SOURCE: Effects of Milk vs Dark Chocolate Consumption on Visual Acuity and Contrast Sensitivity Within 2 Hours–A Randomized Clinical Trial. Jeff C. Rabin, OD, MS, PhD, et al (JAMA Ophthalmol. 2018;136(6):678-681. doi:10.1001/jamaophthalmol.2018.0978)