BACKGROUND AND PURPOSE: 

• It is still unknown whether a diet rich in antioxidant vitamins (carotenoids, vitamins C, and E) or minerals (selenium and zinc) makes one less likely to develop age-related macular degeneration (AMD) 
• Evans et al. (Chochrane Database Syst Rev, 2017) sought to determine whether AMD development could be prevented by taking antioxidant vitamin and/or mineral supplements 

METHODS: 

• Systematic Review and meta-analysis  
• Search of multiple databases 
• Selection Criteria: RCTs comparing antioxidant vitamin and/or mineral supplement vs control 

RESULTS: 

• 5 low-risk of bias RCTs comparing vitamin or mineral supplement to control were included, with data from 76,756 individuals  
  • Follow-up ranged from 4 to 10 years  
• Vitamin E: 
  • Showed no evidence of preventing AMD development (risk ratio (RR) 0.97, 95% confidence interval (CI) 0.90 to 1.06; high-certainty evidence) 
  • Could increase risk of late AMD compared to placebo (RR 1.22, 95% CI 0.89 to 1.67; moderate-certainty evidence) 
  • Low-certainty evidence of excess hemorrhagic strokes in vitamin E group 
• Beta-carotene: 
  • Did not prevent any AMD (RR 1.00, 95% CI 0.88 to 1.14; high-certainty evidence) nor impact late AMD 
  • Was associated with increased risk for lung cancer among smokers 
  • Could increase risk of lung cancer among people exposed to asbestos 
• Vitamin C: 
  • Did not prevent any AMD (RR 0.96, 95% CI 0.79 to 1.18; high-certainty evidence) nor impact late AMD  
  • There was moderate-certainty evidence that multivitamins may increase risk of AMD (RR 1.21, 95% CI 1.02 to 1.43) 
  • Correlated to a possible increased risk of skin rashes 

CONCLUSION: 

• Taking vitamin E, beta-carotene supplements, vitamin C, or multivitamin will not prevent or delay the onset of AMD 
• Lutein and zeaxanthin, other supplements, have not been studied 
• Vitamin supplements may have harmful effects and AMD-related benefits are not clear 

Learn More – Primary Sources:  

Antioxidant vitamin and mineral supplements for preventing age-related macular degeneration

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