Mediterranean Diet (2015-2017) & Macular Degeneration


Learn more about prevention of macular degeneration.

The Mediterranean diet food pyramid has vegetables, fruits, legumes, whole grains and nuts and seeds making up the bulk of the diet. Seafood and fish comprise a much smaller part; poultry, eggs and dairy products a smaller part yet; and red meats and sweets are the smallest tip of the pyramid. The diet also includes drinking plenty of water and moderate wine consumption.


This study assessed the diets and macular health of more than 5,000 randomly selected elderly subjects from seven countries (Estonia, France, Greece, Italy, Norway, Spain, and the United Kingdom.

The participants all received eye examinations and retinal photographs which were then graded according to the International Classification System which assigns values the severity of AMD and presence of drusen. Drusen are the yellowish fatty deposits at the macula which are hallmarks of AMD. The participants also completed a food intake questionnaire which was graded according to their Mediterranean Diet Score (MDS).

The higher the MDS score the less severe the AMD. For patients with very early AMD there was little correlation with the MDS; there was a weak inverse relationship between the MDS and the presence of large drusen. Comparing the patients with the highest and lowest MDS, the risk of AMD was 20% less.

Researchers: R.E. Hogg, J.V. Woodside,
Published: Mediterranean Diet Score and Its Association with Age-Related Macular Degeneration: The European Eye Study, Opthalmology, January, 2017.


These researchers looked at populations in two Portuguese towns, one inland and one coastal. Subjects from the inland town had higher rates of macular degeneration, and pointed to the needed to investigate why geographic location was important.

Researchers: M.L. Cachulo, I. Lains, et al,
Published: Age-related macular degeneration in Portugal: prevalence and risk factors in a coastal and an inland town. The Coimbra Eye Study - Report 2, Acta Ophthalmologica, September, 2016.


For some time researchers and medical practitioners have understood that adhering to a Mediterranean diet lowers the risk of heart disease and other health conditions, even though research does not use an actual Mediterranean diet but an "alternate Mediterranean diet" in which high-ALA margarine is employed instead of olive oil.

This study was a follow-up of over 2,500 patients who had been participants in the AREDS and AREDS2 studies. It is unknown whether this study again used a type of margarine instead of olive oil.

Editor's note: In Greece, the true source of this diet, no one uses margarine. Every town grows their own olives and makes their own olive oil. Margarine is not a natural product and contains additional artificial flavorings, preservatives and other additives to create the texture of butter.

The researchers evaluated the patients' diets over a thirteen year period looking at their consumption of alternate Mediterranean diet components: vegetables, fruits, whole grains, beans, fish, meats, alcohol, and the kinds of fats consumed and assigned a score based on the closeness to the target diet.

They also assigned scores for ten different genetic components that included vulnerabilities to macular degeneration. They assessed the diet score, the genetic score and the combination of diet and genetic scores to determine results.

The researchers found that a high diet scores were associated with the lowest risk of advanced macular degeneration (taking into account age, gender, other health or vision conditions). The high diet score carried even more weight when the genetic risk score was low. When patients had two genes associated with genetic risk, making that genetic risk greater, there was no connection with the diet scores in preventing advanced macular degeneration.

Their conclusion was that if genetic risk is not a strong issue, then the greater the consumption of a Mediterranean diet the lower the risk of developing advanced macular degeneration.

Researchers: Benedicte M.J. Merle, et al.
Published: Adherence to a Mediterranean diet, genetic susceptibility, and progression to advanced macular degeneration: a prospective cohort study, American Journal of Clinical Nutrition, November, 2015.