n the nationwide Age-Related Eye Disease Study (AREDS). Detailed dietary histories were obtained at the start of the study when participants were 55 to 80 years of age and had varying degrees of AMD. The AREDS was designed to assess the effect of high-dose antioxidant vitamins and zinc on the progression of AMD and cataracts, two of the leading causes of vision loss in older adults.

"Although carbohydrate quality was not the main focus in the AREDS, we were fortunate that the investigators had collected the dietary carbohydrate information we needed to do our analyses," says Taylor, who is also a professor at the Friedman School of Nutrition Science and Policy at Tufts and the Tufts University School of Medicine. "Our findings suggest that 20 percent of the cases of advanced AMD might have been prevented if those individuals had consumed a diet with a glycemic index below the average for their age and gender," notes Taylor.

AMD typically occurs after middle age, although the events which cause it may begin earlier. A leading cause of irreversible blindness, AMD results from the gradual breakdown of light-sensitive cells in the central region of the eye's retina, called the macula. Although there is no effective therapy for AMD, dietary intervention may delay its progress. Identifying modifiable risk factors for AMD is becoming increasingly important as the population ages. As Taylor and colleagues point out, the number of people in the US with visually impairing AMD is expected to double and reach three million by 2020.

"Our results support our hypothesis," says Taylor, "that dietary glycemic index, which has been related to the risk of diabetes, is also associated with the risk and severity of AMD." Taylor speculates that carbohydrates that comprise a high-glycemic-index diet may provide eye tissue"It is possible that the type of damage produced by poor quality carbohydrates on eye tissue is similar in both diabetic eye disea
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