CONTENTS:
FEATURE STORY
Keeping an Eye on Macular Degeneration

IN THE NEWS
Vitamin D—Natural Relief for Low Back Pain?

CHECKLIST
Useful Herbs & Supplements

COOKING CORNER
Feta Cheese and Beet Pasta

VITAMINS & MINERALS
Juice Up Your Joints with Glucosamine

HERBAL REMEDIES
Ginkgo on the Brain

EVERYDAY ANSWERS
Exercise for Everyone

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September Is Healthy Aging Month
Keeping an Eye on Macular Degeneration

Keep your vision in good condition by taking care to prevent macular degeneration, a leading cause of blindness later in life. According to research or other evidence, the following self-care steps may be helpful:

• Load up on lutein. Supply the eyes with this healthy antioxidant by taking 10 mg per day and eating plenty of green leafy vegetables.
• Seek support from a multi. Protect your sight by taking a daily multivitamin containing beta-carotene, vitamin C, vitamin E, zinc, copper, manganese, selenium, and riboflavin.
• Block those rays. Wear glasses that block ultraviolet rays to prevent eye damage that can contribute to macular degeneration
• Go for the ginkgo. Get help for early stage macular degeneration by taking 120 to 160 mg a day of a standardized Ginkgo biloba herbal extract.
• Say good-bye to smoking. Kick this unhealthy habit that has been linked to increased risk.

About macular degeneration
Macular degeneration is the degeneration of the macula retinae, also called the macula lutea, an oval disc on the retina in the back of the eye.

What are the symptoms?
Macular degeneration is typically painless and includes symptoms of dark or blurry areas in the center of vision, seeing distortions of straight lines, and difficulty doing activities that require sharp vision (such as driving and reading). Peripheral (side) vision may remain clear.

Dietary changes that may be helpful
In a preliminary study, high intake of saturated fat and cholesterol was associated with an increased risk of developing macular degeneration.

According to preliminary research, people who eat fish more than once per week have half the risk of developing age-related macular degeneration compared with people who eat fish less than once per month.

Total alcohol consumption has not been linked to macular degeneration in most studies. However, one research group has linked beer consumption to macular degeneration, and in one of two trials, wine drinkers were found to have a significantly lower risk of macular degeneration compared with people not drinking wine. Most doctors consider these reports too preliminary to suggest either avoiding beer or increasing wine consumption.

Lifestyle changes that may be helpful
Smoking has been linked to macular degeneration. Quitting smoking may reduce the risk of developing macular degeneration.

Other therapies
Eyeglasses are often prescribed that provide protection from the sun's ultraviolet rays. Underlying medical conditions, such as diabetes and high blood pressure, are treated when present. In some cases, laser eye surgery may be recommended.

Vitamins that may be helpful
Lutein and zeaxanthin are antioxidants in the carotenoid family. These carotenoids, found in high concentrations in spinach, collard greens, and kale, have an affinity for the part of the retina where macular degeneration occurs. Once there, they protect the retina from damage caused by sunlight.

Harvard researchers reported that people eating the most lutein and zeaxanthin—an average of 5.8 mg per day—had a 57% decreased risk of macular degeneration, compared with people eating the least. While spinach and kale eaters have a lower risk of macular degeneration, blood levels of lutein did not correlate with risk of macular degeneration in one trial. In a double-blind study of people with macular degeneration, supplementation with lutein (10 mg per day) for one year significantly improved vision, compared with a placebo. Lutein was beneficial for people with both early and advanced stages of the disease. Lutein and zeaxanthin can be taken as supplements; 6 mg per day of lutein may be a useful amount.

Sunlight triggers oxidative damage in the eye, which in turn can cause macular degeneration. Animals given antioxidants—which protect against oxidative damage—have a lower risk of this vision problem. People with high blood levels of antioxidants also have a lower risk. Those with the highest levels (top 20th percentile) of the antioxidants selenium, vitamin C, and vitamin E may have a 70% lower risk of developing macular degeneration, compared with people with the lowest levels of these nutrients (bottom 20th percentile). People who eat fruits and vegetables high in beta-carotene, another antioxidant, are also at low risk. However, a preliminary study found no association between age-related macular degeneration and intake of antioxidants, either from the diet, from supplements, or from both combined. Moreover, in a double-blind study of male cigarette smokers, supplementing with vitamin E (50 IU per day), synthetic beta-carotene (about 33,000 IU per day), or both did not reduce the incidence of age-related macular degeneration.

Two important enzymes in the retina that are needed for vision require zinc. In a double-blind trial, supplementation with 45 mg of zinc per day for one to two years significantly reduced the rate of visual loss in people with macular degeneration. However, in another double-blind trial, supplementation with the same amount of zinc did not prevent vision loss among people with a particular type of macular degeneration (the exudative form).

In a preliminary trial, supplementation with melatonin (3 mg per day at bedtime for at least three months) resulted in an improvement in the abnormalities observed on eye examination in the majority of cases. Melatonin is believed to work by regulating eye pigmentation (and, consequently, the amount of light reaching the retina) and by functioning as an antioxidant.

In a double-blind study, supplementation with a proprietary blend of acetyl-L-carnitine, omega-3 fatty acids from fish oil, and coenzyme Q10 for 12 months resulted in an improvement in both visual function and in objective findings on eye examination (a decrease in the drusen-covered area on the retina).

In a blinded six-month study of people with macular degeneration, vision was the same or better in 88% people who took a nutritional supplement, compared with 59% of those who refused to take the supplement (a statistically significant difference). The supplement used in this study contained beta-carotene, vitamin C, vitamin E, zinc, copper, manganese, selenium, and riboflavin. People wishing to take all of these nutrients may supplement with a multivitamin-multimineral formula.

Herbs that may be helpful

Ginkgo may help treat early-stage macular degeneration, according to small, preliminary clinical trials. Many healthcare professionals recommend 120 to 240 mg of standardized extract (24% ginkgo flavone glycosides and 6% terpene lactones) in capsules or tablets per day.

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