1. Better Health. No Hassles. Nutrition & Eye Health Sponsored in part by a generous education grant from:

2. Better Health. No Hassles. Age-Related Eye Diseases More than 30 million people age 40 and older suffer vision loss in the U.S. Age-Related Macular Degeneration (AMD) – Approximately 21 million Americans have AMD – AMD cases have risen 25% since 2002, largest increase among major eye diseases Cataracts – More than 22 million Americans have cataracts – 400,000 new cases of cataract occur each year in the U.S. Prevent Blindness America/National Eye Institute 2008 “Vision Problems in the US” W. Reed Moran, Spotlight Health, With medical adviser Stephen A. Shoop, M.D., USA Today, Feb. 2001

3. Better Health. No Hassles. Age-Related Eye Diseases Non-surgical treatments of AMD – Low Vision Rehabilitation – Nutrition −National Eye Institute (of the NIH) - Age-Related Eye Disease Study (AREDS) −3640 patients in high risk AMD categories −7 year supplementation: Beta-carotene, Vitamin C, Vitamin E & Zinc/Copper (2001). "A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age- related macular degeneration and vision loss: AREDS report no. 8." Arch Ophthalmol 119(10): 1417-36.

4. Better Health. No Hassles. AREDS Daily supplement dosage – Beta-carotene – 15 mg – Vitamin C – 500 mg – Vitamin E – 400 IU – Zinc – 80 mg/Copper – 2 mg Conclusions – AMD is a nutrition responsive disorder – 29% decreased risk of progression of advanced AMD – 21% reduction of visual acuity loss (2001). "A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age- related macular degeneration and vision loss: AREDS report no. 8." Arch Ophthalmol 119(10): 1417-36.

5. Better Health. No Hassles. Vitamin C Why is it important? – Body unable to synthesize – Antioxidant capability How much do I need each day? – 75 – 90 mg/day (DRI) – 500 mg/day (eye health) Where can I get it in my diet? – Citrus fruits and juices Jacob, R. A. and G. Sotoudeh (2002). "Vitamin C function and status in chronic disease." Nutrition in clinical care 5(2): 66-74. (2001). "A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age- related macular degeneration and vision loss: AREDS report no. 8." Arch Ophthalmol 119(10): 1417-36. Chiu, C. J. and A. Taylor (2007). "Nutritional antioxidants and age-related cataract and maculopathy." Experimental eye research 84(2): 229-45. Chew, E. (2007). “Age-related eye disease study 2 protocol.” National Eye Institute Protocol 07-EI-0025.

6. Better Health. No Hassles. Vitamin E Why is it important? – Body unable to synthesize – Antioxidant capability How much do I need each day? – 22 IU/day (DRI) – 400 IU/day (Eye Health) Where can I get it in my diet? – Nuts, fortified cereals, sweet potatoes ( 2001). "A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age- related macular degeneration and vision loss: AREDS report no. 8." Arch Ophthalmol 119(10): 1417-36. Chiu, C. J. and A. Taylor (2007). "Nutritional antioxidants and age-related cataract and maculopathy." Experimental eye research 84(2): 229-45. Chew, E. (2007). “Age-related eye disease study 2 protocol.” National Eye Institute Protocol 07-EI-0025.

7. Better Health. No Hassles. Zinc Why is it important? – Essential trace element How much do I need each day? – 8-11 mg zinc/day (DRI) – 40 – 80 mg zinc/day (Eye Health) Where can I get it in my diet? – Red meat, poultry, mixed nuts Copper – High zinc may cause copper deficiency – 2 mg included in AREDS study (2001). "A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age- related macular degeneration and vision loss: AREDS report no. 8." Arch Ophthalmol 119(10): 1417-36. Chew, E. (2007). “Age-related eye disease study 2 protocol.” National Eye Institute Protocol 07-EI-0025. Grahn, B. H., P. G. Paterson, et al. (2001). "Zinc and the eye." Journal of the American College of Nutrition 20(2 Suppl): 106-18.

8. Better Health. No Hassles. Emerging Science

9. Better Health. No Hassles. AREDS2 National Eye Institute (of the NIH) Follow-up to original AREDS 4000 patients in high risk AMD categories 5 year supplementation: – Carotenoids: lutein (10mg/day), zeaxanthin (2 mg/day) – Essential Fatty Acids: DHA (350 mg/day) and EPA (650 mg/day) – Patients allowed to take the original AREDS formula Age-Related Eye Disease study 2 Protocol.www.emmes.com/study/areds2

10. Better Health. No Hassles. Lutein & Zeaxanthin In nature In human diet In blood In retina 600 50 14 2 Ong and Tee, Methods in enzymology (1992) 213:142-167 Krinsky NI, Russett MD, Handelman GJ, Snodderly DM, J Nutr. (1990) 120:1654-1662 Khachik F, Beecher GR, Goli MB, Lusby WR, Smith JC Jr., Anal Chem. (1992) 64: 2111-22

11. Better Health. No Hassles. Why are they important? Body unable to synthesize Blue-light filter – Reduces exposure to the most damaging, high-energy light Antioxidant – Neutralizes or quenches free radicals Stahl and Sies (2005) Biochimica et Biophysica Acta. 1740:101-107.

12. Better Health. No Hassles. Internal pair of sunglasses The sun emits photo oxidizing (UV) rays that are harmful to the eyes Sunglasses reduce free radicals Carotenoids such as lutein and zeaxanthin filter blue light to block production of free radicals Good nutrition helps reduce the risk of chronic eye diseases such as macular degeneration and may improve visual function

13. Better Health. No Hassles. How much do I need each day? 10 mg/day lutein 2 mg/day zeaxanthin Dietary Guidelines for Americans* – Equivalent to 4 - 8 mg lutein & zeaxanthin per day – < 4% Americans meet guidelines – U.S. average: 1 – 2.5 mg/day *9 servings of fruits and vegetables every day; recommendation based on the reference 2,000 calorie diet. HHS/USDA. Dietary Guidelines for Americans 2005. http://www.healthierus.gov/dietaryguidelines/CDC. National Health and Nutrition Examination Survey Data 2001-2002. http://www.cdc.gov/nchs/about/major/nhanes/nhanes01-02.htm Richer, S., W. Stiles, et al. (2004). "Double-masked, placebo-controlled, randomized trial of lutein and antioxidant supplementation in the intervention of atrophic age- related macular degeneration: the Veterans LAST study (Lutein Antioxidant Supplementation Trial)." Optometry 75(4): 216-30. Stringham, J. M. and B. Hammond (2008). "Macular Pigment and Visual Performance Under Glare Conditions." Optometry & Vision Science 85(2): 82-88. Chew, E. (2007). “Age-related eye disease study 2 protocol.” National Eye Institute Protocol 07-EI-0025.

14. Better Health. No Hassles. Where can I get these nutrients in my diet? Increase consumption of: – Green, leafy vegetables – Eggs – Dietary supplements – Functional beverages (a beverage that provides health benefits beyond energy and essential nutrients) Romaine Lettuce Spinach Eggs Supplements U.S. Department of Agriculture, Agricultural Research Service, USDA Nutrient Data Laboratory. USDA National Nutrient Database for Standard Reference, Release 20 (2007). Nutrient Data Laboratory Home Page, http://www.nal.usda.gov/fnic/foodcomp

15. Better Health. No Hassles. Where can I get these nutrients in my diet? Food itemmg lutein & zeaxanthin (per 100 g) Kale, raw39.6 Spinach, raw12.2 Turnip greens, cooked8.4 Collard, cooked7.7 Green peas, cooked2.6 Romaine lettuce, raw2.3 Broccoli, raw1.4 Corn, cooked0.9 Green beans, cooked0.7 Papaya (1 large)0.3 Egg (1 large)0.2 U.S. Department of Agriculture, Agricultural Research Service, USDA Nutrient Data Laboratory. USDA National Nutrient Database for Standard Reference, Release 20 (2007). Nutrient Data Laboratory Home Page, http://www.nal.usda.gov/fnic/foodcomp

16. Better Health. No Hassles. Essential Fatty Acids - DHA/EPA Why are they important? – Important role in many bodily organs/systems especially the brain and retina (eye) How much do I need each day? – 350 mg DHA / 650 mg EPA per day Where can I get them in my diet? – Flax, fleshy fish like tuna or salmon Fliesler, et al. Prog Lipid Res (1983) 22:79-131 Connor, et al. Nutr Rev (1992) 50:21-29 Cho, et al. Am. J. Clin. Nutr. (2001) 73:209-218 Birch, et al. Ped. Res. (1998) 42: 201-209. Chew, E. (2007). “Age-related eye disease study 2 protocol.” National Eye Institute Protocol 07-EI-0025.

17. Better Health. No Hassles. Nutrients for Healthy Eyes 500 mg/day Vitamin C 400 IU/day Vitamin E 25 or 80 mg Zinc / 2 mg Copper per day 10 mg Lutein / 2 mg Zeaxanthin per day 350 mg DHA / 650 mg EPA per day

18. Better Health. No Hassles. For More Nutrition Information www.aoa.com www.eatright.org www.luteininfo.com