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NUTRITIONAL AND LIFESTYLE FACTORS IN AGE-RELATED MACULAR DEGENERATION: A NARRATIVE REVIEW FROM A LIFESTYLE MEDICINE PERSPECTIVE

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1.	Title	Title of document	NUTRITIONAL AND LIFESTYLE FACTORS IN AGE-RELATED MACULAR DEGENERATION: A NARRATIVE REVIEW FROM A LIFESTYLE MEDICINE PERSPECTIVE
2.	Creator	Author's name, affiliation, country	Apiwat Piriyachaiyo; Doctor, Api Clinic, Bangkok, Thailand
3.	Subject	Discipline(s)
3.	Subject	Keyword(s)	age-related macular degeneration, lifestyle medicine, nutrition, Mediterranean diet, AREDS2, carotenoids, smoking cessation, physical activity, retinal health
4.	Description	Abstract	Background: Age-related macular degeneration (AMD) is a leading cause of irreversible vision loss among older adults worldwide, affecting approximately 196 million people globally in 2020, with projections reaching 288 million by 2040. While genetic predisposition plays a significant role, modifiable nutritional and lifestyle factors have emerged as critical determinants in the development and progression of AMD. This narrative review aims to synthesize the current evidence on nutritional and lifestyle interventions relevant to AMD within the framework of lifestyle medicine. Methods: A comprehensive literature search was conducted across PubMed/MEDLINE, Scopus, Cochrane Library, and Google Scholar for English-language articles published from January 2000 through March 2025. Search terms combined “age-related macular degeneration” OR “AMD” with specific lifestyle and nutritional terms. Study types included were randomized controlled trials (RCTs), prospective and retrospective cohort studies, case-control studies, cross-sectional studies, systematic reviews, meta-analyses, and clinical practice guidelines. Exclusion criteria included non-English publications, conference abstracts without full-text availability, case reports, editorials, and studies focused exclusively on pharmacological or surgical interventions without a lifestyle component. The Scale for the Assessment of Narrative Review Articles (SANRA) guidelines were followed. Results: Strong evidence supports the role of AREDS2 supplementation (vitamins C, E, lutein, zeaxanthin, zinc, and copper) in reducing AMD progression by up to 25%. Mediterranean diet adherence is associated with a 41% reduced risk of incident advanced AMD. Smoking is the most significant modifiable risk factor, with current smokers having a 2- to 4-fold increased risk. Physical activity, weight management, and ultraviolet light protection demonstrate additional protective effects. Emerging evidence also links sleep quality, gut microbiome composition, and stress management to retinal health. Conclusion: Nutritional and lifestyle factors play a substantial role in AMD prevention and management. A lifestyle medicine approach integrating dietary optimization, smoking cessation, physical activity, weight management, UV protection, and adequate sleep represents a comprehensive strategy for reducing AMD burden. Clinicians should incorporate these modifiable factors into routine ophthalmic practice.
5.	Publisher	Organizing agency, location	Open Access Publishing Group
6.	Contributor	Sponsor(s)
7.	Date	(YYYY-MM-DD)	2026-04-22
8.	Type	Status & genre	Peer-reviewed Article
8.	Type	Type
9.	Format	File format	PDF
10.	Identifier	Uniform Resource Identifier	https://oapub.org/hlt/index.php/EJFNSM/article/view/253
10.	Identifier	Digital Object Identifier (DOI)	http://dx.doi.org/10.46827/ejfnsm.v7i1.253
11.	Source	Title; vol., no. (year)	European Journal of Fitness, Nutrition and Sport Medicine Studies; Vol 7, No 1 (2026)
12.	Language	English=en	en
13.	Relation	Supp. Files
14.	Coverage	Geo-spatial location, chronological period, research sample (gender, age, etc.)
15.	Rights	Copyright and permissions	Copyright (c) 2026 Apiwat Piriyachaiyo This work is licensed under a Creative Commons Attribution 4.0 International License.