Macular Degeneration: Important Vitamins and Nutrition

February is Macular Degeneration Awareness Month

Macular degeneration is an issue that has personally affected our family.  My paternal grandmother has macular degeneration and she has lost much of her sight due to this disease.  My father also has some early signs, drusen, which are yellow deposits under the retina that a doctor can find using a dilated eye examination.  The kind of macular degeneration that occurs with aging is abbreviated AMD, which is short for Age-Related Macular Degeneration.  AMD destroys the central vision necessary for activities like reading or driving.  A recent study from Prevent Blindness America and the National Eye Institute has shown that women are at twice the risk of losing their sight, compared to men.  My grandmother’s AMD is severe enough that she cannot see clearly to look at pictures of my children.  She can grasp vague and general details when she sees the children in person, such as their fair hair and complexion.  She can no longer read, or pay her own bills.  She needs assistance to shop for her groceries.  So AMD affects many of the basic tasks that an older adult needs to perform in order to maintain independence.  So with a strong family history, I felt it was prudent to research strategies to prevent macular degeneration.  Here are my findings.

Many researchers have found a link between poor nutrition and macular degeneration.  The Beaver Dam Eye Study showed an increased risk for macular degeneration in  patients with the lowest levels of the antioxidant lycopene, found in certain fruits and vegetables.   In the Eye Disease Case Control Study higher serum carotenoid (beta carotene) levels showed a protective effect against macular degeneration.  In patients with high antioxidant blood levels, the Macular Degeneration Risk Factor Study found less of the most serious type of macular degeneration.

A study published by Dr. David Newsome in the Archives of Ophthalmology in February 1988, showed vision was less likely to deteriorate in macular degeneration patients who were treated with zinc supplementation. Zinc was studied because retinal zinc concentrations are usually high, and zinc is an important cofactor in retinal enzymes (such as retinol dehydrogenase and catalase).  Another study in the Journal of the American Medical Association (9 Nov 1994) showed that consumption of foods rich in the specific carotenoids lutein and zeaxanthin resulted in the most reduced risk for macular degeneration. Dark green, leafy vegetables, such as collard greens and spinach, are especially rich in these carotenoids and were specifically linked to substantially reduced risk. This study controlled for smoking and other risk factors. Smoking appears to increase macular degeneration risk.

According to the AREDS Study (Age-Related Eye Disease Study) vitamin supplements can have a protective effect against the advancement of existing macular degeneration.  Patients were given one of four treatments of zinc, antioxidants alone, a combination, and a placebo.   The specific daily amounts of antioxidants and zinc used were 500mg of vitamin C; 400IU of vitamin E; 15 milligrams of beta carotene, which is equivalent to 25,000 IU of vitamin A as beta carotene; 80 milligrams of zinc; and two milligrams of copper (see multivitamin below). In the AREDS study, this combination reduced the chance of developing advanced ARMD by 25% and preserve vision by 19%.

Harvard researchers have found that patients consuming 5-7 servings of green, leafy vegetables which contain high levels of lutein and zeaxanthin, have a lower chance of developing macular degeneration. They comprise the two dominant yellow pigments in the macula, the center of our vision and the site where macular degeneration occurs and filter out visible blue light which may cause photodamage. Here, and also listed above, is a high quality supplement containing a rare blend of alpha-carotene, astaxanthin, beta-carotene, lutein, lycopene, and zeaxanthin delivering of a broad spectrum of carotenoids.   A sufficient dosage should be taken to provide 25,000 IU of beta carotene, per the AREDS recommendation.  Since oxidation and free radical damage is thought to contribute to ARMD (Age Related Macular Degeneration) supplementation clearly has it’s value.

The National Eye Foundation also encourages the use of daily multivitamins because they provide other essential nutrients not contained in the AREDS formulation.  These quality multivitamin formulas are well balanced and provide the 2 mg of copper that is recommended to prevent copper deficiency anemia, a condition associated with high levels of zinc intake.  The amounts of the key nutrients recommended by AREDS would be very difficult to obtain from diet alone.  Remember that no amount of vitamin supplements will take the place of a healthy diet, but they can be an important tool to increase nutrient levels and provide extra insurance.   Be aware that multivitamins that state they contain 100% of the minimum daily requirements: vitamin C 60mg, beta-carotene 5000 IU; vitamin E 30 IU; and zinc 15mg, are not sufficient.  These doses are far below that used in AREDS. Patients with AMD may need far more than the 100% daily requirements.  A multivitamin complements the AREDS formula, it does not replace it.

It is very important to recieve regular eye examinations from an eye care professional.  Early detection of macular degeneration is crucial in order to preserve vision.  For “dry AMD” the most common early sign is blurred vision. It becomes more difficult to see details in front of you, such as faces or words in a book. Often this blurred vision will go away in brighter light.  As AMD advances there becomes a blind spot in the middle of the field of vision, which will enlarge over time.  For “wet AMD” the classic early symptom is that straight lines appear crooked, caused by fluid from the leaking blood vessels behind the macula. A small blind spot may also appear resulting in loss of one’s central vision.  For more information, visit the Macular Degeneration Foundation.

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How Sucralose (aka Splenda) Is Made And Why You Want To Avoid It

I wanted to comment on Splenda.  Splenda, also known as sucralose, was created accidentally when some chemists were trying to produce an insecticide.  Here is the process by which they produce the formula sold in stores:

“1.  Sucrose is tritylated with trityl chloride in the presence of dimethylformamide and 4-methylmorpholine, and the tritylated sucrose is then acetylated with acetic anhydride.

2.  The resulting sucrose molecule TRISPA is chlorinated with hydrogen chlorine in the presence of tolulene.

3.  The resulting 4-PAS is heated in the presence of methyl isobutyl ketone and acetic acid.

4.  The resulting 6-PAS is chlorinated with thionyl chloride in the presence of toluene and benzyltriethylammonium chloride.

5.  The resulting TOSPA is treated with methanol in the presence of sodium methoxide to produce sucralose.”  (Note that methanol, wood alcohol aka paint remover,  is one of the questionable ingredients in aspartame.)

In addition, the bags and packets of Splenda commercially available are not pure sucralose.  They also contain bulking agents.  All artificial sweeteners use bulking agents.  Do you know what they use?  Sugar.  Dextrose, sucrose, and maltodextrin.  (Maltodextrin is corn syrup solids composed primarily from fructose and glucose in a starch form.)   All sweetener packets are at least 96 percent sugar.  Splenda is 99% sugar.

The packets are labelled calorie free as a result of manipulating a loophole in the food labeling laws.  The product can be described as sugar free if a serving contains less than 5 grams of sugar, and calorie free if a serving is less than 5 calories.  So they set the serving size on bags at .5 grams  and the packets contain a serving of 1 gram.  A one gram packet contains 4 calories.   This can be confirmed on the manufacturer’s website in the FAQ section:  “Like many no and low calorie sweeteners, each serving of SPLENDA® No Calorie Sweetener contains a very small amount of common food ingredients, e.g., dextrose and/or maltodextrin, for volume. Because the amount of these ingredients is so small, SPLENDA® No Calorie Sweetener still has an insignificant calorie value per serving and meets FDA’s standards for “no calorie” sweeteners. ”

To make matters worse, when sucralose was shown to not raise blood sugars, it was the pure substance that was tested, not the mixture that is sold to the public.  Dextrose, sucrose, and/or maltodextrin are definitely going to raise a diabetic’s blood sugar.  There is also a great deal of evidence that artificial sweeteners actually cause an increase in appetite, causing people who consume them to take in more calories than they would otherwise.

Stevia, on the other hand, lowers blood sugar, making it a much better choice.  If you have tried stevia in the past and did not like the flavor, you might want to try another brand.  SteviaClear is a good brand which will sweeten beverages and some foods using just a very small amount.  For sweeting hot liquids, you might prefer KAL stevia powder. For baking, recipes are a little harder to convert because sugar in baked goods liquifies when heated.  To replace sugar with stevia for baking, you need to find a way to add extra liquid to the recipe.

Parents, if you want to be sure your children are avoiding sucralose, remember to check their medications.  Many over the counter medications, prescription medications, and even chewable vitamins contain sucralose or other artificial sweeteners.  If you are looking for whole foods vitamins without artificial sweetener, colors, or flavors, here are some safe choices.

Information about artificial sweeteners is available in greater detail in Dr. Mercola’s book, Take Control of Your Health or through his website,

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Calcium and Other Important Nutrients to Prevent Osteoporosis

Calcium and Related Nutrients for Bone Health 

Many individuals make the mistake of thinking that calcium is all that’s needed for bone health. However, bones are made of more than calcium. Bones also contain several minerals as well as protein. The protein serves as a matrix to which the minerals necessary for bone formation attach.

While many perceive osteoporosis to be “not enough calcium in the bones,” osteoporosis is more complicated than that. Insufficient calcium in the bones is called rickets, which is caused by inadequate vitamin D. Osteoporosis involves both low levels of minerals as well insufficient protein in the bones.

So, simply taking calcium by itself will not help bone health. Other minerals, vitamins, and protein are also needed. The intestinal tract also needs to be healthy and fully functional as the site where dietary calcium is absorbed into the bloodstream. Several studies have shown that both prebiotics and probiotics such as these, improve the absorption of calcium by improving intestinal health. Because hormones also play a significant role in bone health, the risk of osteoporosis increases with age, especially in females. Treating hormone deficiencies with the appropriate bioidentical hormones is important for older adults. Lastly, weight-bearing exercises cause the bones to signal the body’s need to increase bone density.

When considering a calcium supplement, it is important to be aware of the supporting nutrients necessary for calcium absorption. Vitamin D is one of these nutrients. The body manufactures its own vitamin D under the right conditions. The first ingredient required is natural oils on the skin. Your body forms vitamin D in these oils. If you take frequent, warm or hot showers with soap, these oils may not be present on your skin in sufficient amounts. Secondly, you must have sufficient exposure to the sun’s ultraviolet light. During winter, in northern latitudes, in areas with smog from air pollution, and when our skin is protected by sunscreen, we cannot form adequate vitamin D from sunlight. Also, be aware that if you shower too soon after sun exposure you may not have the opportunity to absorb the vitamin D from the skin into your bloodstream. Most of us need some extra vitamin D from supplements.

There are still other supporting nutrients required. Vitamin K is a nutrient supported by new research as necessary for modifying osteocalcin, a bone protein, so it can properly bind minerals and hold them in the bone matrix. Magnesium is another important nutrient, which we need to take in proper balance with calcium. To be incorporated into bone, calcium needs the help of certain enzymes, which require magnesium to work properly. We tend to be more deficient in magnesium than calcium. The proper calcium to magnesium ratio is approximately 2:1. Phosphorus is also required for calcium absorption. The American diet tends to be overly abundant in phosphorus, in contrast to calcium and magnesium. Yet another necessary, but little known nutrient, is boron. Boron has been shown in recent studies to aid bone metabolism when taken in the proper amount. Lastly, manganese, copper, and zinc are co-factors that activate enzymes to help build bone mass. Here is an excellent example of a balanced calcium supplement.   Calcium supplements should always be taken with food that includes some fat, because dietary fat increases calcium absorption.  You can also use a complete protein supplement to provide the extra protein necessary to form the bone matrix.

It is also important to know, that while 99% of the body’s calcium in contained in the bones and teeth, the remaining one percent has other very important functions in the body. One of these crucial functions is the conduction on nerve impulses. Undersupply of calcium also can cause irritability of the muscles, resulting in cramps and even spasms.

Pregnant mothers should be aware of the importance of an adequate calcium intake, along with its supporting nutrients. A unmet high demand for calcium during pregnancy or lactation can result in future bone loss for the mother.  During both my pregnancies, I found that a good quality calcium supplement with magnesium, such as one of these provided relief for my leg cramps that I sometimes experienced at night. This also greatly reduced my extreme tooth sensitivity to hot and cold.