Intermittent Fasting Is Associated With a Decreased Risk of Age-Related Macular Degeneration

PURPOSE: To investigate the association between in-termittent fasting and age-related macular degeneration (AMD) in the general older adult population. DESIGN: A cross-sectional study using a population -based, government-led survey data, Korean National Health and Nutrition Examination Survey (KN-HANES). METHODS: A total of 4504 individuals aged > 55 years with comprehensive data including meal frequency and fundus photography were selected using the KNHANES 2015-2018 database. Participants were divided into 2 groups based on breakfast frequency per week; intermit-tent fasting (nearly 0 time/week) and nonfasting (5-7 times/week) groups. Multiple logistic regression analysis was performed to determine the risk factors for AMD identified by fundus photography. RESULTS: AMD was identified in 25.1% of total par-ticipants. The intermittent fasting group had a decreased risk of AMD compared with the nonfasting group (ad-justed odds ratio [aOR] 0.413, 95% CI 0.203-0.841), especially in individuals with a younger age ( < 70 years, aOR 0.357, 95% CI 0.153-0.833), obesity (aOR 0.663, 95% CI 0.424-1.037), and urban residence (aOR 0.437, 95% CI 0.248-0.769). Increased age (aOR 1.058, 95% CI 1.041-1.076) and serum high-density lipoprotein levels (aOR 1.011, 95% CI 1.002-1.021) were also inde-pendent risk factors for AMD. CONCLUSIONS: Using the population-based survey data, we demonstrated that intermittent fasting by skip-ping breakfast was significantly associated with a reduced risk of AMD in a representative older adult population, especially in individuals with age < 70 years, obesity, and urban residence. (Am J Ophthalmol 2022;243: 1-9. (c) 2022 Elsevier Inc. All rights reserved.)