***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Lutein and docosahexaenoic acid ( DHA ) may protect against age-related macular degeneration ( AMD ) . Lutein is a component of macular pigment . DHA is in the retina . OBJECTIVE The objective of this 4-mo study was to determine the effects of lutein ( 12 mg/d ) and DHA ( 800 mg/d ) on their serum concentrations and macular pigment optical density ( MPOD ) . DESIGN Forty-nine women ( 60 - 80 y ) were r and omly assigned to placebo , DHA , lutein , or lutein + DHA supplement . Serum was analyzed for lutein and DHA ( 0 , 2 , and 4 mo ) . MPOD was determined ( 0 and 4 mo ) at 0.4 , 1.5 , 3 , and 5 degrees temporal retinal eccentricities . Serum was analyzed for lipoproteins ( 4 mo ) . RESULTS There was no interaction between lutein and DHA supplementations for serum lutein and MPOD . The lutein supplementation x DHA supplementation x month interaction was significant for serum DHA response ( P < 0.05 ) . In the lutein group , serum lutein increased from baseline at 2 and 4 mo ( P < 0.001 ) , and MPOD increased at 3.0 degrees ( P < 0.01 ) . In the DHA group , serum DHA increased at 2 and 4 mo ( P < 0.0001 ) , and MPOD increased at 0.4 degrees ( P < 0.05 ) . In the lutein + DHA group , serum lutein and DHA increased at 2 and 4 mo ( P < 0.01 ) , and MPOD increased at 0.4 , 1.5 , and 3 degrees ( P = 0.06 , 0.08 , and 0.09 , respectively ) . Differences from placebo in lipoprotein subfractions were greatest for the lutein + DHA group ( 4 mo ) . CONCLUSIONS Lutein supplementation increased MPOD eccentrically . DHA result ed in central increases . These results may be due to changes in lipoproteins . Lutein and DHA may aid in prevention of age-related macular degeneration The number of individuals with age-related cognitive impairment  is rising dramatically in the UK and globally . There is considerable interest in the general hypothesis that improving the diet of older people may slow the progression of cognitive decline . To date , there has been little attention given to the possible protective role of n-3 long-chain polyunsaturated fatty acids ( n-3 LCPs ) most commonly found in oily fish , in age-related loss of cognitive function . The main research hypothesis of this study is that an increased dietary intake of n-3 LCPs will have a positive effect on cognitive performance in older people in the UK.To test this hypothesis , a double-blind r and omised placebo-controlled trial will be carried out among adults aged 70–79 years in which the intervention arm will receive daily capsules containing n-3 LCP ( 0.5 g/day docosahexaenoic acid and 0.2 g/day eicosapentaenoic acid ) while the placebo arm will receive daily capsules containing olive oil . The main outcome variable assessed at 24 months will be cognitive performance and a second major outcome variable will be retinal function . Retinal function tests are included as the retina is a specifically differentiated neural tissue and therefore represents an accessible window into the functioning of the brain . The overall purpose of this public-health research is to help define a simple and effective dietary intervention aim ed at maintaining cognitive and retinal function in later life . This will be the first trial of its kind aim ing to slow the decline of cognitive and retinal function in older people by increasing daily dietary intake of n-3 LCPs . The link between cognitive ability , visual function and quality of life among older people suggests that this novel line of research may have considerable public health importance We studied the macular pigment ocular density ( MPOD ) in patients with early age macular degeneration ( AMD ) before and 1 year after nutritional supplementation with lutein and docosahexaenoic acid ( DHA ) .  Forty-four patients with AMD were r and omly divided into two groups that received placebo ( n = 21 ) or a nutritional supplement ( n = 23 , 12 mg of lutein and 280 mg of DHA daily ) . Heterochromatic flicker photometry was used to determine the MPOD . At baseline , the MPOD in AMD patients with placebo was 0.286 ± 0.017 meanwhile in AMD patients with supplementation it was 0.291 ± 0.016 . One year later , the mean MPOD had increased by 0.059 in the placebo group and by 0.162 in patients receiving lutein and DHA . This difference between groups was significant ( p < 0.05 ) . Lutein and DHA supplementation is effective in increasing the MPOD and may aid in prevention of age related macular degeneration PURPOSE The Age-Related Eye Disease Study ( AREDS ) demonstrated beneficial effects of oral supplementation with antioxidant vitamins and minerals on the development of advanced age-related macular degeneration ( AMD ) in persons with at least intermediate AMD ( bilateral large drusen with or without pigment changes ) . Observational data suggest that other oral nutrient supplements might further reduce the risk of progression to advanced AMD . The primary purpose of the Age-Related Eye Disease Study 2 ( AREDS2 ) is to evaluate the efficacy and safety of lutein plus zeaxanthin ( L+Z ) and /or ω-3 long-chain polyunsaturated fatty acid ( LCPUFA ) supplementation in reducing the risk of developing advanced AMD . The study also assesses the reduction in zinc and the omission of β-carotene from original AREDS formulation . DESIGN Multicenter , phase III , r and omized , controlled clinical trial . PARTICIPANTS Persons aged 50 to 85 with bilateral intermediate AMD or advanced AMD in 1 eye . METHODS All participants were r and omly assigned to placebo ( n = 1012 ) , L+Z ( 10 mg/2 mg ; n = 1044 ) , ω-3 LCPUFAs ( eicosapentaenoic acid + docosahexaenoic acid [ 650 mg/350 mg ] ; n = 1069 ) , or the combination of L+Z and ω-3 LCPUFAs ( n = 1078 ) . All participants were offered a secondary r and omization to 1 of 4 variations of the original AREDS formulation keeping vitamins C ( 500 mg ) and E ( 400 IU ) and copper ( 2 mg ) unchanged while varying zinc and β-carotene as follows : Zinc remains at the original level ( 80 mg ) , lower only zinc to 25 mg , omit β-carotene only , or lower zinc to 25 mg and omit β-carotene . MAIN OUTCOME MEASURES Progression to advanced AMD determined by central ized grading of annual fundus photographs . RESULTS We enrolled 4203 participants at 82 clinical centers located in the United States . Population characteristics at baseline were as follows : Mean age , 74 years ; 57 % female ; 97 % white ; 7 % current smokers ; 19 % with prior cardiovascular disease ; and 44 % and 50 % taking statin-class cholesterol-lowering drugs and aspirin , respectively . Ocular characteristics include 59 % with bilateral large drusen , 32 % with advanced AMD in 1 eye and mean visual acuity of 20/32 in eyes without advanced AMD . CONCLUSIONS This report presents the AREDS2 study design and the participants ' baseline demographic and ocular characteristics PURPOSE Increased dietary intake of lutein/zeaxanthin and omega-long-chain polyunsaturated fatty acids ( omega-3 LCPUFA ) was found to be associated with reduced risk of advanced age-related macular degeneration ( AMD ) . The purpose of the study was to examine the effect of oral supplementation of omega-3 LCPUFA on changes in serum levels of lutein/zeaxanthin  during supplementation in persons 60 years of age and older , with or without AMD . METHODS Forty participants with AMD of various degrees of severity received lutein ( 10 mg ) and zeaxanthin ( 2 mg ) daily and were equally r and omized to receive omega-3 LCPUFA ( 350 mg docosahexaenoic acid [ DHA ] and 650 mg eicosapentaenoic acid [ EPA ] ) or placebo for 6 months . Serum levels of lutein , zeaxanthin , and omega-3 LCPUFAs and macular pigment optical densities were measured at baseline , 1 week , and 1 , 3 , 6 , and 9 months . RESULTS By month 6 , the median serum levels of lutein/zeaxanthin increased by two- to threefold compared with baseline . Increases in serum levels of lutein/zeaxanthin did not differ by omega-3 LCPUFA treatment ( P > 0.5 ) . After 1 month , in the omega-3 LCPUFA-treated group , the median levels of DHA and EPA increased and the placebo group had no changes . At month 6 , participants with AMD had a lower increase in serum lutein concentration than did those without AMD ( P < 0.05 ) . CONCLUSIONS The addition of omega-3 LCPUFA to oral supplementation of lutein/zeaxanthin did not change the serum levels of lutein and zeaxanthin . A long-term large clinical trial is necessary to investigate the benefits and adverse effects of these factors for the treatment of AMD IMPORTANCE It has been shown that the functionality of the macula lutea depends on the nutritional uptake of lutein and zeaxanthin and that it is inversely associated with the risk of age-related macular degeneration ( AMD ) . Additionally , ω-3 long-chain polyunsaturated fatty acids ( LC-PUFAs ) may also be protective . OBJECTIVE To investigate the effect of a 12-month intervention with macular xanthophylls and ω-3 LC-PUFAs on xanthophylls and fatty acids in plasma , antioxidant capacity , and optical density of the macular pigment of patients with nonexudative AMD . DESIGN The LUTEGA study was a r and omized , double-blind , placebo-controlled , parallel clinical trial that was conducted for 12 months . SETTING University Eye Hospital and Institute of Nutrition , Friedrich Schiller University Jena , Germany . PARTICIPANTS A total of 172 individuals with nonexudative AMD . INTERVENTION Individuals were enrolled and r and omly divided as follows : placebo group , group 1 ( a capsule containing 10 mg of lutein , 1 mg of zeaxanthin , 100 mg of docosahexaenoic acid , and 30 mg of eicosapentaenoic acid administered each day ) , and group 2 ( same substances but twice the dose used in group 1 ) . One hundred forty-five participants completed the study successfully . MAIN OUTCOME MEASURES Plasma xanthophyll concentrations and fatty acid profiles , optical density of the macular pigment , and antioxidant capacity in plasma ( 6-hydroxy-2,5,7,8-tetramethylchroman-2-carboxylic acid [ Trolox ] equivalent antioxidant capacity and photochemiluminescence ) . RESULTS The concentrations of the administered carotenoids in plasma as well as the optical density of the macular pigment increased significantly in the groups r and omized to receive supplementary macular xanthophylls and ω-3 LC-PUFAs after 1 month of intervention and remained at this level through the end of the study . Use of the double dose result ed in a beneficial alteration of the fatty acid profile in the plasma of patients with AMD in comparison with the dose in group 1 . The lipophilic antioxidant capacity in plasma was significantly elevated with the intervention . CONCLUSIONS AND RELEVANCE A supplement containing a fixed combination of lutein , zeaxanthin , and ω-3 LC-PUFAs during 12 months significantly improved plasma antioxidant capacity , circulating macular xanthophyll levels , and the optical density of the macular pigment . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00763659 The aim of this r and omized , double-blind , placebo-controlled clinical trial was to determine the efficacy of a combination of acetyl-L-carnitine , n-3 fatty acids , and coenzyme Q10 ( Phototrop ® ) on the visual functions and fundus alterations in early age-related macular degeneration ( AMD ) . One hundred and six patients with a clinical diagnosis of early AMD were r and omized to the treated or control groups . The primary efficacy variable was the change in the visual field mean defect ( VFMD ) from baseline to 12 months of treatment , with secondary efficacy parameters : visual acuity ( Snellen chart and ETDRS chart ) , foveal sensitivity as measured by perimetry , and fundus alterations as evaluated according to the criteria of the International Classification and Grading System for AMD . The mean change in all four parameters of visual functions showed significant improvement in the treated group by the end of the study period . In addition , in the treated group only 1 out of 48 cases ( 
    Output:
    
This review found that omega 3 LCPUFA supplementation in people with AMD for periods up to five years does not reduce the risk of progression to advanced AMD or the development of moderate to severe visual loss .
Currently available evidence does not support increasing dietary intake of omega 3 LCPUFA for the explicit purpose of preventing or slowing the progression of AMD