SCAVI NEWS

A monthly newsletter of the South Central Association of the Visually Impaired

SCAVI, P.O. Box 2216, Bedford, IN 47421

Facebook: [https://m.facebook.com/The-South-Central-Association-of-the-Visually-Impaired]{.underline}

Newsletter written and produced by President Regina Vonderhaar and Edited by Rita Kersh.

Regina may be reached at 812-675-0065

Cell 317-435-8216

e-mail rvonderhaar\@att.net

July 2022

WHAT'S HAPPENING IN SCAVI

Our next meeting will be Monday, August 1 at the Bedford Free Methodist Church, 630 R Street, in the Fellowship Hall in the basement at 9:30 A.M. With the Fourth of July holiday and because some of our members are busy participating in the American Council of the Blind national convention the first week in July, we have decided to cancel our July meeting. Hope to see you in August.

SCAVI BIRTHDAYS

Loney Galey July 10

ACB NEWS

On June 22, 2022, the federal government announced a new initiative to expand the availability of testing options that are more accessible for people who are blind or low vision and who use a smartphone. Now, people who are blind or low vision may order more accessible COVID-19 at-home tests. When connected to a smartphone application, these tests are capable of providing audible testing instructions and results to make the COVID-19 testing process more private and independent for people who are blind or low vision.

"ACB and our members have long fought for accessibility improvements to our nation's healthcare system, including accessible home diagnostic tests and durable medical equipment", said ACB President Dan Spoone. "This announcement and program marks an important first step to provide more accessible COVID-19 at-home tests for people who are blind or low vision."

"Similar to other aspects of our lives and advocacy work, we realize that the accessibility of at-home medical testing is a journey, not a destination, and that these improved offerings from the federal COVID-19 at-home testing service will reduce but not eliminate accessibility barriers for people who are blind or low vision, especially for ACB members and the broader community of people who do not use a smartphone and who do not have access to broadband services", said ACB Executive Director Eric Bridges. "ACB remains resolute in our advocacy efforts to make all forms of at-home medical testing, remote monitoring, and diagnostic equipment and services independently and privately accessible for people who are blind or low vision."

To receive the more accessible COVID-19 at-home tests from the federal government, consumers may click here to order online or call 1-800-232-0233. Each order will include two rapid-antigen tests that are more accessible for people who are blind or low vision. Orders will ship free, while supplies last. The tests work with the free Ellume COVID-19 Home Test app for Apple or Android smartphones to provide users with audible instructions and test results. For additional information regarding this more accessible at-home testing option, including additional resources from the Department of Health and Human Services, please visit: [https://acb.org/accessible-COVID-tests]{.underline}.

If these more accessible tests will not meet your at-home testing needs, please contact the Disability Information and Access Line of the Administration on Community Living for additional COVID-19 testing resources: 1-888-677-1199.

GOJI BERRY INTAKE INCREASES MACULAR PIGMENT OPTICAL DENSITY IN HEALTHY ADULTS: A RANDOMIZED PILOT TRIAL

Age-related macular degeneration (AMD) is the third leading cause of blindness worldwide. Macular pigment optical density (MPOD), a biomarker for AMD, is a non-invasive measure to assess risk. The macula xanthophyll pigments lutein (L) and zeaxanthin (Z) protect against blue light and provide oxidant defense, which can be indexed by MPOD. This study examined the effects of Z-rich goji berry intake on MPOD and skin carotenoids in healthy individuals. A randomized, unmasked, parallel-arm study was conducted with 27 participants, aged 45–65, who consumed either 28 g of goji berries or a supplement containing 6 mg L and 4 mg Z (LZ), five times weekly for 90 days. After 90 days, MPOD was significantly increased in the goji berry group at 0.25 and 1.75 retinal eccentricities (p = 0.029 and p = 0.044, respectively), while no changes were noted in the LZ group. Skin carotenoids were significantly increased in the goji berry group at day 45 (p = 0.025) and day 90 (p = 0.006), but not in the LZ group. Regular intake of goji berries in a healthy middle-aged population increases MPOD may help prevent or delay the development of AMD.

Keywords: goji berry, zeaxanthin, lutein, carotenoids, age-related macular degeneration, macular pigment optical density

1. Introduction

Age-related macular degeneration (AMD) is the leading cause of blindness among seniors in developed countries, and third worldwide after uncorrected refractive errors and cataracts. In early stages, the disease is characterized by small to intermediate drusen with pigmentary changes that may progress rapidly to more advanced forms such as choroidal neovascularization or central geographic atrophy with loss of central vision. Lutein (L), zeaxanthin (Z), and the isomer meso-zeaxanthin (meso-Z) are macular pigments that filter damaging blue light and provide oxidative defense in the macula. These pigments are found in plants as xanthophylls, with increased dietary intake proposed to reduce the development and progression of AMD. The relative concentration of xanthophyll carotenoids in the retina can be measured non-invasively by psychophysical and objective methods, expressed as macular pigment optical density (MPOD). Numerous epidemiological studies reports that individuals with a low MPOD level are at an increased risk of AMD.

Dietary L and Z are found in certain fruits and vegetables with red, yellow, or orange color, egg yolk, and in some green leafy vegetables. The dietary intake of Z is lower than L in all age groups and ethnicities in the U.S. Dietary intakes of L and Z are strongly associated with their serum levels, as well as with MPOD. Previous studies have shown that high intakes of these carotenoids from dietary sources or supplements can increase plasma L and Z, and MPOD. Once early AMD has progressed to the intermediate stage, dietary supplements are indicated, but no clinical evidence yet exists for interventions that can address the prevention of small-intermediate drusen with pigmentary changes, the initial clinical signs of macular disruption.

Goji berry (Lycium barbarum L. and L. chinense), also termed wolfberry or Go Chi Zi, has been used in traditional Chinese medicine for more than 2000 years. The bright red berry contains the highest amount of Z among all known dietary sources and is mainly present in a dipalmitate form. The intake of zeaxanthin dipalmitate (ZD) extracts from goji berry increases plasma Z to a greater extent than non-esterified Z supplementation. The berries also contain unique carbohydrates that are present as conjugates with peptides or proteins, which are often referred to L. barbarum polysaccharides (LBP). These have shown anti-inflammatory and neuroprotective effects in animal and cell culture studies.

The typical adult human eye has approximately 2.4 times more Z than L in the central fovea of the macula, making goji berry intake a prime candidate for increasing MPOD. Nevertheless, there is a paucity of clinical evidence on goji berry and MPOD particularly for the prevention or delay of progression from early to intermediate AMD. In individuals from China with signs of early AMD, 25 g of daily consumption of goji berries for 90 days significantly increased both serum Z and MPOD. However, this study had a broad age range (51 to 92 years of age), some participants smoked, and others had certain pre-existing medical conditions. Additionally, the authors only reported central MPOD values up to 0.5 retinal eccentricity (RE), whereas macular pathology and visual dysfunction in AMD may extend beyond that central region. Therefore, to provide a more complete understanding of the influence of goji berry intake on the progression AMD, data is needed on for different population groups that measures MPOD at eccentricities over the entirety of the macula.

In the current study, we prospectively evaluated if the daily intake of 28 g of goji berries or a commercially available supplement providing 6 mg of L and 4 mg for 90 days can improve MPOD and skin carotenoid levels, an index of total carotenoid intake, among healthy middle-aged adults, 45 to 65 years old, with no signs of drusen or early AMD.

2. Materials and Methods

2.1. Participants

Eighty-eight volunteers, ages from 45 to 65 years old, were recruited from an online website and public advertisements in the area of greater Sacramento, California. Participants provided informed consent and were screened with a questionnaire. Inclusion criteria were being generally healthy (not currently under medical supervision, free from self-reported diabetes, cancer, heart, kidney or liver diseases and gastrointestinal disorders), having a normal macular condition as verified by an optometrist, and if relevant, being prescribed the same medication regimen for at least 6 months that was not related to carotenoid metabolism and was approved by the study physician. Exclusion criteria were a dislike of, or allergy to goji berries, diseases of the eye, malabsorption problems, substance or alcohol abuse, smoking, drugs for management of lipids, glucose, or blood pressure, use of dietary supplements other than multivitamins and minerals that provided greater than 100% of the U.S. Dietary Reference Intake, or any supplement containing L or Z. The intervention was registered on ClinicalTrials.gov (NCT03983525) (accessed on 21 July 2020), with the first posted date of 6 December 2019, complied with the tenets of the Declaration of Helsinki, was approved by the Institutional Review Board of the University of California (UC), Davis (IRB #1220178) and was conducted at the UC Davis Ragle Human Nutrition Research Center.

2.2. Study Design

Qualified participants were randomized into a prospective, parallel-arm, unmasked study to consume either 28 g of goji berries or a commercially available supplement of L and Z five days per week for 90 days. Study measurements were collected at baseline (prior to supplement or goji berry intake; day 0), at 45 ± 2 days and 90 ± 2 days after intake.

Twenty-eight grams of goji berries is considered a single serving size. The berries in this study were USDA-certified organic goji berries grown in the Ningxia region of northern China and provided by Navitas Organics, Novato CA, USA. The goji berries were portioned into clean, single-serving plastic bags and provided in 45-day allotments. The commercially available supplements (Source Naturals, Scotts Valley, CA, USA, lot #FG-91753) were purchased online, contained 6 mg of L and 4 mg of Z per serving and were repackaged into 45-day supplies in clean plastic bottles. Compliance was monitored by a self-administered log. Habitual dietary information was collected with the Automated Self-Administered 24 h dietary assessment web-based tool (ASA24; [https://epi.grants.cancer.gov/asa24]{.underline}, accessed on 10 August 2020) once between day 0 and 45, and once again between day 45 and 90.

The MPOD was assessed by the psychophysical method of customized heterochromatic flicker photometry using a macular densitometer (Macular Metrics, Providence, RI, USA). After participants viewed a 5-minute video detailing the measurement procedures, they were dark-adapted for 7 minutes and then began the test. The light intensity of each relevant wavelength was calibrated with a photodiode. The flicker frequency was selected based on a preliminary test of the participant's sensitivity. The task was to eliminate or minimize the flicker in the visual field three times by turning a dial that changed the intensity of a 460 nm light. Each participant performed the test while looking directly at the flickering light at 0.25, 0.5, 1, and 1.75 RE degrees, representing the MPOD level from the center to the periphery of the macula.

Skin carotenoid content was measured by reflection spectroscopy ("Veggie Meter", Longevity Link Corporation, Salt Lake City, UT, USA). After cleaning, the tip of the right index finger was inserted into the spectrophotometer and three measurements were collected. A skin carotenoid score was calculated by the system software. Carotenoids that exist in human plasma, including β-carotene, lycopene, L, Z, and their isomers have been successfully detected in toto and quantified by this device, which has been validated to reflect fruit and vegetable consumption.

SCAVI MINUTES

The meeting of the South Central Association of the Visually Impaired was held on Monday, May 2, 2022 at 9:30 am in the basement of the Bedford Free Methodist Church. Present at the meeting were Rich and Regina Vonderhaar, Denise Mullis, Mike and Dolly Sowder, Doug and Brenda Eads, Rita Kersh and Ida Galey.

Our speaker was Joni Godsey who talked about some of the mental and psychological hardships caused by the pandemic. She told us about her daughter's serious illness as well as other situations she worked with. Then she gave us the opportunity to ask questions and discuss the topic.

Rita then made a motion that we approve the March minutes and Dolly seconded. Motion was approved.

Brenda made a motion that we give $25 to ACB Brenda Dillon memorial walk. Dolly seconded. Motion was approved. Dolly motioned that we give $25 to Amazon gift card for ACB national convention, Denise seconded. Motion was approved.

Cindy gave the treasurer's report. We spent $114 to have brochures printed by Copy Trolley and have an ending balance of $4,474.

Rita made a motion that we adjourn the meeting. Rich seconded. Motion was approved.

We adjourned the meeting at 10:30 am.

Respectfully Submitted by Secretary Rich Vonderhaar