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Research also shows that several environmental and lifestyle factors can increase the risk of macular degeneration, including smoking, a high-cholesterol diet, carotenoid status, vitamins A and E levels, zinc levels, age, sex, and exposure to heavy metal ions and other chemicals

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The within-individual design helps mitigate some biases, but residual confounding cannot be entirely ruled out

Results require continued use of medication along with lifestyle modifications including reduced caloric intake and increased physical activity

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This means that while it will contribute to the total number of carbohydrates in a food it does not actually cause blood sugar elevations