Abstract
Over a third of older adults in the U.S. experience significant vision loss, which decreases independence and is a biomarker of decreased health span. As the global aging population is expanding, it is imperative to uncover strategies to increase health span and reduce the economic burden of this age-related disease. While there are some treatments available for age-related vision loss, such as surgical removal of cataracts, many causes of vision loss, such as dry age-related macular degeneration (AMD), remain poorly understood and no treatments are currently available. Therefore, it is necessary to better understand the factors that contribute to disease progression for age-related vision loss and to uncover methods for disease prevention. One such factor is the effect of diet on ocular diseases. There are many reviews regarding micronutrients and their effect on eye health. Here, we discuss the impact of dietary patterns on the incidence and progression of age-related eye diseases, namely AMD, cataracts, diabetic retinopathy, and glaucoma. Then, we focus on the specific role of dietary carbohydrates, first by outlining the physiological effects of carbohydrates on the body and then how these changes translate into eye and age-related ocular diseases. Finally, we discuss future directions of nutrition research as it relates to aging and vision loss, with a discussion of caloric restriction, intermittent fasting, drug interventions, and emerging randomized clinical trials. This is a rich field with the capacity to improve life quality for millions of people so they may live with clear vision for longer and avoid the high cost of vision-saving surgeries.
Highlights
Vision loss is a pervasive health impairment affecting over 400 million people worldwide
This study replicated the protective effect of Mediterranean diet (MeDi) on late age-related macular degeneration (AMD) (OR = 0.78; Ptrend < 0.0001), and further defined enhanced protection against dry forms of AMD compared with wet forms of AMD
Based on our literature review of dietary patterns and age-related eye diseases, we found strong evidence about dietary patterns in regard to AMD and some in cataract, but there is surprisingly little conclusive evidence linking specific dietary patters with Diabetic retinopathy (DR) and glaucoma
Summary
Vision loss is a pervasive health impairment affecting over 400 million people worldwide. The four major age-related eye diseases are age-related macular degeneration (AMD), cataracts, diabetic retinopathy (DR), and glaucoma. DR is a diabetic complication of the eye that is similar to wet AMD in that it involves damaged blood vessels in the retina that can cause blurred vision, floating spots, or blindness. The fourth major age-related eye disease, affects an estimated 76 million people across the globe. Age-related cataract has been associated with vitamin and carotenoid status [6,7] Nutrients such as vitamins A, C, and E, lutein, zeaxanthin, and β-carotene were associated with reduced cataract risk in cohort studies, inconsistent results are reported in RCTs [8]. We evaluated the risk for age-related eye diseases from the perspective of dietary patterns, which take into account the effects of groups of various foods. Given the complexity of the nutrient interactions within dietary patterns, we anticipated that the evaluation of differences in dietary patterns will better inform about vision maintenance and health than supplementation with individual nutrients or single whole foods alone and could provide more effective dietary recommendations in the future
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