Abstract
BackgroundCataract is among the major causes of vision impairment and blindness worldwide. Epidemiological studies support the role of antioxidants in the etiology of cataract, but the evidence for one specific antioxidant over another is inconsistent. Few studies have examined the association of cataract with fruit and vegetable intake with inconclusive results. In the present study, the relationship between cataract and fruit and vegetable intake and dietary and blood levels of carotenoids, vitamins C and E were examined in a Spanish Mediterranean population.MethodsThe present work is an analysis of data from 599 elderly ( ≥ 65 years) participants from the Spanish segment of the EUREYE study. This is a European multi-center cross-sectional population-based study. Cataract was diagnosed using a slit-lamp examination and defined as any lens opacity in either eye or evidence of its removal (cataract extraction). Energy-adjusted intake of fruit and vegetables and antioxidant vitamins was estimated using a semi-quantitative food frequency questionnaire. Plasma concentrations of vitamin C were analyzed by a colorimetric method and carotenoids and α-tocopherol by a HPLC method. The associations between cataract and quartiles of fruit and vegetable intake and plasma antioxidants were investigated using logistic regression models.ResultsOf the 599 elderly recruited, 433 (73%) had cataract or cataract extraction, 54% were women and 46% were men. After adjustments, increasing quartiles of combined fruit and vegetable intake were associated with decreasing reduction of odds of cataract or cataract extraction, (P for trend = 0.008). Increasing quartiles of dietary intakes from 107 mg/d of vitamin C showed a significant decreasing association with prevalence of cataract or cataract extraction (P for trend = 0.047). For vitamin E, a protective association was found from intakes from 8 mg/d, but no linear trend was observed across quartiles of intake (P for trend = 0.944).ConclusionsHigh daily intakes of fruit and vegetables and vitamins C and E were associated with a significantly decreased of the prevalence of cataract or cataract surgery. This study reinforces the WHO recommendations on the benefits of diets rich in fruit and vegetables.
Highlights
Cataract is among the major causes of vision impairment and blindness worldwide
There were no significant differences for median intakes of fruit between cataract cases compared to non cataract (186.g/day vs. 200.g/day p = 0.069), for median intakes of vegetables a significant difference was observed (234 g/day vs. 259 g/day p = 0.004, respectively)
Results from this study showed that increasing quartiles of combined fruit and vegetable intake and increasing quartiles of dietary vitamin C were associated with a significant inverse trend of cataract prevalence or previous cataract surgery
Summary
Cataract is among the major causes of vision impairment and blindness worldwide. Epidemiological studies support the role of antioxidants in the etiology of cataract, but the evidence for one specific antioxidant over another is inconsistent. In this framework of ageing, ARC is considered to be the result of lifelong molecular damage by reactive oxygen species to lens proteins [3] To counteract these potentially damaging stress factors, the lens has an elaborate antioxidant defence system including enzymes such as glutathione peroxidase, glutathione reductase, catalase and superoxide dismutase, and the antioxidant vitamins C, E and some carotenoids [4,5,6]. These antioxidants cannot be synthesized by the body and must be obtained from dietary sources, mainly fruit and vegetables. A number of studies have examined the association of cataract with foods [10,11,12,13,14,15,16] or with quality or type of diet [16,17,18]
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