Healthy Lifestyle Score and Incidence of Glaucoma: The Sun Project

Javier Moreno-Montañés,Itziar Gutierrez-Ruiz,Alejandro Fernandez-Montero,Elsa Gándara,Maira Bes-Rastrollo,Laura Moreno-Galarraga,Miguel Ángel Martínez-González,Miguel Ruiz-Canela

doi:10.3390/nu14040779

Abstract

Background: The relationship between modifiable risk factors, such as diet and lifestyle, and glaucoma remains controversial. We analyse the effect of the Mediterranean lifestyle (ML) on glaucoma incidence in the “Seguimiento Universidad de Navarra” (SUN) Project. Methods: The SUN Healthy Lifestyle Score (SHLS) includes 10 healthy habits: never having smoked, moderate to high physical activity, Mediterranean diet adherence, moderate alcohol consumption, low television exposure, no binge drinking, short afternoon napping, meeting up with friends, working at least 40 h/wk, and low body mass index. The information was collected biennially through self-reported questionnaires. The relationship between new glaucoma cases and the SHLS was assessed by Cox regression using hazard ratios. Crude, multi-adjusted, and sensitivity analyses were performed. Results: During a median of 12 years of follow-up, 261 (1.42%) new cases of glaucoma were identified among 18,420 participants. After adjusting for potential confounders, participants in the healthiest SHLS category showed a significantly reduced risk of glaucoma compared to those in the lowest SHLS category (adjusted HR = 0.51, 95% CI = 0.28–0.93). For each point added to the SHLS, the risk of glaucoma relatively dropped 5%. Conclusions: Higher adherence to a ML, measured by the SHLS, was significantly associated with a lower risk of developing glaucoma. Based on our study, the ML is a protective factor for glaucoma incidence.

Highlights

We found that a high SUN Healthy Lifestyle Score (SHLS) score was associated with a lower risk of developing primary cardiovascular disease events [12] and metabolic syndrome [13]
Other authors that combined four lifestyle factors (Mediterranean diet, moderate alcohol use, physical activity, and nonsmoking), in individuals aged 70 to 90 years, found that poor adherence to that combined score was associated with a population attributable risk of 60% for all deaths [20]
Our study shows that a SHLS > 6 is a protective factor for glaucoma incidence, and that for each point added to this healthy lifestyle score, the risk of glaucoma decreases by

Summary

Introduction

Glaucoma is one of the most common eye diseases and includes a group of disorders characterized by the progressive damage of the optic nerve associated with loss of the visual field [1] It is considered the second leading cause of blindness worldwide, and a major public health problem [2]. The intervention on modifiable risk factors, such as those related to lifestyle or diet, may reduce the incidence and progression of glaucoma. In this regard, some of our previous studies obtained that smoking cessation significantly reduced the incidence of glaucoma [6].

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