The inflammatory potential of diet is associated with the risk of age‐related eye diseases

Abstract

Aims/Purpose: Inflammation is involved in the pathogenesis of cataract, age‐related macular degeneration (AMD) and possibly open‐angle glaucoma (OAG). We assessed whether the inflammatory potential of diet (quantified using the dietary inflammatory index; DII) affects the incidence of these eye diseases. Serum inflammation markers were investigated as possible mediators.Methods: Participants aged >45 years were derived from the Rotterdam Study. From 1991 onwards, every 4–5 years, participants underwent extensive eye examinations. At baseline, blood samples and dietary data were collected. The DII was adapted (aDII) based on data availability. Of the 7436 participants free of eye diseases at baseline, 4036 developed incident eye diseases over time (cataract = 2895, early‐intermediate AMD = 891, late AMD = 81, OAG = 169).Results: A higher aDII was significantly associated with increased inflammation. A higher neutrophil‐lymphocyte ratio (NLR) was associated with an increased risk of cataract and AMD. Additionally, complement component 3c (C3c) and systemic immune‐inflammation index (SII) were associated with increased risks of cataract and late AMD, respectively. Every point increase in the aDII was associated with a 9% increased risk of cataract (Odds ratio [95% confidence interval]: 1.09 [1.04–1.14]). The NLR and C3c partly mediated this association. We also identified associations of the aDII with risk of AMD (early‐intermediate AMD, OR [95% CI]: 1.11 [1.03–1.19]; late AMD, OR [95% CI]: 1.24 [1.02–1.53]). The NLR partly mediated these associations. The aDII was not associated with OAG.Conclusions: We observed an unfavourable association between the aDII and cataract. More importantly, we found an association between the aDII and risk of AMD. Especially the NLR, a marker of subclinical inflammation, seems to be involved. These findings are relevant for patients with AMD and substantiate the current recommendations to strive for a healthy lifestyle to prevent blindness.