Abstract
Unhealthy behaviours are linked to a higher risk of eye diseases, but their combined effect on visual function is unknown. We aimed to examine the individual and combined associations of diet, physical activity, smoking and alcohol consumption with visual impairment among French adults. 38 903 participants aged 18–73 years from the CONSTANCES nationwide cohort (2012–2016) with visual acuity measured and who completed, lifestyle, medical and food frequency questionnaires were included. Visual impairment was defined as a presenting visual acuity <20/40 in the better eye. After full multivariate adjustment, the odds for visual impairment increased with decreasing diet quality (p for trend = 0.04), decreasing physical activity (p for trend = 0.02) and increasing smoking pack-years (p for trend = 0.03), whereas no statistically significant association with alcohol consumption was found. Combination of several unhealthy behaviours was associated with increasing odds for visual impairment (p for trend = 0.0002), with a fully-adjusted odds ratio of 1.81 (95% CI 1.18 to 2.79) for participants reporting 2 unhealthy behaviours and 2.92 (95% CI 1.60 to 5.32) for those reporting 3 unhealthy behaviours. An unhealthy lifestyle including low/intermediate diet quality, low physical activity and heavy smoking was associated with visual impairment in this large population-based study.
Highlights
Visual impairment is estimated to affect 191 million people and 33 million are thought to be blind worldwide[1]
After further adjustment for characteristics significantly associated with the number of unhealthy behaviours (diabetes, hypertension, hypercholesterolemia and body mass index (BMI) (Model 2), these associations remained significant
Consistent with our results, the Beaver Dam Eye Study (BDES), a prospective cohort study, showed that sedentary behaviour was associated with an increased risk for visual impairment[47]
Summary
Visual impairment is estimated to affect 191 million people and 33 million are thought to be blind worldwide[1]. While many efforts have been developed in secondary and tertiary prevention of visual impairment, there is a need to better characterize the potential for primary prevention of visual impairment Unhealthy behaviours, such as low diet quality, low physical activity, smoking and heavy drinking are modifiable factors that may contribute to the primary prevention of visual impairment. To our knowledge, no study has examined the combined effect of unhealthy behaviours on visual function. Our objective is to examine the individual and combined associations of diet, physical activity, smoking and alcohol consumption with visual impairment in the CONSTANCES cohort
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