Dietary Carbohydrate in Relation to Cortical and Nuclear Lens Opacities in the Melbourne Visual Impairment Project

Chiu, Chung Jung; Robman, Liubov; McCarty, Catherine A.; Mukesh, Bickol N.; Hodge, Allison; Taylor, Hugh R.; Taylor, Allen

doi:10.1167/iovs.08-2824

Cited by 27 publications

(15 citation statements)

References 46 publications

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“…Previous studies have reported a decreased risk of nuclear cataract with higher intake of n23 PUFAs (30), significant positive associations between linoleic and linolenic acid intakes and nuclear opacity (35), and a reduced prevalence of cortical cataract with increased PUFA intake (31). There was no association of cataract risk with carbohydrate intake, whereas positive associations between cataract and carbohydrate intake and between lens opacity and dietary glycemic index have been reported elsewhere (36,37), although a high dietary glycemic load was not associated with cataract risk in a large prospective study (38). Finally, studies of cataract risk or lens opacity in relation to the use of vitamin supplements have generally (3,24,27,34), but not always (7), shown an inverse association, but we found no difference in cataract risk between regular dietary supplement users and other participants.…”

Section: Discussionmentioning

confidence: 80%

Diet, vegetarianism, and cataract risk

Appleby

Allen

Key

2011

The American Journal of Clinical Nutrition

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Background: Age-related cataract is a major cause of morbidity. Previous studies of diet and cataract risk have focused on specific nutrients or healthy eating indexes but not on identifiable dietary groups such as vegetarians. Objective: We investigated the association between diet and cataract risk in a population that has a wide range of diets and includes a high proportion of vegetarians. Design: We used Cox proportional hazards regression to study cataract risk in relation to baseline dietary and lifestyle characteristics of 27,670 self-reported nondiabetic participants aged 40 y at recruitment in the Oxford (United Kingdom) arm of the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford) by using data from the Hospital Episode Statistics in England and Scottish Morbidity Records.Results: There was a strong relation between cataract risk and diet group, with a progressive decrease in risk of cataract in high meat eaters to low meat eaters, fish eaters (participants who ate fish but not meat), vegetarians, and vegans. After multivariable adjustment, incidence rate ratios (95% CIs) for moderate meat eaters (50-99 g meat/d), low meat eaters (,50 g meat/d), fish eaters, vegetarians, and vegans compared with high-meat eaters (100 g meat/d) were 0. 96 (0.84, 1.11), 0.85 (0.72, 0.99), 0.79 (0.65, 0.97), 0.70 (0.58, 0.84), and 0.60 (0.38, 0.96), respectively (P , 0.001 for heterogeneity). Associations between cataract risk and intakes of selected nutrients and foods generally reflected the strong association with diet group. Conclusion: Vegetarians were at lower risk of cataract than were meat eaters in this cohort of health-conscious British residents.Am J Clin Nutr 2011;93:1128-35.

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Section: Discussionmentioning

confidence: 80%

Diet, vegetarianism, and cataract risk

Appleby

Allen

Key

2011

The American Journal of Clinical Nutrition

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“…9 Data from 3,217 subjects from the Melbourne Visual Impairment Project corroborate the NVP results and indicate that nondiabetics who consumed more than 181 g/day had more than a threefold greater risk of cortical cataract compared with those who consumed the least amount of carbohydrates (95%CI: 1.10–9.27) (Figure 4). 11 …”

Section: Epidemiologic Studies That Relate Intake Of Carbohydrate To mentioning

confidence: 99%

Nutritional modulation of cataract

et al. 2013

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Lens opacification or cataract reduces vision in over 80 million people worldwide and blinds 18 million. These numbers will increase dramatically as both the size of the elderly demographic and the number of those with carbohydrate metabolism-related problems increase. Preventative measures for cataract are critical because the availability of cataract surgery in much of the world is insuficient. Epidemiologic literature suggests that the risk of cataract can be diminished by diets that are optimized for vitamin C, lutein/zeaxanthin, B vitamins, omega-3 fatty acids, multivitamins, and carbohydrates: recommended levels of micronutrients are salutary. The limited data from intervention trials provide some support for observational studies with regard to nuclear – but not other types of – cataracts. Presented here are the beneficial levels of nutrients in diets or blood and the total number of participants surveyed in epidemiologic studies since a previous review in 2007.

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“…However, the associations may vary due to subtle patho-physiological mechanistic differences as well as differences in composition, structure, homeostatic systems, micro-environment, and function between metabolically different regions within tissues. (Brownlee 1995; Chiu et al 2006b; Chiu et al 2005; Chiu et al 2010)…”

Section: Introductionmentioning

confidence: 99%

Dietary hyperglycemia, glycemic index and metabolic retinal diseases

Chiu

Taylor

2011

Progress in Retinal and Eye Research

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133

104

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The glycemic index (GI) indicates how fast blood glucose is raised after consuming a carbohydrate-containing food. Human metabolic studies indicate that GI is related to patho-physiological responses after meals. Compared with a low-GI meal, a high-GI meal is characterized with hyperglycemia during the early postprandial stage (0~2 h) and a compensatory hyperlipidemia associated with counter-regulatory hormone responses during late postprandial stage (4~6 h). Over the past three decades, several human health disorders have been related to GI. The strongest relationship suggests that consuming low-GI foods prevents diabetic complications. Diabetic retinopathy (DR) is a complication of diabetes. In this aspect, GI appears to be useful as a practical guideline to help diabetic people choose foods. Abundant epidemiological evidence also indicates positive associations between GI and risk for type 2 diabetes, cardiovascular disease, and more recently, age-related macular degeneration (AMD) in people without diabetes. Although data from randomized controlled intervention trials are scanty, these observations are strongly supported by evolving molecular mechanisms which explain the pathogenesis of hyperglycemia. This wide range of evidence implies that dietary hyperglycemia is etiologically related to human aging and diseases, including DR and AMD. In this context, these diseases can be considered metabolic retinal diseases. Molecular theories that explain hyperglycemic pathogenesis involve a mitochondria-associated pathway and four glycolysis-associated pathways, including advanced glycation end products formation, protein kinase C activation, polyol pathway, and hexosamine pathway. While the four glycolysis-associated pathways appear to be universal for both normoxic and hypoxic conditions, the mitochondria-associated mechanism appears to be most relevant to the hyperglycemic, normoxic pathogenesis. For diseases that affect tissues with highly active metabolism and that frequently face challenge from low oxygen tension, such as retina in which metabolism is determined by both glucose and oxygen homeostases, these theories appear to be insufficient. Several lines of evidence indicate that the retina is particularly vulnerable when hypoxia coincides with hyperglycemia. We propose a novel hyperglycemic, hypoxia-inducible factor (HIF) pathway, to complement the current theories regarding hyperglycemic pathogenesis. HIF is a transcription complex that responds to decreases in oxygen in the cellular environment. In addition to playing a significant role in the regulation of glucose metabolism, under hyperglycemia HIF has been shown to increase the expression of HIF-inducible genes, such as vascular endothelial growth factor (VEGF) leading to angiogenesis. To this extent, we suggest that HIF can also be described as a hyperglycemia-inducible factor. In summary, while management of dietary GI appears to be an effective intervention for the prevention of metabolic diseases, specifically AMD and DR, more interventional data is...

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Dietary Carbohydrate in Relation to Cortical and Nuclear Lens Opacities in the Melbourne Visual Impairment Project

Abstract: Carbohydrate intake may be optimized to prolong eye lens function. Because of the high proportion of subjects with missing covariates, these results warrant further study.

Cited by 27 publications

References 46 publications

Diet, vegetarianism, and cataract risk

Diet, vegetarianism, and cataract risk

Nutritional modulation of cataract

Dietary hyperglycemia, glycemic index and metabolic retinal diseases

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