Dietary intake and associations with myopia in Singapore children

Abstract

To evaluate associations of dietary factors with myopia, spherical equivalent refractive error (SE) and axial length (AL) in children at age 9 from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort. Methods:We included 467 multi-ethnic children (933 eyes) who participated in the GUSTO prospective birth cohort and were delivered in two major hospitals in Singapore (2009)(2010). At the 9-year visit, we assessed the 6-year incidence of myopia (between ages 3 to 9), cycloplegic SE and AL in children without myopia (SE ≤ −0.5 D in either eye) at the 3-year visit. Using a validated 112-item food frequency questionnaire, parents reported each child's average daily intake of dietary factors (nutrients and food groups) in the past month. Paired eyes were analysed using Generalised Estimating Equations with multivariable logistic or linear regression. Bonferroni corrections were applied, correcting for multiple comparisons between the 13 nutrients (p < 0.004) or 8 food groups (p < 0.006) and each outcome. Results:In children aged 9 years (51.0% boys; 56.3% Chinese), the 6-year incidence of myopia was 35.5%. Overall, the mean (SD) SE and AL were −0.3 (1.7) D and 23.4(1.0) mm, respectively. In multivariable regression, macronutrients or micronutrients were not associated with incident myopia (p ≥ 0.004 for all), adjusting for total energy, gender, ethnicity, time outdoors, near-work and the number of myopic parents (additionally child's height for outcome AL). Similarly, all food groups (including refined grains, sugar-sweetened beverages, protein foods, fruits and vegetables) were not associated with incident myopia (p ≥ 0.006 for all). Additionally, none of the nutrients (p ≥ 0.004 for all) or food groups (p ≥ 0.006 for all) were associated with SE or AL. Conclusions:Our study findings of no significant association between specific nutrients or food groups and incident myopia or SE or AL suggest that diet may not be associated with myopia in children aged 9 years. Well-conducted prospective studies in other populations may clarify the association.

Influence of Lifestyle Patterns On Myopia In Students Aged 9 To 18 In Tianjin, China: A Latent Class Analysis

“…However, no evidence of carbohydrate intakes and SE was discovered in Singapore children by Chua 49 . Meanwhile the lack of associations between dietary habits and myopia also occurs in several other studies 49,50 . Relationship between dietary intakes and myopia development needs further discussion.…”

Association of n-3 polyunsaturated fatty acid intakes with juvenile myopia: A cross-sectional study based on the NHANES database

“…We found that both protein and total fat intakes were lower in juveniles with normal vision and low myopia than those in juveniles with high myopia. However, Li et al ( 32 ) found no significant association between specific nutrients or food groups and incident myopia, indicating that diet may not be associated with myopia in children (9 years old). The inconsistent results may be due to differences in the race, geography, and dietary habits of the study population.…”

Role Of Nutrition on Myopia Progression

“…As a consequence, the images that develop on the retina are distorted. Even though many children are born with significant refractive abnormalities, they often correct themselves as the child develops because the cornea and intraocular crystalline lens can adapt to their changing shape and size [11] as it is seen in Table 1. When used in tandem with an active, visually mediated emmetropization procedure, this passive emmetropization technique may help rectify any remaining refractive errors.…”

“…Myopic patients often consult their doctors for advice on how to alter their daily habits in an effort to slow the progression of their condition. Although gender and age seem to have the most correlation, the findings presented here suggest that insulin levels may also play a key role in the onset of myopia and the degree to which it affects a person's vision [26][27][28], as it can be seen in Table 1. There does not seem to be any additional strong links between myopia and dietary habits or other physical characteristics.…”