Nutritional modulation of cataract

Abstract

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.

Increased risk of Parkinson's disease in cataract patients: A population-based cohort study

“…It is estimated that cataracts account for 39% of the world's 37 million blind individuals [7]. Although the real etiology of cataracts remains inconclusive, to date, many factors have been identified to be associated with the risk of cataracts [8,9].…”

Mutations and mechanisms in congenital and age-related cataracts

“…In contrast, if they are benign enough merely to increase susceptibility to environmental insults, including hyperglycemic and dietary (Weikel et al, 2014), ultraviolet light (Taylor et al, 1988), or oxidative (Brennan et al, 2012; Truscott, 2005) damage, they would tend to contribute to age related cataract (Hejtmancik and Smaoui, 2003; Shiels and Hejtmancik, 2007) by exacerbating the accumulation of damage seen to long lived lens proteins with aging (Truscott and Friedrich, 2016). Consistent with these proposed mechanisms, hereditary congenital cataracts are most often transmitted in a highly penetrant Mendelian fashion, and cataracts with a later origin, including progressive and age-related cataracts, are often multifactorial, with contributions from multiple genes providing from 35% to as much as 58% of the risk (McCarty and Taylor, 2001) as well as environmental insults.…”

Small molecules, both dietary and endogenous, influence the onset of lens cataracts

“…While it has been suggested that fatty acids in the diet do not influence the lipid composition of the lens (Nealon et al, 2008), both sterols and flavonoids in the diet can prevent or even reverse cataract in animal and ex vivo human models (Weikel et al, 2014). One of the impacts of modern –omics is that investigators are returning to a close examination of the metabolome, the summation of all the known physiological pathways as well as pathways of the organism’s associated microbiota.…”

“…A review on the nutritional modulation of cataracts appeared in 2014 (Weikel et al, 2014), which focused on familiar dietary components. This current review examines recent exciting developments in sterol-based small molecule biochemistry in the lens and what led to these findings in order to focus attention on the opportunity to deliver small molecules to prevent and treat lens cataract.…”