The Association of Consumption of Fruits/Vegetables With Decreased Risk of Glaucoma Among Older African-American Women in the Study of Osteoporotic Fractures

Abstract

Purpose To explore the association between consumption of fruits and vegetables and the presence of glaucoma in older African American women. Design Cross-sectional study. Methods Disc photographs and suprathreshold visual fields were obtained from the 662 African American participants in the Study of Osteoporotic Fractures. Masked, trained readers graded all discs, and two glaucoma specialists reviewed photos and visual fields. The Block Food Frequency Questionnaire assessed food consumption. Relationships between selected fruit/vegetable/nutrient consumption and glaucoma were evaluated using logistic regression models after adjusting for potential confounders. Results After excluding women missing Food Frequency Questionnaire and disc data, 584 African American women (88.2% of total African American cohort) were included. Glaucoma was diagnosed in at least one eye in 77 subjects (13%). Women who ate 3 or more servings/day of fruits/fruit juices were 79% (odds ratio [OR]=0.21; 95% confidence interval [CI]: 0.08–0.60) less likely to have glaucoma than women who ate less than one serving/day. Women who consumed more than 2 servings/week of fresh oranges (OR=0.18; 95%CI: 0.06–0.51) and peaches (OR=0.30; 95%CI: 0.13–0.67) had a decreased odds of glaucoma compared to those consuming less than one serving/week. For vegetables, >1 serving/week compared to ≤1 serving/month of collard-greens/kale decreased the odds of glaucoma by 57% (OR=0.43; 95%CI: 0.21–0.85). There was a protective trend against glaucoma in those consuming more fruit/fruit juices (p=0.023), fresh oranges (p=0.002), fresh peaches (p=0.002), and collard greens/kale (p=0.014). Higher consumption of carrots (p=0.061) and spinach (p=0.094) also showed some associations. Individual nutrient intake from food sources found protective trends with higher intakes of vitamin A (p=0.011), vitamin C (p=0.018), and α-carotene (p=0.021), and close to statistically significant trends with β-carotene (p=0.052), folate (p=0.056), and lutein/zeaxanthin (p=0.077). Conclusion Higher intake of certain fruits and vegetables high in Vitamins A and C and carotenoids may be associated with a decreased likelihood of glaucoma in older African American women. Randomized controlled trials are needed to determine whether the intake of specific nutrients changes the risk of glaucoma.

Association of Dietary Nitrate Intake With Primary Open-Angle Glaucoma

“…Also, as both cohorts are 90+% Caucasian, our results may not be generalizable; however, in a study of African-Americans, kale/collard intake was also associated with a lower POAG risk. 46 Finally, these data represent findings from the first population-based observational study, and thus, the association between dietary nitrate consumption and POAG should be interpreted cautiously and confirmed.…”

“…74-79 Therefore, dietary nitrate supplementation represents a practical method to increase NO levels. Indeed, across the two cross-sectional studies in all (95 cases among 1,155 total) 45 or only African-American (77 cases among 587 total) 46 women in the Study of Osteoporotic Fractures, the only vegetable that was consistently inversely associated with POAG was kale/collard greens: ≥ 1 serving/month of kale/collard greens was significantly associated with 55-70% reduced odds of POAG.…”

“…34,39-42 Dietary nitrate is predominately from green leafy vegetables, 43 which contribute ∼ 80% of nitrate intake. 29 Although plasma nitrite levels 16,44 or intake of specific vegetables 45,46 have been associated with POAG; dietary nitrate intake as a specific nutrient has not been evaluated. Therefore, we evaluated dietary nitrate and incident POAG in a 25+ year prospective study of 63,893 women in the Nurses' Health Study (NHS) and 41,094 men in the Health Professionals Follow-up Study (HPFS).…”

Glaucoma: The Silent Thief of Vision

“…It has been reported that a higher intake of certain fruits and vegetables rich in vitamin A, C, B 2 and carotenoids by 1155 older white women was associated with a decreased risk of glaucoma among them [29]. It also been reported that higher intake of vitamin A and C and carotenoids may be associated with decreased likelihood of glaucoma among 662 older African-American women [30].There has been no compelling evidence to suggest a relationship between dietary supplementation with vitamins A or E and glaucomatous disease in the large population-based study. There was, however, weak evidence that supplemental vitamin C intake may perhaps be associated with decreased odds of glaucoma [31].…”

Scientific Opinion on Dietary Reference Values for vitamin A

“…Some observational studies investigated the association between "vitamin A" or retinol intake and eye health-related outcomes, including cataract (one cross-sectional study (Cumming et al, 2000); one prospective study (Chasan-Taber et al, 1999)), age-related maculopathy (one cross-sectional study (Smith et al, 1999)) and age-related macular degeneration (one case-control study (Seddon et al, 1994)) and glaucoma (one cross-sectional study (Giaconi et al, 2012); two cohort studies (Kang et al, 2003;Ramdas et al, 2012)). Results were limited and/or inconsistent.…”