Bright Sight

Oliver Backhouse, Consultant Eye Surgeon www.cataract.org.uk

Can diet affect your vision?

Over recent years a lot of good quality research has led us to conclude that what we eat can indeed affect our eyesight. Exciting results came from the Age-Related Eye Disease Study (AREDS) which found that a combination of vitamin C (500mg), vitamin E (400 IU), betacarotene (15mg) and zinc (80mg) with cupric oxide (2mg) was able to reduce the risk of disease progression in patients with intermediate or advanced Macular Degeneration (ARMD or AMD) by 22% over a 5 year period. Antioxidants such as lutein and zeazanthin, and other nutrients such as omaga-3 fatty acids are probably beneficial as well and have been added into new formularies.

Antioxidants, which are found in fruits, vegetables, nuts and grains may slow the progression or development of Macular Degeneration. Lutein and Zeazanthin are plant pigments and are of particular interest as they have the ability to filter damaging rays of blue light as well as acting as scavengers of free radicals which can damage the macular. Lutein and Zeazanthin are found in kale, spinach and other dark green leafy vegetables and orange fruit and vegetables. Inflammation appears to have causative role in the development of Macular Degeneration and Omega-3 fatty acids have a protective role as they help reduce inflammation and promote proper blood vessel formation. Omega-3 is found in fish.

It should be noted that some other studies have shown a negative effect with regard the increased intake of certain vitamins. An Italian study showed an increased rate of posterior cataract formation with multivitamins – this needs to be confirmed by other research studies. Increased intake of betacarotene is associated with a higher rate of lung cancer in smokers. Higher levels of vitamin E (800 IU) may increase heart failure in people with vascular disease or diabetes although the levels of 400 IU, as used in the AREDS trial, appears safe.

So what should you do? I recommend a healthy balanced diet – one low in saturated fats, rich in fruits, vegetables, wholegrain and fish. You should not smoke. Supplementary vitamin tablets for ‘eye health’ can be used if your Macular Degeneration is intermediate or advanced as they have been shown to reduce progression and may slow any development in the other eye as well. Many vitamin branded formulas are sold in health food shops: Preservision, Ocuvite, Icaps, Visionace, Macushield, Nutrof Total. All have different vitamin levels and can include other antioxidants such as lutein, zeazanthin, bilberry and polyphenols such as resveratrol (found in red wine and nuts) whose effect is theoretically beneficial on the progression of Macular Degeneration but possible side-effects need to be further studied. It is unknown if these supplements are better than changing ones diet alone. I currently believe that smokers should probably not take these vitamin supplements.

Foods for Healthy Eyes:

Vitamin C foods: Peppers, Strawberries, Broccoli, Tomatoes, Citrus Fruits.

Vitamin E foods: Nuts, Seeds, Oils, Sweet potatoes

Lutein / Zeaxanthin: Eggs, Spinich, Kale, Carrots, Broccoli, Green beans, Blueberries

Zinc foods: Wholegrains, Avocado, Seeds, Broccoli, Garlic, Mushrooms, Dark chocolate, Shellfish.

Omega 3 foods: Oily fish like Salmon, Tuna, Mackerel.

LIMIT Omega 6 . Use the right cooking oils such a coconut which has much lower levels of Omega 6. Avoid hydrogenated fats found in biscuits, margarine, fast foods and frozen pies. Don’t cook with Olive oil at a high heat – save it for drizzling or very gentle cooking.

Diet to help reduce inflammation, blood pressure and cholesterol.

Many foods are thought to help but these listed below have some evidence behind them.

1] Celery – 4 sticks a day
2] Fish – salmon, tuna, mackerel, sardine, cod, trout, halibut, herring. Twice a week.
3] Broccoli
4] Dandelion leaves for salad
5] Black beans
6] Blueberries, raspberries, strawberries
7] Low fat dairy – preferably skimmed milk
8] Beetroot juice
9] Hibiscus tea
10] Pomegranate juice
11] Cranberry juice
12] Regular water intake
13] Oats
14] Eggs
15] Eat an apple 1 hour before a meal
16] Cinnamon – 1 teaspoon a day
17] Almonds (20), Walnuts (14 halves)
18] Olive / Avocado oil
19] Dark chocolate
20] Tomatoes
21] Red wine

Additionally do not smoke and do not drink too much alcohol.

Take daily exercise.

Cut down on: Bread, pasta, cakes, biscuits, fizzy drinks, potatoes, fatty meats, dairy products and foods high in salt and sugar especially.

When buying food look at the ‘traffic light’ nutritional information badge. You will see a lot of processed food is high in saturated fats and salt. Chicken is usually the healthy meat option.