This subject is vitally important, not just for eye health but total body, mind and emotional health. The process of making colored, moving pictures all day long which our eyes and brain do for us is a metabolically expensive task. It only makes sense that how we fuel that task is very important.
LIFESTYLE AND AMD
Today Age-Related Macular Degeneration (AMD) is the leading cause of blindness is people over the age of 60. It has been called the new epidemic because more and more it is being diagnosed in more and younger patients. While the exact cause still eludes us, many of the risk factors for heart disease are the same for AMD. Below find a summary of the medical literature to help give guidance for protection from this coming epidemic.
RISK FACTORS FOR MACULAR DEGENERATION
IF YOU HAVE: YOUR RISK OF AMD IS:
Cerebrovascualr Disease (Stroke) 4.64 times the average risk
Age 65-74 4.54
Current Smoking 2.8-5.4
Body Mass Index (25-30kg/m2) 2.35
Total Cholesterol >6.75mmol/L 2.3
Age 55-65 2.13
More than one child 1.8
Triglyceride >2.03mmol/L 1.7
Systolic Blood Pressure >155 1.7
Hyperopia >+1.00 1.7
Fibrinogen level >3.34g/L 1.7
History of vascular disease 1.6
Total Cholesterol >4.6-6.7 mmol/L 1.5
History of cigarette smoking 1.5
Former smoker 1.5
AVERAGE RISK 1.0
PROTECTIVE FACTORS FOR MACULAR DEGENERATION
IF YOU DO: YOUR RISK OF AMD IS:
AVERAGE RISK 1.00
Average Physical Activity 0.70
Fruit Intake (3.5 servings/day) 0.64
Former Estrogen use in women 0.60
High intake of all carotenoids 0.59
Broccoli (4-5 times per week) 0.50
Greater than average physical activity 0.50
Lutein and Zeaxanthin (4-5 times/week) 0.43
Carotenoid levels >2.39 mmol/L 0.40
Current Estrogen use in women 0.30
Spinach (4-5 times/week) 0.14
AREDS STUDY
A 25% less risk for AMD progression was found in a study of those taking a combination of:
Vitamin C - 500mg
Vitamin E - 400mg
Vitamin A –
Zinc - 30mg
Copper - 2mg
Most Ophthalmologists recommend taking the anti-oxidant vitamins and minerals recommended in the AREDS study which consist of Vitamins A,C,and E, and the minerals Zinc and Copper. More recent research finds that Folate, and Vitamins B-1, and B-12 are protective against AMD. The best recommendation presently would be to take a complete multi-vitamin, and eat as many fruits and vegetables (on the lutein and zeaxanthin list) and exercise regularly. Keep an ideal body weight, blood pressure and blood cholesterol.
The above recommendations we all know but realizing this will protect our sight is one more incentive besides good health and appearance.
Some medical references: Dr. Jack Goldberg 1988
Eye Disease Case Control Study Group 1993
Dr. Johanna Seddan 1994
Arch Ophthalmol/Vol 121, June 2003 pp785-792
Arch Ophthalmol/Vol 122, 2004 pp883-892
AREDS Study
LIFESTYLE AND CATARACTS
Cataracts as stated earlier are the leading correctable cause of vision loss. Do you have to just get a cataract not being able to do anything about it?? The answer is NO. Aging and oxidative stress are two causes of cataract development. Lifestyle can slow aging and reduce oxidative stress and the medical literature supports these claims.
RISK FACTORS FOR CATARACT
IF YOU HAVE: YOUR RISK OF CATARACT IS:
Taken Oral Steroids 5.8 times the normal risk
Diabetes 4-6
Alcohol >1 drink/day 2-4
Smoking > 1 pkg/day 3.17
Ultra-violet light excess 1.6-3.3
Gout medications 2.48
Milk >100ml/day 2.50
Non-white race 2.03
Nonprofessional 1.96
Family History 1.50
Low education 1.46
AVERAGE RISK 1.00
PROTECTIVE FACTORS FOR CATARACTS
IF YOU DO OR HAVE: YOUR RISK OF CATARACT IS:
AVERAGE RISK 1.00
A-Carotene (high plasma levels) 0.70
B-Carotene “ 0.50
Lutein “ 0.50
Lycopene “ 0.40
Multivitamin use 0.63-0.73
Vitamin C alone >10 years 0.55
riboflavin B-6, thiamine B-1, C, E,
and niacin combined 0.20-0.40
The majority of studies show vitamin use and/or higher carotenoid blood levels are associated with a lower rate of cataract. A 12 years study on 22,000 US physicians showed that Beta-carotene had no effect on past smokers or non smokers but reduced cataract risk in current smokers by 25%.
Just like AMD, Cataract is associated with heart health factors.
Obesity, high blood pressure and history of angina or heart problems were all associated with an increased cataract risk.
Elevated blood triglycerides in men, has been associated with an increased risk of cataract.
Some medical references: Arch Ophthalmol/Vol 121 March 2003, pp372-377
Ophthalmic Epidemiology/Vol 10(4) 2003, pp227-240
Ophthalmology/Vol 110(3) March 2003. pp578-583
LIFESTYLE AND DIABETIC RETINOPATHY
The fact is that adult onset or type II Diabetes is reversible with lifestyle most of the time. Most people are aware that they can eliminate medications for this type of diabetes with lifestyle choices. Type I Diabetes however requires insulin therapy. Either type of diabetes can be associated with eye damage if the blood sugar is allowed to remain elevated.
Sugar is damaging to the small blood vessels in the eye, kidney and peripheral nerves. Over time the blood vessels develop micro anureysms, they leak blood and fat, and eventually they “drop out” or die. This leaves the retina with poor circulation and new blood vessels grow but they are harmful instead of helpful. If intervention either by better blood sugar control and or medical or surgical treatment is not done blindness can occur within 2 years.
Usually the damage take 7-15 years to occur. The recommendation is to keep the blood sugar between 70-120mg/dl and <180mg/dl after meals. Usually to accomplish this type of excellent control, multiple insulin injections per day or an insulin pump is required. One should work carefully with their physician to assure good blood sugar control.
The monthly exam or Hemoglobin A-1C should be kept <7 to prevent retinopathy.
Lifestyle reduces risk of retinopathy. In the Early treatment diabetic retinopathy study they found the lowering blood lipids(fats) decreased the risk of fat leakage into the retina which leads to visual loss.
Also patients with high blood cholesterol or elevated LDL had twice the amount of leakage into the retina compared to patients with normal blood levels.
9% of retinopathy occurs in non-diabetics related to elevated blood pressure, elevated cholesterol and triglyceride levels, elevated body mass index, and elevated waist to hip ratio.
Some medical references: Arch Ophthalmol/Vol 121(2) 2003, pp245-251
Diabetes Care/Vol 25(8) 2002, pp1320-1325
Arch Ophthalmol/Vol 114 1996 – ETDRS Study
Diabetes Control and Complication Trial Research Group, 1993
LIFESTYLE AND GLAUCOMA
Most people are not aware that lifestyle is definitely related to risk of glaucoma. Again the risks for heart disease are implicated in glaucoma risk. For years it has been known that blood pressure is a cause of increasing intraocular pressure (IOP). Obesity has been shown to be an independent risk factor for elevated IOP. Type II Diabetes and glaucoma have a positive association.
Again the protective recommendations are to maintain an ideal body weight, and blood pressure. One way to do this is to exercise. A 1991 study showed that people who exercise regularly 4 times a week for 40 minutes reduced their IOP 4.6mmHg which is very significant. The average IOP is 18mmHg so this is a 25% reduction.
A debatable factor is coffee or caffeine consumption. An unpublished study done by Mary Lynch M.D. in 1988 found that IOP increased 2.55mmHg (14%) in a person without glaucoma after 4 cups of coffee; while a person with glaucoma after only 2 cups of coffee had a 2mmHg (11%) IOP rise. Her study was done against controls that consumed an equal amount of water. This is important because drinking a large volume of any liquid has been shown to cause IOP elevations.
Dr. Mellgren spent time doing an IOP study at Weimar Institute. There people are treated with lifestyle changes which include: exercise, water treatments, avoidance of harmful agents such as tobacco and caffeine, rest, sunshine in moderation, a plant based diet, and avoidance of stress and trust in divine power. She measured the IOP of participants on arrival and after 19 days of the above lifestyle changes. She found an 11% IOP reduction compared to controls who experienced no lifestyle change.
We may not be able to change our genetics but we can have a great impact on our environment. And environmental or lifestyle can have a great effect on us.
Medical references: Ophthalmology/Vol 91, 1984, pp331-314
Am J Ophthalmol/Vol 101, 1986, pp714-721
Br J Ophthalmol/Vol 71, 1987, pp245-314
Br J Ophthalmol/Vol 59, 1975, pp717-720
Arch Ophthalmol/Vol 102, 1984, pp883-887
Invest Ophthalmol Vis Sci/Vol 33, 1992, pp2224-2228
KoreanI J Ophthalmol 2002
Am J Ophthalmol/Vol 113, 2006, pp1081-1086
Diabet Med/Vol 21, 2004, pp609-614
Br J Ophthalmol/Vol 84, 2000, pp1218-1224
Dr. Michael Passo 1991
THOMAS EDISON once said: “The doctor of the future will give no medicine but will interest his patients in the care of the human frame.”
If you are local to the Oceanside area Dr. Mellgren and associates provide lifestyle classes and cooking classes designed to help in the pursuit of better health and happiness. See our list of recipes and our links to lifestyle information.
