The Big 5 for Your Eyes: An Interview with registered dietitian, Elizabeth Somer

Featured in this article: FloraGLO® Lutein

Morning sunlight on spring flowers. Watching a child grow. The look on a loved one’s face when happy. Our eyes let us experience daily miracles and truly are windows to our amazing world.  Yet, we often take vision for granted or assume vision troubles are inevitable as we age. Not true. Ancient hunter-gatherer populations showed little sign of what we now call “diseases of civilization,” including heart disease, diabetes, and vision loss. (1) Recent research suggests there is much we can do to help support our vision throughout life. (2-5)

We interviewed nationally-recognized registered dietitian, Elizabeth Somer, to learn how our diet impacts the health of our eyes.

QFL: How can we protect our eyes throughout the year?

ES: Age is a major risk factor for eye challenges, likely in part due to decades of exposure to UV light, cigarette smoke, and/or diets low in antioxidant-rich foods. These factors might increase oxidative damage to the lens. (6)

Wear sunglasses that block UVA and UVB light and a big floppy hat whenever out in the sun, avoid tobacco smoke, and eat a healthy diet. Those choices significantly reduce this damage. In addition, catch signs of vision problems early. Have your eye doctor check your eyes after dilating them at least once in your 20s, twice in your 30s, and every two to four years between ages 40 and 64, and every one to two years after that.

QFL: Why are carrots good for eye health?

ES: Carrots are a source of beta-carotene, which converts to vitamin A in the body. This vitamin is the building block for a compound in the eyes’ retina, called rhodopsin, which helps us see at night. Vitamin A deficiency can lead to “night blindness.”

All dark orange or dark green fruits and vegetables, from apricots to spinach, supply beta-carotene, so why did carrots get the fame? The most likely story is that during World War II, in an effort to hide their new secret radar technology, the British promoted the rumor that their pilots were successful at night bombing raids because of carrot-rich diets that improved night vision. (7) Posters even touted the benefits of eating carrots to see during citywide blackouts. (7) Whether the rumor was believed by the German Army is questionable, but the myth lives on today for the rest of us.

QFL: What other nutrients support eye health?

ES: Diet plays an important role in overall eye health throughout different stages of life. The Age-Related Eye Disease Study (AREDS) is an on-going investigation sponsored by the National Eye Institute. It has identified nutrients that support retinal and visual function. There are five nutrients that stand out as major players for eye health: the omega-3s EPA and DHA, lutein and zeaxanthin, and the antioxidant vitamin E. (8-10)

The Big 5 for your eyes

• The omega-3 fats EPA and DHA build healthy cells within the eyes. Research suggests these fats help support retinal and visual function. (11-15) These healthy fats might also help slow the evaporation of moisture, which is critical for keeping eyes from feeling scratchy or gritty (11,16,17).
• Lutein and zeaxanthin are antioxidants that support ocular tissue. They also help form the macular pigment in eye tissue and filter blue light that otherwise damages the macula. (18-23)
• Vitamin E is a potent antioxidant that protects cell membranes within the eyes from oxidative damage caused by UV light, tobacco smoke, and other pollutants. Emerging research suggests that vitamin E might help lower the risk for cataracts and macular degeneration. (6,24-27)

QFL: What foods should you eat for your eyes?

ES: Our bodies are one big package. So, it makes sense that foods typical in a Western diet, such as red meat, might harm the heart and brain also might harm the eyes. On the flip side, foods that are heart and brain-friendly, also support vision throughout life. (28-30)

Here are the best eye-protective foods for the Big 5:

• Fatty fish, such as salmon, mackerel, herring, sardines, and anchovies, are the best sources of the omega-3 fats, EPA and DHA. The American Heart Association recommends at least two servings a week, which is a good starting point for healthy eyes, too.
• The best dietary sources of lutein and zeaxanthin are dark green leafy vegetables, such as spinach, chard, collards, and kale. At least a cup of cooked greens a day helps support healthy eyes. (31-34)
• Vitamin E-rich foods include nuts, avocados, and oils, such as wheat germ oil, olive oil, and safflower oil.

QFL: If you don’t eat these foods on a regular basis, how else can you get these nutrients?

ES: Your eyes need a regular supply of these nutrients. On the days when you don’t eat perfectly, consider a supplement. Look for supplements that supply 10 milligrams of lutein, 2 milligrams of zeaxanthin, 100IU to 400IU of vitamin E, and 1000 milligrams of fish oils containing EPA and DHA. (35-37) Several supplements base their formulations on the AREDS 2 research, including those that include FloraGLO® Lutein. Look for reference to that research on the label to ensure a well-formulated supplement.

References

1. London D, Beezhold B: A phytochemical-rich diet may explain the absence of age-related decline in visual acuity of Amazonian hunter-gatherers in Ecuador. Nutrition Research 2015;35:107-117.

2. Cohen S, Mauget-Faysse M, Oubraham H, et al: Impact of eating habits on macular pathology assessed by macular pigment optical density measure. Journal of French Ophthalmology 2010;33:234-240.

3. Marshall L, Roach J: Prevention and treatment of age-related macular degeneration. The Consultant Pharmacists 2013;28:723-737. (E)

4. Pinazo-Duran M, Gomex-Ulla F, Arias L, et al: Do nutritional supplements have a role in age macular degeneration prevention? Journal of Ophthalmology 2014;2014:901686.

5. Rasmussen H, Johnson E: Nutrients for the aging eye. Clinical Interventions in Aging 2013;8:741-748.                                                                                    

6. Barrett J: Focusing on vision through an environmental lens. Environmental Health Perspectives. 2005;113:A822-A827.

7. Smith K:The WWII propaganda campaign popularized the myth that carrots help you see in the dark. Smithsonian.com. http://www.smithsonianmag.com/arts-culture/a-wwii-propaganda-campaign-popularized-the-myth-that-carrots-help-you-see-in-the-dark-28812484/

8. The Age-Related Eye Disease Study 2 Research Group: Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration. Journal of the American Medical Association 2013;309:2005-2015.

9. Chew E, Clemons T, Agron E, et al: Long-term effects of vitamins C and E, beta carotene, and zinc on age-related macular degeneration: AREDS report no. 35. Ophthalmology 2013;120:1604-1611.

10. Vishwanathan R, Chung M, Johnson E: A systematic review on zinc for the prevention and treatment of age-related macular degeneration. Investigative Ophthalmology & Visual Science 2013;54:3985-3998.

11. McCusker M, Durrani K, Payette M, et al: An eye on nutrition: The role of vitamins, essential fatty acids, and antioxidants in age-related macular degeneration, dry eye syndrome, and cataract. Clinical Dermatology 2016;34:276-285.

12. Arnold C, Winter L, Frohlich K, et al: Macular xanthophylls and omega-3 long-chain polyunsaturated fatty acids in age-related macular degeneration. Journal of the American Medical Association: Ophthalmology 2013;March 21:1-9.

13. Dawczynski J, Jentsch S, Schweitzer D, et al: Long term effects of lutein, zeaxanthin and omega-3-LCPUFAs supplementation on optical density of macular pigment in AMD patients: The LUTEGA study. Archives of Clinical and Experimental Ophthalmology 2013;251:2711-2723. (Excellent reference list as well!)

14. Garcia-Layana A, Recalde S, Alaman A, et al: Effects of lutein and docosahexaenoic acid supplementation on macular pigment optical density in a randomized controlled trial. Nutrients 2013;5:543-551.

15. Nguyen C, Bui B, Sinclair A, et al: Dietary omega 3 fatty acids decrease intraocular pressure with age by increasing aqueous outflow. Investigative Ophthalmology & Visual Science2007;48:756-762.

16. Kwon J, Ham S: Omega-3 supplementation can improve both symptoms and signs of dry eye disease. Clinical Interventions in Aging 2017;12:485-486.

17. Mohammadpour M, Mehrabi S, Hassanpoor N, et al:  Effects of adjuvant omega 3 fatty acid supplementation on dry eye syndrome following cataract surgery. Journal of Current Ophthalmology 2016;29:33-38.

18. Aslam T, Delcourt C, Silva R, et al: Micronutrients in age-related macular degeneration. Ophthalmologica 2013;229:75-79.

19. Bovier E, Lewis R, Hammond B: The relationship between lutein and zeaxanthin status and body fat. Nutrients 2013;5:750-575.

20. Johnson E: A possible role of lutein and zeaxanthin in cognitive function in the elderly. American Journal of Clinical Nutrition 2012;96:1161S-1165S.

21. Johnson E, Maras J, Rasmussen H, et al: Intake of lutein and zeaxanthin differ with age, sex, and ethnicity. Journal of the American Dietetic Association 2010;110:1357-1362.      

22. Murray I, Makridaki M, van der Veen R, et al: Lutein supplementation over a one-year period in early AMD might have a mild beneficial effect on visual acuity. Investigative Ophthalmology and Visual Science 2013;54:1781-1788.

23. Loskutova E, Nolan J, Howard A, et al: Macular pigment and its contribution to vision. Nutrients 2013;5:1962-1969.

24. Chew E: Nutrition effects on ocular disease in the aging eye. Investigative Ophthalmology & Visual Science 2013;54:(14):ORSF42-7.

25. Cui Y, Jing C, Pan H: Association of blood antioxidants and vitamins with risk of age-related cataract. American Journal of Clinical Nutrition 2013;July 10th.

26. Zhang Y, Jiang W, Xie Z, et al: Vitamin E and risk of age-related cataracts. Public Health Nutrition 2015;18:2804-2814.

27. Cui Y, Jing C, Pan H: Association of blood antioxidants ad vitamins with risk of age-related cataract. American Journal of Clinical Nutrition 2013;98:778-786.

28. The long-term health of vegetarians and vegans. Proceedings of the Nutrition Society 2016;75:287-293.

29. Theodoropoulou S, Samoli E, Theodossiadis P, et al: Diet and cataracts: A case-control study. International Ophthalmology 2014;34:59-68.

30. Tavani A, Negri E, La Vecchia C: Food and nutrient intake and risk of cataract. Annals of Epidemiology 1996;6:41-46.

31. Johnson E, McDonald K, Caldarella S, et al: Cognitive findings of an exploratory trial of docosahexaenoic acid and lutein supplementation in older women. Nutritional Neuroscience 2008;11:75-83.                 

32. Johnson E, Vishwanathan R, Johnson M, et al: Relationship between serum and brain carotenoids, alpha tocopherol, and retinol concentrations and cognitive performance in the oldest old from the Georgia Centenarian Study. Journal of Aging Research 2013;2013:951786.

33. Pastor-Valero M: Fruit and vegetable intake and vitamins C and E are associated with a reduced prevalence of cataracts in a Spanish Mediterranean population. BMC Ophthalmology 2013;13:52. http://www.ncbi.nlm.nih.gov/pubmed/24106773               

34. Vishwanathan R, Iannaccone A, Scott T, et al: Macular pigment optimal density is related to cognitive function in older people. Age and Ageing 2014;January 15th.

35. https://www.macular.org/nutritional-supplements-article?gclid=COm9hYuUhNQCFchefgodWXML0w

36. Manikandan R, Thiagarajan R, Goutham G, et al:  Zeaxanthin and health, from bench to bedside. Fitoterapia 2016;109:58-66.

37. Chiu C, Change M, Zhang F, et al: The relationship of major American dietary patterns to age-related macular degeneration. American Journal of Ophthalmology 2014;158:118-127.