Can nutrition help to protect our eyes as we age?
By: Dr. Manfred Eggersdorfer, Senior Vice President, Nutrition Science & Advocacy at DSM and Professor for Healthy Aging at University Medical Center Groningen
Nutritional support for healthy vision
- As the life expectancy of the world’s population continues to rapidly rise, so does the prevalence of age-related diseases and conditions that can affect eye health and quality of life, such as age-related macular degeneration (AMD)
- Visual health has been identified as the top health concern for consumers across the globe, and during Workplace Eye Wellness Month the spotlight is on ways to better protect eye health in the workplace and, as a consequence, minimize visual impairment in later life
- Blue light exposure, from digital devices such as smartphones and computer screens, from a young age can further increase the risk of ocular damage in older adults
- There is a growing body of scientific evidence, backed by European Union (EU) health claims, supporting the role of micronutrients such as lutein, zeaxanthin and omega-3 fatty acids in eye health in older populations when part of a long-term eye health support strategy
Eye health in later life can be influenced by a variety of factors
March is Workplace Eye Wellness Month, which provides a valuable opportunity to consider the impact our lifestyles and day-to-day activities can have on eye health throughout life. With daily consumption of digital technology increasingly widespread across the globe, particularly in office environments, chronic eye problems and injuries are no longer restricted to those in dangerous or labor-intensive careers. Indeed, there is a growing body of evidence to suggest that long-term, prolonged exposure to blue light from sunlight and digital devices, such as computers, tablets and smartphones, may contribute to an increased risk of visual impairment in later life.
An increasing global challenge for health care systems
Eye health continues to be both a challenge and a concern for individuals and healthcare services across the globe. In fact, a DSM survey revealed that eye health is the main health worry for adults worldwide, with 70% of respondents expressing concern for their visual health ahead of other issues such as weight and energy levels.1 In addition to the implications of visual impairment on daily life for individuals, it can also place significant economic strain on societies worldwide, with this burden expected to increase further as the life expectancy of the world’s population continues to skyrocket.
While some factors influencing poor eye health, such as smoking, prolonged exposure to blue light wavelengths (particularly when exposure is from a young age) and high blood pressure, are modifiable and can be addressed as part of a preventative approach, others, like aging and genetics, are nonmodifiable and, therefore, significantly harder to manage and control. Although no longer an inevitable consequence of aging, thanks to medical and scientific advances, it is essential that long-term, preventative measures continue to be put in place in order to protect the visual health of an increasingly aging population. With the number of people aged 60 and above expected to double to two billion by 2050, the time is now for healthcare systems and practitioners the world over to take the necessary steps to address the growing concern.2
Aging and the impact on eye health
Visual impairment can impact people at all stages of life, but it is most prevalent in the elderly generation, with figures estimating that 82% of people living with blindness are aged 50 years and above.3 The number of older individuals with poor vision is expected to rise even further due to the rapidly aging population, thanks to the growing prevalence of conditions such as diabetes and the increased incidence of age-related ocular conditions like cataracts and AMD.
AMD is a progressive eye disease, and is the main cause of blindness in people aged over 50 years. Reports suggest that, due to increases in life expectancy, the prominence of this condition will grow, with figures expected to reach 5.44 million by 2050.4 Other leading causes of visual impairment in later life include:
- Macular pigment (MP) loss, which can contribute to a reduction in visual acuity
- Cataracts, an ocular condition known to reduce quality of vision by clouding the lens of the eye
- Long-term blue light exposure from digital devices, which can destroy photoreceptors and adversely affect the ocular lens when absorbed, particularly with increasing age
- Dry eye syndrome, a common, complex condition that reduces ocular comfort and visual performance
Nutrition as an adjunct to eye health
While significant advances have been made in the management and treatment of conditions contributing to visual impairment – through more frequent and effective ocular examination, for instance – it is clear that damage and degeneration could be reduced further through the implementation of a long-term, preventative strategy. Indeed, emerging evidence is highlighting the scientific potential of nutrition in protecting eye health throughout life. As such, the opportunities presented by a healthier diet and increased micronutrient intake during adulthood and later life have been at the center of increased attention from the medical and scientific community.
Take lutein as an example – a nutrient only accessible through dietary sources, lutein is a carotenoid that is considered to be one of the main nutrients in the prevention of AMD, particularly when combined with zeaxanthin. Although further research is still required, the Age-Related Eye Disease Study 2 (AREDS2) – currently the largest human study on nutritional supplements related to eye health – found that intake of these two carotenoids led to an 18% reduction in the risk of progression to advanced AMD over a five-year period. 5 Benefits in cataract risk reduction and improved visual performance have also been observed.6,7
There is also evidence suggesting that omega-3 fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may be effective in the management of dry eye syndrome, while early findings indicate that vitamins C and E and beta-carotene may help to reduce the risk factors associated with cataracts.8,9
Health claims in the EU
There are a number of authorized health claims in the EU that substantiate the scientific evidence for nutrients in eye health, including:
- Normal health population (Article 13.1)
- DHA contributes to the maintenance of normal vision
- Riboflavin contributes to the maintenance of normal vision
- Vitamin A contributes to the maintenance of normal vision
- Zinc contributes to the maintenance of normal vision
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vision: nutritional solutions to improve eye health across the life
 DSM, ‘Global health concerns’, [report], 2017.
 WHO, ‘Ageing and life course’, [website], 2018, http://www.who.int/ageing/about/facts/en/, (accessed 6 March 2018).
 WHO, ‘Visual impairment and blindness’, [website], 2017, http://www.who.int/mediacentre/factsheets/fs282/en/, (accessed 6 March 2018).
 National Eye Institute, ‘Age-related macular degeneration (AMD)’, [website], https://nei.nih.gov/health/maculardegen (accessed 5 March 2018).
 E. Chew et al., ‘The age-related disease study 2 (AREDS2): study design and baseline characteristics (AREDS2) report number 1,’ Opthamology, vol. 119, no. 11, 2012, p. 2282-2289.
 G. Weigert et al., ‘Effects of lutein supplementation on macular pigment optical density and visual acuity in patients with age-related macular degeneration’, Invest Opthalmol Vis Sci., vol. 52, no. 11, 2011, p. 8174-8178.
 A. Liu and J. Ji, ‘Omega-3 essential fatty acids therapy for dry eye syndrome: a meta-analysis of randomized controlled studies’, Med Sci Monit, vol. 20, no. 6, 2014, p. 1583-1589.
 L. Chylack et al., ‘The Roche European American Cataract Trial (REACT): a randomized clinical trial to investigate the efficacy of an oral antioxidant micronutrient mixture to slow progression of age-related cataract’, Opthalmic Epidemol, vol. 9, no. 1, 2002, p. 49-80.
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