In spite of increasing evidence that diet has a major effect on our eye health, a substantial number of people have yet to be convinced, according to research carried out for Ocuvite®, a specially designed eye vitamin & mineral food supplement from Bausch+ Lomb.
One in six think diet has no effect, and almost one in three are unsure. However, a small majority (51.6%) recognise it does play a significant role in ocular health.
Vitamins C and E, zinc, lutein, zeaxanthin, and omega-3 fatty acids DHA and EPA are good for eye health as well as general health. But, only 8% of women and 14% of men who took part in the One Poll survey1 make a conscious effort to eat things known to be good for their eye health.
And only one in 12 believe a regular multi-vitamin provides all the nutrients necessary for optimum eye health. The vast majority, more than two in three, (70.8%) think it does not or are unsure.
Scarily, one in 12 women and one in seven men do not believe any foodstuff can make a difference to the health of their eyes.
Only a tiny minority – 4.6% of women 7.3% of men – had been taught by their mothers which foods were good for eye health. More than half the women and 42.8% of the men said the subject had never been discussed.
However, more than half the women and almost half of the men knew that carrots, a rich source of Vitamin A, and that green leafy vegetables containing Vitamin C are good for eye health. And two out of five recognised that oily fish contributes to good eye health.
“What we eat today can affect our health in the longer term,” says Dr Emma Derbyshire, a leading nutritionist and member of the eye care advisory panel WINK. “From a young age children need to be encouraged to value their eyes and taught how to prevent them from deteriorating by eating a diet rich in nutrients beneficial to the eyes.
“It is particularly important that the role diet plays in the health of our eyes is discussed in the home. This is especially important today when our eyes are increasingly exposed to technology.”
So what vitamins and minerals are important for supporting eye health?
Vitamin C and E
Tissues of the eye are vulnerable to oxidative stress, a process where there is an imbalance between the production of reactive oxygen species (free radicals) and antioxidant defence systems which are naturally present in the eye.
As ageing itself also places demands on these antioxidant systems this can leave tissues of the eye vulnerable to damage as we get older.4
Subsequently, increasing intakes of nutrients such as vitamin C (ascorbic acid) and E may help to counteract some of these effects.
Laboratory studies showed that a combination of vitamins C and E can help to prevent corneal endothelial cells undergoing lipid peroxidation, free-radical damage and cell death.
This suggests that the combined effects of vitamins C and E could help to prevent corneal cells from ageing, possibly helping to maintain quality of vision. Equally, another study showed that a diet deficient in vitamin E led to increased lipid peroxidation in the retina in addition to accelerated retina damage, particularly with age.5
This indicates that vitamin E may play a role in retaining the health of the retina; a layer of light-sensitive cells at the back of the eye that are important for sight.
Further research found that vitamin E taken in oral tocopherol form can help to protect against ultraviolet radiation-induced cataract; clouding of the lens leading to impaired vision. This is important given that after the skin, the eye is most vulnerable to sunlight, with the lens playing a key role in absorbing ultra-violet radiation.
Research from the Journal of the American College of Nutrition also reports how Zinc is essential for cell metabolism and is present in high levels in eye tissue, especially in the retina and choroid (vascular layer of the eyeball) which is why it is included in Ocuvite® Complete.
Several epidemiological studies have looked at associations between zinc intakes and markers of eye health.
For example, findings from the Age-Related Eye Disease study (AREDS) found that adults (n=534) with advanced AMD and cataract receiving zinc supplements (80 mg zinc oxide) over 6.5 years had lower mortality and eye care rates than those not taking zinc.
The Australian Blue Mountains Eye Study did not find any associations between vitamin and zinc supplement use and early age-related maculopathy (ARM) – this is the early stages of AMD where large whitish-yellow deposits (soft drusen) are found in the macula. Neither did the U.S. Beaver Dam Study when looking at zinc supplementation and incidence of early ARM, possibly because of limitations in study design, or the fact that the number of cases in the study was not high enough to detect significant findings. The European Food Safety Authority has approved the claim that “zinc contributes to the maintenance of normal vision”.
Omega-3 fatty acids
A growing amount of evidence has also looked at the effects of omega-3 fatty acids (e.g., eicosapentaenoic acid; EPA and docosahexaenoic acid; DHA) in relation to eye health. For example, the Nutritional AMD Treatment 2 Study comprised of 290 patients with ‘wet’ AMD (when abnormal blood vessels form in the eye) found that oily fish intakes were lower in AMD cases than controls. Also, higher red blood cell EPA and EPA + DHA levels (essential omega-3 fatty acids needed to support the function of the retina) were associated with a significantly reduced risk of wet AMD.
The German LUTEGA study recruited patients with ‘dry’ AMD (when the macula degenerates with time) randomising these to take lutein, zeaxanthin, 100 mg DHA + 30 mg EPA once or twice daily. After 1 month antioxidant levels and optical density of the macular pigment improved in all groups, indicating that the progression of AMD was reduced. Both wet and dry AMD can lead to the deterioration of the central vision needed for reading, driving, identifying faces and doing fine, detailed work, reducing life quality.
Another randomised controlled trial recruiting 64 patients (45 to 90 years) with dry eye to take two capsules of omega-3 fatty acids containing 180 mg EPA + 120 mg DHA per capsule for 30 days showed reduced rates of tear evaporation, improved tear secretion and significant improvements in dry eye symptoms.
Finally, a 90-day study comprised of 74 healthy adults aged 45 to 77 years receiving 1000 mg tuna oil (providing 252mg DHA, 60mg EPA and 10mg vitamin E), showed this significantly improved plasma DHA levels and amongst those with corrected vision, right eye visual acuity improved when compared with the placebo.
Lutein and Zeaxanthin
Carotenoids such as lutein and zeaxanthin also have a key role to play in helping to maintain vision, often working in synergy with other eye nutrients. One of their main roles is to scavenge free radicals,19 helping to support normal vision. A Chinese study on 37 adults (22 to 30 years) using long-term computer display light exposure found that 12-week supplementation with 12mg lutein daily led to improvements in visual function.
Findings from the previously mentioned AREDS (Part 2) study also found that supplementation with 10mg lutein and 2mg zeaxanthin could be a better alternative to using beta-carotene when intending to slow AMD progression.
In line with these research findings Ocuvite® Complete contains 10mg lutein and 2mg zeaxanthin. Finally, a Randomised Control Trial of 44 AMD patients taking both lutein (12mg) and DHA (280mg) daily for up to one year found that this significantly improved macular pigment ocular density; a risk factor for AMD when compared with the placebo group.
Developed by leading eye care specialists, Bausch + Lomb, who have over 160 years of eye care expertise, the Ocuvite® range has specifically designed unique formulations to help maintain the health of our eyes. There are two products in the range which are available from Boots stores nationwide as well as independent pharmacies and opticians:
Ocuvite® Complete – £14.95
Ocuvite® Lutein – £8.99
Ingredients from premium suppliers to guarantee optimal quality
contains nutrients important for the health of the eyes and maintenance of normal vision
DHA (docosahexaenoic acid) –contributes to normal vision
Zinc – contributes to the protection of cells from oxidative stress and contributes to the maintenance of normal vision
Vitamin C – contributes to reduction of tiredness and fatigue
Vitamin E – contributes to the protection of cells from oxidative damage
Lutein and zeaxanthin – components of the macula at the back of the eye
The Lutein in Ocuvite® Complete is derived from marigold flowers