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In the news: MIND Diet Lowers Glaucoma Risk; Riboflavin Deficit in Keratoconus

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MIND Diet Linked to Lower Glaucoma Risk

Not long ago, the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet was developed as a strategy to promote healthy cognitive aging and neuroprotection. It’s a combination of the “Med” diet and the DASH diet (Dietary Approaches to Stop Hypertension). The MIND diet has recently been associated with a reduced incidence of Alzheimer’s and slower cognitive decline in several large-scale studies.

The MIND diet incorporates many individual dietary components that have been linked to a lower IOP level (green leafy vegetables) and to lower glaucoma incidence: produce with antioxidants and flavonoids which are anti-inflammatory and neuroprotective. One third to one half of eyes with glaucoma have no elevated IOP, suggesting that neurodegeneration is an important contributor to the disease.

The authors of a new study(1) also point out that the eye and brain have a shared embryonic origin, and that glaucoma and Alzheimer’s share multiple common biochemical and pathological changes. Taken together, these factors led the authors to assess the association between adherence to the MIND diet, the Med diet, the Dutch dietary guidelines and incidence of open angle glaucoma (iOAG).

The study evaluated participants in the Rotterdam Study, who were followed since 1991 at 5-year intervals for iOAG. One hundred seventy participants developed glaucoma during follow-up.

Greater adherence to the MIND diet was associated with a 20% lower risk of iOAG for each 10% increase in adherence. A higher intake of green leafy vegetables, berries and fish tended to be protective for iOAG. No significant associations were seen with the Med diet or the Dutch guidelines and iOAG.

Since none of the three examined diets were linked to IOP, this diet may be particularly relevant for protection against neurodegeneration in the eye.

Low Riboflavin a Keratoconus Risk Factor?

Keratoconus (KC) is a degenerative disorder of the eye in which structural changes within the cornea cause it to thin and change to a more conical shape than its normal gradual-curved shape.

Studies are ongoing to learn more about how certain metabolic, genetic, and environmental factors might affect the development of KC. One research team recently compared blood levels of vitamin D, vitamin B12, riboflavin, homocysteine, folic acid and arginine in KC patients with progressive and non-progressive disease with normal controls.

Noting that every substance could directly or indirectly play a role in KC development, they found that only vitamin D levels were significantly lower in both KC groups vs. controls. Decreased vitamin D levels significantly increased nonprogressive KC probability 1.23 times and progressive KC probability 1.29 times more than the control group (P = 0.002, P= 0.001, respectively).

In a newly published prospective study(2), a second research team compared blood levels of B12, folic acid riboflavin and homocysteine in 100 KC patients vs. 200 healthy controls. They found that the mean riboflavin level in the KC group (84 +-21/8 g/L) was significantly lower than in the healthy group (183.6 +-&4.3 g/L), P <0.001.

Low levels of riboflavin, an essential part of two coenzymes that play major roles in energy production, cellular function, growth and development, may be a possible risk factor in the pathogenesis of KC according to the authors. Longitudinal studies are needed and warranted to further explore whether low levels of vitamin D and/or riboflavin contribute to the progression of KC.

References

1. Vergroesen JE, et al. MIND diet lowers risk of open-angle glaucoma: The Rotterdam Study. Eur J Nutr. 62:477-87, 2023.
2. Sozer O, et al. Comparison of blood levels of vitamin B12, folic acid (B9), riboflavin (B2), and homocysteine in keratoconus and healthy subjects. J Catract Refact Surg. Epub Feb 2, 2023.