- lifestyle report
TFOS Lifestyle: Impact of nutrition on the ocular surface
Maria Markoulli a,*, Sumayya Ahmad b, Jayashree Arcot c, Reiko Arita d, Jose Benitez-del-Castillo e, Barbara Caffery f, Laura E. Downie g, Katie Edwards h, Judith Flanagan a,i, Marc Labetoulle j,k, Stuti L. Misra l, Malgorzata Mrugacz m, Sumeer Singh g, John Sheppard n,o, Jelle Vehof p,q,r, Piera Versura s,t, Mark D.P. Willcox a, Jillian Ziemanski u, James S. Wolffsohn v
a School of Optometry and Vision Science, UNSW Sydney, NSW, Australia, b Icahn School of Medicine of Mt. Sinai, New York, NY, USA, c Food and Health, School of Chemical Engineering, UNSW Sydney, Australia, d Department of Ophthalmology, Itoh Clinic, Saitama, Japan, e Universidad Complutense, Hospital Clinico San Carlos, Clinica Rementeria, Madrid, Spain, f Toronto Eye Care, Toronto, Ontario, Canada, g Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia, h School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia, i Vision CRC, USA, j Ophthalmology Department, Hospital Bicˆetre, APHP, Paris-Saclay University, Le Kremlin-Bicˆetre, France, k IDMIT (CEA-Paris Saclay-Inserm U1184), Fontenay-aux-Roses, France, l Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand, m Medical University of Bia?ystok, Bia?ystok, Poland, n Virginia Eye Consultants, Norfolk, VA, USA, o Eastern Virginia Medical School, Norfolk, VA, USA, p Departments of Ophthalmology and Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands, q Section of Ophthalmology, School of Life Course Sciences, King’s College London, London, UK, r Department of Ophthalmology, Vestfold Hospital Trust, Tønsberg, Norway
s Cornea and Ocular Surface Analysis – Translation Research Laboratory, Ophthalmology Unit, DIMEC Alma Mater Studiorum Universit`a di Bologna, Italy, t IRCCS AOU di Bologna Policlinico di Sant’Orsola, Bologna, Italy, u School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA, v College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK
ARTICLE INFO
Keywords:
Diabetes
Diet
Dry eye disease
Food restriction
Gut microbiome
Keratitis
Lifestyle
Mediterranean diet
Ocular surface
Systematic review
ABSTRACT
Nutrients, required by human bodies to perform life-sustaining functions, are obtained from the diet. They are broadly classified into macronutrients (carbohydrates, lipids, and proteins), micronutrients (vitamins and minerals) and water. All nutrients serve as a source of energy, provide structural support to the body and/or regulate the chemical processes of the body. Food and drinks also consist of non-nutrients that may be beneficial (e.g., antioxidants) or harmful (e.g., dyes or preservatives added to processed foods) to the body and the ocular surface. There is also a complex interplay between systemic disorders and an individual’s nutritional status. Changes in the gut microbiome may lead to alterations at the ocular surface. Poor nutrition may exacerbate select systemic conditions. Similarly, certain systemic conditions may affect the uptake, processing and distribution of nutrients by the body. These disorders may lead to deficiencies in micro- and macro-nutrients that are important in maintaining ocular surface health. Medications used to treat these conditions may also cause ocular surface changes. The prevalence of nutrition-related chronic diseases is climbing worldwide. This report sought to review the evidence supporting the impact of nutrition on the ocular surface, either directly or as a consequence of the chronic diseases that result. To address a key question, a systematic review investigated the effects of intentional food restriction on ocular surface health; of the 25 included studies, most investigated Ramadan fasting (56%), followed by bariatric surgery (16%), anorexia nervosa (16%), but none were judged to be of high quality, with no randomized-controlled trials.
read full article