BLOG: What to tell patients with glaucoma about their diet
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One of the most common questions I get asked by my patients with glaucoma is, “Doc, what else can I do to help my disease and prevent blindness?”
The traditional and conservative answer to that question would involve reiterating the importance of medication adherence and scheduled office visits and reassurance that with today’s innovative and efficacious therapies, we are often successful in preventing glaucomatous vision loss. These are the cornerstones of our counseling regimen, but it turns out that dietary factors may modify the course of glaucomatous disease and also deserve mention and recommendation to our patients. Dietary recommendations for patients with glaucoma are evidence based and also empower patients with respect to their disease process.
The power of flavonoids
Flavonoids are ubiquitous plant chemicals that give fruits and vegetables their beautiful bright colors (Figure). In nature, plant colors attributed to flavonoids attract insects in order to allow for pollination. In the human diet, flavonoids are powerful antioxidants that have been shown to have neuroprotective effects. Top sources of dietary flavonoids include berries, green tea, dark chocolate, onions and peppers.
What’s the evidence?
Although large population-based studies have suggested a link between dietary consumption of flavonoids and decreased glaucoma risk, the most convincing study to show the potential for disease modification comes from a meta-analysis by Patel and colleagues. Importantly, this analysis investigated visual field mean deviation as the primary outcome to be associated with dietary flavonoid consumption. Results of the meta-analysis showed that dietary flavonoid consumption was associated with not only maintenance of visual field mean deviation but also an improvement. And, to give hope to our patients with advanced glaucoma, individuals with worse visual field scores at baseline had the greatest benefit. These effects were not related to any improvement in IOP and are attributed to the role that flavonoids play against oxidative stress in retinal ganglion cells.
Counseling our patients
Counseling our patients with regards to the likely beneficial effects of dietary consumption of flavonoids may not only modify their glaucomatous disease process, but flavonoids are also beneficial for general cardiovascular and neurologic health. Furthermore, dietary recommendations empower our patients and may be used as a motivational tool in conjunction with proven IOP-lowering therapies.
Reference:
- Patel S, et al. Graefes Arch Clin Exp Ophthalmol. 2015;doi:10.1007/s00417-015-3168-y.
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