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J. S. Tan, J. Wang, V. Flood, S. Kaushik, J. C. Brand-Miller, A. Barclay, P. Mitchell, Blue Mountains Eye Study; Carbohydrate Nutrition, Particularly Glycemic Index of Foods Consumed, and the 10-Year Incidence of Cataract. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5456.
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While dietary carbohydrates are thought to play a role in cataractogenesis, few studies have examined links between carbohydrate nutrition and cataract. Glycemic index measures the blood glucose response to a food compared with 50 grams of glucose. Glycemic load is the product of a food’s glycemic index and its total available carbohydrate content. It generally represents an indication of both quantity and quality of carbohydrate consumed. We investigated the relationship between dietary glycemic index, glycemic load, carbohydrate & the 10-year incidence of cataract in the Blue Mountains Eye Study.
Of 3654 baseline participants aged 49+years (1992-4), 2406 were seen after 5- and/or 10-years and had photographs taken to assess incident cataract using the Wisconsin System. At each visit, participants completed a detailed food frequency questionnaire. Glycemic index was calculated from a customised database of Australian foods. Glycemic index, glycemic load, and all other nutrients were energy-adjusted. Risk ratios (RR) and 95% confidence intervals (CI) were calculated using discrete logistic models. The outcome measures were incident nuclear, cortical and posterior subcapsular cataract or cataract surgery.
The mean glycemic index of foods consumed at baseline was 57 (standard deviation, SD, 5) and the mean glycemic load was 133 (SD 4). After controlling for age, gender, diabetes, and hypertension, participants in the highest decile of glycemic index, compared to the remaining population, were more likely to develop incident cortical cataract (RR, 1.50, CI, 1.01-2.23). After adjustment for age, sex, diabetes and other factors, higher carbohydrate consumption predicted cataract surgery (RR per SD increase, 1.16; CI, 1.02-1.33). These findings were similar after excluding participants with diabetes, although the association between glycemic index and cortical cataract was attenuated (RR, 1.42, CI, 0.94-2.15). Higher glycemic load predicted cataract surgery after excluding participants with diabetes (per SD increase, RR 1.15; CI, 1.01-1.32).
In an Australian cohort, poorer dietary carbohydrate quality, measured by high glycemic index, predicted incident cortical cataract, and both higher carbohydrate quantity and glycemic load were associated with incident cataract surgery.
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