Reduction in Prevalence of Nuclear Cataract Associated With Adherence to US Dietary Guidelines, an Ancillary Study of the Women’s Health Initiative

Abstract

Purpose: : We examined the association between adherence to the US 1995 Dietary Guidelines and prevalence of nuclear cataract.

Methods: : Women ages 53-86 who participated in the Women’s Health Initiative Observational Study (WHI-OS) cohorts in Portland, OR, Iowa City, IA, and Madison, WI were invited to participate in the Carotenoids in Age-Related Eye Disease Study if their intake in 1994-1997 was above the 78^th and below the 28^th percentile for lutein and zeaxanthin (n=1802). Adherence to US 1995 Dietary Guidelines was estimated by Healthy Eating Index scores adapted to the food frequency questionnaire by the Fred Hutchinson Cancer Research Center and given at baseline entry to the WHI-OS (1994-1998). Nuclear sclerosis (NS) was assessed by slit-lamp photography in CAREDS study visits in 2001-2004. Nuclear cataract, defined as NS severity > 4 (CAREDS scale) or history of cataract extraction in worse eye, was present in 733 women.

Results: : Women who ate healthier diets in 1994-1998 as measured by the HEI score had reduced prevalence of nuclear cataract (age-adjusted odds ratio [OR], 95% Confidence Interval [CI]) for Quantile 5 vs. 1 (0.5, 0.4-0.7) . This association remained significant after adjustment for age, smoking status, iris pigmentation, physical activity, use of a multivitamin, hormone use status, pulse pressure, and body mass index (OR, 95%CI: 0.6, 0.4-0.8). Adjustment for dietary lutein intake group attenuated but did not fully explain this association (OR, 95%CI: 0.6, 0.4-0.9). Odds for nuclear cataract reduced 28% among women in quintiles 2 vs. 1, and remained relatively stable among quintiles 2-5.

Conclusions: : Adherence to the broad US 1995 Dietary Guidelines was associated with reduced risk for nuclear cataract even in this relatively healthy and homogeneous sample of women and is therefore likely to lower risk for cataract in the broader general population.

Clinical Trial: : www.clinicaltrials.gov NCT00000611

Keywords: cataract • clinical (human) or epidemiologic studies: prevalence/incidence • nutritional factors