Ocular Nutrition

A review, analysis, and discussion of the status of ocular nutrition, supplementation, and recommendations for optimum eye health and function

*Any addition to your diet, whether vitamin, mineral, and/or supplement, should only be done after a consultation with and an evaluation by your family physician with respect to your general health, any medications you are currently taking, and any systemic problems that you may have.

Vitamin

A vitamin is an organic compound required as a nutrient in tiny amounts by an organism. A compound is called a vitamin when it cannot be synthesized in sufficient quantities by an organism, and must be obtained from the diet. (Modified from Wikipedia)

Nutraceutical

Nutraceutical, is a food or product that provides health and medical benefits, including the prevention and treatment of disease. Such products may range from isolated nutrients,and specific diets to genetically engineered foods, herbal products, and processed foods such as cereals, soups, and beverages. Another definition: * Nutraceutical foods are not subject to the same testing and regulations as pharmaceutical drugs. (Modified from Wikipedia)

Carotenoids

Carotenoids are organic pigments that are naturally occurring in plants and some other organisms like algae, some types of fungus and some bacteria. There are over 600 known carotenoids; they are split into two classes, xanthophylls and carotenes. Carotenoids in general absorb blue light In humans, carotenoids have vitamin A activity (meaning they can be converted to retinal), and carotenoids can also act as antioxidants. (Modified from Wikipedia)

Minerals

Dietary minerals are the actual chemical elements required by living organisms, except for carbon, hydrogen, nitrogen and oxygen found in organic molecules. There are considered to be about 16 necessary dietary minerals.

Essential Fatty Acids

Are essential fats that can not be made in the body and must be obtained through supplementation or diet.

Proteins

The most essential nutrient for the human body

• Complete Proteins: (generally animal proteins) beef, chicken, fish and soybeans.
• Incomplete Proteins: (generally plant proteins) beans, peas, nuts, seeds and grains.

Fats

Provide the most concentrated source of energy of all food groups

• Saturated: Present in animal products, such as beef and tropical oils, such as coconut and palm (generally a solid at room temperature)
• Trans-fats:Hydrogenated vegetable oils, corn or soybean (hydrogenation prolongs self life) can be soft as in some margarines.
• Unsaturated fats: Present in vegetables, such as corn and grains (rice,barley, bran). Often liquid at room temperature, but susceptible to oxidation with heat and high temperatures.
• Mono unsaturated fats: Present in nut and vegetable oils. Olive, peanut, avocado and canola.

Carbohydrates

• Provide energy to the body, particularly the brain and nervous system.
• Complete: Whole grains, such as bran. Vegetables, such as potatoes.
• Simple or Refined: Found in most fruits as a fructose and galactose form, and some vegetables as a maltose form.
• Selecting Nutritional Supplements

USP

USP:(verified standards have been set for products) The United States Pharmacopoeia (USP) is a non–governmental, official public standards–setting authority for prescription and over–the–counter medicines and other health care products manufactured or sold in the United States. USP also sets widely recognized standards for food ingredients and dietary supplements. USP sets standards for the quality, purity, strength, and consistency of these products–critical to the public health

If USP marked:

• The product contains the ingredients listed on label and in declared potency and amount
• The product does not contain harmful levels of specified contaminants
• The product will break down and release into the body in a specified amount of time
• The product has been made according to FDA's defined goods manufacturing process.

American Optometric Associations Recommendations for a Healthy Diet that maintains and improves Ocular Health

Vitamin E

Vitamin E is an antioxidant found vegetable oils, such as safflower or corn oil, almonds, pecans, sweet potatoes, fortified cereals, and sunflower seeds. The recommended dietary allowance for Vitamin E is 22.5 IU/day from natural sources for both males and females. Science suggests the daily intake for eye health is 400 IU/day.

Benefits of Vitamin E to eye health

• Promotes the health of cell membranes and DNA repair
• Plays a significant role in our immune system
• Evidence suggests Vitamin E with other essential nutrients can slow the progression of AMD by 25% and visual acuity loss by 19%
• Intakes of lutein, zeaxanthin and Vitamin E have been shown to significantly decrease the risks of cataracts.

Foods with Vitamin E

Food	Amount	Mg
Cereal, Wheat Germ	1 Cup	27
Almonds	1 oz.(23 nuts)	11
Sunflower Seeds	1 oz.	11
Hazelnuts	1 oz. (21 nuts)	6.4
Peanut Butter (Creamy)	2 Tbsp.	4.3
Peanuts	1 oz. (23 nuts)	3.6
Peanut Butter (Chunky)	2 Tbs.	3
Sweet Potato (Baked)	1 (Medium)	1.2

Vitamin C

Vitamin C (Asorbic Acid) is an antioxidant found in fruits and vegetables, including oranges, grapefruit, strawberries, papaya, green peppers and tomatoes. Virtually all cells of the body depend on Vitamin C. The RDA for Vitamin C is 90 mg/day for males and 75 mg/day for females. Science suggests the daily intake for eye health is 500 mg.

• Benefits to of Vitamin C to Eye Health:
• Helps promote healthy capillaries, cartilage and iron absorption.
• Supports the health of ocular blood vessels
• Evidence suggests Vitamin C lower the risk of developing cataracts and when taken in combination with  other essential nutrients can slow the progression of AMD by 25% and visual acuity loss by 19%
• *Studies show women taking a daily Vitamin C supplement for ten years or more experienced a 64% reduction in the risk to develop nuclear cataracts.

Foods with Vitamin C

Food	Serving	Mg
Orange Juice	1 Cup	124
Grapefruit Juice	1 Cup	93.9
Orange	1 (medium)	69.7
Spinach (Cooked)	1 Cup	17.6
Tomato (Raw)	1 (medium)	15.6
Banana	1 (medium)	10.3
Apple	1 (medium)	8.4
Peach	1(medium)	9.

Lutein and Zeaxanthin

Are important nutrients naturally found together in colorful fruits and vegetables such as broccoli, spinach, kale, corn, green beans, peas, oranges and tangerines. Through diet and supplementation these nutrients are deposited in various tissues of the eye, including the macula, retina and lens. Lutein and Zeaxanthin are not created in our bodies, so to fulfill the needs of our body we must get them through diet or supplements. While there is no daily recommended daily intake for Lutein and Zeaxanthin, many studies show a health benefit for Luetin supplementation at 10 mg/day and Zeaxanthin at 2 mg/day. Both have been shown to reduce the risk of age-related eye diseases, like AMD and cataracts.

Benefits to Eye Health

• Both nutrients act as antioxidants, helping to protect and maintain healthy cells
• They filter harmful high-energy blue wavelengths of light that can damage cells.
• Studies show that lutein and zeaxanthin supplementation can significantly increase
• MPOD levels in the eye. Individuals with higher MPOD levels have a greater tolerance for the intensity of glaring light and recover more quickly from glare.
• Research findings demonstrate that higher levels of MPOD help increase visual range
• and visual performance.

Foods with Lutein/Zexxanthin

Food	Serving	Mg
Kale (Cooked)	1 Cup	23.8
Spinach (Cooked)	1 Cup	20.4
Collards (Cooked)	1 Cup	14.6
Turnip Greens (Cooked)	1 Cup	12.2
Spinach (Raw)	1 Cup	3.8
Corn (Canned or Cooked)	1 Cup	2.2
Green Peas (Cooked)	1 Cup	2.2
Broccoli (Cooked)	1 Cup	1.6
Romaine Lettuce (Raw)	1 Cup	1.3
Green Beans (Cooked)	1 Cup	0.8
Eggs	2 (Large)	0.3
Orange	1 (Medium)	0.2

Minerals

Zinc is an essential trace mineral or “helper molecule”. Zinc is vital to bringing vitamin A from the liver to the retina in order to produce melanin, a protective retinal pigment. Zinc is found in oysters, seafood, meat, eggs, black eyed peas, tofu, red meat, poultry, liver, shellfish, milk, baked beans, and whole grains and wheat germ. RDA for zinc is 11 mg per day for men and 8 mg for women. with the safe upper limit set at 40 mg per day. Daily intake of 40-80 mg zinc dosage is for people diagnosed as being at high risk for AMD or experiencing early-stage AMD. *Also zinc supplementation has been know to interfere with copper absorption, so 2 mg/day of copper is strongly recommended for people supplementing their diet with zinc.

Foods with Zinc

Food	Serving	Mg.
Oysters (Raw)	6 (Medium)	76.3
Beef (Cooked)	3 Oz.	6.2
Lobster (Cooked)	3 Oz.	2.5
Pork (Cooked)	3 Oz.	2.4
Bran Flakes*	1 Cup	2.0
Yogurt	1 Cup	1.5
Salmon (Cooked)	1/2 Fillet	1.3
Milk (2% milk fat)	1 Cup	1.0
Egg (Hard-boiled)	1 (Large)	0.5

*Different cereals will have different levels of zinc

Essential Fatty acids

Omega-3 fatty acid is a natural anti-inflammatory that exhibits no side effects. Dietary fat is an important source of energy and a necessary part of the human diet. Fatty acids, such as DHA-docosahexaenoic acid /EPA-eicosapentaenoic acid are important parts of fat molecules. DHA and EPA are found in fleshy fish, like salmon, tuna, herring, whole grain foods, lean meats or fish oil supplements. Daily intake: our bodies do not create all the essential fatty acids we need, so it is essential to get them through our diet and/or nutritional supplements. Science suggests a daily intake of essential fatty acids of 500 mg/day. As a general rule everyone should take 1,000 mg of omega-3 fish oil once a day. Be sure each capsule contains a combined total of at least 600mg of DHA and EPA. In the eye low levels of DHA/EPA have been linked to dry eye syndrome and associated with eye diseases such as diabetic retinopathy and AMD.

Foods with DHA/EPA

Food	Serving	Mg.
Salmon (Cooked)	3 Oz.	1800
Tuna (Cooked)	3 Oz.	1300
Mackerel (Cooked)	3 Oz.	1000
Anchovy (Canned In oil)	2 Oz. (1 can)	900
Trout (Cooked)	3 Oz.	800
Halibut (Cooked)	3 Oz.	400
Scallops (Cooked)	1000  grams	350
Snapper (Cooked)	3 Oz.	3

Nutritional Studies Evaluation Various Vitamins, Nutrients, and Supplements

AREDS

The Age-Related_EYE_Disease Study (AREDS) was a major clinical trial conducted by the National Eye Institute.A total of 3640 subjects, 55 to 80 years old. The results released in October 2001 provided strong evidence that combinations of zinc and antioxidant vitamins can slow AMD progression. The AREDS study showed that the combination reduced the relative risk of advanced AMD in people at high risk, by 25% over six years and showed a 19% reduction in visual acuity loss.

• AREDS Formula: Daily Dosage*
• Vitamin C: 500 mg
• Vitamin E: 400 IU
• Beta Carotene: 15mt
• Zinc(as zinc oxide): 80 mg**
• Copper(as cupric oxide): 2mg

*Recommended for patient's with certain early retinal macular degeneration indicators. Without any indicators, no value was found in using formula. Smokers should avoid beta Carotene, since some studies indicate increased risk of lung cancer. A through dilated retinal examination and consultation with your eye care provider can determine, if you have any early macular degeneration indicators.

**The 40-80 mg zinc dosage is for people diagnosed as being at high risk for AMD or experiencing early-stage AMD. The RDA for zinc is 11 mg for men and 8 mg for women. High doses of zinc may cause stomach upset. Also, zinc supplementation has been shown to interfere with copper absorption, so 2 mg/day for copper is strongly recommended for people supplementing their diet with zinc.

AREDS2

A new 5 year study began in June 2008 with the addition of lutein, zeaxanthin and omega-3 fatty acids to the above formula. The study is focusing on the protective effects that lutein (10mg/day), zeaxanthin (2mg/day), and omega-4 fatty acids (1 g/day) may have against AMD as well as the link between nutrition and macular pigment optical density (MPOD), cataract development and visual function.

Nutritional Web Sites

U.S Food and Drug Administration: www.cfsan.fda.gov/wh-nutr.html
American Heart Association: www.americanheart.org
U.S. Department of Agriculture: www.ers.usda.gov
American Dietetic Association: www.eatright.org
American Optometric Association: www.aoa.org