August 2, 2021
By Dwight Akerman, OD, MBA, FAAO, FBCLA
Although genetic factors play a role in the development of myopia, they cannot explain the rapid increase in myopia prevalence. Several environmental factors have been implicated in the development and progression of myopia, with significant research directed at the possible role of near work and, more recently, of reduced time outdoors as risk factors.
Overall, there has been limited investigation into the role of nutritional factors in myopia. The availability of the large U.S. National Health and Nutrition Examination Survey dataset allowed for further study of the relationship between various nutritional and body metric factors and the presence and magnitude of myopia.
Researchers from the University of California at Berkeley School of Optometry examined data from 6,855 Americans aged 12-25 years to assess the relationship between body metrics, nutritional factors (serum vitamin D levels, caffeine intake, glucose/insulin levels), and myopia. Females were more likely than males to be myopic (38% vs. 33%) and had higher levels of myopia. In general, none of the nutritional factors examined proved to be significantly related to the presence of myopia in this participant cohort. However, participants with increased insulin levels had significantly increased odds of being myopic.
These largely negative findings suggest that other environmental factors, such as those related to the visual environment, may contribute more to the development and/or progression of myopia and argue for continued research in these areas to support more evidence-based myopia clinical management.
Nutritional Factors and Myopia: An Analysis of National Health and Nutrition Examination Survey Data
Elise N Harb, Christine F Wildsoet
Significance: The rise in the prevalence of myopia, a significant worldwide public health concern, has been too rapid to be explained by genetic factors alone and thus suggests environmental influences.
Purpose: Relatively little attention has been paid to the possible role of nutrition in myopia. The availability of the large National Health and Nutrition Examination Survey dataset, which includes results from vision examinations, offers the opportunity to investigate the relationship between several nutrition-related factors, including body metrics, and the presence and magnitude of myopia.
Methods: Cross-sectional survey datasets with vision examination, demographic, body metrics, and nutritional data, collected as part of the National Health and Nutrition Examination Survey over the years of 2003 to 2008, were extracted for analysis. Based on already published basic and epidemiological studies, the following parameters were selected for study: body height and body mass index, demographics, serum vitamin D and glucose/insulin levels, and caffeine intake, using multivariable models and objectively measured refractive errors as the main outcome measure.
Results: Data from a total of 6855 ethnically diverse Americans aged 12 to 25 years were analyzed. In final multivariate models, female sex and age were the most significant factors related to myopia status and refractive error. In general, neither body metrics (body mass index) nor nutritional factors (serum vitamin D, glucose levels, and caffeine intake) were found to be associated with refractive error or myopia status; however, increased insulin levels were related to increased odds of having myopia.
Conclusion: These largely negative findings suggest that other environmental factors, such as those related to the visual environment, may contribute more to the development and/or progression of myopia and would argue for continued research in these areas in support of more evidence-based myopia clinical management.
Harb, E. N., & Wildsoet, C. F. (2021). Nutritional Factors and Myopia: An Analysis of National Health and Nutrition Examination Survey Data. Optometry and Vision Science, 98(5), 458-468.