Dietary Patterns and Retinal Vessel Caliber in the Irish Nun Eye Study

Abstract

BackgroundRetinal vessel abnormalities are associated with cardiovascular disease risk. Widening of retinal venules is associated with increased risk of stroke while narrowing of retinal arterioles independently predicts incident hypertension, coronary heart disease and diabetes. Dietary factors are known to play an important role in cardiovascular health. However, few studies have examined the association between dietary patterns (DPs) and retinal microvascular health.ObjectiveTo examine the association between ‘a posteriori’- derived DPs and retinal vascular caliber (RVC) in older women with a restricted lifestyle.MethodsThis was a cross-sectional study of 1233 participants (mean age: 76.3 years) from the Irish Nun Eye Study (INES). Computer-assisted software was used to measure RVC from digital eye images using standardized protocols. Dietary intake was assessed using a food frequency questionnaire (FFQ). DP analysis was performed using principal component analysis from completed FFQs. Regression models were used to assess associations between DPs and retinal vessel diameters, adjusting for age, body mass index, refraction, hypertension, diabetes mellitus, ischemic heart disease, cerebrovascular accident and fellow eye RVC.ResultsTwo DPs were identified: a ‘healthy’ pattern with high factor loadings for fruit, vegetables, wholegrains and oily fish and an ‘unhealthy’ pattern with high factor loadings for sugar and sweets, chips, high fat dairy products and French fries. Adjusted linear regression analysis revealed that those who adhered most closely to the unhealthy DP had wider central retinal venular equivalent (CRVE) (p=0.03) and narrower central retinal arteriolar equivalent (CRAE) (p=0.01) compared to the least unhealthy DP. No independent relationship was observed between the healthy DP and RVC.ConclusionIn this cohort of older women with a restricted lifestyle, an unhealthy DP was independently associated with an unfavorable retinal profile, namely a widening of retinal venules and narrowing of retinal arterioles.

Dietary patterns were not associated with age-related macular degeneration: a cross-sectional analysis in the Irish Nun Eye Study

“…The use of DP to evaluate a broader overview of dietary intake as opposed to the assessment of individual nutrients or foods alone provides a more comprehensive understanding of the synergistic interactions between food consumption and disease risk and reduces the influences of residual confounding. The use of an a posteriori approach for DP analysis is also considered to be an approach that is free from the constraints of a priori hypotheses [34,35].…”

Socioeconomic inequalities, modifiable lifestyle risk factors, and retinal vessel calibers: The African‐PREDICT Study

“…Low SES has been shown to be related to unhealthy food choices such as consumption of energy‐dense foods 32 and less intake of fruits and vegetables 50 . Furthermore, unhealthy dietary patterns, characterized by sugar and sweets, chips, high‐fat dairy products and French fries, 51 and lower intake of vegetables and fish, 52 has been associated with a wider CRVE. In contrast, high diet quality was related to wider retinal arteriolar caliber and narrower venular caliber, which is generally associated with a lower risk of CVD 53 .…”

The importance of microvascular inflammation in ageing and age-related diseases: a position paper from the ESH working group on small arteries, section of microvascular inflammation

“…A sedentary lifestyle can increase vascular nicotinamide adenine dinucleotide phosphate (NADPH)derived reactive oxygen species (ROS) production that affect the endothelial function [54]; similarly, exaggerated exercise training induces mitochondrial dysfunction leading to MD [55]. Unhealthy dietary and eating patterns [56], as well as nutrient overload [57], cause an imbalance in the oxygen supply/demand ratio, activating hypoxia-inducible factor 1a (HIF-1a) and promoting impaired angiogenesis [58]. Additional environment determinants, including environment pollutants, temperature, seasonal changes, circadian rhythm and infections have demonstrated significant role in regulating microvascular inflammation and cardiovascular (CV) diseases [59][60][61][62][63][64][65][66][67][68] The final effector through which all these stressors promote microvascular ageing [69][70][71] is the immune-inflammatory response [60].…”