Healthy Lifestyle Score and Incidence of Glaucoma: the Sun Project

Abstract

The relationship between healthy lifestyles, diet, and glaucoma remains controversial. In this study, we analyse the effect of Mediterranean Lifestyle (ML) on glaucoma incidence in the “Seguimiento Universidad de Navarra” (SUN) cohort. Participants (n=18 420) initially free of glaucoma were followed for a mean of 10.8 years. The SUN Healthy Lifestyle Score (SHLS) ranging from 0 to 10 points included 10 healthy habits: never having smoked, moderate to high physical activity (>20 MET-hour/week), Mediterranean diet (≥4/8 adherence points), moderate alcohol consumption (women, 0.1-5.0 g/d; men, 0.1-10.0 g/d), low television exposure (<2 h/day), no binge drinking (≤5 alcoholic drinks at any time), a short afternoon nap (<30 min/day), meeting up with friends (> 1 h/day), working at least 40 h/week and low body mass index (BMI≤22). Information is collected biennially through self-reported questionnaires. The relationship between new cases of glaucoma and the SHLS was assessed by logistic regression using a hazard ratio. Crude, multi-adjusted and sensitivity analysis were performed. During follow-up, we observed 261 (1.42%) new cases of glaucoma. After adjusting for potential confounders, participants in the healthiest category of SHLS (7-10 points) showed a significantly reduced risk of glaucoma compared to those in the lowest SHLS category (0-3 points) (adjusted HR=0.51, 95% CI=0.28-0.93). For each point added to the SHLS the risk of glaucoma relatively dropped by 5%. In conclusion, higher adherence to a ML, measured by the SHLS, was significantly associated with lower risk of developing glaucoma. The ML is a protective factor for glaucoma incidence.