MYOPIA AND NUTRITION MYOPIA AND NUTRITION Garry D. Kappel, OD, - PDF document

Garry D. Kappel, OD, FCOVD MYOPIA AND NUTRITION MYOPIA AND NUTRITION Garry D. Kappel, OD, FCOVD LVC/LCC LVC/LCC A Society Whose Time Has Come A Society Whose Time Has Come Lakeview Vision Center, LLC www.optometricnutritionsociety.org www.optometricnutritionsociety.org 628 N 1 st St., Ste C Lakeview, OR 97630 541-947-3357 Myopia is extremely Myopia is extremely Myopia epidemic Myopia epidemic prevalent prevalent • Crisis • It affects more than 25 to 35% of European descent populations and up – There is a higher percentage of people with myopia than ever reported in history. to 50% or more of Asian descent populations. – A recent National Eye Institute Study pointed out that in the USA • 1970’s 25% myopia • 2000 41% myopia Causes of Myopia? Causes of Myopia? MYOPIA AND VISION MYOPIA AND VISION • One Nutrient “The Silver Bullet?” • There seems to be five areas of ocular concern that effect the eyes and the development of myopia which • Diet….blood sugar regulation & nutrient can be nutrient oriented. levels – Blood sugar regulation – Blood sugar regulation • Sustained accommodation (strength & – IOP – Clarity of the cornea, crystalline lens tone) – Circulation and nerve function • Increased vitreous IOP (F. Young) – Strength and tone of the retina, sclera and choroid • Scleral Stretching…(strength and tone) • Heredity “Genes” Eastern States Congress Myopia and Nutrition 1

Garry D. Kappel, OD, FCOVD MYOPIA AND VISION MYOPIA AND VISION The “Silver Bullet” The “Silver Bullet” • We will discuss nutrients and studies for • One nutrient or Magic/Silver Bullet? these tissues and conditions of the • It is amazing that patients and doctors eyes. both believe in the Silver Bullet…… It Does Not Exist. Biochemical aspects Biochemical aspects Biochemical aspects Biochemical aspects • Biochemical aspects may be a crucial • Glycosaminoglycans are involoved in collagen fibrillogenesis. link between accommodation/retinal • GAG’s influence collagen size and its defocus and myopic axial elongation. organization and are highly represented in i ti d hi hl t d i • Accommodatively-related eye tissue. defocus/image degradaton appears to • Speculation is that modification of collagen in trigger specific biochemical changes in the sclera of myopes occurs due to retinal the sclera and related stuctures that defocus/image degradation effects results in posterior pole axial elongation Biochemical aspects Biochemical aspects Biochemical aspects Biochemical aspects • GAG metabolism might reflect this • Reduced levels of hydroxyproline process. (related to collagen accummulation) were found in both human blood serum • Uronic acids in the urine, which are , levels and human sclera. related to and correlated with GAG metabolism, have been measured in • The results suggested that myopic axial human myopes and nonmyopes. elongation was the result not only of simple biochemical scleral stretching • Uronic acid was 2-3 times greater in but also to changes in its biochemical myopes. constitution. Eastern States Congress Myopia and Nutrition 2

Garry D. Kappel, OD, FCOVD Further Biochemical Further Biochemical Biochemical aspects Biochemical aspects Aspects Aspects • In my work with nutrition I have found a • These biochemical aspects were taken correlation between myopia and low from “Accommodation, Nearwork and antioxidant levels, moderately increased IOP, Myopia” Ong E, Ciuffreda K; OEPF and diets high in sugars artificial colorings and diets high in sugars, artificial colorings, 1997 page 194 flavorings, and preservatives and low in vegetables and fruits. • Further, hair analysis high in heavy metals consistent in increasing myopia. • Lead, cadmium, mercury and arsenic Further biochemical Further biochemical aspects aspects • For some reason I have been finding more patients/myopes high in bismuth. I Can't eat pork, don’t know the ramifications of this Swine flu... observation. Can't eat chicken, Bird flu. Can't eat Beef, Mad cow.... Can't eat eggs, Salmonella. Can't eat fish, Can t eat fish, heavy metal poisons in their waters. I believe that leaves chocolate and ice cream! Can't eat fruits and veggies, insecticides and herbicides. Eastern States Congress Myopia and Nutrition 3

Garry D. Kappel, OD, FCOVD Diet Diet Diet continued Diet continued • Only 20% of children in the US consume five • French Fries accounted for nearly 25% or more servings of fruits and vegetables of vegetable consumption. daily. Study included 3148 participants, ages • This study confirmed that children’s y 2 to 18. 2 to 18 eating patterns mirror those of adults. • All were low in citrus, melon, berries, and – Antioxidants, Nutraceuticals and Functional dark green or deep yellow vegetables. Foods by Robert A. Ronzio, PhD; • Only 7% met the recommended guidelines of Townsend Letter for Doctors and Patients; two fruits and three veggies daily. Dec. 1996 Diets Diets An Interesting Thought: An Interesting Thought: • High in refined starches, (i.e), breads • Would myopic individuals survive in a and cereals increase insulin levels. hunter gatherer society? • This effects the development of the p • Good distance acuity is required for y q eyeball, making it abnormally long and – location of food causing near sightedness. – recognition of other species members • Suggested by a team led by Loren – awareness of environmental dangers and benefits Cordain, an evolutionary biologist at – recognition and escape from predators Colorado State University. Cordain’s Study Cordain’s Study Genes Genes • 229 hunter-gatherer societies • Myopic genes would be eliminated from a hunter gatherer society? – Although refined cereals and sugars were rarely if ever consumed • Probably as they wouldn’t survive very y y y – with Western contact these foods quickly long. became dietary staples!! Eastern States Congress Myopia and Nutrition 4

Garry D. Kappel, OD, FCOVD Hunter gather societies Hunter gather societies Hunter Gatherer Diets Hunter Gatherer Diets • Myopia prevalence normally occurs in • Characterized by high levels of protein 0-2% of the population. • Moderate levels of fat • Most refractive errors are less than • Low levels of carbohydrate Low levels of carbohydrate minor. • When compared to modern Western • Moderate to high myopia is either non- diets. existent or occurs in about one person out of a thousand. Recently Acculturated Recently Acculturated Carbohydrates Carbohydrates Hunter- Hunter -gatherer Populations gatherer Populations • Carbohydrates present in hunter- • When they adopt a Western diet gatherer diets are of LOW GLYCEMIC – frequently show high levels of INDEX. • hyperglycemia • insulin resistance • That means: they are slowly absorbed • hyperinsulinemia and produce a gradual and minimal rise • type II diabetes in plasma glucose and insulin levels when compared to the sugars and refined starches in Western diets. The Industrial The Industrial Conversely Conversely Revolution Revolution • Hunter-gatherer populations in their • Industrialized countries shifted slowly native environments rarely exhibit these from hunter-gatherer societies. symptoms! • With the advent of the industrial revolution – more refined sugars – more refined cereals Eastern States Congress Myopia and Nutrition 5

Garry D. Kappel, OD, FCOVD Cordain Cordain Modern Urban Diet Modern Urban Diet • When these hunter-gatherer societies • Common elements of the diet are: change their lifestyles and introduce – Highly refined sugars and cereals grains and carbohydrates, they • These were rarely eaten by the average These were rarely eaten by the average RAPIDLY DEVELOP (WITHIN ONE citizen in the 17th and 18th century GENERATION) myopia rates that equal Europe. or exceed those in western societies. • Steel roller mills in the late 19th Century introduced fiber depleted wheat flour of low extraction. Over the last 200- Over the last 200 -250 250 Overnight Epidemics Overnight Epidemics years years • Glycemic load has steadily risen • Fewer than 1% of Inuit and Pacific Islanders had myopia. • Increased consumption of refined cereals and sugars. g • These rates have skyrocketed to as y high as 50% • This increase in sugars is related to increased levels of insulin. • Was this the sudden advent of literacy and compulsory schooling? Cordain Cordain Cordain Cordain • Reading may play a role in myopia • In the island of Vanuatu development, however… • 8 hrs of compulsory schooling per day. • Myopia has remained low in societies y p • Myopia rate is only 2% Myopia rate is only 2% that have adopted Western Lifestyles • Vanuatuans eat but not Western diets. – fish – yam – coconut – no white bread or cereals Eastern States Congress Myopia and Nutrition 6