NUTRITION AND EYE HEALTH
Nutrition advice for patients now Why? When? What? Now is the ideal time to be proactive with nutrition advice, for both patients and your practice, write Steph Moore and Alex France
In the June issue of Vision Now, we looked into how having a proactive approach to nutrition, supplements and eye health can make a big difference to patient care, and to your business. We spoke to two eyecare professionals about their approach to addressing risk factors, and how they believe conversations about lifestyle and supplementation are central to a modern optometry practice.
Another change the pandemic has brought is to our food shopping habits. In a world where patients are now reducing their number of visits to the supermarket, it is particularly important to remind them about the importance of nutrients for eye health; in particular, the regular consumption of fresh fruit, vegetables and fish throughout the week.
WHAT MAKES A GOOD EYE SUPPLEMENT? This article continues the conversation about why now is the time to be engaging with patients on nutrition and their eye health care, and why you should make this central to your business in 2020 and beyond.
IMPACT OF THE PANDEMIC The Covid-19 pandemic has led to patients being increasingly aware of their general health and wellbeing. In just one example, the Couch to 5k running app experienced a 92 per cent increase in downloads between March and June this year versus the same period last year. However, there are some impacts of the pandemic that could adversely affect patients’ eye health.
Previously, we have explored what is important to patients when it comes to choosing which nutritional supplement to recommend, and that simplicity is key. An all-in-one formulation, such as Nutrof Total (Figure 1), provides this – but with many ingredients within (Figure 2). Why are these ingredients chosen for eye health supplements? And how can we communicate their benefits to patients? Nutrients are key vitamins and minerals essential for health, and often only obtainable through what we eat. The following vitamins and minerals are known to support eye health...
Vitamin D
Ophthalmology is normally the busiest department in the NHS, with more than eight million out-patient appointments every year; this is the highest of any department, including trauma. Cataract surgery is the most commonly performed surgical procedure, with 414,000 operations being carried out in England in 2017/2018, and 20,000 in Wales.
UK government guidance is that daily supplementation with vitamin D is a good thing for us, and has re-emphasised this advice in recent months, where more time has been spent indoors. What your patients probably don’t know about is the role vitamin D deficiency plays in eye diseases such as age-related macular degeneration (AMD) (Annweiller 2016).
As a result of the pandemic, and the resultant backlog from three to four months of no routine ophthalmology services, it is arguably essential that we start talking to patients about self-care – and do our part to be proactive in trying to keep patients out of ophthalmology departments.
Very few foods naturally contain vitamin D (some can be found in some oily fish and eggs) so many countries, including the UK, fortify foods such as cereals and milk. The protective effect that vitamin D has on the retina is centred around inhibiting oxidation and reducing inflammation and angiogenesis.
Figure 1: Nutrof Total provides key ingredients for eye health
Zinc An important nutrient to tell your patients about is zinc, a mineral found in high concentration in the retina itself and which occurs naturally in shellfish. Discussions currently are centred around its role in normal immune function, although increased zinc intake has been associated with decreased risk of both early and late stage AMD (Ho 2011). Zinc is known to be a co-factor of many metabolic processes in the eye, which are important in protecting the retina from oxidative damage.
Vitamin E Vitamin E is a powerful antioxidant that helps protect the membranes of cells from free radicals; these are damaging molecules that are a metabolic by-product. Vitamin E can be found naturally in nuts and seeds, particularly in sunflower seeds and almonds. Research suggests that vitamin E may help reduce the worsening of AMD in patients who show early signs of the disease. However, vitamin E is easily stored by the body, it can accumulate and cause potentially unwanted side effects, so caution should be taken before ingesting very high quantities. A supplement such as Nutrof Total, containing 83 per cent of a patient’s nutrient reference value (NRV), means it is safe to recommend for all patients – alongside a healthy diet.
Selenium Selenium is a key antioxidant and supports the action of vitamin E and zinc. It is found naturally in nuts, meat, fish and some seeds, and plays a key role in regulating oxidative stress in the cornea and surrounding tissue. Combined with vitamins C and E, selenium may reduce the risk of advanced AMD. Vision Now SEPTEMBER 2020
21
