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Effects of Dietary Intake and Lifestyle on Eye Health and Ophthalmic Diseases

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A Special Issue of Nutrients (ISSN 2072-6643) belonging to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (25 May 2026) | Viewed by 18614

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Dr. Mohsen Sharifzadeh

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Electrical & Computer Engineering Department, Brigham Young University, Provo, UT, USA
Interests: eye health; retina; ophthalmic diseases; optics; solid state physics; biomedical imaging

Special Issue Information

Dear Colleagues,

The connection between diet and eye health is a growing area of interest, with significant implications for preventing and managing ophthalmic diseases, including age-related macular degeneration, diabetic retinopathy, and glaucoma. Among the hundreds of carotenoids identified in nature, only three—lutein, zeaxanthin, and meso-zeaxanthin—are known to accumulate in the macula of the human eye, where they act as powerful antioxidants and protective pigments. These macular pigment carotenoids are critical for neutralizing oxidative stress, reducing light-induced damage, and improving visual function.

This Special Issue invites contributions exploring the biochemical, clinical, and therapeutic implications of dietary components such as lutein, zeaxanthin, meso-zeaxanthin, and other nutrients in promoting ocular health. Submissions can include original research, reviews, and clinical studies investigating the impacts of carotenoids and other dietary factors on macular health and the progression of ophthalmic diseases. To advance our understanding of these topics, we encourage the development of evidence-based dietary recommendations and interventions for protecting vision and improving quality of life.

We welcome your valuable contributions to this Special Issue and look forward to receiving your submissions.

Dr. Mohsen Sharifzadeh
Guest Editor

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Keywords

eye health
ophthalmic diseases
age-related macular degeneration
diabetic retinopathy
glaucoma
visual function

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Published Papers (7 papers)

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Research

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16 pages, 290 KB

Open AccessArticle

The Relative Bioavailability of Lutein and Zeaxanthin in the Presence of Omega-3 Supplements and Their Effect on Oxidative Stress Levels in Humans: A Pilot Study

by Kingsley Arua Kalu, Charles McMonnies, Sophia Lin and Jayashree Arcot

Nutrients 2026, 18(12), 1914; https://doi.org/10.3390/nu18121914 - 12 Jun 2026

Cited by 1 | Viewed by 678

Abstract

Introduction: Lutein+Zeaxanthin (L+Z) are the major constituents of macular pigments of the retina. There is a lack of information on the bioavailability of the two compounds in the presence and absence of omega-3 fatty acids in L+Z supplements which are commonly prescribed to treat macular degeneration. Despite growing interest in L+Z supplementation, there remains a limited understanding of their short-term bioavailability dynamics and the potential added value of omega-3 co-supplementation. This pilot study reports on the bioavailability of serum responses to L+Z supplements in the presence of omega-3 fatty acids and evaluates time-resolved analytical approaches using Area Under the Curve. Subjects/Methods: A total of 10 men and six women with an average age of 31.38 ± 1.27 years participated in this randomised, non-blinded, controlled study for a total of 19 days (7-day wash-out period plus 12-day intervention period). The control group (n = 9) consumed the L+Z supplement (12 mg/d) only, while the intervention group (n = 7) consumed the L+Z supplement along with 900 mg/d of an omega-3 supplement (540 mg EPA + DHA 360 mg). Each group adhered to a comprehensive low-carotenoid and omega-3 diet list (LCOD) for the 7-day wash-out period and the 12-day intervention period. The participants reported the foods they consumed daily in their diet logbooks, online logs, and the ASA 24 diet assessment log over the study period. The body composition of each subject in the two groups was assessed before and after the study using a SECA body composition analyser, and the relative serum L+Z response in both groups was determined using Area Under the Curve (AUC and incremental AUC) by trapezoidal approximation. Results: The mean ± SEM baseline serum lutein+zeaxanthin (L+Z) concentrations measured at the end of the wash-out period (Day 7) were 2.23 ± 0.65 µg/mL in the control group and 1.20 ± 0.53 µg/mL in the intervention group. Following wash-out, serum L+Z concentrations increased in both groups, reaching 2.81 ± 0.90 µg/mL (control) and 2.63 ± 1.21 µg/mL (intervention) at Day 13, and 2.98 ± 0.69 µg/mL (control) and 3.02 µg/mL (intervention) at Day 19. Total exposure assessed by AUC_7–13 and AUC_13–19 did not differ significantly between the groups (p > 0.05). Incremental exposure analyses identified the post-wash-out period as the primary biologically responsive window, with higher mean incremental L+Z bioavailability in the intervention group (4.36 µg/day/mL) compared with the control group (3.00 µg/day/mL), although this difference was not statistically significant (p > 0.05). No significant effect of omega-3 co-supplementation on oxidative stress biomarkers was observed (p > 0.05). Conclusion: Omega-3 co-supplementation did not demonstrate a consistent additional benefit on L+Z bioavailability or oxidative stress markers. Day-resolved analyses using iAUC revealed temporal patterns not captured by conventional AUC measures. These exploratory findings should be interpreted with caution and confirmed in larger, longer-term studies. Full article

(This article belongs to the Special Issue Effects of Dietary Intake and Lifestyle on Eye Health and Ophthalmic Diseases)

26 pages, 7307 KB

Open AccessArticle

Protective Efficacy of Selenium in Cisplatin-Induced Retinal Toxicity: An Experimental Immunohistochemical and Ultrastructural Analysis

by Ioannis Konstantinidis, Sophia Tsokkou, Pavlos Pavlidis, Kyriaki Papadopoulou, Dimitrios Kavvadas, Vasilis-Spyridon Tseriotis, Georgios Delis, Chrysanthi Sardeli, Dimitrios Kouvelas, Antonia Siogka, Theodora Papamitsou and Sofia Karachrysafi

Nutrients 2026, 18(8), 1236; https://doi.org/10.3390/nu18081236 - 14 Apr 2026

Viewed by 770

Abstract

Background/Objectives: Cisplatin is a potent chemotherapeutic agent whose clinical utility is limited by severe side effects, including neurotoxicity affecting the ocular system. The pathophysiology involves oxidative stress and mitochondrial dysfunction, to which the retina is particularly vulnerable. Selenium (Se), an essential trace element and component of antioxidant enzymes, has shown potential in mitigating cisplatin toxicity, although its efficacy with respect to retinal structure and the influence of administration routes remain underexplored. This study aimed to evaluate the protective efficacy of selenium against cisplatin-induced retinal toxicity and compare the effects of intraperitoneal and oral selenium administration. Methods: Forty adult male Wistar rats were randomized into four groups (n = 10 each): Group A (Cisplatin Monotherapy, 3.5 mg/kg IP for 5 days; cumulative dose 17.5 mg/kg); Group B (Cisplatin + Intraperitoneal Selenium, 2.73 mg/kg; cumulative dose 60 mg/kg); Group C (Control); and Group D (Cisplatin + Oral Selenium). Selenium prophylaxis, administered as sodium selenite (Na₂SeO₃), began two days prior to cisplatin administration and continued for 15 days post-treatment. Retinal evaluation two weeks after cisplatin cessation included light microscopy, semi-quantitative immunohistochemical (IHC) analysis for inflammatory (IL-6) and fibrotic (TGF-β2) markers, and Transmission Electron Microscopy (TEM) for ultrastructural analysis, which were the primary endpoints. Statistical differences in the IHC scores were analyzed via the Kruskal-Wallis H test with Dunn’s post hoc comparisons. Results: Cisplatin monotherapy (Group A) caused severe disruption of the retinal architecture, including edema, reactive gliosis, and significant upregulation of IL-6 and TGF-β2. Ultrastructural analysis revealed mitochondrial swelling (cristolysis) and photoreceptor disk fragmentation. Intraperitoneal selenium (Group B) was associated with significant structural preservation and intact mitochondria, with TGF-β2 levels comparable to those of the controls, although the IL-6 level remained moderately elevated. Conversely, oral selenium (Group D) suppressed both IL-6 and TGF-β2 expression to near-negative levels but provided less ultrastructural protection, resulting in persistent mitochondrial swelling and focal photoreceptor disruption. Conclusions: Systemic cisplatin induces severe subcellular retinal toxicity characterized by mitochondrial damage and photoreceptor degeneration. Selenium supplementation attenuates these effects; however, outcome patterns differ by administration route. Intraperitoneal selenium was associated with greater morphological and ultrastructural preservation despite persistent IL-6 elevation, whereas oral selenium normalized immunohistochemical marker expression to near-control levels but was associated with more pronounced residual subcellular damage on qualitative TEM assessment. These preliminary morphological and immunohistochemical findings suggest that the route of selenium delivery may influence its neuroprotective profile; however, pharmacokinetic measurements and functional retinal assessments, such as electroretinography, are warranted before its clinical translation. Full article

(This article belongs to the Special Issue Effects of Dietary Intake and Lifestyle on Eye Health and Ophthalmic Diseases)

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18 pages, 3653 KB

Open AccessArticle

Changes in Quality of Life Among Glaucoma Patients Following Six Months of Niacinamide Supplementation

by Constantin Alin Nicola, Maria Cristina Marinescu, Anne Marie Firan, Georgica Tartea, Mihaela Simona Naidin, Radu Constantin Ciuluvica, Marina Daniela Dimulescu, Nicoleta Mirela Voicu, Carmen Marinela Mihailescu, Andreea-Daniela Meca, Maria Bogdan and Adina Turcu-Stiolica

Nutrients 2025, 17(17), 2775; https://doi.org/10.3390/nu17172775 - 27 Aug 2025

Cited by 9 | Viewed by 2910

Abstract

Background/Objectives: Glaucoma is the primary cause of irreversible blindness worldwide, with enormous impact on quality of life and activities of daily living. Since one pathogenic mechanism of glaucoma is mitochondrial dysfunction at the retinal ganglion cell level, niacin has been proposed as an adjuvant treatment, with encouraging results. The objective of this prospective, non-randomized, single-arm clinical trial was to investigate the effect of oral supplementation with niacin on the quality of life of a cohort of glaucoma patients in Romania. Methods: Fifty-eight patients diagnosed with primary open angle glaucoma, under topical hypotensive treatment, were evaluated before and after a 6-month period of daily administration of 500 mg of oral niacinamide. Evaluation involved a complete ophthalmological exam and QoL quantification using the Glaucoma Quality of Life-15 (GQL-15) Questionnaire. Results: We found strong evidence that niacin supplementation for 6 months led to a statistically significant improvement in QoL scores among glaucoma patients (mean difference = −2.10, 95% CI: [−2.89, −1.32], p < 0.0001), including central and near vision (mean difference = −2.16, 95% CI: [−3.91, −0.4], p = 0.017), peripheral vision (mean difference = −2.66, 95% CI: [−0.23, −0.08], p < 0.001), and the glare and dark adaptation (mean difference = −5.24, 95% CI: [−0.33, −0.14], p < 0.001). In addition, B3 treatment resulted in a significant reduction in intraocular pressure in both eyes over 6 months (mean difference = 0.53, 95% CI: [0.21, 0.86] in the left eye and mean difference = 0.36, 95% CI: [0.04, 0.68] in the right eye), indicating potential clinical benefits. Conclusions: The observed GQL-15 score reductions suggest that B3 may be of benefit in glaucoma management. Further research with larger sample sizes and placebo-controlled designs is needed to confirm B3 potential impact on disease progression and quality of life. Trial Registration at clinicaltrials.gov: NCT07007260. Full article

(This article belongs to the Special Issue Effects of Dietary Intake and Lifestyle on Eye Health and Ophthalmic Diseases)

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Review

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21 pages, 284 KB

Open AccessReview

Why Skin Carotenoid Measurements Cannot Serve as a Proxy for Macular Pigment Optical Density (MPOD): A Biochemical, Anatomical, Optical, and Statistical Review

by Mohsen Sharifzadeh

Nutrients 2026, 18(3), 492; https://doi.org/10.3390/nu18030492 - 2 Feb 2026

Cited by 1 | Viewed by 1192

Abstract

Carotenoids accumulate in both the skin and the macula, but their biochemical specificity, anatomical localization, optical environments, and temporal kinetics differ fundamentally. Despite superficial similarities, these distinctions raise questions about whether non-invasive skin carotenoid measurements, which are obtained using reflection spectroscopy or resonance Raman spectroscopy, can meaningfully reflect macular pigment optical density (MPOD), a retina-specific biomarker associated with visual performance and neuroprotective function. This review synthesizes evidence across biochemistry, tissue distribution, optical pathways, kinetic behavior, and statistical correlations to evaluate this proposed relationship. Skin carotenoid measurements capture a broad mixture of dietary carotenoids, which are dominated by β-carotene and lycopene, that accumulate superficially within the epidermis and dermis and respond rapidly to short-term dietary and environmental changes. In contrast, MPOD reflects only lutein, zeaxanthin, and meso-zeaxanthin, which are selectively transported into the foveal neurosensory retina and change slowly through regulated retinal uptake and deposition. Across human studies, correlations between skin carotenoids and MPOD are weak, inconsistent, and biologically implausible, with large cohort analyses demonstrating near-zero associations. Collectively, evidence across biochemical, anatomical, optical, physiological, and statistical domains shows that skin carotenoid values encode general systemic antioxidant exposure, whereas MPOD reflects a highly localized, retina-specific carotenoid reservoir. Therefore, skin carotenoid measurements cannot be used to estimate, substitute for, or infer macular pigment levels. Accurate assessment of MPOD requires direct retinal imaging technologies. Full article

(This article belongs to the Special Issue Effects of Dietary Intake and Lifestyle on Eye Health and Ophthalmic Diseases)

24 pages, 1821 KB

Open AccessReview

Polyphenols and Eye Health: A Narrative Review of the Literature on the Therapeutic Effects for Ocular Diseases

by Angela D’Angelo, Giuseppe Giannaccare, Filippo Lixi, Mario Troisi, Ginevra Giovanna Adamo, Deokho Lee, Ilaria De Pascale, Alfonso Pellegrino and Livio Vitiello

Nutrients 2026, 18(1), 69; https://doi.org/10.3390/nu18010069 - 25 Dec 2025

Cited by 3 | Viewed by 2873

Abstract

The worldwide burden of visual impairment is mostly attributed to ocular diseases, which include alterations of the retina, optic nerve, cornea, and ocular surface. Despite advances in medicine, the prevention and management of these conditions remain challenging, driving ongoing research into novel bioactive compounds. Among these, polyphenols—an assorted group of plant-derived compounds abundant in the human diet—have attracted significant attention due to their potential antioxidant, anti-inflammatory, and immunomodulatory properties. Increasing evidence suggests that polyphenols may help counteract oxidative stress and modulate pathways involved in ocular pathologies, assisting the conventional therapeutic strategies. This narrative review aims to analyze the current evidence about the potential therapeutic effects of the main polyphenols (e.g., curcumin, resveratrol, epigallocatechin gallate) currently recognized for the management of ocular diseases. Full article

(This article belongs to the Special Issue Effects of Dietary Intake and Lifestyle on Eye Health and Ophthalmic Diseases)

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15 pages, 564 KB

Open AccessReview

Associations Between Nutritional Factors, Obesity and Ocular Diseases: A Narrative Literature Review

by Corina Georgiana Bogdănici, Camelia Margareta Bogdănici, Irina Andreea Pavel, Cosmin Victor Ganea, Vlad Constantin Donica and Elena Mihaela Cărăușu

Nutrients 2025, 17(23), 3798; https://doi.org/10.3390/nu17233798 - 3 Dec 2025

Cited by 6 | Viewed by 1950

Abstract

Background: Nutritional imbalances significantly affect ocular physiology, contributing to dry eye disease, cataracts, age-related macular degeneration (AMD), and optic neuropathies. This review summarizes recent evidence on how micronutrient deficiencies and obesity influence eye health. Methods: A narrative search was performed in PubMed, Scopus, and ScienceDirect (last 10 years). Human studies evaluating associations between micronutrients, dietary patterns, obesity, and ocular diseases were included. Out of 843 records, 50 studies met the eligibility criteria. Results: Deficiencies in vitamins A, D, E, C, and B-complex were consistently linked to ocular surface inflammation, retinal oxidative stress, cataracts, AMD, and nutritional optic neuropathies. Altered levels of zinc, copper, selenium, and magnesium were associated with impaired photoreceptor function, glaucoma risk, and retinal degeneration. Obesity emerged as an independent risk factor for AMD, diabetic retinopathy, and glaucoma through mechanisms involving oxidative stress and vascular dysfunction. Evidence from AREDS/AREDS2 supports targeted antioxidant supplementation in intermediate AMD. Conclusions: Adequate nutritional status and metabolic balance play a critical role in preserving ocular health. Early detection and correction of deficiencies may prevent or slow the progression of several eye diseases. Further high-quality trials are needed to define optimal nutritional recommendations. Full article

(This article belongs to the Special Issue Effects of Dietary Intake and Lifestyle on Eye Health and Ophthalmic Diseases)

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20 pages, 1002 KB

Open AccessReview

Diet, Exercise, and Lifestyle in Glaucoma: Current Evidence and Future Perspectives

by Akiko Hanyuda, Satoru Tsuda, Noriko Himori, Kota Sato, Naoki Takahashi and Toru Nakazawa

Nutrients 2025, 17(21), 3369; https://doi.org/10.3390/nu17213369 - 27 Oct 2025

Cited by 12 | Viewed by 6759

Abstract

Glaucoma is a major ocular neurodegenerative disease and a leading cause of irreversible blindness worldwide, with prevalence projected to exceed 110 million by 2040. Although lowering intraocular pressure (IOP) remains the only proven treatment, glaucoma arises from a complex interplay of genetic, local, and systemic factors—including oxidative stress, vascular dysregulation, mitochondrial dysfunction, and neuroinflammation. Emerging evidence suggests that modifiable lifestyle factors may influence these pathogenic pathways. In this review, higher dietary nitrate from leafy greens is consistently associated with lower primary open-angle glaucoma risk, aligning with nitric-oxide-mediated endothelial support and more stable ocular perfusion pressure. Flavonoids (anthocyanins and flavanols), carotenoids (lutein/zeaxanthin), and B vitamins have strong biological rationale for glaucoma prevention but have limited support from long-term, large population-based studies. The effect of polyunsaturated fats on glaucoma remains inconsistent and warrants source-(plant vs. animal) and substitution-based analyses. Consistent protective effects of aerobic exercise and high-quality sleep may be associated with favorable metabolic profiles and ocular perfusion, potentially mitigating retinal ganglion cell loss. Conversely, smoking and alcohol use are frequently coupled with poorer diet quality (e.g., lower vegetable intake) and heightened oxidative stress, which may exacerbate glaucomatous neurodegeneration. However, much of the current literature is constrained by cross-sectional designs, reliance on self-reported food frequency questionnaires, and insufficient use of structural endpoints such as retinal nerve fiber layer imaging. This review focuses on the potential of lifestyle modification and future directions in prevention and treatment strategies for glaucoma, highlighting the need for large-scale, multi-ethnic, genotype-stratified longitudinal studies and randomized controlled trials to establish causality and define optimal intervention strategies. Full article

(This article belongs to the Special Issue Effects of Dietary Intake and Lifestyle on Eye Health and Ophthalmic Diseases)

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