The assosiation of diet diversity, healthy eating index and serum anti-oxidant indices in Patients with Different degrees of cataract Compared to healthy subject: a Case control study

Abstract

Background and Aim Cataract is a chronic eye disorder which is related to oxidant/antioxidant situation and is the major cause of blindness. As antioxidants have effect on the prevention of cataract and there is a relationship between Healthy Eating Index (HEI), dietary diversity and antioxidant status, we aimed to investigate the HEI, dietary diversity, serum total antioxidant and oxidant capacity in patients with different degrees of cataract compared to healthy subjects. Materials and Methods In this case-control study, 45 cataract patients (fifteen patients in each three group of cataract degree) aged more than 50 years included in the study with convenient sampling method. They came for the first time to the Mehr Ophtalmology center in Tabriz. Forty-five apparently healthy people who matched for age, sex and body mass index (BMI) included as control group. Diagnosis of cataract and its grading was done by an ophthalmologist based on slit lamp technique. Subjects who had eligibility criteria included in the study after signing the informed consent form. Anthropometric measurements (including weight, height and BMI), dietary intake in the last year (data from 147-item food frequency questionnaire (FFQ)) and subjects' exposure to sunlight (data from researcher-designed questionnaire) were measured. Dietary diversity score and HEI were defined by data acquired from FFQ. Physical activity and mental stress levels were assessed by International Physical Activity Questionnaire (IPAQ) and "Holmes and Rahe" questionnaire respectively. Finally, 10 ml fasting blood samples were gathered from all subjects for assessment of serum Total Antioxidant Capacity (TAC) and Serum Total Oxidant Capacity (TOC) levels. Data analyses were done by SPSS.22 software. Results In the present study there was no significant difference between the study groups in age, weight, height, BMI, stress and physical activity (p>0.05). Although there was a significant higher and lower stress levels in third-degree and first-degree cataract patients compared to the other groups respectively (p<0.05). After adjustment for stress level, serum TAC and TOC levels in healthy subjects were significantly higher and lower than cataract patients respectively (p<0.05). There was no significant difference in serum TAC and TOC levels among patients in different cataract degrees after stress adjustment (p>0.05). Also there were no significant differences in dietary diversity score, moderation and total scores of HEI among the study groups (neither in raw nor in stress adjusted analysis). Only in first-degree cataract patients there was a positive significant correlation between moderation and total HEI scores with serum TAC level (p<0.05). After adjustment for stress level, there was a negative significant correlation between HEI moderation score and serum TOC in first-degree cataract patients. Also there was a positive significant correlation between meats diversity and total diversity scores in first-degree cataract patients. There was a negative significant correlation between serum TOC level with moderation and total HEI scores in cataract patients. In both healthy and cataract groups, there was a significant negative correlation between meats diversity and TOC (p<0.05). Also there was a negative significant correlation between vegetables diversity and total diversity scores with TOC in cataract patients. There was no significant association between HEI and total dietary diversity score quartiles in the both raw and stress adjusted analysis (p>0.05). Conclusion In the present study, results showed that increase in total and food groups' diversity can have a beneficial effect on oxidant/antioxidant situation among cataract patients. It may be assumed that in the first-degree cataract patients with lower mental stress, dietary dependent oxidative stress and HEI could be a more related factor in disease progression.