Handbook of Nutrition and Ophthalmology (eBook)

Series Editor Introduction 8
Foreword 11
Preface 13
Contents 15
1 Nutritional Blindness ( Vitamin A Deficiency Disorders) 16
1. INTRODUCTION 16
2. HISTORICAL BACKGROUND 16
2.1. Early Perspectives on Xerophthalmia 17
2.2. Characterization of Vitamin A 19
2.3. Vitamin A Deficiency and Increased Mortality in Children: Lessons From Denmark 20
2.4. Ellison’s Landmark Trial and Other Therapeutic Trials of Vitamin A, the “ Anti- Infective” Vitamin, 1920 – 1940 21
2.5. Public Health Measures to Improve Vitamin A Status in the United States and Europe 24
2.6. Vitamin A Deficiency, Infection, and Mortality in Developing Countries— A Recurring Theme 24
2.7. Initiation of National Programs of Vitamin A Supplementation in the Early 1970s 27
2.8. Further Investigations of the Relationship Between Vitamin A Deficiency and Child Mortality 28
3. BIOCHEMISTRY AND METABOLISM OF VITAMIN A 3.1. Structure and Characteristics of Vitamin A 29
3.1. Structure and Characteristics of Vitamin A 29
3.2. Dietary Sources and Metabolism of Vitamin A 29
3.3. Retinoic Acid Receptors and Gene Regulation 34
3.4. Dietary Requirements for Vitamin A 35
4. CLINICAL FEATURES 36
4.1. Xerophthalmia and Keratomalacia 36
4.2. Immune Suppression and Inflammation 49
4.3. Increased Infectious Disease Morbidity and Mortality 54
4.4. Growth Retardation 56
4.5. Anemia 57
4.6. Other 62
5. EPIDEMIOLOGY 63
5.1. Prevalence and Incidence 63
5.2. Global Distribution 63
5.3. Risk Factors for Vitamin A Deficiency 72
6. DIAGNOSIS OF VITAMIN A DEFICIENCY 84
6.1. Clinical Diagnosis 84
6.2. Assessment of Vitamin A Status 85
7. TREATMENT OF VITAMIN A DEFICIENCY 90
7.1. Vitamin A Capsules 90
7.2. Adjunct Treatments 91
8. PREVENTION OF VITAMIN A DEFICIENCY 91
8.1. Dietary Modification 91
8.2. Food Fortification 91
8.3. Control of Infectious Diseases 92
8.4. Breastfeeding Practices 92
8.5. Plant Breeding 92
8.6. Vitamin A Capsule Distribution 92
9. CONCLUSIONS 93
REFERENCES 93
2 Cataract 135
1. INTRODUCTION 135
2. HISTORICAL BACKGROUND 135
3. EPIDEMIOLOGY 135
3.1. Definitions 135
3.2. Grading of Lens Opacities 136
3.2. Prevalence and Incidence 136
3.3. Nutritional Risk Factors for Cataract 138
3.4. Other Risk Factors for Cataract 155
3.5. Cataract and Mortality 159
4. CLINCAL FEATURES 160
5. PATHOGENESIS OF CATARACT 160
5.1. Nuclear Cataract 162
5.2. Cortical Cataract 163
5.3. Posterior Subcapsular Cataract 164
5. TREATMENT OF CATARACT 164
6. PREVENTION OF CATARACT 164
7. CONCLUSIONS 168
REFERENCES 169
3 Age-Related Macular Degeneration 176
1. INTRODUCTION 176
2. HISTORICAL BACKGROUND 176
3. EPIDEMIOLOGY 177
3.1. Definitions 177
3.2. Incidence and Prevalence 177
3.3. Risk Factors 178
4. CLINICAL FEATURES 190
5. PATHOPHYSIOLOGY 192
5.1. Pathological Features of Age-Related Macular Degeneration 192
5.2. Oxidative Stress 194
5.3. Carotenoids 197
5.4. Vitamin E 207
5.5. Zinc 215
6. DIAGNOSIS 215
7. TREATMENT 215
8. PREVENTION 215
9. CONCLUSIONS 216
REFERENCES 218
4 The Obesity Epidemic 231
1. INTRODUCTION 231
2. HISTORICAL BACKGROUND 231
3. Patterns of the Nutrition Transition 232
4. DEFINITIONS 232
5. EPIDEMIOLOGY OF THE GLOBAL OBESITY EPIDEMIC 233
5.1. Prevalence and Incidence in Adults 233
5.2. Prevalence and Incidence in Children 233
5.3. Regions of the World 234
6. PATHOGENESIS 238
6.1. High Fat Intake 238
6.3. Television 238
6.4. Low Physical Activity 239
6.5. Poor Community Design 240
6.6. Childhood Obesity as a Predictor of Adult Obesity 241
7. IMPLICATIONS OF THE OBESITY EPIDEMIC FOR EYE HEALTH 241
7.1. The Obesity Epidemic and Diabetes Mellitus 241
7.2. The Changing Epidemiology of Diabetic Retinopathy 242
7.3. Economic Impact 242
7.4. Obesity and Other Eye Conditions 244
8. PREVENTION 245
8.1. Prevention in the Perinatal Period 245
8.2. Promotion of Breastfeeding 245
8.3. Reduction of Sedentary Behavior and Increased Physical Activity 245
8.4. Diet 247
9. CONCLUSION 248
REFERENCES 248
5 Nutrition and Diabetic Retinopathy 253
1. INTRODUCTION 253
2. EPIDEMIOLOGY 253
2.1. Prevalence and Incidence 253
2.2. Risk Factors for Diabetic Retinopathy 254
3. NUTRITION AND DIABETIC RETINOPATHY 256
3.1. Vitamin C 256
3.2. Vitamin E 256
3.3. Zinc 257
3.4. Healthy Dietary Pattern 257
4. CLINICAL FEATURES 258
5. PATHOGENESIS 258
5.1. Diabetic Retinopathy 258
5.2. Systemic Diabetes Mellitus 262
6. TREATMENT 262
7. PREVENTION 263
7.1. Prevention of Diabetic Retinopathy in Diabetics 263
7.2 Prevention of Diabetes in People at High Risk 263
8. CONCLUSIONS 264
REFERENCES 265
6 Retinal Vascular Disease 269
1. INTRODUCTION 269
2. HYPERHOMOCYSTEINEMIA 2.1. Historical Background 269
2.1. Historical Background 269
2.2. Homocysteine Metabolism 269
2.3. Relationship Between Folate Status and Homocysteine 271
2.4. Relationship Between Vitamin B6 Status and Homocysteine 273
2.5. Relationship Between Vitamin B12 Status and Homocysteine 274
2.6. Epidemiology of Hyperhomocysteinemia 274
2.7. Hyperhomocysteinemia and Cardiovascular Disease 274
2.8. Hyperhomocysteinemia and Peripheral Vascular Disease 277
2.9. Hyperhomocysteinemia and Cerebrovascular Disease 277
2.10. Hyperhomocysteinemia and Retinal Vascular Disease 277
2.11. Prevention of Hyperhomocysteinemia 279
3. DISORDERS OF IRON METABOLISM 279
3.1. Iron Deficiency 279
3.2. Excess Iron Stores 282
4. ANOREXIA NERVOSA 284
5. HYPERLIPIDEMIAS AND LIPEMIA RETINALIS 284
5.1. Hyperlipidemias 284
5.2. Historical Background 285
5.3. Clinical Presentation 285
5.4. Laboratory Findings 286
5.5. Management of Hyperlipidemias 286
6. CONCLUSIONS 286
REFERENCES 287
7 Nutritional Amblyopia and B Complex Vitamin Deficiencies 293
1. INTRODUCTION 293
2. PUBLIC HEALTH SIGNIFICANCE 293
3. HISTORICAL BACKGROUND 293
4. EPIDEMIOLOGY 294
5. CLINICAL FEATURES 294
6. PATHOGENESIS 295
6.1. Thiamin Deficiency 295
6.2. Niacin Deficiency 306
6.3. Folate Deficiency 314
6.4. Vitamin B12 Deficiency 318
6.5. So-Called “Tobacco-Alcohol Amblyopia” 323
6.6. Nutritional Amblyopia During Times of War 325
6.7. Case Study: The Cuban Neuropathy Epidemic 332
7. DIAGNOSIS OF NUTRITIONAL AMBLYOPIA 341
8. TREATMENT OF NUTRITIONAL AMBLYOPIA 342
9. RIBOFLAVIN DEFICIENCY 342
9.1. Historical Background 342
9.2. Biochemistry of Riboflavin 343
9.3. Dietary Sources of Riboflavin 343
9.4. Absorption, Storage, and Metabolism of Riboflavin 344
9.5. Functions of Riboflavin 344
9.6. Requirements for Riboflavin 345
9.7. Epidemiology of Riboflavin Deficiency 345
9.8. Assessment of Riboflavin Deficiency 346
9.9. Clinical Manifestations of Riboflavin Deficiency 346
9.10. Treatment of Riboflavin Deficiency 350
10. CONCLUSIONS 350
REFERENCES 351
8 Zinc and Eye Health 367
1. INTRODUCTION 367
2. HISTORICAL BACKGROUND 367
3. BIOCHEMISTRY OF ZINC 368
4. DIETARY SOURCES OF ZINC 368
5. ABSORPTION, METABOLISM, AND STORAGE OF ZINC 369
6. FUNCTIONS OF ZINC 370
7. REQUIREMENTS FOR ZINC 373
8. EPIDEMIOLOGY OF ZINC DEFICIENCY 373
9. ASSESSMENT OF ZINC DEFICIENCY 373
10. CLINICAL MANIFESTATIONS OF ZINC DEFICIENCY 374
10.1. General Clinical Manifestations 374
10.2. Ocular Findings in Acrodermatitis Enteropathica 374
10.3. Acquired Zinc Deficiency 375
10.4. Zinc Deficiency and Impaired Dark Adaptation 376
11. TREATMENT AND PREVENTION OF ZINC DEFICIENCY 376
12. CONCLUSIONS 376
REFERENCES 377
9 Vitamin C and Eye Health 383
1. INTRODUCTION 383
2. HISTORICAL BACKGROUND 383
3. BIOCHEMISTRY OF VITAMIN C 384
4. DIETARY SOURCES OF VITAMIN C 384
5. ABSORPTION, STORAGE, AND METABOLISM OF VITAMIN C 384
6. FUNCTIONS OF VITAMIN C 385
7. REQUIREMENT FOR VITAMIN C 386
8. EPIDEMIOLOGY OF VITAMIN C DEFICIENCY 386
9. ASSESSMENT OF VITAMIN C STATUS 387
10. CLINICAL MANIFESTATIONS OF VITAMIN C DEFICIENCY 388
10.1. General Systemic Manifestations of Scurvy 388
10.2. Ophthalmological Findings During Scurvy 388
10.3. Vitamin C and Corneal Wound Healing 390
10.4. Vitamin C and Cataracts 392
10.5. Vitamin C and the Retina 394
10.6. Vitamin C in Human Tears 395
11. PREVENTION AND TREATMENT OF MARGINAL VITAMIN C STATUS AND DEFICIENCY 395
12. CONCLUSIONS 396
REFERENCES 396
10 The Age-Related Proinflammatory State and Eye Disease 403
1. INTRODUCTION 403
2. BIOMARKERS IN THE PROINFLAMMATORY STATE 403
2.1. Interleukin-1 404
2.2. Tumor Necrosis Factor- 404
2.3. Interleukin-6 404
2.4. Interleukin-18 405
2.5. C-Reactive Protein 405
2.6. Fibrinogen 406
2.7. Transforming Growth Factor-ß1 406
2.8. IL-1 Receptor Antagonist 406
2.9. Interleukin-10 407
3. THE CYTOKINE NETWORK IN THE PROINFLAMMATORY STATE 407
4. UPREGULATION OF THE PROINFLAMMATORY STATE 407
5. ANTIOXIDANT DEFENSE MECHANISMS 410
5.1. Antioxidant Enzymes 410
5.2. Carotenoids 410
5.3. Vitamin E 411
5.4. Selenium 411
5.5. Ascorbate 411
5.6. Plant Polyphenols 411
6. ANTIOXIDANT SUPPLEMENTS VS A HEALTHY DIET 412
7. ROLE OF REDOX SIGNALING IN THE EXPRESSION OF INFLAMMATORY CYTOKINES 413
8. CONCLUSIONS 417
REFERENCES 417
11 Essential Fatty Acids and Visual Development in Infants 427
1. INTRODUCTION 427
2. PUBLIC HEALTH SIGNIFICANCE 427
3. HISTORICAL BACKGROUND 428
4. BIOCHEMISTRY OF FATTY ACIDS 429
5. ABSORPTION AND METABOLISM OF ESSENTIAL FATTY ACIDS 429
6. DIETARY SOURCES OF ESSENTIAL FATTY ACIDS 432
7. ASSESSMENT OF ESSENTIAL FATTY ACID STATUS 433
8. DIETARY REQUIREMENTS FOR ESSENTIAL FATTY ACIDS 434
9. OVERVIEW OF INFANT VISUAL DEVELOPMENT 435
10. ROLE OF ESSENTIAL FATTY ACIDS IN RETINAL FUNCTION 435
10.1. Docosahexaenoic Acid in the Retina 435
10.2. Animal Studies of DHA Depletion and Retinal Function 436
10.3. Potential Functions for DHA in the Retina 437
11. ESSENTIAL FATTY ACIDS IN VISUAL DEVELOPMENT OF INFANTS 438
11.1. Methods Used for Assessing Visual Development of Infants 438
11.2. Observational Studies 439
11.3. Clinical Trials in Preterm Infants 441
11.4. Clinical Trials in Term Infants 443
11.5. Implications of the Clinical Trials 446
12. CONCLUSIONS AND RECOMMENDATIONS 448
REFERENCES 448
12 Inborn Errors of Metabolism 454
1. INTRODUCTION 454
2. ABETALIPOPROTEINEMIA (BASSEN-KORNZWEIG SYNDROME) 454
2.1. Historical Background 454
2.2. Clinical Features 455
2.3. Metabolic Aspects 456
2.4. Nutritional Approaches to the Treatment of Abetalipoproteinemia 457
2.5. Familial Hypobetalipoproteinemia 458
3. GYRATE ATROPHY 3.1. Clinical Features 458
3.1. Clinical Features 458
3.2. Metabolic Aspects 459
3.3. Experimental Animal Studies 460
3.4. Nutritional Approaches to the Treatment of Gyrate Atrophy 461
4. REFSUM DISEASE 462
4.1. Clinical Features 462
4.2. Metabolic Aspects 463
4.3. Nutritional Approaches to the Treatment of Refsum Disease 465
5. GALACTOSEMIA 465
5.1. Clinical Features 465
5.2. Metabolic Aspects 465
5.3. Nutritional Approaches to the Treatment of Galactosemia 466
6. OCULOCUTANEOUS TYROSINEMIA ( TYROSINEMIA TYPE II, RICHNER- HANHART SYNDROME) 468
6.1. Clinical Features 468
6.2. Metabolic Aspects 468
6.3. Nutritional Approaches to the Treatment of Oculocutaneous Tyrosinemia 469
7. X-LINKED ADRENOLEUKODYSTROPHY 469
7.1. Clinical Features 469
7.2. Metabolic Aspects 470
7.3. Nutritional Approaches to the Treatment of Adrenoleukodystrophy 471
8. HOMOCYSTINURIA (CYSTATHIONINE ß-SYNTHETASE DEFICIENCY) 471
8.1. Clinical Features 471
8.2. Metabolic Aspects 472
8.3. Nutritional Approaches to the Treatment of Homocystinuria 473
9. WILSON DISEASE (HEPATOLENTICULAR DEGENERATION) 475
9.1. Clinical Features 475
9.2. Metabolic Aspects 476
9.3. Nutritional Approaches to the Treatment of Wilson Disease 478
10. MENKES DISEASE 478
11. SORSBY FUNDUS DYSTROPHY 479
11.1. Clinical Features 479
11.2. Genetic and Metabolic Aspects 479
11.3. Treatment of Sorsby Fundus Dystrophy With Vitamin A 480
12. RETINITIS PIGMENTOSA 480
12.1. Clinical Features 480
12.2. Metabolic Aspects 480
12.3. Nutritional Intervention for Retinitis Pigmentosa 480
13. MAPLE SYRUP URINE DISEASE 481
14. MOLYBDENUM COFACTOR DEFICIENCY AND ISOLATED SULFITE OXIDASE DEFICIENCY 481
15. OTHER 482
16. CONCLUSIONS AND RECOMMENDATIONS 482
REFERENCES 482
Index 495