U.S. Dietary Guidelines are expected to shift
Optometrists may soon by tweaking the dietary and nutritional advice they give to patients.
"Healthy eyes generally belong to healthy people."
Every five years, the Department of Health and Human Services and the Department of Agriculture release updated, Dietary Guidelines for Americans, and the next publication is due at the end of 2015.
Ahead of the 2015 update, an advisory committee—made up of 14 nationally recognized experts in the fields of nutrition, medicine and public health—recently released their recommendations for the publication.
The recommendations call into question previously held stances about cholesterol intake and label specific nutrients as generally underconsumed or overconsumed.
A. Paul Chous, O.D., AOA representative to the National Diabetes Education Program of the National Institutes of Health (NIH), says optometrists need to take note of the changing dietary recommendations.
"These 2015 recommendations are important because they reflect with high fidelity much of the most recent evidence with respect to diet and disease, including eye disease," says Dr. Chous. "Healthy eyes generally belong to healthy people, so it's imperative for optometrists to be familiar with science-based recommendations that may positively impact a number of systemic and ocular pathologies affected by nutritional intake."
Most notable and controversial, perhaps, is the committee's stance on cholesterol intake, which previous recommendations have limited to no more than 300 mg per day. The recent report, however, states that "cholesterol is not a nutrient of concern for overconsumption."
"The emphasis on reducing dietary fat over the past 40 years has been an abysmal failure for public health," Dr. Chous says. "Overconsumption of highly refined carbohydrates, added sugars and unhealthy fats, coupled with sedentary lifestyle and sleep deprivation, are the major determinants of obesity-related conditions, which increase the risk of insulin resistance, diabetes and all the associated eye complications—retinopathy, cataract, AMD and more."
The report also identifies vitamins A, D, E and C; folate; calcium; magnesium; potassium and fiber as underconsumed "shortfall nutrients." Dr. Chous notes that deficiencies in these nutrients are related to eye health.
Nutrients work in concert, Dr. Chous adds, but most 'vitamin studies' look at single nutrients rather than the synergistic effect of many nutrients. "A healthy diet is the optimal way to receive these nutrients, yet most Americans do not achieve adequate dietary intake, which is why a broad spectrum, dose-appropriate multivitamin and mineral supplement makes sense for most every patient," he says.
ODs can play a role in nutritional counseling
ODs act as an entry point into the health care arena for many Americans, according to Dr. Chous. This is why ODs are often on the front lines of detecting conditions such as diabetes and diabetic retinopathy, age-related macular degeneration, glaucoma, ocular surface disease, cataract and, more generally, hypertension, cardiovascular disease and cancer.
Optometrists should use their direct contact with patients as an opportunity to talk about the importance of good nutrition and maintaining a healthy lifestyle.
"The most important things to let patients know is that inheriting 'bad genes' doesn't doom someone to poor health outcomes," notes Dr. Chous. "Genes load the gun, but our behaviors pull the trigger. Doing something to improve nutritional intake is better than doing nothing."