Mediterranean Diet

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Diabetic retinopathy (DR) is a devastating complication for people with diabetes and can cause decreased vision and blindness. The retina, which is located on the back part of the eye globe, converts visual images to nerve signals that are sent to the visual cortex, located in the back of the brain. The visual cortex then converts the nerve impulses into images that the brain reads as sight. The retina has small arteries and veins in it. The retina is also rich in long-chain omega-3 polyunsaturated fatty acids. These compounds have anti-inflammatory and antiangiogenic (prevents the proliferation of blood vessels) properties. In DR, the blood vessels proliferate and can cause small hemorrhages and bleeding, which can adversely affect vision. The bleeding in the retina often must be treated with lasers. Experimental models support using dietary omega-3 fatty acids as protection against DR, especially in older type 2 diabetics who are more prone to it.

Dietary omega-3 fatty acids mostly come from fish. Oilier fish have more of them. Fish is a large component of the Mediterranean diet, which I have written about before. This diet is rich in olive oil, fruits and vegetables, whole grains, nuts and seeds, and legumes. The diet contains no fats, no sugars, little meat, and no refined (white) flour or rice. Recently the National Institute of Health (NIH) in Bethesda, Maryland published a study comparing the Mediterranean diet to a low-fat diet for the prevention of DR in older patients. There were about 7,500 study participants and 3,600 of them had type 2 diabetes. They were followed for about six years. Participants were randomly assigned to either the Mediterranean diet, which had two to three servings of fish per week, or a low fat diet. The Mediterranean diet group had a significantly lower incidence of DR and DR requiring treatment.

But the study found other benefits from the diet. The Mediterranean diet group had a 30 percent reduction in cardiovascular events (heart attack, stroke, or death from cardiovascular disease) and had a lower all-cause mortality rate. The American Heart Association recommends a diet that includes two servings of fish per week to maintain good cardiovascular health. In addition several studies have shown that ingestion of more fish reduces the risk of developing age-related macular degeneration (AMD), a disease that reduces vision in older individuals and is difficult to treat. There are also some observational studies that have shown a beneficial relationship between dietary fish and the risk of dementia.

Of course weight reduction and tobacco elimination are two big factors in a healthier lifestyle, but it is becoming clear that a healthy diet that contains more fish, fruits and vegetables, whole grains and nuts, and less meat, sugars, and refined flour and rice is the way to go to live a longer and healthier life.

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