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Eggs and Eye Health

Eggs and eye health

Eggs and Eye Health

In 2017-18, 55% of Australians reported having at least one long-term vision disorder.1 Age-related eye disorders have been reported as the leading causes of vision impairment and blindness in Australia.1 These disorders include cataracts, age-related macular degeneration (AMD), diabetic retinopathy and glaucoma1, with age-related macular degeneration being the most common cause of blindness in older Australians.12 Over 240,000 Australians have age-related macular degeneration.1

The major risk factors for age-related eye disorders include smoking, unhealthy diet and lifestyle, family history and increasing age.3-5 Unhealthy lifestyles have been shown to increase AMD risk regardless of AMD risk genotype, though those at high genetic risk benefit more.5 Given Australia’s ageing population, eye health continues to be an important health issue to address. However, eye disorders are not only a problem for older adults - eye disorders are also among the most common long-term health problems experienced by Australian children.1 

Evidence indicates that several dietary factors such as fruit and vegetable intake6, antioxidant intake including lutein and zeaxanthin7-9, fat types8, omega-3 intake10,11, glycemic index12 and adequate intake of key vitamins and minerals6,13, play an important role in the development and progression of some of these disorders including AMD and cataracts. 

People with diabetes, in particular, have an increased risk of developing eye disease with an Australian study finding evidence of diabetic retinopathy in 16% of study participants.14 Improved diabetes control, which ideally involves dietary and lifestyle modification, reduces the risk of developing, and the progression of, diabetic retinopathy.15,16 

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Antioxidants and Eye Disease 

Lutein and zeaxanthin (with their isomer meso-zeaxanthin) are the primary antioxidant carotenoids found in the macular region of the retina.,9,17,18 Numerous studies have indicated lutein and zeaxanthin, (along with other nutrients such as omega-3), are essential components for eye health.9,19,21 Current evidence from human studies, suggest dietary intake of lutein and zeaxanthin can lead to their accumulation in the retina, and as a result may provide protection against retinal degeneration.9,22-24
 
The Blue Mountains Eye Study (BMES) showed that older adults with the highest intake of dietary lutein and zeaxanthin, had a reduced risk of developing late AMD (RR 0.35).10 A similar level of protection was found in a recent study in French adults where higher plasma lutein levels were associated with a 37% reduced risk of late AMD.25 Evidence in Chinese adults has also linked higher intakes of eggs and spinach (both good sources of lutein/zeaxanthin) with a reduced risk of AMD.57 
 
Further support for dietary lutein and zeaxanthin intake as a protective factor in AMD comes from the eye supplement trial, AREDS (Age-Related Eye Disease Study)28,29,30 which found the supplement lost its effectiveness if the background diet was sufficient in lutein and zeaxanthin. The majority of available evidence points towards lutein and zeaxanthin protecting against late AMD26 with limited, emerging evidence suggesting they may also have a role to play in preventing early AMD.22 
 
Individuals at high risk of AMD (i.e., those genetically susceptible to AMD) appear to benefit from a high lutein and zeaxanthin intake.31 Among participants with high genetic risk, the highest intake of lutein and zeaxanthin was associated with a >20% reduced risk of early AMD. No similar association was evident among participants with low genetic risk. 

Bioavailability of Carotenoids in Eggs

Eggs contain both of the antioxidants lutein and zeaxanthin, with one serve* of eggs containing around 300µg. While this is lower than most plant sources of these carotenoids, a number of studies have demonstrated that the lutein and zeaxanthin in eggs is bioavailable while factors in plants may reduce the bioavailability from these sources.9,32-34

Egg consumption has been shown to be an effective vehicle for increased uptake of lutein and zeaxanthin, with a recent systematic review of trials confirming egg consumption effectively raises blood carotenoid levels35-37and macular pigment optical density (MPOD).35,39,40 The level of increase differed in the studies dependent on level of egg consumption (1 to 4 eggs per day), duration of study and type of eggs used (regular verses lutein enriched).

Furthermore, LDL cholesterol levels were not found to increase despite the increases in carotenoid levels with egg consumption.35,36,39,40 Higher MPOD and lutein levels are associated with delayed progression of AMD.35 Due to both their high bioavailability and not being subject to seasonal variation, the consumption of eggs is a favourable source of lutein and zeaxanthin in the diet. 

Currently there is insufficient research to indicate an exact optimal level of intake of lutein and zeaxanthin for protecting against eye disease, although some researchers have suggested levels as high as 6mg per day.41,42 Although more recent research suggests possible protective effects at levels considerably below 6mg per day.7,9,43 
 
Overall, the research to date suggests that eggs are a highly bioavailable source of the dietary carotenoids, lutein and zeaxanthin, and that they are an effective vehicle for increased and site-specific antioxidant uptake. This in turn may have benefits for long term eye health given the data supporting the role of lutein and zeaxanthin.  
 

Omega-3 Fats and Eye Health 

The essential long chain omega-3 fatty acid docosahexaenoic acid (DHA) is a major structural lipid found in the photoreceptors of the retina and DHA deficiency is associated with alterations in the functioning of the retina and visual processing.  
 
Adequate intake of long-chain omega-3 can protect the eye from retinal damage caused by ischemia, oxidation, light, inflammation and age-associated diseases.45 Some research has shown that lower intakes of saturated fat and higher intakes of omega-3 fatty acids are protective against the development of certain eye diseases.10,45,46 
 
Individual studies47-50 as well as a recent meta-analysis of studies51 have found associations between the consumption of omega-3 and/or omega-3 status and a reduced risk of AMD. 
 
Of note, in 2010, the European Food Safety Authority (EFSA) asserted that consuming 250mg of DHA per day (in one or more servings), can make an important contribution towards maintaining vision in the general population.52  

Other Nutrients in Eggs

In addition to omega-3, lutein and zeaxanthin, adequate intakes of vitamin A, other antioxidants are thought to reduce the amount of visual degeneration in older adults.7,42 
 
For people aged 51 years and over, one serve of eggs* provides bioavailable vitamin A (15% RDI for women, 11% RDI for men), vitamin E (29% AI for women, 20% AI for men), selenium (48% RDI for women, 41% RDI for men), and zinc (12% RDI for women, 7% RDI for men). 

Dietary and Lifestyle Effects on Eye Health

Studies have linked diet quality, glycemic index (GI), alcohol intake and body mass index (BMI) with eye health.55,56 Studies using data from the Blue Mountains Eye Study have shown older adults with higher diet quality (better compliance with dietary guidelines) also had healthier retinal vessels53 and a decreased long-term risk of visual impairment.54 
 
Given the nutritional composition of eggs, they can make a valuable contribution to improved diet quality, help lower the GI of a meal/overall diet and may have a role to play in assisting weight management through appetite control. 

Conclusion

Eggs contain a range of nutrients and antioxidants that have been shown to contribute to long-term eye health. Eggs can therefore be enjoyed regularly as part of a healthy lifestyle that also includes the following: 

  • Smoking avoidance 
  • Enjoying at least 2 fish meals per week 
  • Eating other foods rich in carotenoids such as dark green and orange/yellow fruit and vegetables daily 
  • Reducing dietary sources of saturated fat 
  • Exercising regularly to control body weight and blood pressure 
  • Reducing the glycemic index of the diet 
  • Reduce alcohol intake  
  • If overweight, aiming for weight loss to assist with controlling blood glucose levels and fat loss
  • For people with type 2 diabetes, achieving and maintaining optimal blood glucose and cholesterol levels. 

This statement is for healthcare professionals only.

*One serve = 2x60g eggs (104g edible portion)
RDI: Recommended Dietary Intake
AI: Adequate Intake

Discover our super easy & delicious meal plans designed to help you achieve a healthy and balanced diet. Check out our eye health meal plan today! 

Useful links:

Macular Disease Foundation Australia: http://www.mdfoundation.com.au/

Vision Australia: https://www.visionaustralia.org/learn-more/eye-conditions/age-related-macular-degeneration

FAQs

What are antioxidants?

The term antioxidants covers a large number of substances (including some vitamins and minerals) which protect the body’s cells from the harmful effects of oxidation.

What types of vitamins, minerals and antioxidants are in eggs and how does this impact on eye health?

Eggs contain a range of vitamins and minerals including vitamin A, vitamin E and selenium which all act as antioxidants. Eggs also contain the carotenoids, lutein and zeaxanthin which are found in the macular region of the retina. Antioxidants can help protect the retina of the eye from progressive oxidative damage that occurs with ageing. In relation to eye health, the main evidence of benefit from egg nutrients is in relation to lutein and zeaxanthin, as well as long chain omega-3 fatty acids. High intake of these nutrients is associated with protection from age-related macular degeneration – the leading cause of blindness in older Australians.

Does overall lifestyle and diet have an impact on eye health?

Yes. Diet is a key factor in maintaining eye health. Leading causes of vision loss include AMD (age-related macular degeneration), cataract, glaucoma and diabetic retinopathy.

Since the eye is particularly susceptible to oxidative stress, dietary antioxidants such as vitamins A,C, E and selenium as well as lutein and zeaxanthin can provide important protection. Long-chain omega 3 fats also accumulate in the eye and are known to play an important role in eye health. Research is continuing to better understand how diet can impact on eye health.

My patient has diabetes/high cholesterol, can I still suggest eggs as a good source of antioxidants for eye health?

Eggs contain the antioxidants vitamin A, vitamin E, selenium, lutein and zeaxanthin, as well as omega-3 fats which have all been linked with maintenance of eye health. Eye health is of particular importance for patients with diabetes as they are at increased risk of eye disease if their diabetes is not well controlled. The Heart Foundation recommends individuals with diabetes and/or high cholesterol can enjoy up to seven eggs per week which will provide a range of nutrients including lutein and zeaxanthin for eye health.

Why are omega-3s so important?

The health effects of omega 3s have been relatively well established with evidence linking them with protection from heart disease, some inflammatory conditions and certain autoimmune disorders including rheumatoid arthritis. Omega 3s are important for infant growth and development and long chain DHA (a type of omega 3) is heavily concentrated in the brain and retina of the eye.

References:

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