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Carbohydrate nutrition, glycemic index, and the 10-y incidence of cataract^1,2,3

¹ From the Department of Ophthalmology, Centre for Vision Research, Westmead Millennium Institute, University of Sydney, Westmead Hospital, Sydney, Australia (JT, JJW, VF, SK, and PM), and the Human Nutrition Unit, University of Sydney, Sydney, Australia (VF, AB, and JB-M)

Background: Although dietary carbohydrates are thought to play a role in cataractogenesis, few epidemiologic studies have examined links between carbohydrate nutrition and cataract.

Objectives: We investigated the associations between dietary glycemic index (GI), glycemic load (GL), total carbohydrate intake, and 10-y incident nuclear, cortical, and posterior subcapsular cataract.

Design: Of 3654 baseline participants in an Australian population aged 49 y (1992–1994), 933 were seen after 5 and/or 10 y, had completed a detailed semiquantitative food-frequency questionnaire, had no previous cataract surgery or baseline cataract, and had photographs taken to assess incident cataract with the Wisconsin Cataract Grading System. Dietary information was collected with a validated food questionnaire. GI was calculated from a customized database of Australian foods. GI, GL, and all other nutrients were energy adjusted. Hazard ratios (HRs) and 95% CIs were calculated with the use of discrete logistic models.

Results: After age, sex, diabetes, and other factors were controlled for, each SD increase in GI significantly predicted incident cortical cataract (HR: 1.19; 95% CI: 1.01, 1.39). Participants within the highest compared with the lowest quartile of GI were more likely to develop incident cortical cataract (HR: 1.77; 95% CI: 1.13, 2.78; P for trend = 0.035). These findings were similar after excluding participants with diabetes, although they were slightly attenuated and marginally nonsignificant (HR: 1.16; 95% CI: 0.98, 1.37, per SD increase in GI). No association was found between GI and nuclear or posterior subcapsular cataract and between GL or carbohydrate quantity and any cataract subtype.

Conclusion: In an Australian cohort, poorer dietary carbohydrate quality, reflected by high GI, predicted incident cortical cataract.

Key Words: Cataract • cohort study • incidence • population • risk factors • Blue Mountains Eye Study • lens • nutrition • carbohydrate • glycemic index • glycemic load • glycation • humans • epidemiology • aging