Dietary associations with diabetic retinopathy - A cohort study

Purpose: To assess the role of dietary factors in the development of diabetic retinopathy (DR) in diabetics. Methods: This prospective study was carried out on patients attending the outpatient department of ophthalmology for a period of 1 year. An interview-based 24-hour diet recall was used to document average daily dietary nutrient intakes. Each patient was subjected to a comprehensive ocular examination to look for DR. Results: A total of 261 patients attending the outpatient department of ophthalmology were the participants for this study. The mean (+/- SD) age of the participants was 57.73 +/- 11.29 years, and 67% were men. One hundred and six participants had DR. Univariate analysis revealed sex, duration, fish (times/week), egg (yes/no), rice lunch (yes/no), rice dinner, rice (boiled/white), and total calorie intake to be associated with DR (P < 0.05). Logistic regression multivariable analysis revealed males (OR: 3.20, 95% CI: 1.65-6.19), longer duration of diabetes (OR:1.05,95% CI:1.01-1.11), antioxidant intake (OR: 3.42, 95% CI: 1.65-7.05), and consumption of rice (OR: 3.19, 95% CI: 1.17-8.69) to have significant association with DR (P < 0.05), with the odds of developing DR increasing three times in these patients. The odds of developing DR were lesser with more frequent (>2 times/week) fish consumption (OR: 0.42, 95% CI: 0.180.94) and in patients on pharmacological treatment for diabetes mellitus (OR: 0.16, 95% CI: 0.04-0.58). Binary logistic regression revealed chapathi consumption (OR: 9.37, 95% CI: 1.64-53.68) to be associated with severe forms and fish consumption (OR: 0.06, 95% CI: 0.01-1.06) (P < 0.05) to be associated with less severe forms of DR. Conclusion: Males, longer duration of diabetes, antioxidant intake, fish consumption, and consumption of rice were associated with the occurrence of DR. Participants with diabetes who consumed fish more frequently and those who were on pharmacological treatment for diabetes mellitus had a significantly lower risk of DR and frequent fish consumption could reduce the risk of DR progression.