High-fat, High-calorie Diets Can Increase Glaucoma Risk

These findings suggest that glaucoma patients could benefit from targeted life­style interventions, including increasing vitamin A and C intake, moderating water consumption, optimizing sleep quality and avoiding fatty foods. Integrating dietary and sleep assessments into glaucoma care may provide a personalized strat­egy to prevent disease progression and improve patient outcomes. Photo: Ashley Green/Unsplash. Diet and sleep patterns have been shown to affect metabolic health and may also affect optic nerve function. With glaucoma patients having optic nerve damage and the disease being a leading cause of blindness globally, Chinese researchers sought to find out exactly which factors influence the onset and progression of glaucoma. They investigated the relationships between dietary habits, sleep traits, amino acids, metabolites and inflammatory factors with glaucoma subtypes.They found that high-fat, high-calorie diets may increase glaucoma risk through metabolic and inflammatory pathways, while antioxidant-rich fruits, veg­etables, fiber-rich cereals and nutrient-dense foods pro­vide protective effects by mitigating oxidative stress and neurodegeneration. Notably, glaucoma patients had sig­nificantly lower vitamin A and C intake and higher water consumption, which may exacerbate intraocular pres­sure fluctuations and disease progression.Mendelian randomization (MR) analysis assessed the causal effects of 226 dietary factors, 11 sleep traits, 20 amino acids, 1,400 metabolites and 91 inflammatory factors on five glaucoma subtypes: normal-tension glaucoma (NTG), primary open-angle glaucoma (POAG), primary angle-closure glaucoma (PACG), neovascular glaucoma (NVG) and pseudoxfoliation glaucoma (XFG). The researchers then explored the role of amino acids and inflammatory factors in these relationships, and validation was conducted using NHANES cross-sectional data.Cheese, chocolate and bread may have a posi­tive causal relationship with the onset of NTG, while diets rich in meat and eggs showed a significant positive causal association with PACG. In POAG, naan bread was observed to increase the disease risk significantly. For NVG, foods such as bananas, chocolate raisins, sweet­eners, lamb, juice, red wine and biscuits significantly increased the risk of glaucoma.“The observed increase in proline levels due to soft cheese intake and alcohol intake frequency, which significantly elevated the risk of NTG, suggests a possible role in proline-associated oxidative stress in retinal ganglion cell damage,” the authors explained of the underlying mechanism in their Nutrition and Metabolism paper. In contrast, moderate consumption of the same or similar foods, such as grapes, cereals and cereal bars, demon­strated protective effects, highlighting the importance of intake quantity, dietary balance and nutrient composi­tion in NTG development.Foods such as naan bread, hard cheese, lamb, mango, dark chocolate, egg and energy-dense processed items were associated with POAG and PACG risk, suggesting that high-fat, high-calorie diets may contribute to glaucoma progres­sion through metabolic dysfunction or inflammatory pathways. This is consistent with previous studies showing that diets high in fat can exacerbate retinal oxidative stress and neurodegeneration.Regarding the underlying mechanism, the protec­tive effects of avocado intake on PACG through elevated tyrosine levels and complex cheese intake on POAG through tryptophan may reflect the neuroprotective properties of these amino acids, particularly in regulating neurotrans­mitter synthesis and reducing neuroinflammation, the authors explained in their article.Previous studies have shown that fruits and vegetables with antioxidant properties such as kale, collard greens and peaches protect against POAG in Black women. “Similarly, dietary fat may influence IOP through pathways involving endog­enous n-6 prostaglandins, and fat-free diets and paren­teral nutrition have been shown to reduce IOP,” the authors wrote in their paper. “Therefore, a low-fat, high-grain diet combined with antioxidant-rich fruits and vegetables may help prevent neurodegenerative diseases such as glaucoma.”Among sleep traits, daytime napping and daytime sleepiness were found to reduce the risk of POAG, suggesting that short, restorative naps or com­pensatory sleep episodes may help regulate systemic and ocular homeostasis, potentially alleviating stress-related pathways associated with glaucomatous damage, the authors wrote in their paper.“Simi­larly, the protective effect of sleep efficiency on XFG and the number of sleep episodes on PACG underscores the importance of stable and efficient sleep patterns in main­taining neurovascular integrity, as sleep disturbances are often linked to oxidative stress and dysregulation of ocular perfusion pressure,” the authors explained.The mediation analysis fur­ther deepened this understanding by identifying specific inflammatory mediators. “Sleep efficiency reduced XFG risk by promoting IL-1 A, a cytokine involved in tissue repair and immune regulation, which may mitigate tra­becular meshwork dysfunction and extracellular matrix remodeling, processes central to XFG pathology,” the authors wrote in their paper. “Indeed, IL-1α has been shown to induce matrix metalloprotein­ases in trabecular meshwork cells and increase aqueous humor outflow, potentially alleviating the outflow resis­tance characteristic of XFG.”Conversely, the associa­tion between daytime napping and reduced POAG risk through elevated PDL1 levels suggests an immunomodu­latory mechanism.However, the NHANES data showed that sleeping more than 12 hours was associated with an increased glaucoma risk, contracdicting the MR finding that longer sleep is protective. Regardless, the authors wrote that these results indicate that sleep-related interven­tions targeting immune modulation and inflammation could offer potential glaucoma prevention and manage­ment strategies, as well as patients incorporating a low-fat, high-grain diet combined with antioxidant-rich fruits and vegetables.“These findings underscore the importance of dietary interventions targeting amino acid pathways as a promising approach for glaucoma pre­vention and management,” the authors concluded.Click here for the journal source. Shengnan Z, Tao W, Yanan Z, Chao S. Exploring the impact of diet, sleep and metabolomic pathways on glaucoma subtypes: insights from Mendelian randomization and cross-sectional analyses. Nutrition & Metabolism. July 10, 2025. [Epub ahead of print.]