Podcast – Episode 1


Protect, Prevent, Preserve Your Eyes Podcast: EPISODE 1

Elizabeth Nystrom & Olivia Mohney





Elizabeth: Welcome to Protect, Prevent, Preserve Your Eyes. My name is Elizabeth Nystrom, a master of public health student, and this is Olivia Mohney, a public relations student at Baylor University.


Olivia: We will be your guides for this educational podcast which will look at various eye conditions, risk factors for developing these conditions, and what you can do to aid in preventing some of these conditions.


E: We both work for Association for the Blind and Visually Impaired (ABVI), a nonprofit organization focused on helping those with vision loss thrive in a sighted world. More background information on ABVI, the services offered, and ways to donate or get involved can be found on the website abvimichigan.org.


O: Our first episode of this podcast will provide background information on various eye conditions but will primarily focus on how diet and diabetes influence these conditions. With that, let’s get started!





E: Before we get into the segment on diet and diabetes, let’s first gain our footing by briefly discussing the eye conditions that you’ll hear throughout this podcast. If you’re a sighted person following this podcast and want to experience what some of these conditions look like, pop over to our Instagram page where Olivia has provided some examples.


E: Our first condition is age-related macular degeneration, or AMD. This is the leading cause of blindness among individuals age 55 and older and affects approximately 30 to 50 million individuals world-wide. The disease is characterized by damage, called ‘drusen’ to the central part of the retina, which is responsible for detailed vision. This damage to the retina leads to shadows and distortion of central vision.


E (continued): A major study, the AREDS trial, focused on learning about AMD, its risk factors, and potential treatment options. This study classifies AMD based on a severity scale that includes early AMD, intermediate AMD, advanced non-neovascular AMD, which is also known as ‘dry’ AMD, and advanced neovascular AMD, or ‘wet’ AMD. Early AMD is characterized by the presence of a few small or medium-sized drusen and it can be asymptomatic or associated with mild vision impairment. Intermediate AMD is characterized by the presence of at least one large drusen. This can progress to either dry AMD or wet AMD. The dry form involves the presence of large drusen and atrophy, which is weakening, of the retinal pigment epithelium, a component of the retina in your eye. The wet form is characterized by formation of new vessels in the eye and retinal pigment epithelium detachment. Most cases of AMD are dry, but some can slowly progress into the wet stage. There is no treatment available for dry AMD, but wet AMD may be treated with injections through a retinal specialist.


O: Interestingly, almost 90% of severe blindness is a result of wet AMD. Some risk factors for the development of AMD include age, oxidative stress, exposure to UV light, and tobacco use, all of which will be discussed during episodes of this podcast.


O (continued): This leads us to our next condition, cataracts. Similar to AMD, these are also a primary cause of blindness among individuals over age 40. AMD tends to affect individuals older than 55, while cataracts can develop at a younger age.


O (continued): A cataract is defined as ‘cloudiness’ or any visible opacity in the lens of the eye, which leads to progressively blurred vision. There are several forms of cataract which include nuclear, cortical, and posterior subscapular (PSC), all of which affect different portions of the lens and have unique symptoms associated with them. Treatment for cataracts involves surgical removal which can potentially lead to permanent scarring of the lens. Some risk factors for cataract development include age, exposure to UV light, poorly managed diabetes, corticosteroid use, and tobacco use.


E: Next is glaucoma, a progressive, degenerative disease which involves the optic nerve of the eye and is associated with loss of visual field and blindness. Individuals with glaucoma usually struggle with loss of peripheral vision.  There are two main forms of glaucoma. Open-angle glaucoma is painless, generally asymptomatic, and chronic. Closed-angle glaucoma is associated with sudden onset eye pain, redness, nausea, and increased intra-ocular pressure, which is the pressure within the eye. Primary open-angle glaucoma is the most common form and affects approximately 60 million individuals world-wide.


E (continued): Known risk factors for glaucoma include aging, family history of it, African ancestry, and elevated intra-ocular pressure, however, many patients who have primary open-angle glaucoma have normal pressure in their eye. This is referred to as normal tension glaucoma. Normal tension glaucoma is common and is estimated to account for nearly 40% of open-angle glaucoma cases among white individuals and up to 90% of cases among individuals of Asian heritage. There are few effective treatments for glaucoma aside from daily eye drops.


O: Last but not least, we have diabetic retinopathy. This condition is characterized by damage to or abnormal growth of blood vessels in the retina, which then become leaky or blocked. Both can cause scarring of the retina and blindness. Vision loss associated with this condition typically occurs due to swelling in the central part of the retina.


O (continued): Diabetic retinopathy can be further divided into two types, non-proliferative and proliferative. With the non-proliferative form, vision is not compromised, however, with the proliferative form, loss of vision can occur. Progression of the non-proliferative form into the proliferative stage can be delayed through tight control of blood sugars. As stated by the name, the primary risk factor for diabetic retinopathy is poorly managed diabetes of any form.


E: The conditions that we discussed in this section are not exhaustive. There are a multitude of eye conditions, all with different risk factors. But for the purposes of this podcast, we mention only the most common.





O: Diet. When I think about the word diet, I think about those diet trends and fads that seem to come and go faster than ever now. From Keto to Paleo, Intermittent Fasting, Vegan, Whole30 the list seems to be never ending. All these different diets have made it more complicated than ever when it comes to achieving a healthy diet. When I think about changing my diet I automatically think about creating this drastic change, such as cutting out all carbs. Although things like this are never stable, I have found that the most sustainable way to improve my diet is to make small changes. Adding new foods to increase the amount of vitamins I am getting each day and removing a few unhealthy foods is as complicated as it needs to be in order to achieve a healthy diet.


E: In terms of eye health, many aspects of our diet influence our likelihood of developing conditions such as age-related macular degeneration, cataracts, glaucoma, and diabetic retinopathy. There have been many studies examining the effects of various nutrients and supplements on eye health. Today, we’ll look at vitamin C, vitamin E, some carotenoids, fatty acids, zinc, and dietary carbohydrates.


E (continued): A significant portion of studies have found that vitamin C has a protective effect against all forms of cataracts. Meaning, individuals who actively incorporate vitamin C into their diet have a lower risk for developing cataracts over a 10-year period. The suggested dose of vitamin C is near 135 mg per day. For reference, if you go to the store and buy vitamin C supplements, those can range anywhere from 500 mg to 1000 mg. Additionally, the vitamin C content of an orange is roughly 50 mg. In terms of protecting against AMD, vitamin C has little effect. In fact, there have been some studies that found very high intakes of vitamin C could actually increase your risk for developing AMD. But don’t let this create fear, vitamin C is still an essential component of a regular diet. Further, adding vitamin E into your diet could help protect against AMD in addition to protecting against cataracts, as several studies suggest this. Olivia, can you elaborate on how individuals could incorporate vitamin C and E into their diet better?


O: Of course! Now a simple answer to is to simply take a multivitamin each day that has vitamin C and E in it. However, multivitamins can be expensive, and if your like me, I often forget to take my multivitamins. There are lots of foods that you incorporate into your diet to increase the amount of Vitamin C and E. Some of my favorite foods that have vitamin C and E are spinach and avocado which I love to incorporate into my omelet during breakfast each morning. Strawberries, Peppers, broccoli, oranges, and mangos. However there are lots of supplements that can be taken as well if these foods aren’t in season, besides a multivitamin, some of them are pretty creative too, like the AREDS eye drops.


E: I’m sure many of you have seen or heard commercials for AREDS eye drops? Well, these were developed during a pivotal study, the AREDS trial, which found that supplementing the diet with a combination of vitamin C, vitamin E, beta-carotene, and zinc reduced the risk of AMD for persons over the age of 55. Moreover, participants in this trial who already had AMD and were given a zinc supplement were less likely to progress into advanced AMD than those who did not receive zinc.


O: There are lots of other ways to get zinc into your diet, eating foods such as poultry, almonds and cashews are some of my personal favorite foods. However like I said before you can also take a multivitamin that has zinc as well. One of my favorite recipes that incorporates many of the vitamin rich foods are salads. I love to incorporate almonds and grilled chicken into a strawberry spinach salad. This salad is anything but boring, I will provide the link to the recipe on our Instagram @abvimichigan. This salad has a lot of great vitamins and tastes amazing, it also has a lot of great antioxidants as well.


E: Comment on what Olivia said. Several antioxidants have been shown to absorb light, protect against oxidative damage, and protect against inflammation. The two most important antioxidants for eye health are lutein (“loodein”) and zeaxanthin (“zee-AH-zanthin”). Many studies have shown that supplementing the diet with these carotenoids can protect against the development of cataracts and AMD. One study found that individuals who supplemented their diet with at least 6 mg per day had a significant reduction in their risk for developing multiple forms of cataracts and a reduction in the risk for developing AMD. Finally, another study found evidence that these nutrients may aid in preventing the development and progression of glaucoma and diabetic retinopathy. Olivia, what are the best ways for individuals to increase their intake of lutein and zeaxanthin?


O: Now I have high cholesterol, which is fairly unique for someone my age. I work out everyday and eat healthy, but that doesn’t affect my cholesterol levels. So I have to stay away from a lot of other foods that contain zinc such as red meat and dairy. However both of these foods are excellent sources of zinc. This is not to say that I don’t get enough protein, I prefer to get my protein from foods that are rich in essential fatty acids such as chia seeds, mackerel and salmon.


E: Remember when we mentioned the AREDS trial? This trial also looked at the effect of supplementing the diet with essential fatty acids, such as omega-3’s. Basically, there are multiple forms of fatty acids, we hear about ‘trans-fats’, ‘good-fats’, ‘bad-fats’, all kinds of ‘fats’. The ones that are important for eye health are docosahexaenoic acid (DHA) and eicosapentaenoic acid (EHA). Both of which are commonly found in fish, which Olivia will elaborate on in a minute. The AREDS trial found that individuals with AMD who had higher intake of DHA (more than 64 mg per day) had a lower risk for their AMD progressing into advanced AMD. For reference, your average omega-3 supplement that you can buy at the store is about half DHA and half EHA, and these can range from 500 mg supplements to 1200 mg supplements, meaning you’re getting more than the dose that was used in the AREDS trial. Finally, although trans-fats aren’t the healthy fats and they can contribute poorly to your health in other ways, they have not been shown to contribute to the development of eye conditions such as AMD.


O: Now I love fish, but as that one saying goes too much a good thing can be bad. This applies to getting nutrients from fish. Cod liver oil, which I promise is not as gross as it sounds, is an incredible way to get omega 3. However, make sure to only take a tablespoon of oil at a time. Cod liver oil also has a lot of Vitamin A and too much vitamin A can be super harmful. Other fish such as salmon and canned tuna are also great sources of omega 3. However, make sure to not eat too much canned tuna because it contains mercury and could be poisonous if eaten too much at a time. There are also lots of other ways to incorporate omega 3 such as flaxseeds, chia seeds and oatmeal. Taking vitamin supplements are also a great way to incorporate omega 3. I have been talking a lot about taking vitamins, but I wanted to let you all know that my favorite place to get vitamins is at my local health food store. They have lots of organic vitamins that don’t have a lot of unnecessary sugar in it. However, places such as CVS, Walgreens and Target also have a great selection of vitamins and supplements.



E: Lastly, we’ll wrap up our discussion on diet by talking a bit about dietary carbohydrates and how these specifically contribute to eye health and then work our way into diabetes. Dietary carbohydrates and the glycemic index have been the focus of a lot of research into how they contribute to eye health and disease. Glycemic index refers to the ability of a food to raise blood sugar levels. So, a high glycemic index food, like a donut, has the ability to increase blood sugar levels more so than a food of standard comparison. High glycemic index foods aren’t always foods with high sugar content either! A potato is a high glycemic index food.


E (continued): There have been a number of studies that demonstrated a correlation between consuming high glycemic index foods and increased risk for various types of AMD and cataracts. In addition, the consumption of high glycemic index foods and excess dietary carbohydrates can put you at risk for developing type II diabetes, which can additionally contribute to the development of eye disease and will be our topic for next week!


O: Like I said earlier, I have high cholesterol, so I have to be careful in how much carbs and sugar I eat. This was really hard for me because I have a big sweet tooth. But I have found lots of great ways to limit sugar and carb intake. I have found that whenever I am craving a cupcake or ice cream, I will have an apple or grapes instead. Apples also have a low glycemic index which means that they won’t raise your blood sugar after eating them One of my favorite after dinner treats are frozen blueberries. Blueberries also have a low glycemic index as well. Frozen blueberries are often the best way for me to trick my brain into stop craving a popsicle or ice cream. When it comes to sugar and carb intake, sometimes making a few food swaps will make the biggest difference. I have also found that a lot of the “diet friendly” desserts are actually worse for you than the original food. Items such as protein bars often have the same amount of sugar as a candy bar. So, its important to make smart decisions when shopping for healthy alternatives at the grocery store.





O: Thank you for joining us today and listening to our podcast. Next week, we’ll talk a bit about how the various forms of diabetes affect eye health and some ways that you can manage your diabetes to help reduce the risk of developing certain eye conditions. We’ll also have a guest speaker, one of the optometry interns in our office, who can elaborate a bit more!


E: References for this podcast will be uploaded to ABVI website should any of the studies interest you, I will admit though, they are quite technical in their reporting. Thanks so much for listening to the Triple P Podcast if you would like to connect with us in between podcasts make sure to follow us on Instagram and Facebook, @abvimichigan and make sure to join us next week, thanks for listening to the Prevent, Protect and Preserve Podcast.



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