Healthy Dietary Patterns and Risk of Major Eye Diseases: Evidence From Nationally Population-Based Data and Bibliometric Analysis

Abstract

The associations between dietary patterns and major eye diseases remain incompletely understood. This study conducted a cross-sectional analysis of 4241 participants from the 2005-2008 National Health and Nutrition Examination Survey. Eye diseases were assessed using fundus photography and self-reported information, while dietary patterns were evaluated based on two 24-h dietary recalls. Survey-weighted logistic regression and restricted cubic spline models were applied with adjustment for complex sampling design and relevant covariates, alongside subgroup and dietary component-specific analyses. In fully adjusted models, higher HEI-2020 scores were associated with lower odds of retinopathy and composite eye disease outcomes with or without cataract surgery. Similarly, greater adherence to the DASH was inversely associated with retinopathy and composite eye disease outcomes. Mediterranean diet adherence was also associated with reduced odds of retinopathy, and a non-linear association was observed between Mediterranean diet adherence and cataract risk. Subgroup analyses indicated effect modification by age, body mass index, alcohol consumption, and hyperlipidemia status. Whole grains, total vegetables, and nuts emerged as protective dietary components, whereas refined grains were identified as a potential risk factor. In conclusion, higher adherence to HEI-2020, DASH, and Mediterranean dietary patterns was associated with a lower prevalence of selected major eye diseases. These findings reflect associations rather than causation, and prospective studies and randomized trials are needed to clarify temporal and causal relationships.

Keywords: NHANES; age‐related macular degeneration; bibliometric; cataract; healthy dietary patterns; retinopathy.