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.

FIGURE 1

Flowchart of participant selection from NHANES 2005–2008.

FIGURE 2

Associations between dietary patterns and major eye diseases in NHANES 2005–2008. Bolded values indicate statistically significant between‐group differences.

FIGURE 3

Dose response relationships between dietary indices and the risk of eye diseases in NHANES 2005–2008. (A) DII and cataract, (B) DII and AMD, (C) DII and glaucoma, (D) DII and retinopathy, (E) HEI‐2020 and cataract, (F) HEI‐2020 and AMD, (G) HEI‐2020 and glaucoma, (H) HEI‐2020 and retinopathy, (I) MED and cataract, (J) MED and AMD, (K) MED and glaucoma, (L) MED and retinopathy, (M) DASH and cataract, (N) DASH and AMD, (O) DASH and glaucoma, (P) DASH and retinopathy.

FIGURE 4

Stratified analyses of the associations between DII and eye diseases in NHANES 2005–2008. (A) DII and cataract, (B) DII and glaucoma, (C) DII and AMD, (D) DII and retinopathy.

FIGURE 5

Stratified analyses of the associations between HEI‐2020 and eye diseases in NHANES 2005–2008. (A) HEI‐2020 and cataract, (B) HEI‐2020 and glaucoma, (C) HEI‐2020 and AMD, (D) HEI‐2020 and retinopathy.

FIGURE 6

Stratified analyses of the associations between MED and eye diseases in NHANES 2005–2008. (A) MED and cataract, (B) MED and glaucoma, (C) MED and AMD, (D) MED and retinopathy.

FIGURE 7

Stratified analyses of the associations between DASH and eye diseases in NHANES 2005–2008. (A) DASH and cataract, (B) DASH and glaucoma, (C) DASH and AMD, (D) DASH and retinopathy.

FIGURE 8

Associations between dietary pattern components and eye diseases in NHANES 2005–2008. (A) Components of HEI‐2020 in relation to cataract, AMD, glaucoma, and retinopathy. (B) Components of DASH in relation to cataract, AMD, glaucoma, and retinopathy. (C) Components of MED in relation to retinopathy.

FIGURE 9

Bibliometric visualization of global research on dietary patterns and eye diseases. (A) Annual scientific production from 2009 to 2024 (B) Top 10 most frequently occurring author keywords (C) Country‐wise scientific output and international collaboration. (D) Sankey diagram linking authors (AU), affiliated countries (AU_CO), and high‐frequency keywords (KW_Merged).

FIGURE 10

Bibliometric analysis of clinical trials on dietary patterns and eye diseases based on PubMed. (A) Top 10 journals publishing clinical trials on diet and eye health (B) Thematic evolution of MeSH terms over time.

FIGURE 11

Keyword co‐occurrence and temporal trend mapping of researches on dietary patterns and eye diseases. (A) Co‐occurrence network of MeSH keywords. (B) Temporal overlay visualization.