what the bleep we know about cataract & nutrition!

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By Dr. Glen SwartwoutThe clarity of the crystallin


  • What the Bleep We Know About Cataract & Nutrition!

    By Dr. Glen Swartwout

    The clarity of the crystalline lens in the eye is one of the most important predictors of longevity. Theaverage person suffering cataract formation only lives 5 years after cataract surgery, the mostcommon surgical procedure in Medicare. What the bleep do we know about nutrition andcataractogenesis?

    Nutrition in the prevention and reversal of cataracts:


    Free radical pathology is a major theme of cataract formation, as with most age-related anddegenerative processes. Oxidation of cell membrane lipids may play an important role incataractogenesis. Most of the nutritional components of cataract prevention and reversal are relatedto boosting antioxidant defenses. Taking a good optimum potency multivitamin is an importantfoundation for a cataract prevention program, since the use of multi-vitamin/mineral supplementshas been identified as a preventive factor in the medical and epidemiological literature. In the early1950's one doctor had already reported either improvement or little to no progression of cataracts inhis patients who followed a nutritional prevention program including water, beneficial foods andsupplements. He recommended chlorophyll (45 mg/day), vitamin C (1000 mg/day) and vitamin A(200,000 IU/day). A recent study using 26 vitamins and minerals reduced the risk of nuclear cataractby 36 to 44%. While a control group taking placebo tablets had their cataracts worsen from 20/30 to20/40 during a 6 month study, others taking beta carotene and vitamin E experienced an initialimprovement in vision, and never dropped below 20/30. Be aware of a variety of basic adjustmentsthat are able to be madeto a standard

    centrifugal or positive displacement pump. Regarding pumps that have overhung impellers, movingto a solid shaft is a desirable refinement instead of the more common sleeved shafts. Mechanicalseals can be enhanced with tungsten carbide faces, and elastomers ought to be changed to Viton.Furthermore, magnetic bearing protectors will prove to be a vast improvement compared to the lipseals that the vast majority of commercial pumps use to keep bearing sump oil free fromcontaminants.

    Animal cataracts have also been reversed with nutritional supplements.

    As we get older, there is typically a decrease in our ability to absorb and utilize nutrients. Correctingthese factors with such remedies as microwater, friendly bacterial flora, digestive enzymes andhomeopathics to stimulate nutrient utilization can also help us get the most out of our diet and oursupplements. When possible, a nutritional program should be maintained for at least 3 to 4 monthsbefore considering cataract surgery.

    Vitamin-A and Carotenoids:

    Low levels of beta carotene increase cataract risk 7 fold. Beta carotene may act as a filter, absorbinghigh energy photons, protecting against photo-oxidation of the lens. Beta carotene is the primary

  • scavenger of singlet oxygen free radicals and is used to treat photosensitivities. Decreased plasmalevels of beta carotene are linked to increased risk of both cortical and subcapsular cataracts. In onestudy, over 50,000 registered nurses who took in more vitamin A through both diet and supplementsthan 80% of the women in the group showed 39% less cataract risk than the women with intakes inthe lowest 20% of the group. Increased beta carotene intake is associated with decreased risk ofcataract and increased visual acuity with and without glasses (at 20 mg/day). A dosage range from10,000 to 25,000 and even 200,000 IU daily of beta carotene has been recommended. Vitamin A hasalso been suggested at a level of up to 50,000 (or even 200,000) IU per day.

    Carotenoids other than beta carotene (in carrots), including Lutein (in green leafy vegetables),Zeaxanthin, Lycopene (in tomatoes) and Astaxanthin (found in salmon) are increasingly beingrecommended for cataract prevention, as new research highlights their roles in protection againstfree radical damage, including that induced by exposure to UV radiation. Since beta carotenecompetes for absorption with other carotenoids, rotation of carotenoid foods or supplements hasbeen suggested, especially when high levels of beta carotene or carrots (e.g. carrot juice) are beingingested.

    Lutein improves visual acuity in cataract (p < 0.005) compared to controls taking a placebo or a verylow dosage of vitamin E. Glare also decreases with lutein. There was no progression of the cataractsfor four of the five subjects in the lutein group, three of five in the vitamin E group and only one offive in the placebo group. Maximum serum concentrations of lutein and tocopherol were achievedafter 3 to 6 months of supplementation. (Olmedilla B, Granado F, Blanco I, Vaquero M. Lutein, butnot tocopherol, supplementation improves visual function in patients with age-related cataracts: a 2-y double-blind, placebo-controlled pilot study. Nutrition 2003;19:21-4.)


    B vitamins in general are both synergistic and safer taken together. Excesses of one B vitamin caninduce a relative deficiency of another, as they work sequentially as coenzymes in the electrontransport chain. Some practitioners suggest up to 150 mg of a balanced B complex. Activated Bcomplex tablets formulated for optimal sublingual absorption are suggested.

    B1 (Thiamine and Cocarboxylase):

    Supplementation of thiamine up to 50 mg/day in a B complex has been recommended. Thiamine is aco-factor for enzymes that bridge aerobic and anaerobic metabolism. One such enzyme,transketolase, catalyzes two of three reactions for entry into the pentose-phosphate pathway, amajor source of chemical reducing power. Thiamine deprivation (TD) is considered a classic model ofsystemic oxidative stress and is linked with degenerative diseases. TD in mice and rats producesneurodegeneration similar to Alzheimer's disease. Cataract is linked to thiamine and oxidativestress. After 12 days on a thiamine-depleting protocol, posterior sub-capsular (PSC) lens fiber celldegeneration is seen in experimental animals. This area also showed increased levels of Alzheimerprecursor protein, Abeta peptides, and presenilin 1. Thiamine (TTFD) or Cocarboxylase forms ofVitamin B1 are recommended.

    B2 (Riboflavin, FMN & Riboflavin 5-Phosphate):

    Riboflavin is needed to make flavin adenine dinucleotide (FAD), a coenzyme for glutathionereductase which recycles the antioxidant glutathione. Riboflavin deficiency probablycontributes to cataract formation in malnourished populations in the 3rd-World. Riboflavindeficiency is also found in 33% of the geriatric population, although studies have been mixed

  • regarding its link to cataract. Even in healthy individuals who already consume more than the RDAof riboflavin, supplemenation of levels above the RDA increase glutathione reductase activity.Supplementation of 10 mg/day of riboflavin increases plasma glutathione by 83% resulting inimproved antioxidant protection.

    Some researchers recommend that cataract patients should not take more than 10 mg/day of this Bvitamin as in higher concentrations it can combine with light to form free radicals which cancontribute to cataract formation. Other sources suggest up to 50 and even as high as 300 mg/day ofvitamin riboflavin when taken with the full B complex (100 to 150 mg/day), including 50 mg ofthiamine, and up to 500 mg/day each of niacinamide and pantothenic acid. Some practitionerssuggest dosages up to 100 mg taken 3 times a day in conjunction with a B complex supplement. Infact, one study found that all six of the cataract patients in a study on vitamin B2 had their cataractseliminated within 9 months. The cataracts also started coming back when they eliminated thesupplement.

    Riboflavin in cataracts is a good example of the importance of individualized optimal nutrition.Studies in animals show that rats, cats and pigs fed a riboflavin-deficient diet produce cataracts.Low levels in rats increase the cataract forming effects of dietary galactose. Among cataract patientsunder age 50, 20% are deficient in riboflavin, and thus may benefit from moderate levels ofsupplementation. Over age 50, 34% of cataract patients were found deficient in riboflavin, while in acontrol group with normal clear lenses, none were deficient in this vitamin. Another study showed81% of cataract patients to be deficient, while only 12.5% of people without cataract were deficient.Thus a number of studies show that deficiency may cause cataracts, while there is evidence thatexcess may also have the potential to contribute to lens damage.

    Can the same substance cause the same disease in both excess and deficiency, while potentiallytreating it in intermediate doses? Most definitely. In fact, this common fact is part of the basis of theentire science of pharmacology, known as the Arndt-Schultz Law. The pharmacological law ofdosage effects states that minute doses, as used in homeopathy and nutrition tend to stimulate bodyfunctions, yet moderate doses as used in drug and even nutritional megadose therapies suppressthese functions, and still higher levels can destroy the very same body functions.

    Active coenzyme forms of Vitamin B2, such as Flavin Mononucleotide (FMN) or Riboflavin 5-Phosphate are recommended.

    B3 (Niacin, Niacinamide (B4) & NADH):

    Niacinamide supplementation has been suggested at a level of 500 mg/day with a full B complex.

    An active coenzyme form of Vitamin B3, NADPH, is needed to regenerate adequate levels of thecrucial lens anti-oxidant glutathione (GSH). Cataract is associated with increased oxidative stress. Inlens tissue, movement of glucose through the polyol pathway is the major cause of hyperglycemicoxidative stress. The enzyme Aldose Reductase (AR) reduces glucose to sorbitol and contributes tooxidative stress