García-Layana, AlfredoGianfranco, CiufoToledo, EstefaniaMartínez-González, Miguel Ángel, 1957-Corella, DoloresFitó Colomer, MontserratEstruch, RamónGómez-Gracia, EnriqueFiol, MiquelLapetra, JoséSerra-Majem, LuisPinto, XavierPortillo, María P.Sorlí, José VicenteBulló, MònicaVinyoles, ErnestSala Vila, AleixRos, EmilioSalas-Salvadó, JordiArós, Fernando2018-07-052018-07-052017García-Layana A, Ciufo G, Toledo E, Martínez-González MA, Corella D, Fitó M. et al. The Effect of a Mediterranean Diet on the Incidence of Cataract Surgery. Nutrients. 2017 May 3;9(5): E453. DOI: 10.3390/nu90504532072-6643http://hdl.handle.net/10230/35037BACKGROUND: Cataract is a leading cause of vision impairment worldwide, and surgery is the only available treatment. The process that initiates lens opacification is dependent on the oxidative stress experienced by the lens components. A healthy overall dietary pattern, with the potential to reduce oxidative stress, has been suggested as a means to decrease the risk of developing cataract. We aimed to investigate the hypothesis that an intervention with a Mediterranean diet (MedDiet) rather than a low-fat diet could decrease the incidence of cataract surgery in elderly subjects. METHODS: We included 5802 men and women (age range: 55-80 years) from the Prevención con Dieta Mediterránea study (multicenter, parallel-group, randomized controlled clinical trial) who had not undergone cataract surgery. They were randomly assigned to one of three intervention groups: (1) a MedDiet enriched with extra-virgin olive oil (EVOO) (n = 1998); (2) a MedDiet enriched with nuts (n = 1914), and a control group recommended to follow a low-fat diet (n = 1890). The incidence of cataract surgery was recorded yearly during follow-up clinical evaluations. Primary analyses were performed on an intention-to-treat basis. Cox regression analyses were used to assess the relationship between the nutritional intervention and the incidence of cataract surgery. RESULTS: During a follow-up period of 7.0 years (mean follow-up period: 5.7 years; median: 5.9 years), 559 subjects underwent cataract surgery. Two hundred and six participants from the MedDiet + EVOO group, 174 from the MedDiet + Nuts group, and 179 from the control group underwent cataract surgery. We did not observe a reduction in the incidence of cataract surgery in the MedDiet groups compared to the control group. The multivariable adjusted hazard ratios were 1.03 (95% confidence interval [CI]: 0.84-1.26, p = 0.79) for the control group versus the MedDiet + EVOO group and 1.06 (95% CI: 0.86-1.31, p = 0.58) for the control group versus the MedDiet + Nuts group. CONCLUSIONS: To our knowledge, this is the first large randomized trial assessing the role of a MedDiet on the incidence of cataract surgery. Our results showed that the incidence of cataract surgery was similar in the MedDiet with EVOO, MedDiet with nuts, and low-fat diet groups. Further studies are necessary to investigate whether a MedDiet could have a preventive role in cataract surgery.application/pdfengCopyright © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).Cataractes -- CirugiaDieta mediterràniainfo:eu-repo/semantics/articlehttp://dx.doi.org/10.3390/nu9050453Mediterranean dietPREDIMEDAntioxidantsCataractCataract surgeryExtra-virgin olive oilLow-fat dietNutsinfo:eu-repo/semantics/openAccess