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See the benefits of a healthy lifestyle Sponsor of National Eye Week 2009 Healthy Eyes, Healthy You! The Eyecare Trust is a registered charity that exists to promote awareness of ocular health and the importance of good eye care. As the number of people with sight-threatening eye conditions continues to rise we are “uncovering growing evidence that lifestyle factors play a significant role in determining the long-term health of our eyes. Making the right lifestyle choices from the start can help preserve your vision. However, it’s never too late to start making changes, as in some instances vision that is already in decline can be restored by following a healthy diet, taking regular exercise and generally cutting down on the things that we know are bad for us like cigarettes and alcohol! Read on to find out how your lifestyle could be affecting the quality of your vision. ” At Simplyhealth, health is the most important thing of all. So we offer individuals and families a range of health plans that provide cover towards check-ups, treatment and emergencies. Helping them budget for the costs of expected and unexpected healthcare. A cash plan for example means that every time someone visits the optician they will receive money back, up to an annual limit. In a world where so many people can’t be bothered, we’re proud to be the ones that can. Smoking Drinking Weight Diet Obesity Exercise Nutrition Antioxidants Smoking Drinking Weight Diet Obesity Exercise Nutrition Antioxidants Smoking Drinking Weight Diet Obesity Exercise Nutrition Antioxidants Smoking Drinking Weight Diet Obesity Exercise Nutrition Antioxidants Smoking Drinking Weight Diet Obesity Exercise Nutrition Antioxidants Smoking Drinking Weight Diet Obesity Exercise Nutrition Antioxidants Smoking Drinking Weight Diet Obesity Exercise Nutrition Antioxidants Smoking Drinking Weight Diet Obesity Exercise Nutrition Smoking Drinking Weight Diet Obesity Exercise Nutrition Iain Anderson, Chairman, Eyecare Trust At Simplyhealth, we think health is the most important thing of all and that’s why we are proud to “support the Eyecare Trust. As this booklet explains, there are a number of lifestyle choices which can have an impact on a person’s eye health. Worryingly, recent research by the Eyecare Trust and Simplyhealth has found that cost can also have an impact, with 75 per cent of people putting off having their eyes tested through concerns over the examination fee and the subsequent expense of glasses or contact lenses. Having your eyes tested needn’t be expensive, as there are many options available to help people budget for eyecare. Cash plans, such as those from Simplyhealth, provide cover for eye tests, prescription glasses and sunglasses, and contact lenses, plus other healthcare benefits such as dental care and complementary therapies. We hope that by taking away the financial bother of visiting the optician, you will be able to enjoy regular appointments to check the health of your eyes. ” Raman Sankaran, Sales and Marketing Director – Direct, Simplyhealth SMOKE GETS IN YOUR EYES SMOKE GETS IN YOUR EYES Blind to the risk of sight loss Smokers have a significantly greater risk of sight loss than non-smokers. Yet, worryingly, awareness of blindness from smoking, amongst Britain’s 13 million smokers, is low (9.7%) compared to lung cancer (92.2%) and heart disease (87.7%)1. Toxic chemicals in tobacco smoke can damage the delicate surface and the internal structure of the eye. This can lead to an increased risk of many eye conditions including age-related macular degeneration (AMD), nuclear cataracts; thyroid eye disease; dry eye and poor colour vision. Smoking is a key risk factor for both ‘wet’ and ‘dry’ AMD. AMD is the leading cause of blindness in the developed world and affects 600,000 people in the UK. Double or quit Smokers are twice (47%)2 as likely to suffer AMD than non-smokers and also likely to suffer from the condition earlier than non-smokers. The average age for a non-smoker to develop AMD is 74.4 years of age. This is five years later than smokers, whose average age is 69.2 years3. Smokers are also likely to experience a more rapid progression of AMD and a poorer outcome of treatment. Smoking increases your risk of developing cataracts as tobacco toxins cause oxidative damage to the lens proteins. The risk of nuclear cataracts (those that form in the centre ‘nucleus’ of the lens) is 2.9 times greater in smokers4. Smoking facts One in four adults in the UK smoke. Cigarettes contain 4,000 chemicals including tar, arsenic and ammonia. Tobacco chemicals damage blood vessels inside the eye and interfere with tear production and the health of the cornea. Fear of blindness is as compelling a motivation to quit smoking as fear of lung cancer, heart disease, and stroke. SMOKE GETS IN YOUR EYES Sore, gritty eyes Smoking increases your risk of thyroid eye disease – sore, gritty eyes – by up to eight times5. Smoking cigarettes has also been found to increase the risk of dry eye syndrome and can exacerbate existing eye conditions7. Thyroid eye disease affects more than 400,000 people in the UK6. Colour vision Smokers who consume more than 20 cigarettes per day may suffer colour vision defects as a result8. The conjunctiva – the clear membrane that covers the sclera (the white part of the eye) and lines the inside of the eyelids – is sensitive to airborne chemicals, fumes, and irritative gases that originate in tobacco smoke. This can lead to a reddening of the conjunctiva, excessive tear production and general discomfort. NUTRITION AND THE EYE NUTRITION AND THE EYE NUTRITION AND THE EYE Eat right for good sight Vitamins B and E can help A poor diet can put your sight at risk. Yet, awareness of the link between diet and good eye health is low. 60% of people surveyed by the Eyecare Trust had no idea that what they eat can affect the health of their eyes9. Eye-friendly nutrients found in many fruit and vegetables and fatty acids in fish oils can all help protect your sight. Eliminate free radicals Kiwis, spinach and oranges are all good sources of Vitamin C, which is a key antioxidant, and vital for eliminating free radicals that cause eye damage. protect against cataracts whilst omega-3 fish oils help maintain healthy blood vessels inside the eye. Research has shown that eating just one portion of fish a week can reduce your risk of developing AMD by up to 40%10. It’s also been shown that eating three portions of fruit a day reduces your risk of developing age-related macular degeneration by more than a third11. Nutritional advice To help keep your eyes healthy for longer the Eyecare Trust has put together some simple nutritional advice: Try to eat the recommended five portions of fruit and vegetables a day. Ten top superfoods for good eye health. Maintain a low-fat diet. A diet high in fat and cholesterol can lead to a build-up of fatty deposits in the blood vessels under the macula, which can hamper blood flow and increase the risk of agerelated macular degeneration. Spinach, kale and green leafy vegetables. These plants are rich in carotenoids, especially lutein and zeaxathin. Lutein, a yellow pigment, helps protect the macula from sun damage. Eat foods rich in antioxidants (beneficial chemicals found in vitamins and minerals) that may neutralise ‘free radicals’ which can injure healthy cells. Papaya. This juicy yellow fruit is a good source of beta carotene which helps to prevent free radical damage inside the eye. Eye healthy foods include: leafy green vegetables, carrots, melons, papaya, tomatoes, red peppers, blueberries, plums, red grapes and aubergines. Fruits and vegetables contain vitamins A, C, and E and beta-carotene. Yellow vegetables, such as carrots and squash, are important for good daytime vision. Cold water fish (sardines, cod, mackerel, tuna). Cold water fish are an excellent source of DHA, and omega-3 fatty acids, which provide structural support to cell membranes and are recommended for dry eyes, the treatment of macular degeneration, and general sight preservation. Eggs are rich in cysteine, sulfur, lecithin, amino acids and lutein. Sulfur helps protect the lens of the eye from cataracts. Garlic, onions, shallots and capers. These are also rich in sulfur, which is necessary for the production of glutathione, an important antioxidant required to help maintain health sight. Nuts and berries are high in the beneficial omega-3 fatty acids, which help lower cholesterol and stabilise cell membranes. Soy contains essential fatty acids, phytoestrogens, vitamin E and natural anti- inflammatory agents. Blueberries and grapes. These fruits contain anthocyanins, which can help improve night vision. Virgin olive oil This is a mono-unsaturated oil, and is a healthy alternative to butter and margarine. WATCH YOUR WEIGHT A weighty issue More than half of all British adults weigh more than their recommended weight and an astonishing 23% are obese12. This can lead to eye health problems. Maintaining a healthy weight helps preserve macula pigment density which, in turn, helps protect the retina against the breakdown of cells and the onset of AMD. WATCH YOUR WEIGHT High BMI = low PD! Recent research in Israel and Singapore13 has established the link between obesity and eye health problems, while studies in the USA have shown how people with a high Body Mass Index (BMI) tend to have low pigment density (PD), putting them at greater risk of AMD. People who are genetically predisposed to AMD (those with a family history of the condition) must be particularly careful about their weight as their risk of the condition can rise by almost 300% if they are obese. Damage to blood vessels in the eye caused by excess body weight has also been linked to the onset of glaucoma. Increased risk of diabetes Early obesity is associated with diabetes. Someone with a BMI of 35 or more is up to 80 times more likely to develop diabetes than someone with a BMI of less than 22. 60% of people with type two diabetes will develop diabetic retinopathy – a disease of the retina that can ultimately lead to total sight loss. Overweight people are also twice as likely to develop cataracts. Body Mass Index is a measure of body fat based on height and weight that applies to both men and women. BMI Results 18.5 and under = underweight 18.5 – 25 = ideal weight 25 – 30 = overweight 30+ = obese Calculate your BMI To calculate your BMI simply divide your weight in kilogrammes by your height in metres squared. For example, if you weigh 10 stone (63.5kg) and are 5ft 7in (1.7m) tall, the calculation is 63.5 ÷ 1.72 (2.89). Your BMI = 22 (ideal weight range) REGULAR EXERCISE / EXCESS ALCOHOL REGULAR EXERCISE Work it out! It’s a little known fact that regular exercise can help maintain good eye health. In fact, a recent survey by the Eyecare Trust revealed that only 12% of us know that regular exercise can be beneficial for our eye health14. The eyes need oxygen to stay healthy and comfortable. Lower intraocular pressure Aerobic exercise can help increase oxygen supply to the optic nerve and lower pressure that builds up in the eye. Reducing intraocular ‘eye’ pressure can help control conditions such as glaucoma and ocular hypertension. Studies commissioned by the Glaucoma Foundation indicated that glaucoma patients who exercise at least three times a week can reduce their intraocular eye pressure an average of 20 per cent. ALCOHOL Regular exercise can also improve blood flow to the retina and the optic nerve. Aerobic exercise has also been found to prevent the progression of diabetes, which in severe cases can lead to diabetic retinopathy and total sight loss. Excess alcohol While a small amount of red wine can be beneficial for your eyes – it contains powerful antioxidants – too much alcohol can lead to sight loss. 30 mins five times a week The Department of Health recommends doing 30 minutes exercise five days a week. Excess alcohol can interfere with your liver functions and reduce the production of glutathione. Brisk walks, cycling and swimming are all excellent ways to reduce intraocular pressure and maintain healthy eyes. Glutathione prevents a particular kind of cell damage that can lead to the development of cataract, glaucoma and retinopathy. REFERENCES 1. Perceptions of blindness related to smoking: a hospital-based cross-sectional study, G Bidwell et al 2. Ronald Klien et al, Arch Ophthalmol. 2008;126(1): 115-121 3. Ronald Klien et al, Arch Ophthalmol. 2008;126(1): 115-121 4. BMA Tobacco Control Resource Centre 2006 5. Tayside University NHS Trust 6. National Institute for Clinical Excellence 7. Satici A, Bitiren M, Ozardali I, et al. The effects of chronic smoking on the ocular surface and tear characteristics: a clinical, histological and biochemical study. Acta Ophthalmology Scand 2003;81:583-7 8. Erb C; Nicaeus T; Adler M; Isensee J; Zrenner E; Thiel HJ Graefes Archive for Clinical Experimental Ophthalmology. vol. 237, no. 5 (1999 May): 377-80 9. Eyecare Trust healthy eye, healthy you research 2006 10. Dietary Fatty Acids and the 5-Year Incidence of Age-related Maculopathy, Brian Chua et al 11. Prospective study of intake of fruits, vegetables, vitamins, and carotenoids and risk age-related maculopathy. Cho E, Seddon JM, Rosner B, Willett WC, Hankinson SE. Arch Ophthalmol. 2004 Jun: 122(6): 883-92 12. Economic and Social Research Council, Diet and obesity in the UK 13. Professor Michael Belkin and Dr Zohar Habot-Wilner of the Goldschleger Eye Institute, Tel Aviv, and Tien Wong of the Singapore Eye Research Institute. 14. Eyecare Trust healthy eyes, healthy you research 2006 PO Box 804, Aylesbury, Hambleden House BUCKS HP20 9DF Andover Tel: 0845 129 5001 Hampshire SP10 1LQ [email protected] [email protected] www.eyecaretrust.org.uk www.simplyhealth.co.uk ET120 Simplyhealth