Category Archives: Vision & Vitamins

Vision & Vitamins: No clear evidence Coenzyme Q10 helps eye health

By | Calgary, Cataracts, LASIK, Mayo Clinic, Ophthalmologist, Refractive Surgery, Vision & Vitamins | No Comments

eyelabeledCoenzyme Q10 (CoQ10) has become a popular supplement which is said to help with a number of health issues including cataract and macular degeneration in the eye, but the Mayo Clinic gives it a “C” grade for its benefits in the eye (meaning the evidence is unclear to support its use).  CoQ10 is also called Q10, Vitamin Q10, ubiquinone, and ubidecarenone.  It acts as an antioxidant in the body and has a role in producing ATP which is a molecule which provides energy to cells.  CoQ10 deficiency has not been reported in the general population and it is estimated that a varied diet will provide up to 25% of the measured plasma CoQ10 and that the body naturally makes the remainder.  Primary CoQ10 deficiency is a rare inherited disorder that causes neurologic and muscular dysfunction.

For healthy individuals there is not strong evidence to show that CoQ10 supplements improve athletic performance or prolong life.  There may be some specific circumstance where CoQ10 supplementation may be helpful.  There is some scientific evidence to show that it may be helpful in chronic heart failure and in the treatment of high blood pressure but more studies are needed.  CoQ10 has also been thought to be helpful in specific cancer patients who are undergoing chemotherapy.  There are not enough studies to show that CoQ10 is helpful for eye conditions such as macular degeneration.  According to some sources CoQ10 should not be used for diabetes, hepatitis C, or Huntington’s disease.

There have been some studies that use CoQ10 eye drops for some specific conditions affecting the retina, cornea, and optic nerve.  While early studies are promising for specific diseases, more studies are needed.  More commonly studies have used a tablet or capsule, injection, or intravenous (IV) CoQ10.   There are some side effects including insomnia, elevated liver enzymes, rash, heartburn, and fatigue that have been reported when using CoQ10.  As with all supplements be sure to check with your doctor or pharmacist before starting to take CoQ10 as it may interact with other medications (in particular blood thinners).

Foods that contain higher amounts of CoQ10 include beef, herring, chicken, soybean, canola oil, rainbow trout, roasted peanuts, sesame seeds, pistachio nuts, broccoli, cauliflower, orange, strawberries, and eggs.  A varied diet is helpful in providing a wide variety of nutrients and since CoQ10 appears to act in concert with other vitamins such as vitamin E, having a dietary source of this vitamin may help provide CoQ10 along with other nutrients and co-factors that will aid in absorption and in action.  CoQ10 naturally declines with age so maintaining a healthy diet is increasingly important.  Given the scientific evidence to date it seems unlikely that CoQ10 supplementation is helpful for vision in healthy people.

If you have questions about laser vision correction or wish to book a complimentary evaluation with Dr. Anderson Penno, contact Western Laser Eye Associates.

 

 

 

Vision & Vitamins: Can supplements prevent/treat nearsightedness (myopia)?

By | Calgary, Eye health, Food for thought, Vision & Vitamins | No Comments

Beautiful young woman wearing glasses portrait.If you or your children wear glasses for nearsightedness (myopia) you have probably seen advertisements for vitamins and supplements that claim to prevent or reduce nearsightedness.  Approximately 1.6 billion people were nearsighted in 2000, and up to 2.5 billion worldwide are expected to be nearsighted by 2020.  The myopia boom in East Asia has resulted in an increase in myopia from 10-20% in China in the mid-twentieth century to up to 90% of teens and young adults with nearsightedness today.  According to a recent article in the journal Nature up to 96% of 19 year olds in Seoul are nearsighted.  While there is a genetic or hereditary cause for nearsightedness, this increase in myopia worldwide indicates that other factors may be important.

It has been a longstanding theory that prolonged near work including reading and screen time may lead to an increase in nearsightedness.  A newer finding is that light levels and time spent outdoors in natural light may be protective in preventing myopia progression – and in some countries public health posters tell children to “Keep Myopia Away, Go Outside And Play!”  There does seem to be a positive effect of natural light (and not just that playing outside does not involve reading or near work) since some animal studies confirm this finding.

Can vitamins prevent increasing nearsightedness?  There is little evidence to prove most of the various vitamins and supplements that are marketed to reduce myopia, except more recently for Vitamin D.  There may be a connection between the findings that more time in natural light seems to reduce increases in nearsightedness and the Vitamin D findings.  When UVB from sunlight shines on bare skin the body produces Vitamin D.  This vitamin can also be found in fortified milk, cereal, and other foods.  In spite of this many people may be deficient.  A blood test can determine your Vitamin D levels to find out if you are deficient.  Supplements can boost your Vitamin D levels, but too much can lead to dangerously high calcium levels – so as with all supplements and vitamins more isn’t always better.  It is advisable to work with a nutritionist or physician to determine the dose that is right for you.

While there is no strong studies to support taking other supplements to prevent increasing nearsightedness, it is a good idea to have a diet which includes colored fruits and veggies, fish, and nuts.

If you have questions about laser vision correction or wish to book a complimentary evaluation with Dr. Anderson Penno, contact Western Laser Eye Associates.

 

Vision & Vitamins: Food versus Supplements

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IMG_2327I am a fan of food.  The most powerful health advice is common sense – simple and straightforward.  Don’t smoke, exercise, get your blood pressure and blood sugar checked, and have regular screening exams both for eyes and general health.  Michael Pollan’s seven words – Eat Food, Mostly Plants, Not Too Much – are a beautiful example of this simple approach.  My other favorite is one I heard at a conference years ago – Eat a little bit of everything and not too much of any one thing.  Another favorite is – Eat around the outside of the grocery store.  The outside perimeter almost always contains the fresh vegetable, dairy, and fish/meats and the center has more of the processed foods. With whole foods (not processed) the ingredients are reliable and unknown additives will not be an issue.  Supplements are not regulated like prescription medications so some of them may not contain the listed ingredient and some have harmful additives that are not listed on the labels.  It is nearly impossible to harm yourself with food when eaten in usual amounts – “not too much” .  One exception to this is eating polar bear liver which can harm the eye due to overloading vitamin A.

By eating a wide variety of foods and not too much, most adults will be able to consume the nutrients needed for good eye health.  Foods also contain fiber and other micronutrients that are essential for good health.  It is also less likely that food will interfere with prescription medications, although there are exceptions to this.  Grapefruit is know to interact with a number of prescription medications and blood thinners may be more likely to be affected by certain foods like broccoli.  With mindful eating the eye healthy nutrients will be part of your diet including the colorful fruits and veggies, and in fish and nuts.

With that said, it your diet is poor or if you have early high risk macular degeneration then supplements may be helpful.  However, if you smoke then it is probably a waste of money to buy supplements unless you first quit smoking.    Other groups of people that may benefit from supplements include pregnant women and people with problems absorbing vitamins. There is no definite evidence to show that vitamins will prevent eye disease, but there is some scientific evidence to support taking AREDS 2 formula vitamins for people with early but high risk macular degeneration.  There is also some suggestion that certain fatty acids such as those found in flaxseed and fish oil may be helpful for treatment of dry eye.  The effects of vitamins and supplements is very hard to study in a scientifically rigorous way due to the need for very large number of people who will need to be included in the studies and the length of time, possibly years, needed to see statistically significant effects.  So the risks and benefits are sometimes not clear for decades.  There are also a lot of confounding factors like smoking, diabetes, or other chronic diseases that may impact health whether or not supplements are taken.  In fact in some cases long term studies show that supplements may be causing harm as in the case of vitamin E.  There has been some suggestion in the scientific literature that vitamin E supplementation might be associated with an increase in total mortality (death), heart failure, and stroke.

The best approach is mindful eating for everyone and mindful supplementation for select people.  At worst vitamins and supplements may harm you, and they may be a waste of money.  Regardless if you need glasses or contacts,  certain people are likely to benefit from select supplements, so do your homework and talk to your doctor and nutritionist to make sure you are making good choices with your health and nutrition.  Exercise and don’t smoke.  If you have questions about laser vision correction or wish to book a complimentary evaluation with Dr. Anderson Penno, contact Western Laser Eye Associates.

Vision & Vitamins: What is bilberry?

By | Uncategorized, Vision & Vitamins | No Comments

Bilberry is a shrub that produces berries that resemble blueberries.  It is found in Northern and Central Europe.  In Scandanavia wild bilberries are the most common.  Various medicinal effects have been attributed to this natural source of antioxidants.  The compounds that are responsible for the dark color are anthocyanins.  This berry has been reported to lower blood sugar and lipids, and to fight inflammation.  Bilberry has been classified as safe when consumed appropriately by the American Herbal Products Association.

Does Bilberry improve night vision?  According modern folklore the Royal Air Force used Bilberry during the second world war to improve night vision – although the same claim is made for carrots.  There have been some peer reviewed studies (peer reviewed means the studies are analyzed by other scientists prior to being accepted for publication) over the years to suggest that there may be some benefits to Bilberry, but the dose has not been determined and the most of the studies are somewhat small.  So the benefit of bilberry to eye health is not strongly supported by science and future studies will be needed to find out the true benefits.

Is Bilberry better for the eyes than other antioxidants?  There does not seem to be any evidence that Bilberry is better, but since deeply colored fruits and vegetables all contain a variety of beneficial nutrients including antioxidants it makes some sense to include Bilberry along with a variety of other eye healthy foods.  A professor of mine once told me, “Eat a little bit of everything and not too much of any one thing.”  It is uncommon but it is possible to harm your health with supplements.  Consumer reports published an article about twelve supplements you should avoid. It is less likely to harm yourself with real food, but it is wise to be cautious about the amounts of vitamins that are in your diet.  For example, vitamin A is necessary for vision but too much can lead to blindness.  It would be unlikely to ingest too much vitamin A unless you eat polar bear livers, but in general more vitamins are not necessarily better.  The stuctures and biochemistry in the eye (just like the rest of your body) is like a delicate fine tuned watch which require specific amounts of various nutrients for the best function.  Mega doses of vitamins are like trying to fix the delicate watch with a hammer.  Bilberry shows promise as part of well rounded eye healthy diet.

If you have questions about laser vision correction or wish to book a complimentary evaluation with Dr. Anderson Penno, contact Western Laser Eye Associates.

Vision & Vitamins: Can supplements prevent nearsightedness?

By | Cataracts, Diabetes, Laser Eye Surgery, Laser vision correction, Ophthalmologist, Ophthalmology, Opthamologist, Optometry, science, Vision & Vitamins | No Comments

Nearsightedness (also called myopia) affects from 20% to 50% of North Americans and up to >80% of some populations in Asian countries.  The need for nearsighted correction with glasses or contacts can run in families and is more likely to be present if both parents are myopic.  The natural course of nearsightedness is that it can start in childhood or young adulthood and continue to progress up to age 20 or in higher corrections into the 30’s.

There are some conditions that may be associated with nearsightedness so regular eye examinations are recommended even if the prescription has stopped changing.  Nearsighted people and parents of nearsighted children are of course interested in finding ways to slow or prevent the progression of myopia.  There has been conflicting scientific evidence to support the relationship between reading and near work and higher myopia, however there was no proven association between nearsightedness and computer work.  There has also been some evidence to suggest that more time spent in natural light (outdoors) can help to reduce the increase in prescription over time.

There have been a number of studies to try and find a link between nutrition and nearsightedness and to this date there has not been anything proven to prevent natural progression of myopia in children and adults.

It is important for anyone affected by nearsightedness to have regular eye examinations with and optometrist or ophthalmologist even if the prescription isn’t changing.  Sudden shifts in the degree of nearsightedness can indicate conditions like diabetes or cataracts if changes are happening at an older age.

Correcting nearsightedness is usually involves using glasses or contact lenses.  Laser vision correction can be considered after the prescription has stabilized for at least 2 years.

If you have questions about laser vision correction or wish to book a complimentary evaluation with Dr. Anderson Penno, contact Western Laser Eye Associates.

Vision & Vitamins: Ginkgo Biloba, Glaucoma, and Macular Degeneration

By | Epi-lasik, Epilasik, Eye health, FDA, Food for thought, Ginkgo Biloba, glaucoma, Health Canada, Laser Eye Surgery, Laser vision correction, macular degeneration, Mayo Clinic, Ophthalmologist, Ophthalmology, Opthamologist, Optometry, Pubmed, Refractive Surgery, science, Uncategorized, Vision & Vitamins | No Comments

Vitamins and natural herbs have become more and more popular for alternative treatment as additional treatments for medical conditions.  Ginkgo Biloba has been used for centuries as a traditional treatment which may help blood flow to the brain and aid in treatment of dementia or Alzheimer’s disease.  It might help treat leg pain that results from blood vessel disease, and there is some suggestion that ginkgo biloba might also help PMS symptoms, depression, multiple sclerosis, and ADHD.  Ginkgo Biloba is extracted from the leaves of the Ginkgo Biloba tree.  As far as vision and eye health are concerned, it is possible that Gingko Biloba might be helpful to eye health but as with many natural products the scientific studies show some favorable and some unfavorable results.

There are some scientific studies that have been reported in the peer reviewed literature which is a data base of articles that have been reviewed by scientists with expertise in the particular field of study before the article is allowed to be published.  Peer review helps to make sure that studies are done in a way that will provide strong statistical evidence for or against a specific area of study.  The most powerful studies are randomized and double-blinded which means the researcher and the subject who is taking the supplement do not know if it is the actual supplement or a placebo being taken.  The “placebo” effect has been well studied and up to 30% of people taking a fake pill who are told it will have beneficial effects will report that it helps whether or not there is any measurable effects.  By double-blinding and using large and randomized numbers of subjects the results will show with more confidence that a particular supplement is helpful or not for a specific condition.  Because there are a lot of different conditions that are being studied, so far there are only a few published peer reviewed scientific studies that have been done to find out if Ginkgo Biloba is good for your eyes.

According to the Mayo Clinic there is some scientific evidence suggesting that Ginkgo Biloba may be helpful in preventing worsening in age related macular degeneration which can lead to central vision loss, but there is little evidence to suggest it might be helpful for treatment of glaucoma.  In the peer reviewed literature there are a few studies including this 2012 study by Cybulska-Heinrich, Mozafferieh and Flammer that suggests supplementation with Ginkgo Biloba might be helpful in addition to traditional medical treatment in cases that are not responding as well as needed to these traditional treatments.  They suggest that antioxidant effects along with a variety of other effects on blood flow might be responsible for the beneficial effects of supplementation with Ginkgo Biloba.  The American Academy of Ophthalmology reported there was a single small randomized trial that showed promise for using Gingko Biloba to slow macular degeneration.

A commonly reported dose of Ginkgo Biloba is a standardized extract, standardized to 24% flavone glycosides and 6% terpene lactones starting at 40 milligrams of that extract three times daily, but there does not seem to be enough evidence in the scientific studies to prove the most effective doses for a specific condition.  Risks and side effects of Ginkgo Biloba supplements include headaches and dizziness, bleeding, and other side effects.  If you are on a blood thinner or aspirin, or are on other medications you should talk to your pharmacist and/or doctor to make sure that there won’t be dangerous interactions.  There is also some question about the quality of the products in some cases and as with all supplements it is important to be sure you are getting a high quality product.  In Canada a DIN or NPH number can be found on products that have been reviewed by Health Canada.  In the US the FDA does not require approval of supplements before the product is marketed but does collect information on adverse events.  The other thing to consider is the cost of a product like Ginkgo Biloba versus the proof that it will be helpful for your health.

Whether you already had LASIK, Intralasik, EpiLasik, PRK, wear glasses or contacts, reading glasses or no glasses at all you should be sure to get regular checks with your eye care specialist (optometrist or ophthalmologist) in order to optimize your vision for the rest of your life.  If you have questions about laser vision correction or wish to book a complimentary evaluation with Dr. Anderson Penno, contact Western Laser Eye Associates.

 

 

Vision & Vitamins: eat your carrots!

By | Eye health, Food for thought, Laser Eye Surgery, Laser vision correction, Ophthalmologist, Refractive Surgery, Uncategorized, Vision & Vitamins | No Comments

Is the old wives’ tales about eating carrots fact or fiction?  Carrots are high in beta-carotene which the body converts to vitamin A.   Carrots also provide vitamin C, iron, calcium and fiber.  Carrots and other foods rich in vitamins C and E, zinc, lutein, zeaxanthin, and omega-3 fatty acids DHA and EPA benefit eye health and general health, as hown by the the Age-Related Eye Diseases Study (AREDS), funded by the National Eye Institute. These nutrients are linked to lower risk for age related macular degeneration (AMD) and cataracts.

The myth that eating carrots can improve your vision seems to have been made popular during World War II when a propaganda campaign was run to convince the Germans that Royal Air Force pilots had superior night vision due to eating carrots.  This campaign was started to cover up the fact that the pilots were using a secret new radar technology that allowed them to strike under cover of darkness.  According to the Smithsonian Magazine and the World Carrot Museum (a virtual museum about all things carrot) RAF fighter pilots told newspaper reporters that carrots improved their night vision and it was picked up in the popular press of the time.

In reality carrots and other deeply colored fruits and vegetables do contain vitamins that are important for healthy eyes, but in most developed countries vitamin A deficiency is rare so eating carrots is not likely to result in a noticeable improvement in vision.  It is possible that in ancient societies there may have been improvements in vision from eating carrots in areas where vitamin A deficiency may have been common due to seasonal changes in diet.

Eating too many carrots will turn your skin orange but is not likely to harm you.  According to the USDA 1 cup of chopped carrots contains 0 fat, 0 cholesterol, 88mg sodium, 12gm carbohydrate (4gm dietary fiber, 6 gm sugar), 1 gm protein, 428% daily recommended Vitamin A, 13% daily recommended Vitamin C, 4% daily recommended calcium, and 2% daily recommended iron.  There are some reports that pesticides can build up in the skin so peeling carrots may be a healthier option.

In general it is good advice to –  eat a little bit of everything and not too much of any one thing.  As it turns out the stories about carrots are both fact and fiction!

 

If you have questions about laser vision correction or wish to book a complimentary evaluation with Dr. Anderson Penno, contact Western Laser Eye Associates.

 

Vision & Vitamins: What is really in your vision supplement?

By | Laser vision correction, Ophthalmologist, PRK, Refractive Surgery, Vision & Vitamins | No Comments

Do you know what is in that herbal pill or vitamin you are swallowing or if it will really help?  The American Academy of Opthalmology (AAO) recently published a study that compared ingredients in top selling brands of supplements marketed for macular degeneration.  The Age-Related Eye Disease Study did show evidence that a formula called the AREDS and now the AREDS2 did lower the risk of vision loss from macular degeneration for some people.  The 11 top selling brands of ocular nutritional supplements in the United States were studied were reviewed for ingredients and manufacturers claims.  All of these vitamins contained some of the ingredients from the AREDS or AREDS2 formulas, but none of them contained all the ingredients.  According to the study all of the ocular supplement marketing included claims that the products support, protect, help, or promote vision and eye health even though there is no proven benefit in using supplements for primary prevention of eye diseases (the Age-Related Eye Disease Study was done in patients with macular degeneration and the formulas studied were intended to prevent further vision loss rather than prevent macular degeneration from starting).

Health Canada has a license program that provides consumers with some assurance that vitamins and supplements are manufactured correctly and contain the ingredients that are listed on the product.  These Licensed Natural Health Products will have an eight-digit Natural Product Number (NPN) or Homeopathic Medicine Number (DIN-HM) on the label. Products with a NPN or DIN-HM marking on their label have been reviewed by Health Canada and found to be safe, effective and of high quality according to their recommended conditions of use.

Should you take vitamins or supplements to prevent eye diseases?  There are some scientific studies that show some vitamins and supplements might be helpful and other studies that show that these products do not help prevent eye diseases – and in some cases scientific studies have linked supplements like beta-carotene to an increased risk of cancer.  There are also numerous reports in the scientific journals of harmful contaminants in unregulated supplements from arsenic to steroids. The bottom line is that vitamins and supplements may not prevent eye disease so you may be wasting your money and products without an NPN or DIN-HM in Canada have not been assessed by Health Canada.  If you take other medications be sure to talk to your pharmacists to be sure that supplements will not interfere or create dangerous interactions.  So if you choose to take nutritional supplements do your homework to be sure you aren’t putting yourself at risk by taking certain products.

There are other ways to prevent eye disease and vision loss that don’t involve buying ocular nutritional supplements.  Keep in mind that anything that is good for your heart is good for your eyes.

1. Don’t Smoke

2. Exercise

3. See your family doctor for regular check ups including blood sugar and blood pressure checks.

4. Eat your carrots – and other deeply colored fruits like blueberries and citrus and veggies like leafy greens, as well as nuts like almonds, eggs, and fish

5. Get your eyes checked regularly and follow up as recommended by your ophthalmologist or optometrist

 

If you have questions about laser vision correction or wish to book a complimentary evaluation with Dr. Anderson Penno, contact Western Laser Eye Associates.