A recent multi-omics Mendelian randomization (MR) study published in Nutrition & Metabolism has provided compelling evidence linking dietary patterns, sleep traits, amino acids, and inflammatory markers to the risk and subtype-specific pathophysiology of glaucomas. Integrating genetic data from UK Biobank and metabolic profiling, alongside cross-sectional validation in the National Health and Nutrition Examination Survey (NHANES), the study sheds further light on modifiable risk factors with implications for clinical management.
The china-based authors investigated five glaucoma subtypes – normal tension (NTG), primary open-angle (POAG), primary angle-closure (PACG), neovascular (NVG), and exfoliation glaucoma (XFG) – and their associations with 226 dietary factors, 11 sleep traits, 1400 metabolites, and 91 inflammatory markers. Diets high in fat and calories, including cheese, chocolate, and refined carbohydrates, were causally linked to increased glaucoma risk across subtypes. Conversely, antioxidant-rich and fiber-dense foods like fruits, whole grains, and vegetables were shown to have protective effects, due to their ability to mitigate neurodegeneration and oxidative stress.
Sleep quality emerged as another modifiable factor – daytime napping and self-reported longer sleep durations were associated with a reduced risk of POAG and NTG, respectively, while high sleep efficiency was shown to be protective against XFG.
Amino acid profiling revealed that elevated proline and asparagine levels increased NTG risk, whereas tyrosine and tryptophan appeared protective in PACG and POAG, respectively. Mediation analysis confirmed that dietary components (e.g., soft cheese, avocado) influenced glaucoma via these amino acids, suggesting neuroprotective mechanisms mediated through neurotransmitter precursors.
Cross-sectional NHANES data corroborated these findings, showing lower intake of vitamins A and C and higher water intake among glaucoma patients. Excessive sleep duration was also linked to increased glaucoma risk, highlighting potential discrepancies between observational and genetic findings.
Overall, the study underscores the potential of personalized lifestyle interventions – particularly targeted dietary and sleep modifications – in mitigating glaucoma risk via metabolic and inflammatory pathways, with further longitudinal and interventional studies now needed to translate these findings into clinical strategies.
