Could what children eat influence whether they develop myopia? New research from a large cross-sectional study in China suggests dietary patterns may indeed play a modest role in myopia risk among young people.
The researchers analyzed data from 24,797 children and adolescents aged 6–18 years who participated in the Tianjin Child and Adolescent Research of Eye (TCARE), a citywide school-based screening program conducted between August and October 2022.
Parents were asked to complete food-frequency questionnaires covering 17 food groups, including grains, fruits, vegetables, meats, dairy products, and snack foods. Using principal component analysis, investigators identified three distinct dietary patterns: a “refined grains–eggs pattern”; a “nuts–tubers vegetables pattern”; and a “snacks” pattern characterized by fried foods, fast food, sugar-sweetened beverages, desserts, and processed meats.
After adjusting for age, sex, region, parental myopia, homework time, and outdoor activity, adherence to the nuts–tubers vegetables pattern (i.e. a high intake of nuts, legumes, vegetables and whole grains) was associated with a slightly reduced risk of myopia. Children in the highest adherence tertile had a lower likelihood of myopia compared with those in the lowest tertile.
In contrast, the snacks dietary pattern was associated with increased myopia risk. Participants with the highest intake of fried and barbecued foods, fast foods, sugar-sweetened beverages, desserts, and processed meats had a higher likelihood of myopia.
The refined grains–eggs pattern – characterized by refined grains, eggs, fruits, red meat, dairy, and leafy vegetables – was not significantly associated with myopia after adjustment for confounders.
The nuts–tubers vegetables pattern shares similar features with other well-known healthy diets, such as the Dietary Approaches to Stop Hypertension (DASH) and Planetary Health diets, which emphasize whole grains, vegetables, legumes, nuts, and seafood, while limiting processed foods and added sugars. These diets are associated with improved metabolic health, and the authors note that glucose metabolism may be relevant to both refractive and axial myopia development.
Despite its large sample size and comprehensive dietary assessment, the study has several limitations. Its cross-sectional design prevents causal conclusions, and dietary intake was parent-reported, introducing potential recall bias. Additionally, the use of noncycloplegic refraction may overestimate myopia prevalence in children.
Nevertheless, the study authors suggest their results highlight diet as a potentially modifiable environmental factor in myopia prevention. While behavioral interventions such as increased outdoor time remain central to myopia control strategies, dietary modification could also represent an additional public health approach worth further investigation.
Prospective longitudinal studies – ideally incorporating cycloplegic refraction and more precise nutritional assessments – will now be needed to confirm whether dietary changes can meaningfully influence the onset or progression of childhood myopia.
The researchers analyzed data from 24,797 children and adolescents aged 6–18 years who participated in the Tianjin Child and Adolescent Research of Eye (TCARE), a citywide school-based screening program conducted between August and October 2022.
Parents were asked to complete food-frequency questionnaires covering 17 food groups, including grains, fruits, vegetables, meats, dairy products, and snack foods. Using principal component analysis, investigators identified three distinct dietary patterns: a “refined grains–eggs pattern”; a “nuts–tubers vegetables pattern”; and a “snacks” pattern characterized by fried foods, fast food, sugar-sweetened beverages, desserts, and processed meats.
After adjusting for age, sex, region, parental myopia, homework time, and outdoor activity, adherence to the nuts–tubers vegetables pattern (i.e. a high intake of nuts, legumes, vegetables and whole grains) was associated with a slightly reduced risk of myopia. Children in the highest adherence tertile had a lower likelihood of myopia compared with those in the lowest tertile.
In contrast, the snacks dietary pattern was associated with increased myopia risk. Participants with the highest intake of fried and barbecued foods, fast foods, sugar-sweetened beverages, desserts, and processed meats had a higher likelihood of myopia.
The refined grains–eggs pattern – characterized by refined grains, eggs, fruits, red meat, dairy, and leafy vegetables – was not significantly associated with myopia after adjustment for confounders.
The nuts–tubers vegetables pattern shares similar features with other well-known healthy diets, such as the Dietary Approaches to Stop Hypertension (DASH) and Planetary Health diets, which emphasize whole grains, vegetables, legumes, nuts, and seafood, while limiting processed foods and added sugars. These diets are associated with improved metabolic health, and the authors note that glucose metabolism may be relevant to both refractive and axial myopia development.
Despite its large sample size and comprehensive dietary assessment, the study has several limitations. Its cross-sectional design prevents causal conclusions, and dietary intake was parent-reported, introducing potential recall bias. Additionally, the use of noncycloplegic refraction may overestimate myopia prevalence in children.
Nevertheless, the study authors suggest their results highlight diet as a potentially modifiable environmental factor in myopia prevention. While behavioral interventions such as increased outdoor time remain central to myopia control strategies, dietary modification could also represent an additional public health approach worth further investigation.
Prospective longitudinal studies – ideally incorporating cycloplegic refraction and more precise nutritional assessments – will now be needed to confirm whether dietary changes can meaningfully influence the onset or progression of childhood myopia.
