Research Shows Food Insecurity Linked to Glaucoma Development

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A recent cross-sectional population-based study indicated a positive association between glaucoma and food insecurity.1

Food insecurity is well documented as a cause for a variety of negative behaviors that can influence disease risk in individuals. Decreased quality of diet, increased or decreased weight gain, and chronic disease have been linked to food insecurity in the past.2 Notably, as a stressor, food insecurity naturally also promotes inflammation: past studies have indicated an increased presence of C-reactive protein – a systemic and nonspecific inflammatory marker – in individuals experiencing food insecurity.3

“Food insecurity may drive the development of glaucoma through cycles of dietary variation and chronic stress,” wrote Ramin Talebi, Sidney Kimmel Medical College, Thomas Jefferson University, and colleagues.1

The team gathered data from the All of Us (AoU) research program from its inception in 2015 until July 2022. A total of 78,694 participants were included; of these, 9732 (12.4%) reported food insecurity, 2095 (2.7%) had glaucoma, 1398 (1.8%) had age-related macular degeneration (AMD), 1127 (1.4%) had diabetic retinopathy (DR), and 10,135 (12.9%) had cataracts.1

Covariates for the study included age, race, ethnicity, income, level of education, access to eye care, body mass index, hypertension, diabetes, and nutritional deficiency. Food insecurity was determined via a 2 question survey, answered on a scale from “often true” to “never true.”1

Investigators calculated associations between food insecurity and each eye disease using multivariable logistic regression. When compared to those without food insecurity, those with had increased odds of glaucoma (adjusted odds ratio [aOR], 1.43; 95% CI, 1.18-1.72; P ≤.001). Interestingly, investigators noted that their odds for AMD (aOR, 0.91; 95% CI, 0.67-1.21; P = .544), DR (aOR, 1.15; 95% CI, 0.93-1.42; P = .180) and cataracts (aOR, 0.97; 95% CI, 0.87-1.08; P = .635) were not significantly higher than participants without food insecurity.1

While glaucoma’s relation to food insecurity was successfully identified, Talebi and colleagues were unable to demonstrate any association between insecurity and AMD, DR, or cataracts. Additionally, the study displayed a strong negative correlation between food insecurity and both AMD and cataracts. The team indicates that this is likely a product of the effects of the covariates of age, ethnicity, and race. In addition to a lower average age in the food insecurity cohort, the team called attention to a lower proportion of White race and ethnicity, which are risk factors for AMD.1

Investigators noted that previous studies have not found a correlation between food insecurity and eye disease. The Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine (MI-SIGHT) showed no association whatsoever. Talebi and colleagues explained this discrepancy by indicating that MI-SIGHT included a smaller cohort of first-year applicants drawn solely from 2 clinics in Michigan, while AoU provided the team with data from a national population over the course of several years.1

Although the connection between food insecurity and various chronic diseases has been studied in the past, Talebi and colleagues stated that a lack of data surrounding its connection to eye disease specifically motivated the study. The team also calls for more research to be dedicated to the prevention of vision impairment and loss due to food insecurity.1

“Further studies should seek to understand disease-specific mechanisms for this association to better inform holistic strategies to prevent vision loss,” wrote Talebi and colleagues. “Adequate social determinants of health screening and population interventions to improve stable access to healthy food options may prove vital for reducing the risk of eye disease.”1

References

1. Talebi R, Yu F, Tseng VL, Coleman AL. Association between food insecurity and chronic eye disease in the National Institutes of Health’s All of US Research Program. Ophthalmology Science. 2025;5(3):100697. doi:10.1016/j.xops.2024.100697

2. Laraia BA. Food insecurity and chronic disease. Advances in Nutrition. 2013;4(2):203-212. doi:10.3945/an.112.003277

3. Gowda C, Hadley C, Aiello AE. The association between food insecurity and inflammation in the US adult population. American Journal of Public Health. 2012;102(8):1579-1586. doi:10.2105/ajph.2011.300551