Nutrition and cataract in low-income Mexicans: experience in an Eye Camp

Surgical Eye-camps for cataract treatment of low-income adult Mexicans have been undertaken over the last 10 years. Despite the high prevalence of cat aracts among these subjects, no assessment of their nutritional or health s tatus has ever been made. We compare the results obtained for 81 adults (44 men and 37 women) who received treatment in May 1997 with those for a "con trol" group of age and sex-matched but affluent individuals in Mexico City. alpha -Tocopherol and beta -carotene were assessed and analysed by HPLC an d colorimetric procedures, respectively. The plasma tocopherol to cholester ol ratio did not reveal deficiencies of this vitamin, and only 5 patients ( 2 men and 3 women) had low beta -carotene plasma levels. The patients had h igh BMI values, with 32% of men and 30% of women overweight, and 2% and 14% , respectively, obese, with higher glucose, cholesterol and triglyceride va lues reflecting enhanced insulin resistance and lipid abnormalities. The al kaline phosphatase values were elevated suggesting that many of these blind patients are osteomalacic because they now remain indoors. Although it has been suggested that an adequate intake of carotenes and tocopherol are ass ociated with absence of cataract, this appears not to be the case in our st udy population. Surveys in Mexico have revealed, however, a highly prevalen t deficiency of other vitamins such as niacin and riboflavin, both of which have been proved to be protective against cataract. It appears that nutrit ional deficiencies, obesity, incipient diabetes and lipid disorders co-exis t in modem Mexico. We have identified a need for research to aid the design of preventive nutritional approaches at the population level that could be applied in parallel with ongoing surgical treatment.