Adjuvant Therapies in Diabetic Retinopathy as an Early Approach to Delay Its Progression: The Importance of Oxidative Stress and Inflammation
Table 1
Diet compositions and servings in DR. In this table, we exemplify the different diets mentioned above with their compositions and servings. A row with the average American diet was added in order to contrast its composition to the recommended dietary regimens.
Daily: (i) 4-5 fruit servings (ii) 4-5 vegetable servings (iii) 7-8 servings of grains or their products (iv) 2-3 low-fat or fat-free dairy servings (v) 2 or less servings of meats, poultry, or fish (vi) 2-3 servings of fats and oils Weekly: (i) 4-5 servings per week of nuts, seeds, or dry beans (ii) 5 servings of sweets Recommended sodium intake is roughly 2400 mg per day [55]
Clinical outcomes: ↑ Glycemic and metabolic control in DM patients [27–29, 51, 52] ↓ Incidence of DN [49] Biomarkers: ↓ ACR, FBG, HbA1c, TC, and serum Cr [49] ↑ Plasma antioxidant capacity ↔ F2-isoprostanes [50].
In every meal: (i) 1-2 fruit servings (ii) 2 or more vegetable servings (iii) Olive oil (iv) 1-2 servings of bread/pasta/rice/couscous/other cereals Daily: (i) 1-2 servings of olives/nuts/seeds (ii) Herbs/spices/garlic/onions (less salt) (iii) 2 servings of dairy products (preferably low fat) Weekly: (i) 2 servings of white meat (ii) 3 or less servings of potatoes (iii) 2 or less red meat servings (iv) 2-4 eggs (v) 2 or more servings of legumes (vi) 2 or less servings of sweets Wine in moderation [57]
Clinical outcomes: Play a protective role in DM [34–37] and its microvascular complications such as DR [31, 32] Biomarkers: ↓ ACR, FBG, HbA1c, TC, and serum Cr [49] ↓ MCP-1, NF-κβ, IL-8, VCAM, and ICAM ↓ TNF-α-induced VEGF expression, ROS-induced lipid peroxidation ↑ Nrf2 protection against OS [39, 42]
Low-calorie diets
May be as strict as 600 kcal Carbohydrates may go from 20 to 60 g/day Consumption of protein and fat is increased to compensate [58]
Example of one-day low-calorie diet Breakfast: coffee (12 oz), cottage cheese (1.5 cup), and fruit cocktail (0.5 cup) Morning snack: medium apple, medium banana Lunch: medium apple, bread whole wheat slice (2), cheddar cheese (2 cubic inches), mayonnaise (0.15 cup), and turkey breast/white meat (3 oz) Afternoon snack: bread slice rye 7 grain (2), any fruit-flavored jelly (4tsp), and peanut butter (2 tbsp) Dinner: chicken breast/white meat (4 oz); rice: white cook steamed (1.5 cups); low-calorie dressing (salad); mayonnaise (4tbsp); croutons plain (0.25 cup); and 1 small garden salad with tomato and onion [59]
Clinical outcomes: Decreased risk of progression to DR [26] Independently, carbohydrate intake is not associated with DR or other complications of DM [30] Biomarkers: ↑ Glutathione, GPx, GR, and ascorbic acid [53, 54]
