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Does daily dietary intake affect diabetic retinopathy progression? 10-year results from the 45 and Up Study
  1. Xixi Yan1,2,
  2. Xiaotong Han2,3,
  3. Changfan Wu2,4,
  4. Stuart Keel2,
  5. Xianwen Shang2,
  6. Lei Zhang2,5,6,7,
  7. Mingguang He3,8,9
  1. 1 Eye Center, Renmin Hospital of Wuhan University, Eye Institute of Wuhan University, Wuhan, China
  2. 2 Centre for Eye Research Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
  3. 3 State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
  4. 4 Department of Ophthalmology, Yijishan Hospital of Wannan Medical College, Wuhu, China
  5. 5 Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
  6. 6 Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia
  7. 7 Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
  8. 8 Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
  9. 9 Ophthalmology, Department of Surgery, Universityof Melbourne, Melbourne, Victoria, Australia
  1. Correspondence to Dr Mingguang He, Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC 3002, Australia; mingguanghe{at}


Background/aims To evaluate the associations of dietary consumption with the 10-year incidence of diabetic retinopathy (DR) progression in working-aged Australians with diabetes.

Methods We obtained longitudinal data of all diabetic subjects aged 45–65 years from the baseline of the 45 and Up Study and linked this data with Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme claims until 2016. Retinal photocoagulation (RPC), as determined based on the MBS data, was used as a proxy measure of DR progression. Dietary measurements were assessed via self-reported consumption of meat, dairy products, whole-meal bread, breakfast cereal, vegetables, fruit and fruit juice using a self-administered questionnaire at baseline. Cox regression was used to assess the association between dietary consumption and incident RPC during the follow-up period.

Results A total of 8122 participants were included in the current analysis with a mean age of 57.2±5.2 years. During a mean follow-up of 8.6 years, 314 participants (3.8% of baseline) received RPC. Higher consumption of cheese and whole-meal bread was associated with a lower risk of incident RPC, with the HRs of the highest quartiles versus the lowest being 0.58 (95% CI 0.41 to 0.83; test for trend, p=0.007) and 0.64 (0.46 to 0.89; p=0.04), respectively. Body mass index, insulin treatment and gender were significant modifiers for the association between cheese/whole-meal bread and RPC.

Conclusion Consumption of cheese and whole-meal bread could reduce the risk of DR progression among the working-aged Australian population with diabetes.

  • epidemiology
  • public health
  • diabetic retinopathy

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  • Correction notice This paper has been amended since it was published Online First. The contributorship statement has been updated.

  • Contributors XY and XH designed the study, drafted and revised the paper, they have made equal contributions. CW designed the study and revised the paper. SK revised the paper. XS analysed the data and revised the manuscript draft. LZ designed the study and coordinated the analysis. MH initiated the project, designed the study and revised the manuscript. LZ and MH have made equal contributions.

  • Funding This study was funded by National Natural Science Foundation of China (81420108008).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The Royal Victorian Eye and Ear Hospital Human Research Ethics Committee (HREC) (HREC no. 17/1330HS).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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