Associations between the Mediterranean lifestyle and incident age-related eye diseases: a longitudinal analysis from the UK Biobank

Jan 12, 2026Journal of global health

Links between the Mediterranean lifestyle and new cases of age-related eye diseases over time

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Abstract

During a median follow-up of 10.5 years, 9954 cases of cataract were identified among 113,829 participants.

Higher adherence to the Mediterranean lifestyle index is associated with a reduced risk of developing cataracts.
A one-point increase in the Mediterranean lifestyle score correlates with a 1.5% reduction in cataract risk.
Adherence to Mediterranean dietary habits is linked to a decreased incidence of age-related macular degeneration (AMD), with a 2.4% reduction per score increment.
The dietary habits block and physical activity block are associated with lower cataract risk, indicated by hazard ratios of 0.97.
No significant association was found between the Mediterranean lifestyle index and glaucoma, although the physical activity block is associated with a 6% reduced risk.

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BACKGROUND: The Mediterranean lifestyle (MEDLIFE) is generally considered to have a positive effect on several health outcomes. However, little is known about its impact on age-related eye diseases. We aimed to assess the effect of MEDLIFE on the risk of three such diseases: cataract, glaucoma, and age-related macular degeneration (AMD).

METHODS: We included 113 829 participants from the UK Biobank who were free of age-related eye diseases at baseline and followed them up prospectively for disease occurrence. Adherence to MEDLIFE was assessed using 25 items, categorised under three blocks: 'Mediterranean food consumption' (block 1), 'Mediterranean dietary habits' (block 2), and 'physical activity, rest, social habits' (block 3). We used a Cox proportional hazard model to examine the associations of the MEDLIFE index and each of its blocks with incident age-related eye diseases.

RESULTS: During a median follow-up of 10.5 years, 9954 cases of cataract, 1956 cases of glaucoma, and 1736 cases of AMD were identified. We noted an inverse association between the MEDLIFE index and new-onset cataract (P-value for trend = 0.005). A one-point increment in the MEDLIFE score was associated with a 1.5% (95% confidence interval (CI) = 0.7-2.3) reduction in the risk of cataract, and with a 2.4% (95% CI = 0.5-4.3) reduction in AMD incidence. Analysis of MEDLIFE blocks indicated that block 2 (hazard ratio (HR) = 0.97; 95% CI = 0.95-0.99) and block 3 (HR = 0.97; 95% CI = 0.95-0.99) were associated with lower risk of cataract. Block 2 was further related to reduced risk of AMD (HR = 0.95; 95% CI = 0.91-0.99). Although we found no association between the MEDLIFE index and incident glaucoma, block 3 was associated with lower glaucoma risk (HR = 0.94; 95% CI = 0.90-0.98).

CONCLUSIONS: Higher adherence to MEDLIFE was associated with decreased incidence of cataract and AMD, while the 'physical activity, rest, and social interactions' block was related to a lower risk of glaucoma. Our findings suggest that MEDLIFE may serve as a potential behavioural intervention for preventing age-related eye diseases.

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Associations between the Mediterranean lifestyle and incident age-related eye diseases: a longitudinal analysis from the UK Biobank

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