ONCE YOU start talking with your patients about their diets, you’ll learn that many of them follow specific regimens and may not realize they’re lacking in certain essential nutrients as a result.

Here, I discuss two of the most popular diets and how to promote and compensate for the nutrients that are essential for eye health.


Developed in 2002, by Dr. Loren Cordain, this diet is based on what our Paleolithic ancestors ate via hunting and gathering. The foods that comprise the paleo diet:

  • Lean meats (preferably grass fed) or fish at every meal. (Grass- fed meat tends to be leaner than grain-fed meat and has higher amounts of omega-3 fatty acids.)
  • Unlimited fruits and non-starchy vegetables, such as broccoli.
  • One handful or ¼ cup per day of nuts and seeds.

The Paleo diet is comprised of a relatively high amount of animal protein compared with a typical North American diet. However, by choosing lean meats, such as turkey and chicken breast, grass-fed beef tenderloin and fish, and avoiding processed meats, such as hot dogs, one consumes a moderate amount of fat.

In addition, if one chooses grass-fed meat and consumes a high amount of fish, one can combat inflammation.

To promote eye-healthy Paleo diet food items (those that contain lutein, zeaxanthin, vitamin C, vitamin E, zinc, DHA and EPA), recommend these patients eat:

  • Leafy greens, such as kale, orange peppers, broccoli and brussels sprouts (lutein and zeaxanthin, vitamin C, vitamin E, beta-carotene)
  • Kiwi, cantaloupe, avocado, berries and citrus fruits, such as oranges (vitamin C, beta-carotene [cantaloupe] and vitamin E [avocado])
  • Fish (especially, wild salmon, sardines, rainbow trout and mackerel, which are high in the omega-3s, DHA and EPA and low in contaminants) four times a week
  • A handful of nuts, such as almonds, walnuts, pistachios and cashews (vitamin E, ALA [plant-based omega-3], zinc) daily
  • Four eggs (lutein, vitamin E, zinc) per week

The Paleo Diet ranks No. 36 in US News & World Report’s “Best Diets Overall” list. See
PHOTO CREDIT: Mara Zemgaliete/


Since the publication of the 20-year China-Cornell-Oxford Project, which concluded that those who have a high consumption of animal-based foods have higher death rates from cancer and other chronic diseases vs. those with plant-based diets, many consumers have gravitated toward a vegan diet.

A vegan diet often includes large amounts of fruits and vegetables, which provide high levels of antioxidants and carotenoids. However, when cold-water fish, eggs and lean meats are not consumed, the important ocular nutrients of omega-3 fatty acids — DHA and EPA — lutein, zinc and vitamin E, respectively, may be lacking.

To compensate for nutrients that might be lacking in a vegan diet, recommend:

  • A high-quality (comes from a company that maintains quality control and purity standards), vegan omega-3 supplement that includes DHA. (Flax seed, walnuts, avocados, soy and chia seeds are plant sources high in omega-3s, but the conversion from ALA into DHA and EPA upon consumption is often not adequate.)
  • At least one handful a day of leafy green vegetables, such as spinach, with a healthy fat, such as extra-virgin olive oil, to aid in the absorption of lutein
  • The consumption of ½ cup to 1 cup daily of beans, legumes and whole grains for zinc.
  • The consumption of almonds, sunflower seeds, (1/4 or 1 handful per day) leafy greens (1 cup or handful per day), orange peppers (2 peppers per week), wheat germ and olive oil for vitamin E, (1 tbsp. per day) individually for adequate vitamin E.


Promoting and compensating for the nutrients that promote ocular health is important, as doing so can enable patients to maintain a lifetime of healthy eyes. OM