Phillips Russell
Flinders Medical Centre, Adelaide, Australia.
Queen Elizabeth Hospital, Adelaide, Australia.
Ophthalmol Ther. 2025 May 28. doi: 10.1007/s40123-025-01160-9.
There is abundant evidence in medical literature that Western diet and lifestyle drive the cellular and metabolic processes which underlie chronic non-communicable diseases. However, non-pharmaceutical interventions, which focus on nutrition, the microbiome and lifestyle, to prevent non-communicable diseases are not part of mainstream treatment, for a variety of reasons. Lack of progress in stemming the rise in chronic non-communicable diseases can be attributed to the current 'downstream' medical paradigm which is focused on treating disease and symptoms, rather than preventing disease via an 'upstream' approach, which looks at cause and process. Metabolic abnormalities and obesity have previously been noted as correlated with common chronic ophthalmic conditions such as age related macular degeneration (AMD), glaucoma, ocular inflammation, diabetic retinopathy and retinal vascular occlusive disease. These are ocular manifestations of an underlying common cause. The aim of this paper, using an ophthalmic context, is to provide an overview of the cellular pathophysiological mechanisms that underlie chronic non-communicable diseases, including ophthalmic diseases, and to draw the links between diet and lifestyle, the microbiome and chronic non-communicable diseases.
医学文献中有大量证据表明，西方饮食和生活方式推动了构成慢性非传染性疾病基础的细胞和代谢过程。然而，由于种种原因，专注于营养、微生物群和生活方式以预防非传染性疾病的非药物干预措施并非主流治疗的一部分。慢性非传染性疾病发病率上升趋势难以遏制，这可归因于当前“下游”的医学模式，该模式专注于治疗疾病和症状，而非通过着眼于病因和过程的“上游”方法预防疾病。代谢异常和肥胖此前已被指出与常见的慢性眼科疾病相关，如年龄相关性黄斑变性（AMD）、青光眼、眼部炎症、糖尿病视网膜病变和视网膜血管阻塞性疾病。这些都是潜在共同病因的眼部表现。本文旨在结合眼科背景，概述构成慢性非传染性疾病（包括眼科疾病）基础的细胞病理生理机制，并阐述饮食与生活方式、微生物群和慢性非传染性疾病之间的联系。
