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Adherence to the EAT-lancet diet and the odds of cataract: a case-control study in an Iranian population

Year: 2026

Type: article

Abstract: The EAT‑Lancet reference diet was developed to align human nutrition with environmental sustainability. To date, no study has examined its association with cataract. We investigated whether adherence to the EAT‑Lancet diet is associated with the odds of cataract in an Iranian adult population. This hospital‑based case‑control study included 97 incident cataract cases and 198 frequency‑matched controls (aged ≥ 40 years). Dietary intake was assessed using a validated 168‑item food frequency questionnaire. Adherence to the EAT‑Lancet diet was quantified using two validated scoring approaches: the Stubbendorff index (graduated, 0–42 points) and the Knuppel index (binary, 0–14 points). Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Higher adherence to the EAT‑Lancet diet was strongly associated with lower odds of cataract. In fully adjusted models, participants in the highest tertile of the Stubbendorff index had 86% lower odds compared with the lowest tertile (OR = 0.14, 95% CI: 0.06–0.32; P‑trend < 0.001). Each standard deviation increment was associated with 60% lower odds (OR = 0.40, 95% CI: 0.28–0.55). Results were consistent using the Knuppel index (highest vs. lowest tertile OR = 0.12, 95% CI: 0.05–0.27). Sensitivity analyses adjusting for sunlight exposure and individual antioxidant nutrients did not materially alter the findings. Greater adherence to the EAT‑Lancet diet was associated with substantially lower odds of cataract in this Iranian population. These preliminary findings suggest that a sustainable, plant‑forward dietary pattern may confer dual benefits for planetary and eye health. Replication in prospective cohorts is needed. Not applicable.

Source: BMC Nutrition

DOI: 10.1186/s40795-026-01467-1

Authors: Parham Kamrani, Farzam Kamrani, Ali Nikparast, Elahe Etesami, Soroush Rezvani, Matin Ghanavati