Here's a crazy idea - Could milk have something to do with MGD?

[Tankie]

Before you call me crazy, read this abstract:

http://www.ncbi.nlm.nih.gov/pubmed/21849420

Correct me if I'm wrong, but my understand is that people with MGD have lower levels of cholesteryl esters in their meibum. If this is true, perhaps drinking more 2% milk (which I believe contains chloesteryl esters) could help fix the problem?

What do you think? Is this idea totally crazy, or is there a slither of hope for it?





On a personal note, I started having my dry eye problems when I was 20... and conveniently, it was around that same age that I started to drink a lot less milk...

For the record, I will be as shocked as anyone if any of what I'm saying has merit to it, so please don't think of me as crazy! Even I think this is a super long shot, and I'm the person posting it!

[PotatoCakes]

It probably wouldn't hurt to try drinking more milk. When I was tested for allergies, I had a reaction to casein (protein in milk) so I eliminated all dairy for three months. It didn't change anything for me so I went back to consuming dairy. My understanding is that you need to eliminate something for at least 3 months to clean out your system and allow your body to recover from any damage. You could try adding more milk for three months and see what happens.

[Hopeful2]

It is an interesting speculation. I have heard that milk can produce more mucus in mucus membranes, (eg nasal congestion). I don't know what this means for the eyes.

One thing to consider is that milk is also a source of protein. You might want to consider if you are still getting enough quality protein in your diet. Adequate protein is essential for healthy regulation of hormones?

Was there anything else that happened around the time that your dry eyes developed? Diet wise, physically, stress wise . . . ?

Happy Christmas

[DCRdryeye]

Good thinking Tankie - the pubmed paper does confirm that cholesterol esters are contained in meibum. So how do you get more cholesterol esters? I personally wouldn't advise drinking more milk to obtain cholesterol esters, although your line of thinking is definately going in the right direction. Dairy is one of the foremost common food intolerance, whether it be casein or lactose, we simply weren't meant to drink another mammals milk.

Why does milk create mucous? What has to happen in the body for mucous to occur? What is mucous? basically, mucous is caused from an inflammatory reaction. It is apart of the inflammatory pathway. Milk can stimulate an immune reaction, even at a very mild, undetected level that you may not be aware of. No doubt, we know that dry eye is an inflammatory disease and we want to reduce inflammation wherever possible.

Food intolerance blood tests are available, and depending on the laboratory, up to 150 foods can be tested. They basically test your blood to see if you have an IgG reaction to a variety of foods. This is the high tech way to go rather than an "Elimination diet" which is very difficult to do. The lab should give you results of varying degrees of intolerance from EXTREMELY intolerant to moderate and mild intolerance. Usually there is only 1 to 4 foods that will be EXTREMELY intolerant, and more in the "moderate intolerance" section (possibly up to 20 foods). Usually, the EXTREMELY intolerant foods are avoided where possible, but not totally (have it as a once in a while treat). The moderately intolerant foods are placed on a rotation diet where you don't eat the same food more than once within 4 days. Eg: If "apples" were a food that is "moderately intolerant" for you, you may have apples on day one, then again on day four. By doing this, your body is not seeing the same food too often and not allowing the immune system to react. Here's a link to learn a bit more: http://www.tldp.com/issue/174/IgG%20Food%20Allergy.html and the following are some pubmed studies:

http://www.ncbi.nlm.nih.gov/pubmed/19842221
http://www.ncbi.nlm.nih.gov/pubmed/21788754
http://www.ncbi.nlm.nih.gov/pubmed/18498540

I'm not suggesting eliminating the "foods" your body reacts too will solve dry eye problems. What I'm saying is that a "collective" approach works best, and certainly diet has a large role to play.

Tankie I don't think your crazy, with a complex problem such as dry eye we need to take long shot ideas and put them out there. It's never my intention to debunk anyone's opinions and ideas on here. But in general cow's milk is considered a bad thing where inflammation is concerned. It contains hormones, imbalanced nutrients (remember it's not meant for human consumption), and has been linked to cancers in humans:

http://www.ncbi.nlm.nih.gov/pubmed/22081693
http://www.ncbi.nlm.nih.gov/pubmed/22043817

If I was to recommend a "diet" for dry eyes, I'd go for the Mediterranean diet because of it's well known anti-inflammatory, antioxidant and anti-microbial effects. It also contains the "good fats" derived from olive oil, fish, olives, etc, where "cholesterol esters" can be obtained. A pubmed search for olive oil / oleic acid and "dry eyes" or "meibum" might locate studies. Here are a few studies on the "anti-inflammatory" effects of the Mediterranean diet.

http://www.ncbi.nlm.nih.gov/pubmed/20515519
http://www.ncbi.nlm.nih.gov/pubmed/21139128

Extra sites of interest:

http://news.harvard.edu/gazette/2006.../11-dairy.html
http://www.rense.com/general26/truth.htm
http://www.notmilk.com/
http://www.waoy.org/9.html
http://www.godairyfree.org/Personal-...Your-Milk.html

[tearless2]

Hi,

Well, since we are discussing diets that might help dry eye just thought I'd mention a book/diet I was reading recently and will be trying to implement. It is by Joel Fuhrman called superimmunity. In it, he discusses actually reversing diseases like cancer and symptoms of autoimmune diseases by sticking to a specific diet regimen. Most importantly whole foods, more vegetables and fruits, a lot less meats...like only 10% of your intake. For auto immune he secifically mentions increasing fish oil, controlling intestinal flora (I think he means probiotics), LOTs of leafy greens (kale and spinach)beans and some nuts, taking a multivitamin, avoiding wheat and....going vegan.

His book has recipes which I will try to slowly introduce. I don't want to take on too much or I will quit. I'm not hoping for a miracle but at the very least I will be eating a lot more healthy. The vegan part may not be possible for me. I have already mostly taken out milk and red meat products from my diet but I don't think I can give up eggs and fish occassionally. Actually, I have been known to eat fast food occassionally so I don't know if I will be able to stick to this diet at all.

In any case, Dr. Fuhrman would seem to agree with decreasing milk intake in auto immune cases.

[Tankie]

Wow, you guys are awesome Thanks for the detailed replies!

Fair enough if milk is not be the best food for this but I have two further questions:

1. Does anyone know of specific foods I could try eating which contain chloesteryl esters?
2. Is there an eye drop that contains chloesteryl esters?

[PotatoCakes]

I emailed a physician about this and here's his reply (note difference between cholesteryl and cholesterol):

A cholesteryl ester is, as its name would imply, an ester of cholesterol. The ester bond is formed between the carboxylate group of a fatty acid and the hydroxyl group of cholesterol. Cholesteryl Esters have a lower solubility in water than Cholesterol and, in other words, are more hydrophobic. (Hydrophobic meaning they don't mix with water very well.)

2. To my knowledge, there is unlikely to be any change in diet that would make any difference. Cholesterol itself is mostly made by our bodies and what we ingest has only a small effect except for those who consume large quantities. Even people on a very strict almost no fat diet can rarely lower their cholesterol level significantly without doing something else too.

3. Lastly, based on the fact that babies have levels similar to people with MGD, the article itself says this is unlikely to have much or anything to do with MGD but is more useful as a molecular marker to follow the effect of other treatment.

[Tankie]

I emailed a physician about this and here's his reply (note difference between cholesteryl and cholesterol):

A cholesteryl ester is, as its name would imply, an ester of cholesterol. The ester bond is formed between the carboxylate group of a fatty acid and the hydroxyl group of cholesterol. Cholesteryl Esters have a lower solubility in water than Cholesterol and, in other words, are more hydrophobic. (Hydrophobic meaning they don't mix with water very well.)

2. To my knowledge, there is unlikely to be any change in diet that would make any difference. Cholesterol itself is mostly made by our bodies and what we ingest has only a small effect except for those who consume large quantities. Even people on a very strict almost no fat diet can rarely lower their cholesterol level significantly without doing something else too.

3. Lastly, based on the fact that babies have levels similar to people with MGD, the article itself says this is unlikely to have much or anything to do with MGD but is more useful as a molecular marker to follow the effect of other treatment.

Wow, thanks potatoCakes!

In response to point 3, I agree that the abstract says that people with MGD have the same level as babies, but "normal" adults have higher levels... so I'm not totally convinced it's unrelated.

In response to point 2, I can't say I'm speaking from experience here, but I've heard of people lowering their cholesterol before.

Overall, this is great stuff that you asked a doctor for us! I'd be interested to hear a few second opinions from other doctors.

[PotatoCakes]

Re: #2 - I think the key is this

except for those who consume large quantities.

.
Someone who eats a healthy (little or no red meat, low fat, low sugar, etc) diet already probably wouldn't see a dramatic difference in cholesterol levels by changing their diet. Unfortunately, with rising obesity rates and the proliferation of fast food restaurants, I'm guessing the average person doesn't fall into the healthy diet category so they could see a change if they suddenly went healthy. Of course, they'd get tons of other benefits too...

[spmcc]

This thread reminded me of a research article from 2000 entitled Prevalence of and Risk Factors for Dry Eye Syndrome (see abstract on pubmed: pmid 10980773)

In the article (I have the full text), the authors state that using logistic regression and controlling for age, sex, and their other variables in a stepwise fashion (i.e., they are trying to identify factors associated with dry eye while the others are held constant) they found that

persons with a higher total to HDL cholesterol ratio were less likely to have dry eye.

In their discussion/conclusion section, they write

The apparent protective effect of the total to HDL cholesterol ratio has not been reported previously, although the presence of cholesterol in the lipid layer of the tears has been noted. The lipid layer has been reported to be critical in maintaining tear film. It is possible that there is a correlation between serum cholesterol and cholesterol found in the lipid layer of tears.

***

Of course, the catch is that a high ratio of total cholersterol to HDL is unhealthy... it's linked to a higher risk of heart attacks!

[Tankie]

Ways to increase HDL Cholesterol:

Aerobic exercise. Many people don't like to hear it, but regular aerobic exercise (any exercise, such as walking, jogging or bike riding, that raises your heart rate for 20 to 30 minutes at a time) may be the most effective way to increase HDL levels.

Lose weight. Obesity results not only in increased LDL cholesterol, but also in reduced HDL cholesterol. If you are overweight, reducing your weight should increase your HDL levels.

Cut out the trans fatty acids. But trans fatty acids not only increase LDL cholesterol levels, they also reduce HDL cholesterol levels. Removing them from your diet will almost certainly result in a measurable increase in HDL levels.

Alcohol. With apologies to the American Heart Association, which discourages doctors from telling their patients about the advantages of alcohol: one or two drinks per day can significantly increase HDL levels. More than one or two drinks per day, one hastens to add, can lead to substantial health problems including heart failure.

Increase the monounsaturated fats in your diet. Monounsaturated fats such as canola oil, avocado oil, or olive oil and in the fats found in peanut butter can increase HDL cholesterol levels without increasing the total cholesterol.

Add soluble fiber to your diet. Soluble fibers are found in oats, fruits, vegetables, and legumes, and result in both a reduction in LDL cholesterol and an increase HDL cholesterol. For best results, at least two servings a day should be used.

Other dietary means to increasing HDL. Cranberry juice has been shown to increase HDL levels. Fish and other foods containing omega-3 fatty acids can also increase HDL levels. In postmenopausal women (but not, apparently, in men or pre-menopausal women) calcium supplementation can increase HDL levels.

[gilligan_1434]

This thread reminded me of a research article from 2000 entitled Prevalence of and Risk Factors for Dry Eye Syndrome (see abstract on pubmed: pmid 10980773)

Thanks for posting this. It's worth noting that the Odds Ratio for increased Trigs/HDL was 0.88 to 0.99 for 95% CI.... meaning it's not a very strong cause of dry eye if it is one at all; certainly not strong enough to go try to make triglycerides increase unhealthily! It could be that older people tend to get dry eye and also tend to have higher trig/HDL ratio.

More interesting to me was that current or past multivitamin use increased risk of dry eye. Current use: 1.09 to 1.82 Odds ratio for 95% CI... meaning there's a good chance multi vitamin use might contribute to a person's chance of getting dry eye. There is also the possibility that there is a less direct link, Ie older people tend to get dry eye and also tend to use multivitamins.

[spmcc]

Ways to increase HDL Cholesterol:.

Tankie - IF (and I mean a BIG IF) you wanted to get the results the authors reported, you'd want to become LESS healthy - maybe gain weight, cut out exercise, eat crap etc. to INCREASE your total cholesterol or DECREASE your HDL (the good cholesterol).

(to make a ratio bigger, you need to increase the numerator and/or decrease the denominator)

NOT GOOD!!!!!

[spmcc]

It could be that older people tend to get dry eye and also tend to have higher trig/HDL ratio.

Ie older people tend to get dry eye and also tend to use multivitamins.

The authors controlled for age in their statistical model. In other words, it didn't matter if the participants were young or old, a higher ratio of TC/HDL was related to less dry eye (i.e., protective) and the use of multivamins was related to more dry eye.

caveat: There are probably tons of things wrong with this study as with all other observational studies. But (I think) it's still interesting to note quirky similarities between unrelated studies.

[Tankie]

Ah, I see. Well in that case it's time to pack on the pounds haha Just kidding, that would be a terrible idea