Omega-3 fatty acid intake linked to reduced risk of myopia in children

Omega-3 fatty acid intake linked to reduced risk of myopia in children | Image Credit: © airborne77 - stock.adobe.com.

A diet high in omega-3 polyunsaturated fatty acids (PUFAs), primarily obtained from fish oils, may lower the risk of myopia in children, according to findings published in the British Journal of Ophthalmology. In contrast, a diet rich in saturated fats, such as those found in butter, palm oil, and red meat, may increase the risk of the condition.

The global prevalence of myopia continues to rise, with projections suggesting that nearly half of the world’s population will be affected by 2050. Risk factors for myopia are understood to include excessive near work, limited time outdoors, and genetic predisposition. Diet, however, has been less well established as a modifiable factor influencing refractive development.

Researchers from the Hong Kong Children Eye Study (HKCES) analyzed dietary patterns and ocular health outcomes in 1005 Chinese children aged 6 to 8 years. The cross-sectional study used a validated food frequency questionnaire encompassing 280 food items across 10 food categories. Axial length (AL) and cycloplegic spherical equivalent (SE) refraction were measured to assess eye growth and refractive status.

Among the participants, 276 children (27.5%) were found to have myopia. Analysis demonstrated that axial length was significantly longer in children in the lowest quartile of omega-3 fatty acid intake compared with those in the highest quartile (adjusted mean, 23.29 mm vs 23.08 mm; p = .01). SE also showed a protective association, with the lowest quartile group averaging more myopic refractions (−0.13 D) compared with the highest quartile (+0.23 D; p = .01). Conversely, children in the highest quartile of saturated fat intake demonstrated longer AL and more myopic SE compared with those in the lowest quartile.

“This study provides the human evidence that higher dietary ω-3 PUFA intake is associated with shorter axial length and less myopic refraction, highlighting ω-3 PUFAs as a potential protective dietary factor against myopia development,” the investigators concluded.

The biological mechanisms underlying these associations may relate to ocular blood flow. Omega-3 fatty acids are believed to increase choroidal blood circulation, supplying oxygen and nutrients to the sclera and thereby reducing scleral hypoxia, a known factor in myopia development. In contrast, saturated fats are associated with insulin resistance, which has been hypothesized to play a role in excessive axial elongation.

The study builds on prior animal research that has suggested a protective role for omega-3 fatty acids in slowing myopia progression. For example, supplementation in animal models has been shown to suppress experimentally induced myopia and reduce scleral hypoxia. However, this is the first large-scale study in humans to establish a significant association between dietary omega-3 intake and myopia.

While the findings highlight a potential dietary strategy for mitigating myopia risk, the authors acknowledged important limitations. As an observational cross-sectional study, the data cannot establish causality. The use of food frequency questionnaires introduces the possibility of recall bias, and dietary intakes were not validated with serum biomarkers. Additionally, the study population was limited to Chinese children in Hong Kong, a population with one of the world’s highest myopia prevalence rates, which may limit generalizability to other ethnic groups and geographic regions.

Despite these limitations, the results suggest that dietary interventions may play a role in public health strategies for addressing myopia. “Our findings indicated a possible effect of diet on myopia, of which ω-3 PUFAs intake may play a protective role against myopia development in children,” the authors noted.

Further longitudinal studies and randomized clinical trials are warranted to confirm these findings and determine whether omega-3 supplementation or dietary modification can effectively reduce the onset or progression of myopia in pediatric populations.

References:

1. BMJ Group. Diet rich in omega-3 fatty acids may help ward off short sightedness in children. Eurekalert. August 19, 2025. Accessed August 20, 2025. https://www.eurekalert.org/news-releases/1095033
2. Zhang XJ, Zhang Y, Zhang YJ, et al. Dietary omega-3 polyunsaturated fatty acids as a protective factor of myopia: the Hong Kong Children Eye Study. British Journal of Ophthalmology. Published Online First: 19 August 2025. doi: 10.1136/bjo-2024-326872