What Foods Should You Eat If You Have Diabetic Retinopathy?

Certain foods may have benefits for your eyes and diabetes management overall. Fish, leafy green vegetables, the Mediterranean diet, and foods with vitamin A or omega-3 may be most beneficial.

Facing a diabetes-related complication like retinopathy can be scary all on its own. Managing diabetes and its effects on your vision can require lifestyle adjustments, such as changing what you decide to eat.

Aside from possibly experiencing vision changes, diabetic retinopathy doesn’t take away the rest of diabetes management responsibilities. Food choices, included.

This article will serve up a plate of knowledge about foods that may be beneficial to your eye health and diabetes management overall, and whether certain foods or ingredients can help you manage diabetic retinopathy if it develops.

More than half of people with diabetes will develop retinopathy at some point. You’re more likely to develop this diabetes complication the longer you’ve lived with the condition, according to the American Diabetes Association (ADA).

Almost two-thirds of that $3.3 trillion cost – 64% – is paid for by American tax dollars, and that amount is growing. A study by the American Journal of Public Health predicts that taxpayers will shoulder 67.3% of the burden of healthcare costs by the year 2024, Physicians for a National Health Program

But keeping blood sugars in your target range and A1C levels around 7% can help reduce your risk of complications, including retinopathy. That’s why eating habits are an important part of diabetes management.

There are no guarantees that your eating habits will prevent any diabetes-related complication, let alone retinopathy. However, the foods you choose to eat can benefit your eye health and help diabetes management overall.

There’s no known way to completely prevent a diabetes complication, including retinopathy.

However, food is a key part of managing diabetes, and there are many clinical studies exploring the impact certain foods and ingredients may have on diabetic retinopathy.

In a 2018 systematic review of clinical studies dating back to 1967, a team of researchers analyzed more than 4,200 studies about the link between dietary habits and diabetic retinopathy.

Researchers determined that foods higher in fiber, oily fish, and reduced calories, and the Mediterranean diet were most associated with lower risk of diabetic retinopathy. An update in 2022 included many more studies in the subsequent years, and reached the same conclusion.

Below, you’ll find the specifics on each food category that you may consider adding to your meal plans to help in your diabetes management and reduce the risk of diabetes-related eye disease.

Fish

There are many studies showing that a higher intake of fish have benefits relating to diabetic retinopathy.

Fish oil is a rich source of long-chain omega-3 polyunsaturated fatty acid (PUFA), which reduces the risk of diabetes and has a protective effect against diabetic retinopathy.

In a 2016 study of people with type 2 diabetes, researchers found that eating at least 500 mg/d of dietary omega-3 fatty acids can help decrease the risk of sight-threatening diabetic retinopathy. This means eating two or more weekly servings of oily fish, which researchers noted was associated with a nearly 60% reduction in the risk of retinopathy.

Those types of fish may include:

Another study found that eating 85 to 141 grams of dark oily fish at least once a week could also protect against diabetic retinopathy, reducing retinopathy risk by 70% compared with those who never eat this fish. Those types of fish include:

salmon
mackerel
swordfish
sardines
bluefish

That same study noted that eating the same amounts of other fish — cod, perch, catfish — every week didn’t seem to have an impact on diabetic retinopathy risk.

That same pattern is present in multiple other studies, including research involving people who live in coastal communities and have higher consumption rates of fish and seafood.

Fish are also known to have many other health benefits, beyond just being good for your eye health and diabetes management overall. You can read more about those other potential health benefits here.

Omega-3 fatty acids

These have a number of benefits for your body and brain, and many health organizations (including the ADA) recommend that adults eat at least 250 to 500 milligrams (mg) of omega-3 each day.

While fatty fish is a main source for omega-3, you can also find this in algae, seeds, and high-fat plant foods. Some options beyond seafood might include:

Chia seeds:Chia seeds are full of manganese, selenium, magnesium, and other nutrients. A standard 1-ounce (28-gram) serving of chia seeds contains 5 grams of protein, including all eight essential amino acids.
Flaxseed:Flaxseed are small brown or yellow seeds that you’ll typically find ground, milled, or pressed to extract oil. These are a good source of fiber, magnesium, and other nutrients, including a lot of omega-3 fatty acids.
Walnuts:Walnuts contain fiber and high amounts of copper, manganese, and vitamin E, as well as important plant compounds.
eggs
yogurt
soy beverages

Fruits

Raw, fresh fruit is generally considered the best sources of vitamins and nutrients. Frozen or canned fruit without added sugars can also be a good choice for a balanced eating plan.

Foods rich in lutein and zeaxanthin — two carotenoid molecules that color food — have antioxidant properties and are known to help protect your eyes, in particular the macula and retina.

An older study cited in 2022 research notes that lutein, in fact, can delay diabetic retinopathy progression by 5 years . Adding just 10 mg of lutein each day could improve sensitivity to contrast, glare, and visual acuity in those in the early stages of diabetic retinopathy, according to research.

You can find these in orange, red, yellow, and purple fruits that might include:

orange
bananas (including red bananas)
berries
honeydew melon
mangoes
prunes
kiwis

An older research from 2013 surveyed nearly 1,000 people with type 2 diabetes who shared details about their fruit consumption and how it might have affected their diabetic retinopathy and eyesight. The study concluded that increased fruit intake was associated with reduced risk of diabetic retinopathy for those who ate a low fat, energy-restricted diet.

A 2021 study noted that “fruits are known to be low-glycemic-index foods rich in dietary fiber, which can slow down the conversion of carbohydrates into glucose after ingestion.” That research cited older research from 2014 that had concluded “more frequent consumption of foods rich in flavonoid particularly fruits like citrus fruit, apples, berries… was associated with reduced odds of developing diabetic retinopathy.”

However, in this latest study, researchers didn’t find any association with fruit intake on diabetic retinopathy — possibly a result of fewer people in the study consuming fruits.

Still, the research supports the general link between better eating — which includes fruits — and improved blood sugars and diabetes management. This in turn can help lower A1C levels and overall reduced risk of diabetes-related complications.

Vegetables

Green, leafy veggies are the best source of vitamins and nutrients.

As with fruit, vegetables containing lutein and zeaxanthin are recommended for eye health. These may include both green leafy vegetables as well as highly pigmented ones, such as:

kale
broccoli
lettuce
parsley
peas
spinach
turnip greens
corn
carrots
pumpkin
red and orange peppers
squash

Vitamins

Different vitamins play a role in your diabetes management, including how you may be affected by diabetic retinopathy. People with diabetic retinopathy tend to have lower levels of these vitamins, according to research .

A 2020 research review explored the diabetes eye affects related to several vitamins, minerals, and other nutrients including vitamins A, B, C, D, and E. The study also mentions zinc, copper, and others that are more beneficial. This research also points out certain vitamins can be important in preventing retinopathy.

In particular, vitamin A helps protect the surface of the eyes and is beneficial for night vision. This vitamin can be found in carrots, sweet potatoes, spinach, kale, and cantaloupe.

However, the ADA’s yearly guidelines note that there’s no clear evidence that supplements alone can improve your blood sugar levels or other long-term outlooks, such as the development of retinopathy — not unless a vitamin or mineral deficiency already exists.

This means you shouldn’t take vitamin or mineral supplements and expect they’ll have an effect on your diabetes management or diabetic retinopathy. Consult your diabetes care team before making any changes or taking new medications or supplements.

You’ll likely notice that many of the food items mentioned here share many of the same nutrient and vitamin benefits. A number of the foods contain properties that are beneficial for your diabetes management and eye health.

Many of those foods are also part of the Mediterranean diet, which is based on the traditional foods that people eat in countries bordering the Mediterranean Sea (France, Spain, Greece, Italy). The diet focuses on fruits, vegetables, whole grains, legumes, nuts, seeds, olive oil, and heart-healthy fats.

Several studies have shown that the Mediterranean diet can promote weight loss and help prevent heart attacks, strokes, and premature death. It’s also helpful for the prevention of type 2 diabetes, and may improve blood sugar levels for those with other types of diabetes.

Specific to diabetes eye health, the Mediterranean diet contains anti-inflammatory and antioxidant compounds. These indirectly improve the peripheral uptake of glucose and reduce insulin resistance, which can in turn have a protective effect in reducing risk for diabetes complications. Olive oil provides oleic acid, which may help prevent diabetic retinopathy.

A 2015 research that involved over 3,600 people with type 2 diabetes also found that Mediterranean diets enriched with extra virgin olive oil may protect against diabetic retinopathy.

Eating patterns recommended by diabetes experts are essentially the same for diabetic retinopathy as they are for overall diabetes management.

The ADA’s standards of care focus on eating more fruits and vegetables, high fiber whole grains, lean protein, and healthy fats while minimizing processed foods and added sugars.

The eating guidelines for both diabetes and diabetes-related eye health are tied to stable blood sugars, making sure glucose levels stay within target ranges and don’t dramatically fluctuate. As a result, experts emphasize lower A1C levels that are proven to reduce the risk for diabetes-related complications.

Diabetes plate method

The ADA and the Centers for Disease Control and Prevention (CDC) recommend using what’s known as the “plate method” for diabetes meal planning. You can practice this method by following these steps:

Start with a 9-inch dinner plate (about the length of a business envelope).
Fill half with nonstarchy vegetables, such as salad leaves, green beans, broccoli, cauliflower, cabbage, and carrots.
Fill one quarter with a lean protein, such as chicken, turkey, beans, tofu, or eggs.
Fill one quarter with carb foods. Foods that are higher in carbs include grains, starchy vegetables (such as potatoes and peas), rice, pasta, beans, fruit, and yogurt. A cup of milk also counts as a carb food.
Then choose water or a low calorie drink, such as unsweetened iced tea to go with your meal.

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What Foods Should You Eat If You Have Diabetic Retinopathy?