Pro-inflammatory diet linked to relapse rate, MRI marker in patients with MS

Key takeaways:

• Patients with MS who had higher energy-adjusted Dietary Inflammatory Index scores were more than twice as likely to relapse.
• E-DII score and FLAIR lesion volume in periventricular region also were linked.

Consuming a pro-inflammatory diet was associated with higher risk for relapse and greater FLAIR lesion volume in the periventricular region in adults with MS, according to research in the Multiple Sclerosis Journal.

“An inflammatory diet has been posited to contribute to chronic inflammation within the [central nervous system], which can lead to the loss of immune self-tolerance,” Alice M. Saul, a medical researcher and PhD candidate at the Menzies Institute for Medical Research at the University of Tasmania, and colleagues wrote. “The Dietary Inflammatory Index was developed to assess the potential of diet to cause chronic inflammation.”

Seeking to investigate whether a link exists between Dietary Inflammatory Index (DII) scores and certain markers of MS progression and inflammatory activity, researchers conducted a prospective cohort study utilizing data from the Ausimmune Longitudinal Study, which included individuals with a diagnosis of CNS demyelination who were monitored annually for 10 years.

Researchers narrowed data analysis to 190 participants who developed MS and calculated DII and energy-adjusted DII (E-DII) scores based on a food frequency questionnaire at 5- and 10-year reviews. Those scores were assessed as predictors of relapses, change in Expanded Disability Status Scale (EDSS) score and MRI measures of fluid-attenuated inversion recovery (FLAIR) lesion volume and black hole lesion volume.

According to results, the DII of the cohort ranged from –2.89 to 4.01 at 5 years and –3.3 to 4.22 at 10 years for a mean change of +0.23, while E-DII ranged from –4.02 to 3.84 at 5 years and –3.84 to 3.85 at 10 years for a mean change of –0.11.

When analyzing participants by groups, those with an E-DII score in the highest quartile had a higher relapse risk than those in the lowest quartile (HR = 2.24; 95% CI, –1.16 to 4.33), suggesting a link between a more pro-inflammatory diet and relapse. Researchers did not report associations between DII or E-DII and changes in EDSS or FLAIR and black hole lesion volume, although there was evidence of a link between DII and E-DII and FLAIR lesion volume when researchers limited analysis to those with the same scanner and a classic first demyelinating event at study entry.

“We found evidence to suggest that a more pro-inflammatory diet was associated with a higher hazard of relapse and greater FLAIR lesion volume in the periventricular region in people with MS,” Saul and colleagues wrote. “Further prospective studies, including randomized controlled trials, are important to confirm that anti-inflammatory diets are beneficial on relapse rate and MRI markers in people with MS.”