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Fat intake linked to risk for pediatric MS relapse

Children with multiple sclerosis who consume a high-fat diet may be at increased risk for relapse; however, high vegetable intake may protect against this risk, according to findings published in the Journal of Neurology, Neurosurgery, and Psychiatry.

“The role of diet in disease susceptibility and course remains largely unknown,” Saeedeh Azary, MD, MPH, from the department of neurology at the University of California, San Francisco Regional Pediatric Multiple Sclerosis Center, and colleagues wrote. “Children with MS have a higher relapse rate compared with MS in adults. Thus, studying the effect of diet on relapse rate in this age group is likely to provide more robust answers.”

To assess the association between dietary intake and relapse risk among children with MS, researchers examined longitudinal and prospective data from a multicenter study conducted at 11 pediatric MS centers in the United States. They included 219 patients with pediatric relapsing-remitting MS or clinically isolated syndrome who completed the food frequency questionnaire, and had disease onset before 18 years of age and duration of less than 4 years.

Azary and colleagues found that fat intake was linked to an increase in the risk for pediatric MS relapse, and saturated fat may drive this association. Analysis of dietary intake during the week before enrollment showed that each 10% increase in energy intake from fat increased the risk for relapse by 56% (adjusted HR = 1.56; 95% CI, 1.05-2.31). Specifically, each 10% increase in saturated fat tripled this risk (aHR = 3.37; 95% CI 1.34-8.43). However, each additional 1-cup equivalent of vegetables reduced the risk for relapse by 50% (aHR = 0.50; 95% CI 0.27-0.91). Examination of other nutrients showed no association with relapse.

“Further work confirming and refining any relationship between fat, vegetable and other nutrients and MS relapse is needed,” Azary and colleagues wrote. “Our results provide preliminary evidence for healthy dietary recommendation for pediatric patients with MS. These findings must be confirmed, and their causality must be established with future dietary intervention trials.”

In a related editorial, Kathryn Fitzgerald, PhD, from the department of neurology at Johns Hopkins School of Medicine, Baltimore, wrote that this study used questionnaires that did not describe the different types of dietary fat associated with MS relapse. She explained that these types of observational studies regarding diet and a chronic disease like MS need unique considerations to determine the most accurate, long-term results.

“Ultimately, the role of diet in MS is an activity evolving area of research that will be further enriched by complementary evidence derived from a combination of interventional as well as high-quality longitudinal observational studies,” Fitzgerald wrote. – by Savannah Demko

Disclosures: Azary and Fitzgerald report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.