Dietary intake influences relapse in kids with MS

By Will Boggs MD

NEW YORK (Reuters Health) - Pediatric multiple sclerosis (MS) relapse rates increase with fat intake and decrease with vegetable intake, according to a U.S. multicenter study.

Several environmental factors and genetic polymorphisms play a role in the development and disease course of MS, but the role of diet remains largely unknown.

Dr. Emmanuelle Waubant from the University of California San Francisco and colleagues from 11 pediatric MS centers used the Block Kids Food Screener food-frequency questionnaire to investigate the effect of diet on relapse in 219 children (mean age, 15 years) with relapsing-remitting MS or clinically isolated syndrome (CIS) at high risk of MS.

During a median follow-up of 1.8 years, 93 patients (42.5%) experienced relapse, according to the October 9 Journal of Neurology, Neurosurgery and Psychiatry online report.

In multivariable analyses, each 10% increase in energy intake from fat increased the risk of relapse by 56%, and each 10% increase in saturated fat increased the risk of relapse more than threefold. In contrast, each additional cup of vegetable intake reduced the relapse risk by 50%.

"Despite reports that meals rich in refined carbohydrates and sugars increase insulin level and production of proinflammatory molecules and free radicals," the researchers note, "our study findings did not support the association between sugar intake and relapse risk in pediatric MS."

“Further work confirming and refining any relationship between fat, vegetable and other nutrients and MS relapse is needed,” they conclude. “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.”

Dr. Kathryn Fitzgerald from Johns Hopkins School of Medicine, in Baltimore, who wrote an accompanying editorial, told Reuters Health by email, “I think this study adds to the evidence about the importance of maintaining a healthy lifestyle for people with MS, including having a healthy diet.”

“While the study is an observational study (so we can’t make definitive conclusions about cause and effect), results suggest that higher intakes of vegetables and lower intakes of saturated fat are associated with a lower risk of relapse,” she said. “It also provides evidence to help direct further research in this area and expand to larger studies, a more diverse set of MS outcomes, and those conducted in adults.”

“Ultimately,” her editorial concludes, “the role of diet in MS is an actively 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.”

Dr. Waubant did not respond to a request for comment.

SOURCES: http://bit.ly/2y6f34s and http://bit.ly/2yUxeqi

J Neurol Neurosurg Psychiatry 2017.

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