A Higher Mediterranean Diet Score, Including Unprocessed Red Meat, Is Associated with Reduced Risk of Central Nervous System Demyelination in a Case-Control Study of Australian Adults

Abstract

Background The evidence associating diet and risk of multiple sclerosis (MS) is inconclusive. Objectives The aim of this study was to investigate associations between a Mediterranean diet and risk of a first clinical diagnosis of central nervous system demyelination (FCD), a common precursor to MS. Methods We used data from the 2003–2006 Ausimmune Study, an Australian multicenter, case-control study examining environmental risk factors for FCD, with participants matched on age, sex, and study region (282 cases, 558 controls; 18–59 y old; 78% female). The alternate Mediterranean diet score (aMED) was calculated based on data from a food-frequency questionnaire. We created a modified version of the aMED (aMED-Red) where ∼1 daily serving (65 g) of unprocessed red meat received 1 point. All other components remained the same as aMED. Conditional logistic regression (254 cases, 451 controls) was used to test associations between aMED and aMED-Red scores and categories and risk of FCD, adjusting for history of infectious mononucleosis, serum 25-hydroxyvitamin D concentrations, smoking, education, total energy intake, and dietary underreporting. Results There was no statistically significant association between aMED and risk of FCD [per 1-SD increase in aMED score: adjusted odds ratio (aOR): 0.89; 95% CI: 0.75, 1.06; P = 0.181]. There was evidence of a nonlinear relation between aMED-Red and risk of FCD when a quadratic term was used (P = 0.016). Compared with the lowest category of aMED-Red, higher categories were significantly associated with reduced risk of FCD, corresponding to a 37% (aOR: 0.63; 95% CI: 0.41, 0.98; P = 0.039), 52% (aOR: 0.48; 95% CI: 0.28, 0.83; P = 0.009), and 42% (aOR: 0.58; 95% CI: 0.35, 0.96; P = 0.034) reduced risk of FCD in categories 2, 3, and 4, respectively. Conclusions A Mediterranean diet, including unprocessed red meat, was associated with reduced risk of FCD in this Australian adult population. The addition of unprocessed red meat to a Mediterranean diet may be beneficial for those at high risk of MS.

High Prudent diet factor score predicts lower relapse hazard in early multiple sclerosis

“…2,30 Also, the Ausimmune case–control study, 13 from which the AusLong Study derives, has explored a range of lifestyle factors, including diet. 8–11,26 Our results are in keeping with the previous Ausimmune findings that a healthy diet, 8 particularly one rich in fish, 11 was inversely associated with case status. That our present study did not show a significant association between Prudent diet factor score and MS conversion risk contrasts with these results, although the focus of that analysis was an FCD, rather than MS conversion.…”

“…The AusLong cohort has previously examined a range of factors for their associations with clinical progression in early MS, ranging from sun and vitamin D metabolite levels 29 , BMI and dyslipidaemia 8,28 , tobacco and marijuana smoking 8 , and genetic risk factors 2,30 . Also, the Ausimmune case-control study 13 from which the AusLong Study derives, has explored a range of lifestyle factors, including diet [8][9][10][11]26 . Our results are in keeping with the previous Ausimmune findings that a healthy diet 8 , particularly one rich in fish 11 , was inversely associated with case status.…”

“…In addition, demonstrating prospective associations between patterns and clinical outcomes could guide dietary recommendations for people with MS and indicate points for intervention. The present study builds upon the work conducted in the Ausimmune Study, [8][9][10][11] which indicated a beneficial impact of healthy dietary intake in reducing the risk of MS onset, and to ascertain whether this effect is evident in relation to the disease course over 5 years of follow-up. The objectives of this study were to use a prospective cohort study to (1) determine diet factor scores soon after the first diagnosis of central nervous system (CNS) demyelination (baseline) using factor analysis; (2) investigate predictors of diet factor scores and change thereof between baseline and 5-year follow-up using diet data from baseline and 5-year reviews; and (3) test associations between diet factor scores and hazards of MS conversion and relapse.…”

Dietary habits in a group of patients with multiple sclerosis are similar to those of healthy control subjects

“…There are few case-control studies on the dietary habits of patients suffering from MS. Epidemiological data suggest that a pro-inflammatory diet increases the risk of developing MS 23,24 , while fish oils 25 and a Mediterranean diet 26 could protect individuals from having the disease. The present study neither found any correlation between dietary habits and neurological disability, nor any significant difference between food intake by patients with MS and controls.…”

An exploratory study of diet in childhood and young adulthood and adult-onset multiple sclerosis

“…see literature). [1][2][3][4] Although there is little evidence associating early life diet and later MS, childhood and adolescence have been identified as periods of importance for other environmental risk factors such as obesity and low sun exposure/low vitamin D status. 5 In an Iranian study, higher consumption of various foods (fresh fish, canned tuna, poultry, cheese, yoghurt, butter, fruit and vegetables) in adolescence (13-19 years) was associated with reduced likelihood of having MS between 15 and 50 years.…”