Dietary factors and pediatric multiple sclerosis: A case-control study

Pakpoor, Julia; Seminatore, Brandon; Graves, Jennifer; Schreiner, Teri; Waldman, Amy; Lotze, Timothy; Belman, Anita; Greenberg, Benjamin; Weinstock‐Guttman, Bianca; Aaen, Gregory; Tillema, Jan‐Mendelt; McDonald, Jamie; Hart, Janace; Ness, Jayne; Harris, Yolanda; Rubin, Jennifer; Candee, Meghan; Krupp, Lauren; Gorman, Mark; Benson, Leslie; Rodriguez, Moses; Chitnis, Tanuja; Mar, Soe; Kahn, Ilana; Rose, John; Carmichael, Suzan L.; Roalstad, Shelly; Waltz, Michael; Casper, T. Charles; Waubant, Emmanuelle

doi:10.1177/1352458517713343

Cited by 29 publications

(25 citation statements)

References 26 publications

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“…Serum Trp was obtained after the onset of MS and there is a possibility that levels were affected by the disease itself, such as patients changing their diet after diagnosis. However, as patients were enrolled shortly after disease and there is no consensus about specific dietary recommendations for MS,11 this appears unlikely. We did not have MRI data to assess the association of serum Trp with radiological disease activity.…”

Section: Discussionmentioning

confidence: 99%

“…For example, dietary salt intake has been studied as a possible contributing factor to disease onset and subsequent disease activity with conflicting results 7, 8, 9, 10. In addition, lower iron intake (but not other dietary factors) were associated with increased risk of pediatric MS, while higher saturated fat and vegetable intake were associated with increased and decreased relapse risk, respectively 11, 12. Although prevention of relapses is an important treatment outcome, preservation of cognitive and physical functioning in patients with MS are also important goals.…”

Section: Introductionmentioning

confidence: 99%

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Altered tryptophan metabolism is associated with pediatric multiple sclerosis risk and course

Nourbakhsh

Bhargava

Tremlett

et al. 2018

Ann Clin Transl Neurol

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ObjectiveTo determine if altered tryptophan (Trp) metabolism is associated with MS risk or disease severity in children.MethodsParticipants with pediatric‐onset MS and clinically isolated syndrome (CIS) within 4 years of disease onset and healthy controls underwent collection of serum. Longitudinal disability and processing speed measures and relapse data were collected in cases. Global metabolomics were conducted in 69/67 cases/controls. Targeted Trp measurement was performed in a discovery group (82 cases, 50 controls) and a validation group (92 cases, 50 controls), while functional gut microbiome analysis was done in 17 cases. Adjusted logistic, linear and negative binomial regression and Cox‐proportional hazard models were used.ResultsUsing global metabolomics data, higher relative abundances of Trp and indole lactate, a known gut microbiota‐derived Trp metabolite, were associated with lower risk of MS. In cases, higher relative abundances of gut microbiota‐derived Trp metabolites were associated with lower disability and higher processing speed scores and higher relative abundance of kynurenine was associated with higher relapse rate. Using targeted tryptophan measures, in the discovery and validation groups, each 1 mcg/mL increase in serum Trp level was associated with 20% (95% CI: 4–34%) and 32% (95% CI: 16–44%) decrease in adjusted odds of having MS, respectively. A lower relative abundance of gut microbial genes involved in Trp catabolism was associated with higher relapse risk.InterpretationTrp metabolism by the gut microbiota and the kynurenine pathway may be relevant to the risk of MS in children as well as MS activity and severity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Altered tryptophan metabolism is associated with pediatric multiple sclerosis risk and course

Nourbakhsh

Bhargava

Tremlett

et al. 2018

Ann Clin Transl Neurol

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“…27 While there is significant interest in dietary factors (e.g., salt intake) and risk of MS in children, no definite associations have been reported. 34,35…”

Section: Obesity and Dietmentioning

confidence: 99%

Multiple Sclerosis in Children: Current and Emerging Concepts

et al. 2020

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Multiple sclerosis is being increasingly recognized and diagnosed in children. In the past several years, advances have been made in diagnosing multiple sclerosis in children, identifying new genetic and environmental risk factors, delineating underlying immunobiology, characterizing imaging findings, and implementing new treatment strategies. In this review, we discuss these advances. Future research into the determinants of multiple sclerosis in children and into new treatment options will be aided by continued international collaboration.

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“…5 Yet, disease-related mechanisms or treatment after disease onset could underlie these changes and the evidence for a role of minerals in MS pathogenesis is scarce and preliminary, as based on ecological, cross-sectional, and retrospective studies. [8][9][10][11][12] Zinc has been of particular interest due to its immune-regulating anti-inflammatory and antioxidant potential. 2,13 While zinc levels seemed to be lower in patients with MS 6 and zinc may ameliorate experimental autoimmune encephalomyelitis, an MS animal model, 14,15 its role in MS etiology is unclear.…”

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confidence: 99%

Total intake of different minerals and the risk of multiple sclerosis

et al. 2019

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Objective To investigate the association between mineral intake (potassium, magnesium, calcium, phosphorus, iron, zinc, manganese, copper) and multiple sclerosis (MS) risk. Methods In a prospective cohort study, we assessed dietary and supplemental mineral intake by a validated food frequency questionnaire administered every 4 years to 80,920 nurses in the Nurses' Health Study (1984-2002) and 94,511 in the Nurses' Health Study II (1991-2007). There were 479 new MS cases during follow-up. We estimated hazard ratios and 95% confidence intervals for the association of energy-adjusted mineral intake with MS risk using Cox regression, adjusting for age, residence latitude at age 15, ancestry, body mass index at age 18, supplemental vitamin D, smoking, and total energy intake. Results We did not find any association between the minerals and MS risk, either for baseline or cumulative intake during follow-up. The associations were null comparing women with highest to those with lowest intakes in quintiles or deciles and there was no significant trend for higher intakes (p trend across baseline quintiles: potassium 0.35, magnesium 0.13, calcium 0.22, phosphorus 0.97, iron 0.85, zinc 0.67, manganese 0.48, copper 0.59). Conclusions Our findings suggest that mineral intake is not an important determinant of MS risk.

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Dietary factors and pediatric multiple sclerosis: A case-control study

Abstract: Pediatric MS cases may be less likely to consume sufficient iron compared to controls, and this warrants broader study to characterize a temporal relationship. No other significant difference in intake of most dietary factors was found.

Cited by 29 publications

References 26 publications

Altered tryptophan metabolism is associated with pediatric multiple sclerosis risk and course

Altered tryptophan metabolism is associated with pediatric multiple sclerosis risk and course

Multiple Sclerosis in Children: Current and Emerging Concepts

Total intake of different minerals and the risk of multiple sclerosis

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