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Dietary factors and pediatric multiple sclerosis: A case-control study
Julia Pakpoor1, Brandon Seminatore2, Jennifer S Graves2
1Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Insights
Children with pediatric multiple sclerosis (MS) may consume less dietary iron. Further research is needed to understand this link between low iron intake and pediatric MS.
Area of Science:
- Pediatric Neurology
- Nutritional Science
- Epidemiology
Background:
- The dietary impact on pediatric multiple sclerosis (MS) remains largely unknown.
- Understanding nutritional factors in early-onset MS is crucial for potential interventions.
Purpose of the Study:
- To investigate the association between various dietary components and the risk of developing MS in children.
- To identify specific nutritional factors that may influence pediatric MS onset.
Main Methods:
- A case-control study involving 312 pediatric MS patients and 456 controls across 16 US centers.
- Dietary intake was assessed using the Block Kids Food Screener questionnaire.
- Statistical analyses included chi-squared tests, Kruskal-Wallis tests, and multivariable logistic regression.
Main Results:
- No significant differences were observed in the intake of fats, proteins, carbohydrates, sugars, fruits, or vegetables between cases and controls.
- Children with pediatric MS showed lower dietary iron intake compared to controls.
- Insufficient iron consumption (below recommended guidelines) was significantly associated with pediatric MS (OR=1.80, p<0.01).
Conclusions:
- Lower iron consumption may be a potential risk factor for pediatric multiple sclerosis.
- Further investigation is required to establish a definitive temporal relationship between iron intake and pediatric MS.
- Most other dietary factors examined did not show a significant association with pediatric MS.
Background:
The role of diet in multiple sclerosis (MS) is largely uncharacterized, particularly as it pertains to pediatric-onset disease.
Objective:
To determine the association between dietary factors and MS in children.
Methods:
Pediatric MS patients and controls were recruited from 16 US centers (MS or clinically isolated syndrome onset before age 18, <4 years from symptom onset and at least 2 silent lesions on magnetic resonance imaging). The validated Block Kids Food Screener questionnaire was administered 2011-2016. Chi-squared test compared categorical variables, Kruskal-Wallis test compared continuous variables, and multivariable logistic regression analysis was performed.
Results:
In total, 312 cases and 456 controls were included (mean ages 15.1 and 14.4 years). In unadjusted analyses, there was no difference in intake of fats, proteins, carbohydrates, sugars, fruits, or vegetables. Dietary iron was lower in cases ( p = 0.04), and cases were more likely to consume below recommended guidelines of iron (77.2% of cases vs 62.9% of controls, p < 0.001). In multivariable analysis, iron consumption below recommended guidelines was associated with MS (odds ratio = 1.80, p < 0.01).
Conclusion:
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.
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