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Updated: Jan 29, 2026
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Dietary and lifestyle factors in multiple sclerosis progression: results from a 5-year longitudinal MRI study
Dejan Jakimovski1, Bianca Weinstock-Guttman2, Sirin Gandhi1
1Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA.
Background:
Evidence regarding the role, if any, of dietary and lifestyle factors in the pathogenesis of multiple sclerosis (MS) is poorly understood.
Objective:
To assess the effect of lifestyle-based risk factors linked to cardiovascular disease (CVD) on clinical and MRI-derived MS outcomes.
Methods:
The study enrolled 175 MS or clinically isolated syndrome (CIS) patients and 42 age- and sex-matched healthy controls (HCs) who were longitudinally followed for 5.5 years. The 20-year CVD risk was calculated by Healthy Heart Score (HHS) prediction model which includes age, smoking, body mass index, dietary intake, exercise, and alcohol consumption. Baseline and follow-up MRI scans were obtained and cross-sectional and longitudinal changes of T2-lesion volume (LV), whole brain volume (WBV), white matter volume (WMV), gray matter volume (GMV), and lateral ventricular volume (LVV) were calculated.
Results:
After correcting for disease duration, the baseline HHS values of the MS group were associated with baseline GMV (rs = - 0.20, p = 0.01), and longitudinal LVV change (rs = 0.19, p = 0.01). The association with LVV remained significant after adjusting for baseline LVV volumes (rs = 0.2, p = 0.008) in MS patients. The diet component of the HHS was associated with the 5-year T2-LV accrual (rs = - 0.191, p = 0.04) in MS. In the HC group, the HHS was associated with LVV (rs = 0.58, p < 0.001), GMV (rs = - 0.57, p < 0.001), WBV (rs = - 0.55, p = 0.001), T2-LV (rs = 0.41, p = 0.027), and WMV (rs = - 0.38, p = 0.042). Additionally, the HC HHS was associated with the 5-year change in LVV (rs = 0.54, p = 0.001) and in WBV (rs = - 0.45, p = 0.011).
Conclusion:
Lifestyle risk factors contribute to accelerated central brain atrophy in MS patients, whereas unhealthier diet is associated with MS lesion accrual. Despite the lower overall effect when compared to HCs, lifestyle-based modifications may still provide a beneficial effect on reducing brain atrophy in MS patients.
Insights
Lifestyle risk factors, including diet, are linked to brain atrophy and lesion accrual in multiple sclerosis (MS). Modifying these factors may help reduce brain atrophy in MS patients.
Area of Science:
- Neurology
- Neuroimmunology
- Cardiovascular Disease Risk Factors
Background:
- The role of dietary and lifestyle factors in multiple sclerosis (MS) pathogenesis is not well understood.
- Cardiovascular disease (CVD) risk factors are increasingly being investigated for their potential impact on MS.
- Understanding these links can inform preventative and therapeutic strategies for MS.
Purpose of the Study:
- To investigate the association between lifestyle-based risk factors for cardiovascular disease (CVD) and clinical/MRI outcomes in MS.
- To determine if factors like diet, exercise, and smoking influence disease progression and brain changes in MS patients.
Main Methods:
- A longitudinal study followed 175 MS/clinically isolated syndrome (CIS) patients and 42 healthy controls (HCs) for 5.5 years.
- The Healthy Heart Score (HHS) was used to assess 20-year CVD risk, incorporating age, smoking, BMI, diet, exercise, and alcohol.
- MRI outcomes included T2-lesion volume (LV), whole brain volume (WBV), gray matter volume (GMV), and lateral ventricular volume (LVV).
Main Results:
- In MS patients, higher baseline HHS was associated with lower baseline GMV and increased longitudinal LVV.
- The diet component of HHS correlated with 5-year T2-lesion accrual in MS.
- In HCs, HHS strongly correlated with various MRI measures, including LVV, GMV, WBV, T2-LV, and WMV, and their longitudinal changes.
Conclusions:
- Lifestyle risk factors contribute to accelerated brain atrophy in MS patients.
- An unhealthier diet is linked to increased MS lesion accumulation.
- Lifestyle modifications may offer benefits in reducing brain atrophy, even with a lesser effect compared to healthy controls.
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