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

Area of Science:

• Neurology
• Nutrition Science
• Epidemiology

Background:

• The relationship between dietary habits and the clinical progression of early multiple sclerosis (MS) remains under-researched.
• Understanding these associations is crucial for managing the disease course following initial demyelination.

Purpose of the Study:

• To identify distinct dietary patterns among individuals experiencing their first clinical demyelinating event.
• To investigate the association between these dietary patterns and the risk of MS conversion and subsequent relapse over a five-year period.

Main Methods:

• A cohort of individuals with a first clinical diagnosis of central nervous system (CNS) demyelination was analyzed.
• Baseline dietary intake was assessed using food frequency questionnaires, and participants were followed for five years.
• Iterated principal factor analysis identified dietary patterns, while Cox proportional hazards models evaluated MS conversion and relapse risks, adjusting for covariates.

Main Results:

• Three primary dietary patterns were identified: 'Prudent' (high in fruits, vegetables, fish, whole grains, nuts), 'High-Vegetable' (starchy vegetables, legumes), and 'Mixed' (meats, alcohol).
• Dietary pattern scores were not significantly associated with the risk of converting to MS.
• Individuals with a 'Prudent' dietary pattern above the median exhibited a significantly lower risk of relapse (adjusted hazard ratio = 0.54, 95% CI 0.37-0.81).

Conclusions:

• A 'Prudent' dietary pattern, characterized by high intake of plant-based foods and fish, shows a prospective association with a reduced risk of relapse in the five years following a first clinical demyelinating event.
• These findings suggest that dietary choices may play a role in modulating the clinical course of early multiple sclerosis.