A pro-inflammatory diet in people with multiple sclerosis is associated with an increased rate of relapse and increased FLAIR lesion volume on MRI in early multiple sclerosis: A prospective cohort study

Saul, A.M.Taylor, B.V.Blizzard, L.Simpson-Yap, S.Oddy, W.H.Shivappa, N.Hébert, J.R.Black, L.J.Ponsonby, A.L.Broadley, S.A.Lechner-Scott, J.van der Mei, I.Lucas, R.M.Dear, K.Dwyer, T.Broadley, S.Kilpatrick, T.Williams, D.Shaw, C.Chapman, C.et al.2023-07-052023-07-052023Multiple Sclerosis Journal, 2023; 29(8):1012-10231352-45851477-0970https://hdl.handle.net/2440/138870First published online May 6, 2023Background: A pro-inflammatory diet has been posited to induce chronic inflammation within the central nervous system (CNS), and multiple sclerosis (MS) is an inflammatory disease of the CNS. Objective: We examined whether Dietary Inflammatory Index (DII®)) scores are associated with measures of MS progression and inflammatory activity. Methods: A cohort with a first clinical diagnosis of CNS demyelination was followed annually (10 years, n=223). At baseline, 5- and 10-year reviews, DII and energy-adjusted DII (E-DIITM) scores were calculated (food frequency questionnaire) and assessed as predictors of relapses, annualised change in disability (Expanded Disability Status Scale) and two magnetic resonance imaging measures; fluid-attenuated inversion recovery (FLAIR) lesion volume and black hole lesion volume. Results: A more pro-inflammatory diet was associated with a higher relapse risk (highest vs. lowest E-DII quartile: hazard ratio=2.24, 95% confidence interval (CI)= −1.16, 4.33, p=0.02). When we limited analyses to those assessed on the same manufacturer of scanner and those with a first demyelinating event at study entry (to reduce error and disease heterogeneity), an association between E-DII score and FLAIR lesion volume was evident (β=0.38, 95% CI=0.04, 0.72, p=0.03). Conclusion: There is a longitudinal association between a higher DII and a worsening in relapse rate and periventricular FLAIR lesion volume in people with MS.en© The Author(s), 2023. Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Article reuse guidelines: https://au.sagepub.com/en-gb/oce/journals-permissionsDiet; inflammation; dietary inflammatory index; multiple sclerosis; MRI; EDSS; time to relapse and conversion to MSA pro-inflammatory diet in people with multiple sclerosis is associated with an increased rate of relapse and increased FLAIR lesion volume on MRI in early multiple sclerosis: A prospective cohort studyJournal article10.1177/135245852311677392023-07-05648187Dear, K. [0000-0002-0788-7404]