Association between dietary inflammatory index and risk of demyelinating autoimmune diseases
A cross-sectional study
Abstract
Abstract:Background: Considering limited data on the association between dietary inflammatory index (DII) and demyelinating autoimmune diseases, here, we studied this issue in the early diagnosed patients [e.g., preceding Multiple Sclerosis (MS) diagnosing level (Clinically Isolated Syndrome (CIS), and Radiologically Isolated Syndrome (RIS), MS, and Neuromyelitis Optica Spectrum Disorder (NMOSD)] using a case-control study among the Iranian population. Methods: A total of 291 subjects were selected as the cases (Patients with demyelinating autoimmune diseases including CIS, RIS, MS, and NMOSD, who were diagnosed less than six months before recruitment) and 297 others as controls. A 117-item semi-quantitative food frequency questionnaire (FFQ) was obtained from all of the participants and DII was calculated. Results: After controlling for potential confounders, adherence to a pro-inflammatory diet was associated with a higher risk of demyelinating autoimmune diseases (OR=2.05, 95% CI: 0.51, 3.58), EDSS (OR=2.02, 95% CI: 0.51, 3.53), active plaque (OR=1.90, 95% CI: 0.08, 3.71), higher lesion load (OR=2.11, 95% CI: 0.58, 3.64), LETM (OR=2.19, 95% CI: 0.27, 4.11), higher number of plaques (OR=2.11, 95% CI: 0.58, 3.64), and brain atrophy (OR=2.12, 95% CI: 0.57, 3.67). Conclusion: Our study suggests a possible link between the inflammatory potential of the diet and demyelinating autoimmune disease; however, further prospective cohort studies are needed to draw a causal link on this issue.
References
1 . The world incidence and prevalence of autoimmune diseases is increasing. Int J Celiac Dis. 2015;3(4):151–5.
2 . Epidemiology and estimated population burden of selected autoimmune diseases in the United States. J Clin Immunol Immunopathol. 1997;84(3):223–43.
3 . Waterpipe smoking associated with multiple sclerosis: A population-based incident case-control study. Mult Scler J. 2017;23(10):1328–35.
4 Vitamin D status and the risk of multiple sclerosis: a systematic review and meta-analysis. Neurosci Lett. 2014;570:108–13.
5 Body size and the risk of multiple sclerosis in Norway and Italy: the EnvIMS study. Mult Scler J. 2015;21(4):388–95.
6 Population attributable fractions and joint effects of key risk factors for multiple sclerosis. Mult Scler J. 2016;22(4):461–69.
7 . Fatty fish intake is associated with decreased occurrence of multiple sclerosis. Mult Scler J. 2014;20(6):726–32.
8 . Estimating the marginal causal effect of fish consumption during adolescence on multiple sclerosis: a population-based incident case-control study. Neuroepidemiology. 2018;50(2–3):111–8.
9 . Dietary fat in relation to risk of multiple sclerosis among two large cohorts of women. Am J Epidemiol. 2000;152(11):1056–64.
10 . The risk of multiple sclerosis in the USA in relation to sociogeographic features: a factor-analytic study. J Clin Epidemiol. 1994;47(1):43–8.
11 . Zinc in multiple sclerosis: A systematic review and meta-analysis. ASN Neuro. 2016;8(3):1759091416651511.
12 . Update on riboflavin and multiple sclerosis: a systematic review. Iran J Basic Med Sci. 2017;20(9):958.
13 . Effect of omega-3 fatty acids and fish oil supplementation on multiple sclerosis: a systematic review. Nutr Neurosci. 2021;24(7):569–79.
14 . Diet and the geographical distribution of multiple sclerosis. Lancet (London, England). 1974;2(7888):1061–6.
15 . Nutrition, latitude, and multiple sclerosis mortality: an ecologic study. Am J Epidemiol. 1995;142(7):733–7.
16 Dietary inflammatory index and risk of multiple sclerosis: Findings from a large population-based incident case-control study. Clin Nutr. 2020;39(11):3402–7.
17 . Dietary pattern and risk of multiple sclerosis. Iran J Neurol. 2012;11(2):47.
18 . Role of “Western diet” in inflammatory autoimmune diseases. Curr Allergy Asthma Rep. 2014;14(1):1–8.
19 Dietary total antioxidant capacity and neuromyelitis optica spectrum disorder susceptibility. Nutr Food Sci. 2019;50(4):653–63.
20 . Dietary inflammatory index and risk of multiple sclerosis in a case-control study from Iran. Neuroepidemiology. 2016;47(1):26–31.
21 Dietary inflammatory index and healthy eating index-2015 are associated with rheumatoid arthritis. Public Health Nutr. 2021;24(18):6007–14.
22 Dietary inflammatory potential and risk of Crohn’s disease and ulcerative colitis. Gastroenterology. 2020;159(3):873–83.e1.
23 . 1543-P: Dietary Inflammatory Index Associated with Complications in Long Duration Type 1 Diabetes. Diabetes. 2020;69(1):1543-P.
24 Effects of dietary fibre intake on risk factors for cardiovascular disease in subjects at high risk. J Epidemiol Community Health. 2009;63(7):582–8.
25 Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69(2):292–302.
26 International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015;85(2):177–89.
27 Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17(2):162–73.
28 Anti-Müllerian hormone (AMH) in the Diagnosis of Menstrual Disturbance Due to Polycystic Ovarian Syndrome. Front. Endocrinol. 2019;10:656.
29 . Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33(11):1444–52.
30 Diet and its relationship to sarcopenia in community dwelling Iranian elderly: a cross sectional study. Nutrition. 2015;31(1):97–104.
31 . The manual for household measures, cooking yields factors and edible portion of foods. Tehran: Nashre Olume Keshavarzy. 1999;7:213.
32 . Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr. 2014;17(8):1689–96.
33 . The validated sun exposure questionnaire: association of objective and subjective measures of sun exposure in a Danish population-based sample. Br J Dermatol. 2017;176(2):446–56.
34 . Validity and reliability of adult recall of past sun exposure in a case-control study of multiple sclerosis. Cancer Epidemiol Biomark Prev. 2006;15(8):1538–44.
35 . The Iranian Version of International Physical Activity Questionnaire (IPAQ) in Iran: content and construct validity, factor structure, internal consistency and stability. World Appl Sci J. 2012;18(8):1073–80.
36 The Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2019). Hypertens Res. 2019;42(9):1235–481.
37 . Headache Classification Committee of the International Headache Society (IHS) the international classification of headache disorders, asbtracts. Cephalalgia. 2018;38(1):1–211.
38 . Epidemiology, diagnosis and management of sexual dysfunction in multiple sclerosis. Acta Neurol Belg. 2020;120(4):791–7.
39 . Dietary Inflammatory Index and Risk of Multiple Sclerosis in a Case-Control Study from Iran. Neuroepidemiology. 2016;47(1):26–31.
40 Dietary and lifestyle factors in multiple sclerosis progression: results from a 5-year longitudinal MRI study. J Neurol. 2019;266(4):866–75.
41 Dietary inflammatory index and risk of multiple sclerosis: Findings from a large population-based incident case-control study. Clin Nutr. 2020;39(11):3402–7.
42 Interactions between dietary inflammatory index, nutritional state and multiple sclerosis clinical condition. Clin Nutr ESPEN. 2018;26:35–41.
43 Pathogenesis of multiple sclerosis: insights from molecular and metabolic imaging. Lancet Neurol. 2014;13(8):807–22.
44 . The gut microbiome and multiple sclerosis. Cold Spring Harb Perspect Med. 2018;8(6):a029017.
