Diet shows no association with relapses, disability progression

A higher quality diet is associated with reductions in certain types of brain lesions in multiple sclerosis (MS), but no link was seen between a good diet and the risk of MS relapses or disability progression, a new study from Australia indicates.

The study, “Higher dietary quality is prospectively associated with lower MRI FLAIR lesion volume, but not with hazard of relapse, change in disability or black hole volume in people with Multiple Sclerosis,” was published in Multiple Sclerosis and Related Disorders.

The foods a person eats can have profound effects on their health, from ensuring proper nutrition to altering inflammation. While some specialized diets have been developed for MS, there isn’t any one diet that’s been proven to be best for the disease.

It’s generally recommended that people with MS maintain a well-balanced diet that provides all the needed nutrients while avoiding excessive amounts of fat and sugar. That’s similar to what’s recommended for the general population.

In this study, scientists evaluated the association between dietary quality and various disease-related outcomes in people with MS. For the analysis, a high-quality diet was defined as one “generally low in saturated fat and processed meats, and high in vegetables, fruit, nuts, and fish.”

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Diet and relapses, disability progression

The analysis included data on 190 people who were followed for 10 years after presenting with an initial attack of MS-like disease. All were formally diagnosed with MS in a follow-up.

In order to assess dietary quality, two standardized measures were used: the Australian Recommended Food Score (ARFS) and the Diet Quality Tracker (DQT). The scientists constructed statistical models in order to look for significant associations between the scores and MS relapses, disability progression, or disease activity on MRI scans.

Patients with better ARFS scores at five and 10 years had significantly less lesion volume in brain tissue near fluid-filled cavities in the brain, called the periventricular region. DQT scores showed no association with periventricular lesions.

Other measures, including a risk of relapses, disability progression, and actively inflamed lesions, didn’t show statistically significant associations with either score.

When patients were divided into two groups based on ARFS score — the half with higher scores compared to the half with lower scores — the overall risk of relapses was significantly lower, by about 43%, for patients with higher ARFS scores, indicating better diet quality.

“We found that a higher dietary quality, at least using the ARFS, was cross-sectionally associated with lower levels of … lesion volume in the periventricular region. There was less evidence of association between dietary quality and [actively inflamed] lesion volume, hazard of relapse or annualized [disability] change with either no dose dependency or a lack of significance,” the scientists said.

They noted that researching diet is inherently tricky, as it’s difficult to quantify everything people eat and drink into a single score. Changes in disability and relapses usually take longer to develop than disease activity on MRI scans, so changes in lesions on a MRI may be a harbinger of differences in disease activity that might only become obvious with a longer follow-up, they said.

“MRI may be a more sensitive indicator of disease activity and more likely to be impacted by diet than clinical manifestations, as suggested by previous studies,” wrote the researchers, who emphasized that more research into the complex effects of diet on MS was needed.