Whole grain food diet may reduce risk of pediatric-onset MS: Study

A higher intake of whole grain food is significantly associated with a lower likelihood of developing pediatric-onset multiple sclerosis (MS), according to a study led by researchers in Canada.

Conversely, an overall more pro-inflammatory diet — one containing higher amounts of fats and proteins — was linked to increased odds for pediatric-onset MS, known as POMS, though that association failed to reach significance.

This study “raises the possibility that [whole grain]-rich diets, including Mediterranean-style, could reduce the risk of MS,” the researchers wrote.

The Mediterranean diet includes plenty of fruits and vegetables, whole grains, and olive oil, and moderate amounts of low-fat dairy products, fish, poultry, and red wine. Based on the traditional and healthy dietary choices of people living near the Mediterranean Sea, the eating plan typically is low in red meat, animal fats, and processed sugars.

Titled “Assessment of dietary intake and its inflammatory potential in persons with pediatric-onset multiple sclerosis,” the study was published in the journal Multiple Sclerosis and Related Disorders.

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Exploring whole grain vs. inflammatory food diets in POMS

POMS, fully pediatric-onset multiple sclerosis, is a form of MS that develops during childhood or adolescence. Patients have a relapsing-remitting disease course, characterized by periods of new or worsening symptoms followed by periods of remission, but usually experience more active disease than adults.

A number of studies have reported associations between dietary habits and the risk of developing MS. There also have been reports that disease activity in POMS can be impacted by diet. However, it remains unknown if eating more or less inflammatory foods also can have an impact in POMS.

To know more, a team of researchers across Canada and in the U.S. assessed the dietary habits of patients enrolled via the Canadian Pediatric Demyelinating Disease Network. Their study involved 38 POMS patients and 45 individuals with a similar condition called monophasic acquired demyelinating syndrome, or monoADS, as well as 48 people without either condition, who served as controls.

All patients were younger than age 18 at symptom onset. At the time of the analysis, the POMS patients were, on average, four years older than those with monoADS (18.4 vs. 14.4 years), while the controls had a mean age of 16.2 years.

The participants were asked to complete a dietary questionnaire, which allowed researchers to estimate the impact of one’s diet on inflammation using the modified dietary inflammatory index (mDII).

The score sums the inflammatory index of 25 dietary parameters, including total energy, carbohydrate, protein, fat, fiber, and cholesterol, saturated unsaturated fats, caffeine. A number of vitamins and minerals also are assessed.

Generally, red and processed meat, refined grains (e.g., white flour, bread, or rice), and sugary foods and beverages have greater pro-inflammatory scores, while anti-inflammatory dietary options include whole grain food, fatty fish, nuts, fruits, and vegetables.

The results showed that the participants who had POMS consumed significantly less whole grains and milk than did controls or patients with monoADS. After adjusting for age at questionnaire completion, however, only a higher consumption of whole grain food remained significantly associated with the likelihood of developing POMS.

Whether our findings imply that [whole grain] enriched diets could protect against POMS or whether individuals with POMS cannot tolerate [whole grains] or choose to avoid such foods, cannot be determined [from this study]. … Nonetheless, [the] findings are of interest as avoidance of [whole grains] could negatively impact overall health.

POMS patients also had a higher mDII score, suggesting a possible association between a more pro-inflammatory diet and a higher risk for POMS, but the difference was not statistically significant. This association was not observed in monoADS patients.

“Whether our findings imply that [whole grain] enriched diets could protect against POMS or whether individuals with POMS cannot tolerate [whole grains] or choose to avoid such foods, cannot be determined” from this study, the researchers wrote.

“Nonetheless, [the] findings are of interest as avoidance of [whole grains] could negatively impact overall health,” the team wrote.

Among the study limitations noted by the researchers were its small size and the possibility of so-called response/recall bias, given that the questionnaire was completed after the onset of the disease.

The team called for more study into the question they raised as to cause and effect.

“This warrants further investigation,” the researchers wrote, adding that “it would be of particular value to ascertain the direction of this effect and explore dietary intake before/around the time of diagnosis.”