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Rad EY, Saboori S, Tektonidis TG, Simpson-Yap S, Reece J, Hebert JR, Nicholas R, Middleton R, Tammam J, Black L, Coe S. A systematic review and meta-analysis of Dietary Inflammatory Index and the likelihood of multiple sclerosis/ demyelinating autoimmune disease. Clin Nutr ESPEN 2024; 62:108-114. [PMID: 38901931 DOI: 10.1016/j.clnesp.2024.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/11/2024] [Accepted: 04/25/2024] [Indexed: 06/22/2024]
Abstract
Diet and inflammation may contribute to the development of multiple sclerosis (MS). The aim of this systematic review and meta-analysis was to assess the association between proinflammatory diet, as estimated by the Dietary Inflammatory Index (DII®), and the likelihood of developing MS or other demyelinating autoimmune diseases. A systematic search was performed of search engines and databases (PubMed, ISI Web of Sciences, Scopus, and Embase) to identify relevant studies before 10th June 2023. The search identified 182 potential studies, from which 39 full-text articles were screened for relevance. Five articles with case-control design (n = 4,322, intervention group: 1714; control group: 2608) met the study inclusion criteria. The exposure variable was DII, with studies using two distinct models: quartile-based comparisons of DII and assessment of continuous DII. The meta-analysis of high versus low quartiles of DII with four effect sizes showed a significant association with MS/demyelinating autoimmune disease likelihood, with an odds ratio (OR) of 3.26 (95% confidence interval (CI) 1.16, 9.10). The meta-analysis of four studies with DII fit as a continuous variable showed a 31% increased likelihood of MS per unit increment; which was not statistically significant at the nominal alpha equals 0.05 (OR 1.31; 95% CI 0.95, 1.81). In conclusion, this systematic review and meta-analysis provides evidence of a positive association between higher DII scores with the likelihood of developing MS, highlighting that diet-induced inflammation could play a role in MS or other demyelinating autoimmune diseases risk.
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Affiliation(s)
- Esmaeil Yousefi Rad
- Oxford Brookes Centre for Nutrition and Health (OxBCNH), Department of Sport, Health Sciences and Social Work, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Somayeh Saboori
- Oxford Brookes Centre for Nutrition and Health (OxBCNH), Department of Sport, Health Sciences and Social Work, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Thanasis G Tektonidis
- Oxford Brookes Centre for Nutrition and Health (OxBCNH), Department of Sport, Health Sciences and Social Work, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Steve Simpson-Yap
- Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jeanette Reece
- Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - James R Hebert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Department of Nutrition, Connecting Health Innovations LLC (CHI), Columbia, SC, USA
| | - Richard Nicholas
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - Rod Middleton
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Jonathan Tammam
- Oxford Brookes Centre for Nutrition and Health (OxBCNH), Department of Sport, Health Sciences and Social Work, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | | | - Shelly Coe
- Oxford Brookes Centre for Nutrition and Health (OxBCNH), Department of Sport, Health Sciences and Social Work, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK.
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Hajianfar H, Mirmossayeb O, Mollaghasemi N, Nejad VS, Arab A. Association between dietary inflammatory index and risk of demyelinating autoimmune diseases. INT J VITAM NUTR RES 2024; 94:19-26. [PMID: 35311600 DOI: 10.1024/0300-9831/a000754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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.
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Affiliation(s)
- Hossein Hajianfar
- Food Safety Research Center (Salt), Semnan University of Medical Sciences and Health, Semnan, Iran
- Community Health Research Center, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omid Mirmossayeb
- Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Negar Mollaghasemi
- Research Committee of Nutrition and Food Sciences, Semnan University of Medical Sciences, Semnan, Iran
| | | | - Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Nasab MG, Heidari A, Sedighi M, Shakerian N, Mirbeyk M, Saghazadeh A, Rezaei N. Dietary inflammatory index and neuropsychiatric disorders. Rev Neurosci 2024; 35:21-33. [PMID: 37459114 DOI: 10.1515/revneuro-2023-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/24/2023] [Indexed: 01/10/2024]
Abstract
Neuropsychiatric disorders (NPDs) are considered a potential threat to mental health. Inflammation predominantly plays a role in the pathophysiology of NPDs. Dietary patterns are widely postulated to be involved in the physiological response to inflammation. This review aims to discuss the literature on how dietary inflammatory index (DII) is related to inflammation and, consequently, NPDs. After comprehensive scrutiny in different databases, the articles that investigated the relation of DII score and various NPDs and psychological circumstances were included. The association between dietary patterns and mental disorders comprising depression, anxiety, and stress proved the role of a proinflammatory diet in these conditions' exacerbation. Aging is another condition closely associated with DII. The impact of proinflammatory and anti-inflammatory diet on sleep quality indicated related disorders like sleep latency and day dysfunctions among the different populations are in relation with the high DII score. The potential effects of genetic backgrounds, dietary patterns, and the gut microbiome on DII are discussed as well. To plan preventive or therapeutic interventions considering the DII, these factors, especially genetic variations, should be considered as there is a growing body of literature indicating the role of personalized medicine in different NPDs. To the best of our knowledge, there is a limited number of RCTs on this subject, so future research should evaluate the causality via RCTs and look for therapeutic interventions with an eye on personalized medicine using information about DII in NPDs.
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Affiliation(s)
- Mahsa Golshani Nasab
- Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tabriz, Iran
| | - Arash Heidari
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mohammadreza Sedighi
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Shakerian
- Student Research Committee, School of Rehabilitation, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Ahvaz, Iran
| | - Mona Mirbeyk
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Amene Saghazadeh
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Meta Cognition Interest Group (MCIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity, Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Hatami A, Ahmadi-khorram M, Keykhaei F, Esfehani AJ, Nematy M. Association Between the Risk of Multiple Sclerosis and Dietary Proinflammatory/Anti-Inflammatory Food Intake and Dietary Diversity: A Case-Control Study. Clin Nutr Res 2024; 13:61-73. [PMID: 38362132 PMCID: PMC10866681 DOI: 10.7762/cnr.2024.13.1.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/27/2024] [Accepted: 01/31/2024] [Indexed: 02/17/2024] Open
Abstract
A diet rich in proinflammatory components and inflammation are suggested to be significant risk factors for multiple sclerosis (MS). This study aimed to investigate the association between the risk of MS and the inflammatory potential of an individual's diet and dietary diversity through pro-inflammatory/anti-inflammatory food intake score (PAIFIS) and dietary diversity score (DDS). In a hospital-based case-control study, 397 participants, including 197 patients with MS and 200 healthy participants aged over 18 years, were evaluated. The history of smoking, dietary intake, and anthropometric characteristics, including body mass index, waist circumference, total body fat, and fat-free mass were assessed. A validated 160-item semiquantitative food frequency questionnaire was used to calculate the PAIFIS and DDS scores. The mean age of the participants was 32.45 ± 8.66 years, and most were females (274, 79.4%). The PAIFIS score was significantly higher among MS patients than healthy participants (p = 0.001). Between PAIFIS and DDS, only PAFIS was significantly related to MS risk (odds ratio, 1.002; 95% confidence interval, 1.001-1.004; p = 0.001). PAIFIS, as an index of dietary inflammation, can predict MS. Further studies are needed to document these findings.
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Affiliation(s)
- Alireza Hatami
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran
| | - Maryam Ahmadi-khorram
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran
| | - Fatemeh Keykhaei
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran
| | - Ali Jafarzadeh Esfehani
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran
| | - Mohsen Nematy
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran
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Rouzitalab T, Shivappa N, Daneshzad E, Izadi A, Sanoobar M, Khandouzi N, Shiri-Shahsavar MR, Khalili M. Dietary patterns and risk of multiple sclerosis: Results of a double-center case-control study in Iran. Nutr Health 2023; 29:531-539. [PMID: 35234101 DOI: 10.1177/02601060221082379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: It has been suggested that nutrition might contribute to multiple sclerosis etiology (MS). Aim: This case-control study aimed to determine the role of food habits and dietary patterns in preventing or developing MS in a multicenter study in Iran (Tehran and Shiraz). Methods: In this study, food intake of (106 patients with relapsing/remitting MS (RRMS) and 72 healthy controls in Tehran) and (75 patients with relapsing/remitting MS (RRMS) and 72 healthy controls in Shiraz) were collected using a validated semi-quantitative food frequency questionnaire. Dietary patterns were extracted using factor analysis. The association between dietary patterns and the risk of MS was analyzed by Logistic regression. Results: Two major dietary patterns were extracted: the "healthy" and the "unhealthy" patterns. After adjustment for potential confounders, in Tehran city, subjects in the highest tertile of the unhealthy dietary pattern score had greater odds of having MS, compared with those in the lowest tertile (OR: 2.16; 95% CI: [1.95-2.41]; p for trend = 0.01). In Shiraz city, subjects in the highest tertile of the unhealthy dietary pattern score had greater odds with MS than those in the lowest tertile (OR: 3.08; 95% CI: [1.27-7.38]; p for trend = 0.01). However, in both groups, no significant association was found between healthy dietary pattern and MS risk. Conclusions: Adherence to unhealthy dietary pattern may increase the risk of MS in Iran. The results can be used for developing interventions that aim to promote healthy eating for preventing MS.
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Affiliation(s)
- Tohid Rouzitalab
- Department of Biochemistry and Diet Therapy, Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Elnaz Daneshzad
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Azimeh Izadi
- Department of Biochemistry and Diet Therapy, Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Meisam Sanoobar
- Clinical Nutrition Department, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Nafiseh Khandouzi
- Department of Clinical Nutrition & Dietetics, Faculty of Nutrition & Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Shiri-Shahsavar
- Department of Nutrition, School of Health, Qazvin University of Medical Science, Qazvin, Iran
- Health Products Safety Research Center, Qazvin University of Medical Science, Qazvin, Iran
| | - Mohammad Khalili
- Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
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KAYA S, UZDİL Z, SHIVAPPA N, HEBERT JR, SÖKÜLMEZ KAYA P, TERZİ M. Dietary Inflammatory Index score and its association with body mass index, body fat percentage, body fat mass, and lipid profile in patients with multiple sclerosis. Turk J Med Sci 2023; 53:1155-1165. [PMID: 38813018 PMCID: PMC10763805 DOI: 10.55730/1300-0144.5681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/26/2023] [Accepted: 06/21/2023] [Indexed: 05/31/2024] Open
Abstract
Background/aim Multiple sclerosis (MS) may cause modifications in body composition, particularly for body fat associated with obesity and some biochemical parameters such as lipid profiles. We investigated whether there is a link between the inflammatory contents of diets and body composition and lipid profiles in patients with MS. Materials and methods This was a cross-sectional study that included 85 MS patients. The study data of the patients were collected in the Neurology Clinic of Ondokuz Mayıs University's Health Practice and Research Center. The data included demographic characteristics; anthropometric measurements such as body weight, height, body mass index, waist circumference, hip circumference, body fat mass, body fat-free mass, and waist-hip ratio; and biochemical parameters such as high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol, triglyceride, and total cholesterol. Results The body fat percentages of the patients were higher among those with proinflammatory diets (p < 0.05). Body fat percentage had a positive and very weak correlation with the Dietary Inflammatory Index (DII) score (rho = 0.206 and rho = 0.217, respectively; p < 0.05). HDL-c levels were higher in the group with high DII scores and there was a positive and weak correlation between HDL-c and DII scores (rho = 0.307, p < 0.05). Crude and adjusted linear regression models showed that the effect of HDL-c on DII scores was significant (p < 0.05). Conclusion We showed that DII scores, associated with the inflammatory potential of the diet and proinflammatory diets, may be associated with adiposity in MS patients and can be used from a clinical point of view for assessment.
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Affiliation(s)
- Seda KAYA
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Ankara,
Turkiye
| | - Zeynep UZDİL
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun,
Turkiye
| | - Nitin SHIVAPPA
- Department of Epidemiology and Biostatistics and the Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina,
USA
- Connecting Health Innovations, LLC, Columbia, South Carolina,
USA
| | - James R. HEBERT
- Department of Epidemiology and Biostatistics and the Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina,
USA
- Connecting Health Innovations, LLC, Columbia, South Carolina,
USA
| | - Pınar SÖKÜLMEZ KAYA
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun,
Turkiye
| | - Murat TERZİ
- Department of Neurology, Faculty of Medicine, Ondokuz Mayıs University, Samsun,
Turkiye
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Plafker SM, Titcomb T, Zyla-Jackson K, Kolakowska A, Wahls T. Overview of diet and autoimmune demyelinating optic neuritis: a narrative review. IMMUNOMETABOLISM (COBHAM (SURREY, ENGLAND)) 2023; 5:e00022. [PMID: 37128292 PMCID: PMC10144304 DOI: 10.1097/in9.0000000000000022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 03/29/2023] [Indexed: 05/03/2023]
Abstract
This review summarizes the cellular and molecular underpinnings of autoimmune demyelinating optic neuritis (ADON), a common sequela of multiple sclerosis and other demyelinating diseases. We further present nutritional interventions tested for people with multiple sclerosis focusing on strategies that have shown efficacy or associations with disease course and clinical outcomes. We then close by discuss the potential dietary guidance for preventing and/or ameliorating ADON.
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Affiliation(s)
- Scott M. Plafker
- Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- *Correspondence: Scott M. Plafker, E-mail:
| | - Tyler Titcomb
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Katarzyna Zyla-Jackson
- Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Aneta Kolakowska
- Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Terry Wahls
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
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Snetselaar LG, Cheek JJ, Fox SS, Healy HS, Schweizer ML, Bao W, Kamholz J, Titcomb TJ. Efficacy of Diet on Fatigue and Quality of Life in Multiple Sclerosis: A Systematic Review and Network Meta-analysis of Randomized Trials. Neurology 2023; 100:e357-e366. [PMID: 36257717 DOI: 10.1212/wnl.0000000000201371] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/23/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Emerging evidence suggests a role for diet in multiple sclerosis (MS) care; however, owing to methodological issues and heterogeneity of dietary interventions in preliminary trials, the current state of evidence does not support dietary recommendations for MS. The objective of this study was to assess the efficacy of different dietary approaches on MS-related fatigue and quality of life (QoL) through a systematic review of the literature and network meta-analysis (NMA). METHODS Electronic database searches were performed in May 2021. Inclusion criteria were (1) randomized trial with a dietary intervention, (2) adults with definitive MS based on McDonald criteria, (3) patient-reported outcomes for fatigue and/or QoL, and (4) minimum intervention period of 4 weeks. For each outcome, standardized mean differences (SMDs) were calculated and included in random effects NMA to determine the pooled effect of each dietary intervention relative to each of the other dietary interventions. The protocol was registered at PROSPERO (CRD42021262648). RESULTS Twelve trials comparing 8 dietary interventions (low-fat, Mediterranean, ketogenic, anti-inflammatory, Paleolithic, fasting, calorie restriction, and control [usual diet]), enrolling 608 participants, were included in the primary analysis. The Paleolithic (SMD -1.27; 95% CI -1.81 to -0.74), low-fat (SMD -0.90; 95% CI -1.39 to -0.42), and Mediterranean (SMD -0.89; 95% CI -1.15 to -0.64) diets showed greater reductions in fatigue compared with control. The Paleolithic (SMD 1.01; 95% CI 0.40-1.63) and Mediterranean (SMD 0.47; 95% CI 0.08-0.86) diets showed greater improvements in physical QoL compared with control. For improving mental QoL, the Paleolithic (SMD 0.81; 95% CI 0.26-1.37) and Mediterranean (SMD 0.36; 95% CI 0.06-0.65) diets were more effective compared with control. However, the NutriGRADE credibility of evidence for all direct comparisons is very low because of most of the included trials having high or moderate risk of bias, small sample sizes, and the limited number of studies included in this NMA. DISCUSSION Several dietary interventions may reduce MS-related fatigue and improve physical and mental QoL; however, because of the limitations of this NMA, which are driven by the low quality of the included trials, these findings must be confirmed in high-quality, randomized, controlled trials.
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Affiliation(s)
- Linda G Snetselaar
- From the Department of Epidemiology (L.G.S.), College of Public Health, University of Iowa, Iowa City; Department of Kinesiology (J.J.C., S.S.F.), Central College, Pella, IA; Hardin Library for the Health Sciences (H.S.H.), University of Iowa, Iowa City; William S. Middleton Memorial Veterans Hospital (M.L.S.), Madison, WI; Division of Life Sciences and Medicine (W.B.), University of Science and Technology of China, Hefei, Anhui; Departments of Neurology (J.K.), and Internal Medicine (T.J.T.), Carver College of Medicine, University of Iowa, Iowa City
| | - Joshua J Cheek
- From the Department of Epidemiology (L.G.S.), College of Public Health, University of Iowa, Iowa City; Department of Kinesiology (J.J.C., S.S.F.), Central College, Pella, IA; Hardin Library for the Health Sciences (H.S.H.), University of Iowa, Iowa City; William S. Middleton Memorial Veterans Hospital (M.L.S.), Madison, WI; Division of Life Sciences and Medicine (W.B.), University of Science and Technology of China, Hefei, Anhui; Departments of Neurology (J.K.), and Internal Medicine (T.J.T.), Carver College of Medicine, University of Iowa, Iowa City
| | - Sara Shuger Fox
- From the Department of Epidemiology (L.G.S.), College of Public Health, University of Iowa, Iowa City; Department of Kinesiology (J.J.C., S.S.F.), Central College, Pella, IA; Hardin Library for the Health Sciences (H.S.H.), University of Iowa, Iowa City; William S. Middleton Memorial Veterans Hospital (M.L.S.), Madison, WI; Division of Life Sciences and Medicine (W.B.), University of Science and Technology of China, Hefei, Anhui; Departments of Neurology (J.K.), and Internal Medicine (T.J.T.), Carver College of Medicine, University of Iowa, Iowa City
| | - Heather S Healy
- From the Department of Epidemiology (L.G.S.), College of Public Health, University of Iowa, Iowa City; Department of Kinesiology (J.J.C., S.S.F.), Central College, Pella, IA; Hardin Library for the Health Sciences (H.S.H.), University of Iowa, Iowa City; William S. Middleton Memorial Veterans Hospital (M.L.S.), Madison, WI; Division of Life Sciences and Medicine (W.B.), University of Science and Technology of China, Hefei, Anhui; Departments of Neurology (J.K.), and Internal Medicine (T.J.T.), Carver College of Medicine, University of Iowa, Iowa City
| | - Marin L Schweizer
- From the Department of Epidemiology (L.G.S.), College of Public Health, University of Iowa, Iowa City; Department of Kinesiology (J.J.C., S.S.F.), Central College, Pella, IA; Hardin Library for the Health Sciences (H.S.H.), University of Iowa, Iowa City; William S. Middleton Memorial Veterans Hospital (M.L.S.), Madison, WI; Division of Life Sciences and Medicine (W.B.), University of Science and Technology of China, Hefei, Anhui; Departments of Neurology (J.K.), and Internal Medicine (T.J.T.), Carver College of Medicine, University of Iowa, Iowa City
| | - Wei Bao
- From the Department of Epidemiology (L.G.S.), College of Public Health, University of Iowa, Iowa City; Department of Kinesiology (J.J.C., S.S.F.), Central College, Pella, IA; Hardin Library for the Health Sciences (H.S.H.), University of Iowa, Iowa City; William S. Middleton Memorial Veterans Hospital (M.L.S.), Madison, WI; Division of Life Sciences and Medicine (W.B.), University of Science and Technology of China, Hefei, Anhui; Departments of Neurology (J.K.), and Internal Medicine (T.J.T.), Carver College of Medicine, University of Iowa, Iowa City
| | - John Kamholz
- From the Department of Epidemiology (L.G.S.), College of Public Health, University of Iowa, Iowa City; Department of Kinesiology (J.J.C., S.S.F.), Central College, Pella, IA; Hardin Library for the Health Sciences (H.S.H.), University of Iowa, Iowa City; William S. Middleton Memorial Veterans Hospital (M.L.S.), Madison, WI; Division of Life Sciences and Medicine (W.B.), University of Science and Technology of China, Hefei, Anhui; Departments of Neurology (J.K.), and Internal Medicine (T.J.T.), Carver College of Medicine, University of Iowa, Iowa City
| | - Tyler J Titcomb
- From the Department of Epidemiology (L.G.S.), College of Public Health, University of Iowa, Iowa City; Department of Kinesiology (J.J.C., S.S.F.), Central College, Pella, IA; Hardin Library for the Health Sciences (H.S.H.), University of Iowa, Iowa City; William S. Middleton Memorial Veterans Hospital (M.L.S.), Madison, WI; Division of Life Sciences and Medicine (W.B.), University of Science and Technology of China, Hefei, Anhui; Departments of Neurology (J.K.), and Internal Medicine (T.J.T.), Carver College of Medicine, University of Iowa, Iowa City.
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Alhaj OA, Trabelsi K, Younes AM, Shivappa N, Bragazzi NL, Hebert JR, Jahrami HA. Diet-related inflammation increases the odds of multiple sclerosis: Results from a large population-based prevalent case-control study in Jordan. Front Nutr 2023; 10:1098883. [PMID: 37090771 PMCID: PMC10113660 DOI: 10.3389/fnut.2023.1098883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/21/2023] [Indexed: 04/25/2023] Open
Abstract
Background Multiple sclerosis, a chronic inflammatory disease in young and middle-aged adults, is one of the leading causes of non-traumatic disability in adults. Diet is known to have an important role in the modulating inflammatory processes and influencing molecular pathways. Purpose This study aims to examine the association of the inflammatory capacity of diet measured by DII with MS in Jordan. Methods This prevalent case-control study included participants of both sexes, aged between 20 and 60 years. The cases (n = 541) had a confirmed diagnosis of prevalent Multiple Sclerosis (MS) in the previous 3 years, and controls (n = 607) were apparently healthy individuals matched on sex and age (42 ± 4 years). A validated Arabic food frequency questionnaire (FFQ) was utilized to obtain estimated dietary intake. Dietary data from the FFQ were analyzed using ESHA's Food Processor® nutrition analysis software, and the results were used to calculate the DII scores. Logistic regression analyses, controlling for covariates such as age, sex, body mass index, and smoking status, were used to measure the association between DII score and MS outcomes. Results Cases represent a mixed sample of MS phenotypes and controls were comparable on age and sex. However, controls tended to be taller, lighter, had a lower BMI, and had a lower smoking rate. After controlling for age, BMI, sex, and smoking status, there was a consistent increase in MS risk according to DII score, with a 10-fold increase in odds in quartile 4 vs. quartile 1 [ORquartile 4vs1 = 10.17 (95% CI: 6.88; 15.04)]. For each point increase in DII score, there was nearly a doubling of odds [OR1 = 1.75 (95% CI: 1.59; 1.92)]. Individual nutrients and food values aligned according to their contribution to the DII score calculations. Conclusion The findings of this study, obtained in MS patients with varied illness duration over the previous 3 years, are consistent with an association between the overall inflammatory potential of diet and MS odds. Our findings among MS participants showed a significantly more pro-inflammatory DII scores than age- and sex-matched controls. Our results also suggest that MS group had a diet rich in pro-inflammatory foods and nutrients.
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Affiliation(s)
- Omar A. Alhaj
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | | | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- The Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, United States
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, United States
| | - Nicola L. Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Statistics, York University, Toronto, ON, Canada
- Human Nutrition Unit, Department of Food and Drugs, University of Parma Medical School, Parma, Italy
- Nicola L. Bragazzi,
| | - James R. Hebert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- The Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, United States
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, United States
| | - Haitham A. Jahrami
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
- Ministry of Health, Government Hospitals, Manama, Bahrain
- *Correspondence: Haitham A. Jahrami,
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10
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Saul A, Taylor BV, Blizzard L, Simpson-Yap S, Oddy WH, Probst YC, Black LJ, Ponsonby AL, Broadley SA, Lechner-Scott J, van der Mei I. Associations between diet quality and depression, anxiety, and fatigue in multiple sclerosis. Mult Scler Relat Disord 2022; 63:103910. [DOI: 10.1016/j.msard.2022.103910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/05/2022] [Accepted: 05/22/2022] [Indexed: 10/18/2022]
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11
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Keykhaei F, Norouzy S, Froughipour M, Nematy M, Saeidi M, Jarahi L, Amiri F, Malek Ahmadi M, Norouzy A. Adherence to healthy dietary pattern is associated with lower risk of multiple sclerosis. J Cent Nerv Syst Dis 2022; 14:11795735221092516. [PMID: 35558004 PMCID: PMC9087291 DOI: 10.1177/11795735221092516] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background Different studies have confirmed the role of nutritional factors in the
etiology of Multiple sclerosis (MS). However, dietary patterns associated
with the risk of MS remain unknown. Objectives This study aimed to investigate the possible relationship between the
existing dietary patterns and the risk of MS. Methods This case-control study was conducted in Mashhad city, Iran in 2015. In
total, 197 MS patients and 200 control subjects (matched in terms of age,
gender, education level, and body mass index) were enrolled in this study.
The required data were collected through interviews and questionnaire
completion. Moreover, the data on the usual dietary intake of each
participant during the past year were evaluated using a valid and reliable
semi-quantitative food frequency questionnaire (160 items). Logistic
regression analysis was applied to discover the associations between dietary
patterns and the risk of MS. Results Four major dietary patterns were identified in this study, including
Unhealthy, Western, Healthy, and Traditional. After adjustment for smoking
habits, the family history of autoimmune diseases and the duration of
breastfeeding, the highest tertile of Healthy dietary pattern was found to
be associated with the reduced risk of MS by 74% (OR = .26;
P < .001), whereas the Unhealthy dietary pattern was
associated with a three-fold increased risk of MS (OR = 3.04;
P < .001). However, no correlation was observed
between the Western and Traditional dietary patterns and the risk of MS. Conclusion According to the results of this study, a healthy diet may reduce the risk of
MS, whereas an unhealthy dietary pattern may.
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Affiliation(s)
- Fatemeh Keykhaei
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Somayeh Norouzy
- Department of Management and Medical Information, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohsen Froughipour
- Department of Neurology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Nematy
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Morteza Saeidi
- Department of Management and Medical Information, Kerman University of Medical Sciences, Kerman, Iran
| | - Lida Jarahi
- Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Amiri
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahsa Malek Ahmadi
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abdolreza Norouzy
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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A proinflammatory diet is associated with an increased likelihood of first clinical diagnosis of central nervous system demyelination in women. Mult Scler Relat Disord 2021; 57:103428. [PMID: 34856497 DOI: 10.1016/j.msard.2021.103428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/17/2021] [Accepted: 11/21/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND While a number of studies have examined associations between dietary factors and risk of multiple sclerosis (MS), little is known about intakes of inflammation-modulating foods and nutrients and risk of MS. OBJECTIVES To test associations between the Dietary Inflammatory Index (DII®) and risk of a first clinical diagnosis of central nervous system (CNS) demyelination (FCD) (267 cases, 507 controls) using data from the Ausimmune Study. METHODS The 2003-2006 Ausimmune Study was a multicentre, matched, case-control study examining environmental risk factors for an FCD, a common precursor to MS. The DII is a well-recognised tool that categorises individuals' diets on a continuum from maximally anti-inflammatory to maximally pro-inflammatory. The DII score was calculated from dietary intake data collected using a food frequency questionnaire. Conditional logistic regression models were used to estimate the association between DII and FCD separately for men and women. RESULTS In women, a higher DII score was associated with increased likelihood of FCD, with a 17% increase in likelihood of FCD per one-unit increase in DII score (adjusted odds ratio 1.17, 95% confidence interval 1.04-1.33). There was no association between DII and FCD in men (adjusted odds ratio 0.88, 95% confidence interval 0.73-1.07). CONCLUSIONS These findings suggest that a pro-inflammatory diet is associated with an increased likelihood of FCD in women.
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13
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Marx W, Veronese N, Kelly JT, Smith L, Hockey M, Collins S, Trakman GL, Hoare E, Teasdale SB, Wade A, Lane M, Aslam H, Davis JA, O'Neil A, Shivappa N, Hebert JR, Blekkenhorst LC, Berk M, Segasby T, Jacka F. The Dietary Inflammatory Index and Human Health: An Umbrella Review of Meta-Analyses of Observational Studies. Adv Nutr 2021; 12:1681-1690. [PMID: 33873204 PMCID: PMC8483957 DOI: 10.1093/advances/nmab037] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/17/2021] [Accepted: 03/11/2021] [Indexed: 12/20/2022] Open
Abstract
Numerous observational studies have investigated the role of the Dietary Inflammatory Index (DII®) in chronic disease risk. The aims of this umbrella review and integrated meta-analyses were to systematically synthesize the observational evidence reporting on the associations between the DII and health outcomes based on meta-analyses, and to assess the quality and strength of the evidence for each associated outcome. This umbrella review with integrated meta-analyses investigated the association between the DII and a range of health outcomes based on meta-analyses of observational data. A credibility assessment was conducted for each outcome using the following criteria: statistical heterogeneity, 95% prediction intervals, evidence for small-study effect and/or excess significance bias, as well as effect sizes and P values using calculated random effects meta-analyses. In total, 15 meta-analyses reporting on 38 chronic disease-related outcomes were included, incorporating a total population of 4,360,111 subjects. Outcomes (n = 38) were examined through various study designs including case-control (n = 8), cross-sectional (n = 5), prospective (n = 5), and combination (n = 20) study designs. Adherence to a pro-inflammatory dietary pattern had a significant positive association with 27 (71%) of the included health outcomes (P value < 0.05). Using the credibility assessment, Class I (Convincing) evidence was identified for myocardial infarction only, Class II (Highly suggestive) evidence was identified for increased risk of all-cause mortality, overall risk of incident cancer, and risk of incident site-specific cancers (colorectal, pancreatic, respiratory, and oral cancers) with increasing (more pro-inflammatory) DII score. Most outcomes (n = 31) presented Class III (Suggestive) or lower evidence (Weak or No association). Pro-inflammatory dietary patterns were nominally associated with an increased risk of many chronic disease outcomes. However, the strength of evidence for most outcomes was limited. Further prospective studies are required to improve the precision of the effect size.
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Affiliation(s)
- Wolfgang Marx
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Nicola Veronese
- University of Palermo, Department of Internal Medicine, Geriatrics Section, Palermo, Italy
| | - Jaimon T Kelly
- Centre of Applied Health Economics, Griffith University, Brisbane, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Meghan Hockey
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Sam Collins
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Gina L Trakman
- Department of Dietetics, Nutrition, and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Erin Hoare
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Scott B Teasdale
- School of Psychiatry, UNSW Sydney, Sydney, New South Wales, Australia
| | - Alexandra Wade
- Alliance for Research in Exercise, Nutrition, and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Melissa Lane
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Hajara Aslam
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Jessica A Davis
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Adrienne O'Neil
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia
- Melbourne School of Population & Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - James R Hebert
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - Lauren C Blekkenhorst
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Michael Berk
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Toby Segasby
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Felice Jacka
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia
- Black Dog Institute, Sydney, New South Wales, Australia
- James Cook University, Townsville, Queensland, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, VIC, Australia
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Dietary risk factors of primary progressive multiple sclerosis: A population-based case-control study. Mult Scler Relat Disord 2021; 56:103233. [PMID: 34488182 DOI: 10.1016/j.msard.2021.103233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 07/14/2021] [Accepted: 08/29/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES There are growing evidences on the role of nutritional factors in multiple sclerosis (MS) occurrence. But dietary data are limited in primary progressive type of MS (PPMS). We assessed the role of dietary factors during adolescence in PPMS risk. METHODS An incident case-control study on 143 PPMS cases with definite diagnosis and 400 controls were conducted in Sina hospital, Tehran, Iran. Demographic data were collected. Data on nutritional habits during adolescence were obtained using questionnaire designed for multinational case-control studies of environmental risk factors for multiple sclerosis (EnvIMS-Q). Logistic regression models were run to evaluate the role of diet in PPMS risk. RESULTS A significant association was founded between higher intake of dairy, seafood, red meat, poultry, vegetable, fruit and nut and lower risk of PPMS (P< 00.5). This association was dose dependent for all mentioned food groups except fruit. In the fully adjusted model, more intake of dairy (OR: 0.27; 95%CI: 0.14-0.53), seafood (OR: 0.21; 95%CI: 0.10-0.44), red meat (OR:0.44; 95%CI: 0.22-0.90), vegetable (OR: 0.19; 95%CI: 0.09-0.39), fruit (OR: 0.47; 95%CI: 0.22-0.99) and nut (OR: 0.29; 95%CI: 0.15-0.56) in the third tertiles resulted in significant reduction in PPMS risk. In case of poultry consumption, the association was meaningful just in the third tertile of crude model (OR: 0.54; 95%CI: 0.30-0.95). Nutrient supplementation with calcium, iron, folic acid, vitamin B12 and C were also related with more than 84% lower risk of PPMS. CONCLUSION Our data proposed that adequate intake of food groups and nutrient supplementation during adolescence may be effective in reducing adult-onset PPMS risk.
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15
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Modified Mediterranean Diet VS. Traditional Iranian Diet: Efficacy of Dietary Interventions on Dietary Inflammatory Index Score, Fatigue Severity and Disability in Multiple Sclerosis Patients. Br J Nutr 2021; 128:1274-1284. [PMID: 34392854 DOI: 10.1017/s000711452100307x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Current evidence suggests that adherence to the Mediterranean Diet (MeD) can reduce inflammation in chronic diseases; however, studies pertaining to Relapsing-Remitting Multiple Sclerosis (RRMS) are limited. Therefore, the aim of this study was to investigate the potential of the modified MeD (mMeD) in improving Dietary Inflammatory Index (DII) scores, disability, and fatigue severity, compared to Traditional Iranian Diet (TID), in RRMS patients. METHODS After initial screening (n=261), 180 RRMS patients were randomized to receive mMeD or TID (as control) for six months. DII score, Expanded Disability Status Scale (EDSS) and 21-item Modified Fatigue Impact Scale (MFIS) were evaluated at baseline and trial cessation. Multivariate analysis of covariance was conducted and adjusted for age, gender, body weight, body mass index, education level, supplement use, family history and duration of MS. RESULTS Of the 180 patients enrolled, 147 participants were included in the final analysis (n of mMeD=68; n of TID=79). Self-reported adherence was good (˜81%). Dietary intakes of 45 food parameters were assessed through the food frequency questionnaire. The mMeD significantly reduced DII scores after six months (2.38±0.21 to -1.87±0.86, P<0.001), but TID did not elicit any changes (2.21±0.44 to 2.14±1.01, P=0.771). Additionally, MFIS total score decreased significantly (72.4±17.2 to 63.9±14.2, P<0.001), whereas there was no considerable improvement for EDSS in the mMeD group. CONCLUSION Adherence to mMeD, for six months, improved dietary inflammatory status and fatigue severity in RRMS patients, however, the traditional Iranian diet did not positively impact dietary inflammation and MFIS score.
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Atuk Kahraman T, Yılmaz M, Yetkin MF, Mirza M. The nutritional status of relapsing-remitting multiple sclerosis (RRMS) patients compared to that of healthy people: a Turkish hospital-based study. Nutr Neurosci 2021; 25:2279-2287. [PMID: 34311682 DOI: 10.1080/1028415x.2021.1956253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study compares the nutritional status and physical activity levels of relapsing-remitting multiple sclerosis (RRMS) patients and healthy people. METHOD The study included 120 participants: 60 multiple sclerosis (MS) patients and 60 controls. RRMS diagnoses were made based on the 2017 McDonald criteria. The food intake frequency questionnaire was administered to the participants, their threeday food intake records were collected, their activity levels were determined, and anthropometric measurements were made. The differences between the groups were analyzed using the Mann-Whitney U test and Pearson's exact chi-squared test. RESULTS The participants with MS (46.7%) had a significantly lower rate of shopping for their own food compared to the control group (68.3%) (p = 0.002). The MS group (3.3%) had a lower rate of intake of green leafy vegetables 5 times weekly or more frequently than the control group (20.0%) (p < 0.05); and the control group (35.0%) had a higher consumption rate of pastry more than 1 to 2 times monthly than the MS group (13.3%) (p < 0.05). The participants with MS had a higher intake of fiber, insoluble fiber, and omega 3 fatty acid than the control group (p < 0.05). Expanded Disability Status Scale (EDSS) scores indicates that a positive correlation was found between daily intake of fiber and insoluble fiber (p < 0.05). The patients with MS in the inactive group had a higher EDSS median [2.00(0.00 -5.00)] than the minimal active group [1.25(0.00 -4.00)] (p = 0.034). CONCLUSION With the increase in disability in MS patients, their physical activity levels decrease and it becomes difficult for them to shop on their own. In addition, the consumption frequency of green leafy vegetables, which take time to prepare and a source of fiber, is also decreasing. It has been shown that fiber intake decreases when the disability increase. Therefore, preventing the progression of disability in MS patients is very important in ensuring diversity in food consumption.
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Affiliation(s)
- Tutku Atuk Kahraman
- Department of Nutrition and Dietetics, Erciyes University Faculty of Health Sciences, Kayseri, Turkey
| | - Müge Yılmaz
- Department of Nutrition and Dietetics, Erciyes University Faculty of Health Sciences, Kayseri, Turkey
| | - Mehmet Fatih Yetkin
- Department of Neurology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Meral Mirza
- Department of Neurology, Erciyes University Faculty of Medicine, Kayseri, Turkey
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Maroufi H, Mortazavi SH, Sahraian MA, Eskandarieh S. Environmental risk factors of multiple sclerosis in the Middle East and North Africa region: A systematic review. CURRENT JOURNAL OF NEUROLOGY 2021; 20:166-184. [PMID: 38011462 PMCID: PMC8984778 DOI: 10.18502/cjn.v20i3.7693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/05/2021] [Indexed: 11/24/2022]
Abstract
Background: The environmental factors play a major role as risk factors of multiple sclerosis (MS). This study aimed at gathering environmental risk factors of MS in the Middle East and North Africa (MENA). Methods: We used MEDLINE and EMBASE databases by a systematic review method. Out of a total of 123 studies, 16 studies met the eligibility criteria. Results: Totally, 47 risk factors were assessed as follows: six studies found sunlight exposure as a protective factor with the odds ratio (OR) ranging from 0.06 to 0.57. Six studies evaluated smoking as a risk factor with the OR ranging from 1.69 in all patients to 6.48 in female patients. Four studies supported measles infection as a risk factor with the OR ranging from 1.60 to 3.77, and in 3 studies, stressful events had a significant association with the OR of 1.80, 1.90, and 32.57. Conclusion: Among 47 assessed risk factors, sunlight exposure, cigarette smoking, measles infection, Epstein-Barr virus (EBV) infection, and stressful events had a significant association with MS.
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Affiliation(s)
- Hossein Maroufi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyyed Hosein Mortazavi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Paz ÉS, Maciel PMCT, D'Almeida JAC, Silva BYDC, Sampaio HADC, Pinheiro ADV, Carioca AAF, de Melo MLP. Excess weight, central adiposity and pro-inflammatory diet consumption in patients with neuromyelitis optica spectrum disorder. Mult Scler Relat Disord 2021; 54:103110. [PMID: 34214879 DOI: 10.1016/j.msard.2021.103110] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/18/2021] [Accepted: 06/20/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To characterize the nutritional status and the consumed Dietary Inflammatory Index (DII) by individuals with Neuromyelitis Optica Spectrum Disorder (NMOSD). METHODS Anthropometric, clinical data (Expanded Disability Status Scale, EDSS) anthropometric data (Body Mass Index - BMI; Waist Circumference - WC; Waist-to-hip ratio - WHR; and percentage of fat mass -%FM) and data on food consumption (24-hour recall) were collected to determine the Dietary Inflammatory Index (DII), according to Shivappa et al. For the statistical analysis, descriptive measures and statistical tests were used, with the significance level set at p <0.05. RESULTS There was a higher prevalence of females (86.8%). The abdominal fat accumulation in individuals was demonstrated in 57.9%, 73.0%, 70.3% and 30.0%, according to BMI, WC, WHR and%FM, respectively. There was no correlation between the EDSS score and the nutritional status, but there was a positive correlation between the administered corticosteroid dose and BMI (r = 0.55; p = 0.002), WC (r = 0.55; p = 0.003) and WHR (r = 0.41; p = 0.033). The mean DII was 4.99 (± 1.09), indicating the consumption of a pro-inflammatory diet. There was a difference in the DII according to gender (p <001). In the case-control segment, there was a significant difference in the DII between the groups (β = 2.51; 95% CI: 1.73; 3.27) and a higher risk of developing the disease when the DII was ≥4.41 (OR = 30.25; 95% CI: 6.70; 136.47). CONCLUSIONS Diets with high inflammatory potential are associated with increased risk of NMOSD.
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Affiliation(s)
- Éllen Sousa Paz
- Postgraduate Program in Nutrition and Health, Ceara State University (UECE), Fortaleza, Brazil. Dr. Silas Munguba Avenue, #1700 Campus do Itaperi, Fortaleza, CE, Brazil
| | - Paula Maria Cals Theophilo Maciel
- Postgraduate Program in Nutrition and Health, Ceara State University (UECE), Fortaleza, Brazil. Dr. Silas Munguba Avenue, #1700 Campus do Itaperi, Fortaleza, CE, Brazil
| | - José Artur Costa D'Almeida
- Multiple Sclerosis Interdisciplinary Center, Neurology Department, Fortaleza General Hospital (HGF-SUS), Fortaleza, Brazil. R. Ávila Goularte, #900 Papicu, Fortaleza, CE, Brazil
| | - Bruna Yhang da Costa Silva
- Federal Institute of Education, Science and Technology of Ceará, Limoeiro do Norte, Brazil Rua Estevão Remígio de Freitas, #1145 Monsenhor Otávio, Limoeiro do Norte, CE, Brazil; Postgraduate Program in Collective Health, Ceara State University (UECE), Fortaleza, Brazil. Dr. Silas Munguba Avenue, #1700 Campus do Itaperi, Fortaleza, CE, Brazil
| | - Helena Alves de Carvalho Sampaio
- Postgraduate Program in Collective Health, Ceara State University (UECE), Fortaleza, Brazil. Dr. Silas Munguba Avenue, #1700 Campus do Itaperi, Fortaleza, CE, Brazil
| | - Alexandre Danton Viana Pinheiro
- Postgraduate Program in Nutrition and Health, Ceara State University (UECE), Fortaleza, Brazil. Dr. Silas Munguba Avenue, #1700 Campus do Itaperi, Fortaleza, CE, Brazil
| | - Antônio Augusto Ferreira Carioca
- Postgraduate Program in Nutrition and Health, Ceara State University (UECE), Fortaleza, Brazil. Dr. Silas Munguba Avenue, #1700 Campus do Itaperi, Fortaleza, CE, Brazil; Undergraduate Course in Nutrition, University of Fortaleza, Av. Washington Soares, #1321 Edson Queiroz, Fortaleza, CE, 60811-905, Brazil
| | - Maria Luisa Pereira de Melo
- Postgraduate Program in Nutrition and Health, Ceara State University (UECE), Fortaleza, Brazil. Dr. Silas Munguba Avenue, #1700 Campus do Itaperi, Fortaleza, CE, Brazil; Multiple Sclerosis Interdisciplinary Center, Neurology Department, Fortaleza General Hospital (HGF-SUS), Fortaleza, Brazil. R. Ávila Goularte, #900 Papicu, Fortaleza, CE, Brazil.
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Kiani S, Vakilian A, Kamiab Z, Shamsizadeh A. Correlation of Dietary Intake and Helicobacter pylori Infection with Multiple Sclerosis, a Case-Control Study in Rafsanjan, Iran, 2017-18. Qatar Med J 2021; 2020:45. [PMID: 33623753 PMCID: PMC7878158 DOI: 10.5339/qmj.2020.45] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 09/09/2020] [Indexed: 12/25/2022] Open
Abstract
Background: Multiple sclerosis (MS) is an autoimmune disease affecting the central nervous system. Some environmental factors, such as Helicobacter pylori infection (HPI), are likely to be considered a protective factor in MS. Dietary intake may provide exposure to or have protective effects for MS. The present study aimed to determine the relationship between serum anti-H. pylori IgG antibody (HPIA) level and dietary intake in patients with MS referred to the MS Clinic in Rafsanjan city, Iran. Methods: The present case-control study was conducted on 97 patients with MS and 95 controls. The two groups had no significant difference in age and gender (p > 0.05). HPIA was checked, and the food frequency questionnaire was completed in both groups to measure nutritional intake. All data were analyzed by the SPSS 20 software using independent t-test, Chi-Square, Mann–Whitney U test, and correlation. Results: The median serum HPIA level was significantly lower in MS cases than in controls. Furthermore, the median consumption of glutamic acid, arginine, serine, aspartic acid, alanine, proline, and caffeine was significantly lower in MS cases than in controls. A significant positive correlation was found between the levels of linoleic acid, lactose, Ca, molybdenum, galactose, leucine, and valine, and the level of HPIA in controls. Conclusion: Our study results demonstrated that some dietary nutrients had correlations with MS and HPI. Therefore, professionals from multiple disciplines must find which foods contain these dietary nutrients in future studies.
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Affiliation(s)
- Sara Kiani
- Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.,Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | | | - Zahra Kamiab
- Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.,Department of Family Medicine, Ali-Ibn Abi-Talib Hospital, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Ali Shamsizadeh
- Department of Physiology and Pharmacology, School of Medicine, Physiology-Pharmacology Research Center, Research Institute on Basic Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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20
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Abdollahpour I, Jakimovski D, Shivappa N, Hébert JR, Vahid F, Nedjat S, Mansournia MA, Weinstock-Guttman B. Dietary inflammatory index and risk of multiple sclerosis: Findings from a large population-based incident case–control study. Clin Nutr 2020; 39:3402-3407. [DOI: 10.1016/j.clnu.2020.02.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 02/15/2020] [Accepted: 02/27/2020] [Indexed: 12/11/2022]
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21
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MACHADO SB, CABRAL R, MURADE N, ARES NC, SCORCINE C, FRAGOSO YD. Dietary habits in a group of patients with multiple sclerosis are similar to those of healthy control subjects. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:638-641. [DOI: 10.1590/0004-282x20200065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 05/26/2020] [Indexed: 12/28/2022]
Abstract
ABSTRACT Background: Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system. Over time, patients with MS accumulate neurological disabilities. MS typically affects young adults and is associated with an inflammatory profile of cytokines and lymphocytes. If a patient were to consume a potentially inflammatory diet, it is possible that the evolution of MS in that individual would be more aggressive. Objective: To investigate whether patients with MS living in and around the city of Santos, São Paulo, Brazil, had a profile of inflammatory diet. Methods: Patients with MS and healthy control subjects were individually interviewed, and the 24-hour Diet Recall and the Bristol Stool Form Scale were applied. Salt intake was calculated using the WebDiet 2.0 software. Results: There were no remarkable differences in dietary habits between healthy control subjects (n=34) and patients with MS (n=66), except for higher consumption of carbohydrates by patients. Both patients with MS and control subjects had higher protein and lower carbohydrate intake than the World Health Organization’s recommended daily amounts. There was no correlation between food intake and neurological disability in patients with MS. Conclusion: The dietary patterns of patients with MS and healthy controls were similar in the city of Santos, São Paulo, Brazil, and surrounding towns, except for higher intake of carbohydrates by patients. No profile of pro-inflammatory diets was identified among the patients with MS enrolled in this study.
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Rezaeimanesh N, Jahromi SR, Ghorbani Z, Moghadasi AN, Hekmatdoost A, Moghadam NB, Sahraian MA. Low carbohydrate diet score and odds of neuromyelitis optica spectrum disorder: A case-control study. INT J VITAM NUTR RES 2020; 92:321-330. [PMID: 32795169 DOI: 10.1024/0300-9831/a000677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Introduction: Neuromyelitis optica spectrum disorder (NMOSD) is a demyelinating inflammatory disease of The Central nervous system. We aimed to investigate the association between low carbohydrate diet (LCD) and NMOSD odds. Method: Seventy NMOSD patients with definite diagnosis and 164 hospital-based controls were enrolled in this case-control study. Dietary data was obtained using a validated 168-item food frequency questionnaire. To determine the LCD score, participants were stratified into 11 groups according to carbohydrate, protein, fat, animal fat, animal protein, vegetable fat and vegetable protein intakes. Higher intake of protein and fat, and lower intake of carbohydrate received a higher score between 0-10. Macronutrients scores were summed together and LCD scores calculated. The association between LCD scores and likelihood of being assigned to NMOSD group was investigated using multiple regression models. Results: Total LCD scores increased from the median of 21.00 in the first decile to 53.00 in the tenth decile of LCD score. After adjustment for confounding factors including age, gender, BMI, energy intake, cigarette smoking and alcohol consumption, an inverse association was detected between LCD scores and odds of NMOSD. The odds of suffering from NMOSD declined significantly about 78% (OR: 0.22; 95% CI: 0.05-0.87) and 76% (OR: 0.24; 95% CI: 0.06-0.93) in the fifth and sixth deciles of LCD score compared to the first decile. Conclusion: From the obtained results it can be speculated that higher carbohydrate and lower protein and fat intakes may be associate with the increased odds of NMOSD. However, further studies are needed to confirm these results.
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Affiliation(s)
- Nasim Rezaeimanesh
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran, Student Research Committee, Department and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soodeh Razeghi Jahromi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Ghorbani
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.,Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Azita Hekmatdoost
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nahid Beladi Moghadam
- Department of neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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23
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Kheirouri S, Alizadeh M. Dietary Inflammatory Potential and the Risk of Neurodegenerative Diseases in Adults. Epidemiol Rev 2020; 41:109-120. [PMID: 31565731 DOI: 10.1093/epirev/mxz005] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 02/17/2019] [Accepted: 02/26/2019] [Indexed: 01/12/2023] Open
Abstract
Nutrition and diet have been suggested to enhance or inhibit cognitive performance and the risk of several neurodegenerative diseases. We conducted a systematic review to elucidate the relationship between the inflammatory capacity of a person's diet and the risk of incident neurodegenerative diseases. We searched major medical databases for articles published through June 30, 2018. Original, full-text, English-language articles on studies with human participants which investigated the link between dietary inflammatory potential and risk of developing neurodegenerative diseases were included. Duplicate and irrelevant studies were removed, and data were compiled through critical analysis. Initially, 457 articles were collected via the searching method, of which 196 studies remained after removal of duplicates. Fourteen articles were screened and found to be relevant to the scope of the review. After critical analysis, 10 were included in the final review. In all studies but one, a higher dietary inflammatory index (DII) was related to higher risk of developing neurodegenerative disease symptoms, including memory and cognition decline and multiple sclerosis. Of 3 studies that assessed the association of DII with levels of circulating inflammation markers, 2 indicated that DII was positively correlated with inflammatory marker levels. Low literacy, an unhealthy lifestyle, and individual nutritional status were the factors involved in a diet with inflammatory potential. These findings enhance confidence that DII is an appropriate tool for measurement of dietary inflammatory potential and validate the role of diets with inflammatory potential in the pathophysiology of neurodegenerative diseases. DII may be correlated with levels of circulating inflammatory markers.
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Affiliation(s)
- Sorayya Kheirouri
- Department of Community Nutrition, School of Health and Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Alizadeh
- Nutrition Research Center, School of Health and Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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24
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Shivappa N, Hébert JR, Akhoundan M, Mirmiran P, Rashidkhani B. Association between inflammatory potential of diet and odds of gestational diabetes mellitus among Iranian women. J Matern Fetal Neonatal Med 2019; 32:3552-3558. [PMID: 29661051 PMCID: PMC6424648 DOI: 10.1080/14767058.2018.1466275] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 04/15/2018] [Indexed: 12/11/2022]
Abstract
Background: The possible relationship between diet-related inflammation and the risk of gestational diabetes mellitus (GDM) requires further investigation, especially in non-Western populations. We examined the association between dietary inflammatory index (DII) scores and GDM in a case-control study conducted in Iran. Methods: This study included 122 GDM cases and 266 controls hospitalized for acute non-neoplastic diseases. Cases were pregnant women aged 18-40 years, who visited major general hospitals in different regions of Tehran. Pregnant women were screened for gestational diabetes between the 24th and 28th week of gestation with a 50-g, 1-hour glucose challenge test (GCT). Cases were diagnosed positive for GDM. Controls were pregnant women who had normal GCT test. DII scores were computed from dietary intake assessed by a previously validated 147-item food frequency questionnaire. Logistic regression models adjusted age, gestational age, energy, exercise, BMI, smoking exposure, family history of diabetes, and history of multivitamin intake were used to estimate odds ratios (ORs) and 95% confidence intervals (CI). Results: Subjects with higher DII scores (i.e. indicating a more proinflammatory diet) had a higher odd of GDM with the DII being used as both a continuous (OR = 1.20; 95% CI = 0.94-1.54) and as categorical (ORtertile 3vs1 = 2.10; 95% CI = 1.02-4.34, p-trend = .03). Conclusions: These results indicate that a proinflammatory diet, as evidenced by higher DII scores, is associated with increased odds of GDM among Iranian women.
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Affiliation(s)
- Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Connecting Health Innovations, Columbia, SC 29208, USA
| | - James R. Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Connecting Health Innovations, Columbia, SC 29208, USA
| | - Mahdieh Akhoundan
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahram Rashidkhani
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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25
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Dardiotis E, Tsouris Z, Aslanidou P, Aloizou AM, Sokratous M, Provatas A, Siokas V, Deretzi G, Hadjigeorgiou GM. Body mass index in patients with Multiple Sclerosis: a meta-analysis. Neurol Res 2019; 41:836-846. [DOI: 10.1080/01616412.2019.1622873] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Zisis Tsouris
- Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Paraskevi Aslanidou
- Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Athina-Maria Aloizou
- Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Maria Sokratous
- Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Antonios Provatas
- Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Georgia Deretzi
- Papageorgiou hospital, Neurology clinic, Thessaloniki, Greece
| | - Georgios M. Hadjigeorgiou
- Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
- Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
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26
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Rafiee P, Shivappa N, Hébert JR, Nasab SJ, Bahrami A, Hekmatdoost A, Rashidkhani B, Sadeghi A, Houshyari M, Hejazi E. Dietary Inflammatory Index and Odds of Colorectal Cancer and Colorectal Adenomatous Polyps in A Case-Control Study from Iran. Nutrients 2019; 11:E1213. [PMID: 31142015 PMCID: PMC6628332 DOI: 10.3390/nu11061213] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/22/2019] [Accepted: 05/24/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Chronic inflammation is implicated in the development of colorectal cancer (CRC) and its precursor; colorectal adenomatous polyps (CAP). Some dietary factors are important triggers for systemic inflammation. Therefore, the present study aimed to investigate the association between the dietary inflammatory index (DII®) and the risk of CRC and CAP in an Iranian case-control study. METHODS 134 newly diagnosed CRC patients, 130 newly diagnosed CAP patients, and 240 hospitalized controls were recruited using convenience sampling. Energy-adjusted DII (E-DII) scores were computed based on dietary intake assessed using a reproducible and valid 148-item food frequency questionnaire. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CI) after adjusting for confounders. RESULTS The E-DII score ranged between -4.23 (the most anti-inflammatory score) to +3.89 (the most pro-inflammatory score). The multivariable-adjusted ORs for participants in the 3rd tertile compared to the 1st tertile was 5.08 (95%CI: 2.70-9.56; P-trend < 0.0001) for CRC and 2.33 (95% CI: 1.30-4.02; P-trend = 0.005) for CAP. CONCLUSIONS Our findings suggest that more pro-inflammatory diets, indicated by higher E-DII scores, might increase the risk of both CRC and CAP. Future steps should include testing these associations in a prospective setting in Iran.
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Affiliation(s)
- Pegah Rafiee
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology, Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 11369, Iran.
- Student Research Committee, Department and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 11369, Iran.
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
- Connecting Health Innovations LLC, Columbia, SC 29201, USA.
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
- Connecting Health Innovations LLC, Columbia, SC 29201, USA.
| | - Saeede Jaafari Nasab
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology, Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 11369, Iran.
| | - Alireza Bahrami
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology, Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 11369, Iran.
| | - Azita Hekmatdoost
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology, Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 11369, Iran.
| | - Bahram Rashidkhani
- Community Nutrition Department, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Shahid Beheshti University of Medical Sciences, Tehran 11369, Iran.
| | - Amir Sadeghi
- Gastroenterology and liver diseases research center, Research institute for gastroenterology and liver diseases, Shahid Beheshti University of Medical Sciences, Tehran 11369, Iran.
| | - Mohammad Houshyari
- Radio-Oncology Department, Shohadae Tajrish hospital, Shahi Beheshti University of Medical Sciences, Tehran 11369, Iran.
| | - Ehsan Hejazi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology, Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 11369, Iran.
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27
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Chenard CA, Rubenstein LM, Snetselaar LG, Wahls TL. Nutrient Composition Comparison between a Modified Paleolithic Diet for Multiple Sclerosis and the Recommended Healthy U.S.-Style Eating Pattern. Nutrients 2019; 11:E537. [PMID: 30832289 PMCID: PMC6470485 DOI: 10.3390/nu11030537] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 02/17/2019] [Accepted: 02/20/2019] [Indexed: 01/04/2023] Open
Abstract
Multiple sclerosis (MS) is a demyelinating disease that attacks the central nervous system. Evidence-based dietary guidelines do not exist for MS; the default advice is to follow the Dietary Guidelines for Americans (DGA). A modified Paleolithic Wahls Elimination (WahlsElim) diet promoted for MS excludes grains and dairy and encourages 9+ cups fruits and vegetables (F/V) and saturated fat for cooking. This study evaluated the nutritional adequacy of seven-day menus and modeled them with varying amounts of F/V for comparison with the DGA Healthy US-Style Eating Pattern (HEP) for ages 31⁻50 years. WahlsElim menus had low added sugar and glycemic index. Nutritional adequacy of the menus and modeled versions were similar to HEP for 17 vitamins and minerals (mean adequacy ratio ≥92%). Nutrient shortfalls for the modeled diet with 60% F/V were identical to HEP for vitamin D, iron (females), magnesium (marginally males), choline and potassium; this modeled diet was also low in dietary fiber and calcium but met vitamin E requirements while HEP did not. WahlsElim-prescribed supplements corrected vitamin D and magnesium shortfalls; careful selection of foods are needed to meet requirements of other shortfall nutrients and reduce saturated fat and sodium. Doctors should monitor nutritional status, supplement doses, and possible contraindications to high vitamin K intake in individuals following the WahlsElim diet.
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Affiliation(s)
- Catherine A Chenard
- Department of Internal Medicine, University of Iowa, Iowa City, IA 52242, USA.
| | - Linda M Rubenstein
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA.
| | - Linda G Snetselaar
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA.
| | - Terry L Wahls
- Department of Internal Medicine, University of Iowa, Iowa City, IA 52242, USA.
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Ghazavi Y, Bahadoran Z, Nikfarjam M, Moghaddam NB, Mirmiran P, Heydari MR. Comparison of Food Intake in Multiple Sclerosis Patients and Healthy Individuals: A Hospital-Based Case-Controlled Study. IRANIAN JOURNAL OF CHILD NEUROLOGY 2019; 13:143-154. [PMID: 31645874 PMCID: PMC6789084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/15/2018] [Accepted: 10/16/2018] [Indexed: 11/02/2022]
Abstract
OBJECTIVES Nutritional factors affect the incidence, severity of symptoms and progression of multiple sclerosis (MS). However, the role of specific nutritional factors remains largely unknown in MS. We conducted this hospital-based case-controlled study to investigate the association between dietary intake and risk of MS. MATERIALS & METHODS This study was conducted on 93 MS patients and 94 age-matched controls from Oct 2015 to Sep 2016 in Tehran, Iran. MS was diagnosed based on 2010 McDonald criteria and Brain Magnetic Resonance Imaging. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire. Odds ratio and 95% confidence interval of MS was calculated in different food groups using multiple logistic regression models adjusted for potentially confounding variables and compared between the two groups. RESULTS There was no significant difference between the age (34.62 ±9.68 vs. 33.96±8.75) and BMI (23.96 ±4.07 vs. 24.47 ±4.07) of MS and control group, respectively. Higher intake of processed meat (OR (95% CI))=(2.07(1.18-3.63) and non-processed meat (1.38(1.13-1.68)) were found in the MS group compared with the control. CONCLUSION Higher intake of processed meat and non-processed meat was associated with increased risk of MS. Further studies on the probable role of these nutritional factors in the pathogenesis of MS are suggested.
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Affiliation(s)
- Yasaman Ghazavi
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Bahadoran
- Nutrition and Endocrine Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mana Nikfarjam
- Nutrition and Endocrine Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nahid Beladi Moghaddam
- Department of Neurology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Reza Heydari
- Department of Neurology, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
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29
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Association between dietary inflammatory index and psychological profile in adults. Clin Nutr 2018; 38:2360-2368. [PMID: 30415907 DOI: 10.1016/j.clnu.2018.10.015] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 10/01/2018] [Accepted: 10/23/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND & AIMS Limited data are available on the association of inflammatory potential of the diet and odds of psychological disorders. We investigated the association between adherence to a pro-inflammatory diet, as measured by Dietary Inflammatory Index (DII), and odds of psychological disorders. METHODS In this cross-sectional study, dietary intakes of 3363 Iranian adult participants were collected using a validated Dish-based 106-item Semi-quantitative Food Frequency Questionnaire (DS-FFQ). DII score was calculated based on participants' dietary intakes obtained from DS-FFQ. The Iranian validated version of Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ) was used to assess psychological disorders. For depression and anxiety, scores of 8 or more on either subscale were considered as psychological disorders and scores of 0-7 were defined as "normal". In terms of psychological distress, the score of 4 or more was defined as psychological distress. RESULTS Overall, 28% (n = 943) of study participants had depression, 13.3% (n = 448) were affected by anxiety and 22.6% (n = 760) by psychological distress. After controlling for potential confounders, individuals in the highest quintile of DII score had higher scores of depression (6.56 ± 0.16 vs. 5.48 ± 0.16; P < 0.001), anxiety (3.85 ± 0.17 vs. 3.09 ± 0.17; P = 0.006), and psychological distress (2.42 ± 0.13 vs. 1.77 ± 0.13; P = 0.001), compared with those in the lowest quintile. Participants in the top quintile of DII score had greater odds of depression (OR: 1.84, 95% CI: 1.30-2.60), anxiety (OR: 1.69, 95% CI: 1.07-2.67), and psychological distress (OR: 1.72, 95% CI: 1.20-2.46) than those in the bottom quintile. CONCLUSIONS We found that adherence to a pro-inflammatory diet was positively associated with psychological disorders.
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30
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Dietary Inflammatory Index and clinical course of multiple sclerosis. Eur J Clin Nutr 2018; 73:979-988. [DOI: 10.1038/s41430-018-0294-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 07/07/2018] [Accepted: 08/13/2018] [Indexed: 11/08/2022]
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Kord Varkaneh H, Fatahi S, Tajik S, Rahmani J, Zarezadeh M, Shab-Bidar S. Dietary inflammatory index in relation to obesity and body mass index: a meta-analysis. ACTA ACUST UNITED AC 2018. [DOI: 10.1108/nfs-09-2017-0203] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Purpose
Studies investigating the association between dietary inflammatory index (DII) and body mass index (BMI) have led to inconsistent findings. Therefore, to decisively conclude, this paper aims to clarify the relationship between DII and obesity by performing meta-analysis.
Design/methodology/approach
PubMed, Scopus and Google Scholar were searched up to July 2017 using key words selected from Medical Subject Headings and other related keywords to identify all relevant articles. In total, 22 articles were entered into the meta-analysis; 22 studies compared the mean of BMI among subjects with highest versus the lowest DII and 4 studies had data on the hazard risk (HR) or odds ratio (OR) for obesity.
Findings
A meta-analysis on included studies indicated a significant association on either mean differences (MD) in BMI (MD = 0.811; 95 per cent CI: 0.365-1.256; p: 0.0001) or obesity OR (OR: 1.310; 95 per cent CI: 1.144-1.500; p = 0.000) by comparing the highest and lowest DII categories. Between-study heterogeneity was high (Cochrane Q test, p < 0.001, I2 = 98.1 per cent, df = 21, τ2 = 0.9273), and only dietary assessment methods could explain the source of heterogeneity in which 24-h dietary recalls were homogeny (I2 = 8.4 per cent, df = 2, p = 0.335).
Originality/value
The results of the present meta-analysis suggest that adherence to high DII score increased BMI and obesity. More prospective studies in different populations are needed to better clarify this relation.
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Labuschagne IL, Blaauw R. An anti-inflammatory approach to the dietary management of multiple sclerosis: a condensed review. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2018. [DOI: 10.1080/16070658.2018.1465652] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- IL Labuschagne
- Division of Human Nutrition, Stellenbosch University, Cape Town, South Africa
| | - R Blaauw
- Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town, South Africa
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