Association between multiple sclerosis and dietary patterns based on the traditional concept of food nature: a case-control study in Iran

Abstract

Introduction It remains a matter of debate whether traditional concepts regarding the nature of food affect the development and progression of multiple sclerosis (MS).To date, there are limited studies that have investigated the association between MS and dietary patterns based on the categories of food nature (hot, cold, or balanced) defined in traditional medicine. Method This case-control study was conducted from October 2019 to February 2020. In total, 60 patients diagnosed with MS within the preceding 6 months and referred to our neurology outpatient clinic were included in our case group. The control group included 180 patients who were referred to the same center for general or orthopedic surgery. Dietary intake was assessed in both groups through a reliable and valid semi-quantitative food frequency questionnaire. Data were assessed using principal component analysis. Results The mean age of the participants was 44.9 ± 17.33 years. The analysis showed that four food patterns were distinguished (eigenvalue > 1), namely “additives and cold-natured foods”, “hot and balanced foods and nuts”, “dairy and legumes”, and “hot and balanced starches”. These food patterns explained 57.8% of the total variance. After adjusting all confounding factors, individuals in the highest quartile and medium quartile of “additives and cold-natured foods” had an elevated MS risk compared with the lowest quartile (OR = 7.21, 95%CI = 2.01–12.38 and OR = 3.37, 95%CI = 1.02–11.35, respectively). Furthermore, individuals in the highest quartile of the “hot and balanced foods and nuts” group were protected against MS compared with its lowest quartile (OR = 0.28, 95%CI = 0.08–0.90). Moreover, a protective effect against MS was seen in the highest quartile of the “hot and balanced starches” group relative to its lowest quartile (OR = 0.34, 95%CI = 0.12–0.98). No significant association was found between “dairy and legumes” and the risk of MS. Conclusion This study revealed that dietary patterns based on the traditional concept of food nature might be associated with the risk of developing MS. This represents the first work in this area, so further research is recommended.

Inverse association between Mediterranean diet and risk of multiple sclerosis

“…Several observational studies regarding the influence of diet on MS risk have considered diet at the time of MS onset or thereafter. [5][6][7][8][9] Some studies found that patients with MS tend to have a less healthy diet compared with controls. 4,5 An Australian study found that patients with a diagnosis of central nervous system demyelination consumed a diet with higher inflammatory index, based on the overall inflammatory effect of the diet, compared with controls.…”

“…Previous observational studies regarding the influence of diet on MS risk have had limited case numbers and have considered diet at the time of MS onset or after. 5–9 They found that patients with MS tend to have a less healthy diet 5,6 or a more pro-inflammatory diet, 8 compared with controls. However, since dietary changes are likely post-diagnosis, reverse causation cannot be ruled out.…”

Involvement of the Intestinal Microbiota in the Appearance of Multiple Sclerosis: Aloe vera and Citrus bergamia as Potential Candidates for Intestinal Health

“…It has been demonstrated that diet exerts a systemic influence on all three of these pathways, resulting in more or less beneficial effects [42,43]. A Mediterranean-style diet with a low content of saturated fat and processed foods, many polyunsaturated and monounsaturated fats, especially fish and olive oil, and plentiful fruits and vegetables has been associated in MS with reduced disability [44], neurodegeneration [45], and cognitive decay [46]. In recent years, a close correlation between MS and vitamin levels has been highlighted.…”

Dietary patterns and the risk of Alzheimer’s disease in an elderly Iranian population: a case–control study

“…Studies related to the effect of food on health have been conducted by two different approaches in which either the effect of the nutrients are investigated alone or the total food intake as a pattern is considered. In the first approach, the interactions of nutrients with each other are ignored, whereas from another point of view, all the interactions between nutrients are examined and DPs are identified [ 13 – 15 ].…”