Dietary Inflammatory Index and clinical course of multiple sclerosis

Silva, Bruna Yhang da Costa; Sampaio, Helena Alves de Carvalho; Shivappa, Nitin; Hébert, James R.; Albuquerque, Larissa da Silva; Carioca, Antônio Augusto Ferreira; D'Almeida, José Artur Costa; Maia, Carla Soraya Costa; Melo, Maria Luísa Pereira de

doi:10.1038/s41430-018-0294-8

Cited by 11 publications

(11 citation statements)

References 43 publications

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“…Using less food parameters generally also results in a lower variation in DII [ 11 ]. However, all other studies that calculated the DII also were unable to include all 45 food parameters and used a number of food parameters that was comparable to our study [ 12 – 14 , 20 , 21 ]. The DII only consists of food parameters, supplement use is not included.…”

Section: Discussionmentioning

confidence: 81%

“…Therefore, it is likely that the DII better reflects the influence of diet on inflammation and thus on the course of disease than analyses with single foods [ 9 – 11 ]. The DII has been used in several other patient groups to predict the dietary inflammatory potential related risk for development of disease or the influence on clinical course of disease [ 12 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

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The association between inflammatory potential of diet and disease activity: results from a cross-sectional study in patients with inflammatory bowel disease

2020

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Background Diet may play a role in disease status in patients with inflammatory bowel disease. We tested whether the inflammatory potential of diet, based on a summation of pro- and anti-inflammatory nutrients, is associated with disease activity in patients with Crohn’s disease and ulcerative colitis. Methods Participants completed a disease activity questionnaire (short Crohn’s Disease Activity (sCDAI) or Patient Simple Clinical Colitis Activity Index (P-SCCAI)) and a Food Frequency Questionnaire (FFQ). FFQ data were used to calculate the Dietary Inflammatory Index (DII) which enables categorization of individuals’ diets according to their inflammatory potential on a continuum from pro- to anti-inflammatory. Associations with disease activity were investigated by multiple linear regression. Results The analysis included 329 participants; 168 with Crohn’s disease (median sCDAI score 93 [IQR 47–156]), and 161 with ulcerative colitis (median P-SCCAI score 1 [IQR 1–3]). Mean DII was 0.71 ± 1.33, suggesting a slightly pro-inflammatory diet. In Crohn’s disease, the DII was positively associated with disease activity, even after adjustment for confounders (p = 0.008). The mean DII was significantly different between participants in remission and with mild and moderately active disease (0.64, 0.97 and 1.52 respectively, p = 0.027). In ulcerative colitis, the association was not significant. Conclusions Disease activity was higher in IBD participants with a more pro-inflammatory diet with statistical significance in Crohn’s disease. Although the direction of causality is not clear, this association strengthens the role for diet in medical treatment, which should be tested in an intervention study.

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Section: Discussionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

The association between inflammatory potential of diet and disease activity: results from a cross-sectional study in patients with inflammatory bowel disease

2020

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“…There is only one cross-sectional study that has examined this and they found no association between the DII and relapse rate in the previous 2 years (p = 0.433). 10 When we assessed the DII scores in relation to lesion volume, we found that a higher DII was associated with a higher FLAIR lesion volume in the periventricular legion with evidence of a dose-response and consistency with E-DII. While no clear associations were seen in the total sample, the associations strengthened somewhat when we limited to those with the same scanner (i.e.…”

Section: Discussionmentioning

confidence: 88%

A pro-inflammatory diet in people with multiple sclerosis is associated with an increased rate of relapse and increased FLAIR lesion volume on MRI in early multiple sclerosis: A prospective cohort study

et al. 2023

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Background: A pro-inflammatory diet has been posited to induce chronic inflammation within the central nervous system (CNS), and multiple sclerosis (MS) is an inflammatory disease of the CNS. Objective: We examined whether Dietary Inflammatory Index (DII®)) scores are associated with measures of MS progression and inflammatory activity. Methods: A cohort with a first clinical diagnosis of CNS demyelination was followed annually (10 years, n = 223). At baseline, 5- and 10-year reviews, DII and energy-adjusted DII (E-DIITM) scores were calculated (food frequency questionnaire) and assessed as predictors of relapses, annualised change in disability (Expanded Disability Status Scale) and two magnetic resonance imaging measures; fluid-attenuated inversion recovery (FLAIR) lesion volume and black hole lesion volume. Results: A more pro-inflammatory diet was associated with a higher relapse risk (highest vs. lowest E-DII quartile: hazard ratio = 2.24, 95% confidence interval (CI) = −1.16, 4.33, p = 0.02). When we limited analyses to those assessed on the same manufacturer of scanner and those with a first demyelinating event at study entry (to reduce error and disease heterogeneity), an association between E-DII score and FLAIR lesion volume was evident (β = 0.38, 95% CI = 0.04, 0.72, p = 0.03). Conclusion: There is a longitudinal association between a higher DII and a worsening in relapse rate and periventricular FLAIR lesion volume in people with MS.

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“…Recently, it was reported that DII was not significantly associated with the clinical condition of individuals with MS (50) . Moreover, Silva et al (51) , in a cross-sectional study, reported that DII does not correlate to waist circumference, waist-hip ratio, body roundness index, body shape index, body shape z score index and percentage of body fat among MS patients.…”

Section: Discussionmentioning

confidence: 97%

Modified Mediterranean diet v. traditional Iranian diet: efficacy of dietary interventions on dietary inflammatory index score, fatigue severity and disability in multiple sclerosis patients

et al. 2021

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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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Dietary Inflammatory Index and clinical course of multiple sclerosis

Abstract: The Dietary Inflammatory Index did not affect the clinical condition of individuals with multiple sclerosis.

Cited by 11 publications

References 43 publications

The association between inflammatory potential of diet and disease activity: results from a cross-sectional study in patients with inflammatory bowel disease

The association between inflammatory potential of diet and disease activity: results from a cross-sectional study in patients with inflammatory bowel disease

A pro-inflammatory diet in people with multiple sclerosis is associated with an increased rate of relapse and increased FLAIR lesion volume on MRI in early multiple sclerosis: A prospective cohort study

Modified Mediterranean diet v. traditional Iranian diet: efficacy of dietary interventions on dietary inflammatory index score, fatigue severity and disability in multiple sclerosis patients

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