Department of Epidemiology, School of Public Health, Arak University of Medical Sciences, Arak, Iran; Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
Clin Nutr. 2020 Nov;39(11):3402-3407. doi: 10.1016/j.clnu.2020.02.033. Epub 2020 Mar 6.
BACKGROUND & AIMS: For many decades diet, mainly its "pro-inflammatory" quality has been pondered as a possible risk factor for developing MS. However, the complexity of different dietary composition analysis provided controversial results. Recently a dietary inflammatory index (DII), a population-based score, was developed to objectify the inflammatory characteristics of a specific dietary intake.
We investigated the potential association between DII (expressed as energy adjusted-DII (E-DII) and non-energy adjusted DII (DII)) assessed from a validated FFQ based on the participants' diet habits during adolescence and the risk for developing MS in a population-based incident case-control study. Multiple logistic regression was used to estimate the adjusted.
We recruited 547 incident MS cases and 1057 general population controls from Tehran, Iran (August 2013-February 2015). A statistically significant higher risk of MS was found in analyses using E-DII scores as a continuous variable with an adjusted odds ratio (AOR) of 1.53 (95% confidence interval (CI): 1.42-1.65, P = 0.001), and as a categorical variable (4th quartile OR 7.01, 95% CI: 4.87-10.1, vs the first quartile), test for trend; OR 1.86 (95% CI: 1.67-2.07), P for trend <0.001. A similar pattern was demonstrated for DII score and risk for MS.
We identified a pro-inflammatory diet characterized by higher E-DII and DII scores during adolescence as a strong risk factor for MS onset. Given the worldwide role of diet in general population health, improving nutritional pattern through educational programs is likely to reduce MS risk.
几十年来，饮食主要是其“促炎”特性，一直被认为是患多发性硬化症的可能风险因素。然而，不同饮食成分分析的复杂性提供了相互矛盾的结果。最近，开发了一种饮食炎症指数（DII），这是一种基于人群的评分，旨在客观评估特定饮食摄入的炎症特征。
我们调查了基于参与者青少年时期饮食习惯的验证性 FFQ 评估的 DII（表示为能量调整-DII（E-DII）和非能量调整 DII（DII））与多发性硬化症发病风险之间的潜在关联，在基于人群的病例对照研究中。使用多变量逻辑回归来估计调整后的风险比（OR）。
我们从伊朗德黑兰招募了 547 名多发性硬化症病例和 1057 名一般人群对照（2013 年 8 月至 2015 年 2 月）。E-DII 评分作为连续变量的分析显示多发性硬化症的风险显著增加，调整后的优势比（AOR）为 1.53（95%置信区间（CI）：1.42-1.65，P=0.001），并且作为分类变量（第四四分位数 OR 7.01，95%CI：4.87-10.1，与第一四分位数相比），趋势检验；OR 1.86（95%CI：1.67-2.07），P 趋势 <0.001。DII 评分与多发性硬化症风险也显示出类似的模式。
我们发现青少年时期促炎饮食的特点是 E-DII 和 DII 评分较高，这是多发性硬化症发病的一个强烈风险因素。鉴于饮食在全球范围内对一般人群健康的作用，通过教育计划改善营养模式可能会降低多发性硬化症的风险。
