High-Fat Diets May Increase Relapse Risk in Pediatric MS

High-fat diets may increase the risk of relapse in children with MS, while high-vegetable diets may be protective.

Diets high in fat may increase the risk of relapse in children with multiple sclerosis (MS), while diets high in vegetables may be protective, according to findings presented at the 32nd Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in London, September 14-17, 2016.

The researchers, led by Saeedeh Azary, MD, MPH, of the Multiple Sclerosis Center at the University of California in San Francisco, aimed to examine whether diet plays a role in MS relapse. While it has been reported that a high-fat diet may exacerbate experimental autoimmune encephalomyelitis (EAE), it is unknown whether diet plays a part in relapse in MS.

Using the validated self-reported Block Kids Food Screener (NutritionQuest), the researchers examined the dietary intake of fat, vegetables, fiber, fruits, carbohydrates, protein, sugar, dairy, and iron the week before enrollment of 219 patients with early pediatric relapsing-remitting MS (61.2% girls, 39.3% non-whites, mean age 15.1 years, mean disease duration 10.8 months at enrollment). The median follow-up time after completing the food frequency questionnaire was 1.8 years (SD: 0.1-4.1).

Patients who had prospective relapse data available in the Pediatric MS Network registry after enrolling in an ongoing case-control study of environmental risk factors in pediatric MS were included in the study. (The ongoing case-control study is assessing patients at 16 centers in the US, enrolling patients with clinically isolated syndrome (CIS) or MS who developed MS before age 18, and have a less than 4-year duration.)

The researchers found that in multivariable analyses, every 1% increase in energy intake from fat increased the risk of MS relapse by 4% (adjusted hazard rate [HR]: 1.04, Confidence Interval [CI]: 1.0-1.08, P =.04). However, patients with a high intake of vegetables had a lower risk of relapse (adjusted HR: 0.58, CI: 0.35-0.96, P =.03).

Patients’ total energy intake and percentage of energy obtained from carbohydrates, proteins, fruits, and fibers were not associated with a risk of relapse.

“This study suggests that high energy intake from fat may increase the risk of MS relapse in children while vegetable intake may be protective. These findings, if confirmed, may have direct clinical implications for dietary recommendations for patients with MS,” the authors concluded.

The authors report no relevant disclosures.

For more coverage of ECTRIMS 2016, go here. 


Azary S, Graves J, Schreiner T, et al. Diet is associated with relapse rate in pediatric multiple sclerosis. Presented at: ECTRIMS 2016. September 14-17, 2016; London, UK. Poster 295.