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.

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 (ß = 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.

Dietetic intervention in psoriatic arthritis: the DIETA trial.

AIM: To evaluate whether dietary pattern changes, antioxidant supplementation or 5-10% weight loss could improve disease activity (skin and joint) in patients with psoriatic arthritis (PsA). METHODS: A total of 97 PsA patients were enrolled in this 12-week randomized, double-blinded, placebo-controlled trial. Patients were randomized into three groups: Diet-placebo (hypocaloric diet + placebo supplementation); Diet-fish (hypocaloric diet + 3 g/day of omega-3 supplementation; and Placebo. Food intake (3-day registry, Healthy Eating Index (HEI), and the Dietary Inflammatory Index (DII)), body composition (whole-body dual-energy X-ray absorptiometry (DXA), weight and waist circumference) and disease activity (PASI, BSA, BASDAI, DAS28-ESR, DAS28-CRP and MDA) were evaluated at baseline and after the 12-week intervention. Statistical analysis used the intention-to-treat approach. The P value was considered to indicate significance when below 0.05. RESULTS: After 12 weeks, DAS28-CRP and BASDAI scores improved, especially in the Diet-placebo group (- 0.6 ± 0.9; p = 0.004 and - 1.39 ± 1.97; p = 0.001, respectively). In addition, a higher proportion of patients achieved minimal disease activity (MDA) in all groups. The Diet-fish group showed significant weight loss (- 1.79 ± 2.4; p = 0.004), as well as waist circumference (- 3.28 ± 3.5, p < 0.001) and body fat (- 1.2 ± 2.2, p = 0.006) reductions. There was no significant correlation between weight loss and disease activity improvement. Each 1-unit increase in the HEI value reduced the likelihood of achieving remission by 4%. Additionally, each 100-cal daily intake increase caused a 3.4-fold DAS28-ESR impairment. CONCLUSION: A 12-week hypocaloric intervention provided suitable control of joint disease activity in patients with PsA, regardless of weight loss. Adding omega-3 supplementation caused relevant body composition changes but not disease activity improvement. TRIAL REGISTRATION: The study was recorded on Clinicaltrials.gov (NCT03142503).

Greater cumulative exposure to a pro-inflammatory diet is associated with higher metabolic syndrome score and blood pressure in young Mexican adults.

Low-grade inflammation is a suggested mechanism in the development of metabolic syndrome (MetS), and diet could act as a regulator. Therefore, we hypothesized that the cumulative Dietary Inflammatory Index (DII®) exposure from diet during infancy through adulthood would be positively associated with the MetS and its components in young Mexican adults. One hundred participants from the Early Life Exposures in Mexico to Environmental Toxicants cohort were included in this analysis. The dietary inflammatory potential of the diet (without supplements) was assessed using 27 nutrients obtained from repeated food frequency questionnaires (1-22 years) using the DII, a validated score. The cumulative exposure of DII was constructed using the area under the curve (AUC of DII). The MetS was defined using the International Diabetes Federation criteria, and the Metabolic Syndrome Risk Z-score (MetRisk Z-score) was estimated. Linear regressions were conducted to assess the association between the AUC of DII with MetRisk Z-score and MetS components, adjusting for sex, socioeconomic status, smoking status, physical activity, birth weight, and body mass index. In adulthood, the mean age was 21.5 years, 54% were male, and 17% had MetS. Positive associations were found between AUC of DII with MetRisk Z-score (ß = .12; 95% confidence interval [CI]: 0.03-0.22; P = .009) and systolic (ß = .33; 95% CI: 0.05-0.61; P = .023) and diastolic blood pressure (ß = .24; 95% CI: 0.01-0.47; P = .040). A cumulative proinflammatory diet from infancy through young adulthood is associated with higher MetRisk Z-scores as well as blood pressure. These findings may provide evidence for the implementation of anti-inflammatory diet interventions throughout early life for the prevention of cardiometabolic risk.