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Diet and Multiple Sclerosis: Is There a Relationship?
Multiple Sclerosis Centers of Excellence
Diet and Multiple Sclerosis: Is There a Relationship?
Vijayshree Yadav, MD, MCR, FANA, FAAN
Research suggests that vascular disease risk factors (VDRFs) such as obesity, hypertension, hyperlipidemia, and diabetes contribute to the worsening of disability in people with multiple sclerosis (MS). Studies involving thousands of people with MS indicate that nearly 50% have at least one VDRF at the time of their diagnosis. Among Veterans, VDRFs are highly prevalent, with over 80% of Veterans with MS having at least two of these risk factors. A pilot study at the VA in Portland, OR, found that hypertension, hyperlipidemia, and diabetes were common among Veterans with MS, further emphasizing the connection between these comorbidities and MS progression.
Obesity, defined as a body mass index (BMI) over 30, is strongly linked to increased disability in MS. Being overweight or obese can also lead to other serious health conditions, such as diabetes, hypertension, and depression. These comorbidities decrease quality of life and increase the odds of disability.
Hypertension may be another factor in MS progression. Research from the North American Research Committee on MS (NARCOMS) registry found that individuals with MS and hypertension had a significantly higher risk of disability, including gait problems and visual disability. The study showed that people with MS who developed hypertension had a 32% higher risk of mild visual disability and a 16% higher risk of severe visual disability.
Hyperlipidemia, specifically high levels of low-density lipoprotein (LDL) cholesterol, has also been associated with greater MS-related disability. Conversely, higher levels of high-density lipoprotein (HDL) cholesterol appear to reduce inflammatory disease activity in the brain, as seen in MRI studies.
Diabetes mellitus type 2 (DMII) is prevalent in about 5% (2-9%) of people with MS worldwide. Those with DMII had a much higher risk of developing MS-related disability, including difficulties with mobility and vision.
Ongoing research at the VA Portland Health Care System and Oregon Health & Science University aims to better understand the relationship between VDRFs and MS progression. The current study includes MRI scans and various tests to assess the impact of VDRFs on brain function and disease progression. The researchers hope to identify ways in which improving vascular health might slow the progression of MS and help develop interventions to manage VDRFs in people with MS.
The study underscores the importance of early identification and management of VDRFs in people with MS. Although managing VDRFs may not cure MS, addressing these factors could potentially slow disease progression, improve quality of life, and reduce the risk of additional comorbidities.
