Mediterranean Diet and Associations with the Gut Microbiota and Pediatric-onset Multiple Sclerosis Using Trivariate Analysis

Overview

Journal Commun Med (Lond)

Publisher Nature Portfolio

Specialty General Medicine

Date 2024 Jul 19

PMID 39030379

Authors

Ali I Mirza

Feng Zhu

Natalie Knox

Lucinda J Black

Alison Daly

Christine Bonner

Gary Van Domselaar

Charles N Bernstein

Ruth Ann Marrie

Janace Hart

E Ann Yeh

Amit Bar-Or

Julia OMahony

Yinshan Zhao

William Hsiao

Brenda Banwell

Emmanuelle Waubant

Helen Tremlett

Affiliations

Soon will be listed here.

Abstract

Background: The interplay between diet and the gut microbiota in multiple sclerosis (MS) is poorly understood. We aimed to assess the interrelationship between diet, the gut microbiota, and MS.

Methods: We conducted a case-control study including 95 participants (44 pediatric-onset MS cases, 51 unaffected controls) enrolled from the Canadian Pediatric Demyelinating Disease Network study. All had completed a food frequency questionnaire ≤21-years of age, and 59 also provided a stool sample.

Results: Here we show that a 1-point increase in a Mediterranean diet score is associated with 37% reduced MS odds (95%CI: 10%-53%). Higher fiber and iron intakes are also associated with reduced MS odds. Diet, not MS, explains inter-individual gut microbiota variation. Several gut microbes abundances are associated with both the Mediterranean diet score and having MS, and these microbes are potential mediators of the protective associations of a healthier diet.

Conclusions: Our findings suggest that the potential interaction between diet and the gut microbiota is relevant in MS.

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PMID: 39599673 PMC: 11597849. DOI: 10.3390/nu16223887.

References

Sedaghat F, Jessri M, Behrooz M, Mirghotbi M, Rashidkhani B . Mediterranean diet adherence and risk of multiple sclerosis: a case-control study. Asia Pac J Clin Nutr. 2016; 25(2):377-84. DOI: 10.6133/apjcn.2016.25.2.12. View

Noormohammadi M, Ghorbani Z, Naser Moghadasi A, Saeedirad Z, Shahemi S, Ghanaatgar M . MIND Diet Adherence Might be Associated with a Reduced Odds of Multiple Sclerosis: Results from a Case-Control Study. Neurol Ther. 2022; 11(1):397-412. PMC: 8857348. DOI: 10.1007/s40120-022-00325-z. View

Armon-Omer A, Waldman C, Simaan N, Neuman H, Tamir S, Shahien R . New Insights on the Nutrition Status and Antioxidant Capacity in Multiple Sclerosis Patients. Nutrients. 2019; 11(2). PMC: 6413226. DOI: 10.3390/nu11020427. View

Vandeputte D, Falony G, Vieira-Silva S, Tito R, Joossens M, Raes J . Stool consistency is strongly associated with gut microbiota richness and composition, enterotypes and bacterial growth rates. Gut. 2015; 65(1):57-62. PMC: 4717365. DOI: 10.1136/gutjnl-2015-309618. View

Valdes A, Walter J, Segal E, Spector T . Role of the gut microbiota in nutrition and health. BMJ. 2018; 361:k2179. PMC: 6000740. DOI: 10.1136/bmj.k2179. View

Cekanaviciute E, Yoo B, Runia T, Debelius J, Singh S, Nelson C . Gut bacteria from multiple sclerosis patients modulate human T cells and exacerbate symptoms in mouse models. Proc Natl Acad Sci U S A. 2017; 114(40):10713-10718. PMC: 5635915. DOI: 10.1073/pnas.1711235114. View

Cao Z, Liang J, Liao X, Wright A, Wu Y, Yu B . Effect of dietary fiber on the methanogen community in the hindgut of Lantang gilts. Animal. 2016; 10(10):1666-76. DOI: 10.1017/S1751731116000525. View

Zhang Y, Liu Y, Li J, Xing T, Jiang Y, Zhang L . Dietary resistant starch modifies the composition and function of caecal microbiota of broilers. J Sci Food Agric. 2019; 100(3):1274-1284. DOI: 10.1002/jsfa.10139. View

Black L, Hetherton S, Forkan M, Gonzales E, Smith J, Daly A . An exploratory study of diet in childhood and young adulthood and adult-onset multiple sclerosis. Mult Scler. 2021; 27(10):1611-1614. PMC: 8286980. DOI: 10.1177/1352458520986964. View

10.

Sand I, Benn E, Fabian M, Fitzgerald K, Digga E, Deshpande R . Randomized-controlled trial of a modified Mediterranean dietary program for multiple sclerosis: A pilot study. Mult Scler Relat Disord. 2019; 36:101403. DOI: 10.1016/j.msard.2019.101403. View

11.

Berer K, Gerdes L, Cekanaviciute E, Jia X, Xiao L, Xia Z . Gut microbiota from multiple sclerosis patients enables spontaneous autoimmune encephalomyelitis in mice. Proc Natl Acad Sci U S A. 2017; 114(40):10719-10724. PMC: 5635914. DOI: 10.1073/pnas.1711233114. View

12.

Rotstein D, Cortese M, Fung T, Chitnis T, Ascherio A, Munger K . Diet quality and risk of multiple sclerosis in two cohorts of US women. Mult Scler. 2018; 25(13):1773-1780. PMC: 6478561. DOI: 10.1177/1352458518807061. View

13.

Flanagin A, Frey T, Christiansen S . Updated Guidance on the Reporting of Race and Ethnicity in Medical and Science Journals. JAMA. 2021; 326(7):621-627. DOI: 10.1001/jama.2021.13304. View

14.

Olsson T, Barcellos L, Alfredsson L . Interactions between genetic, lifestyle and environmental risk factors for multiple sclerosis. Nat Rev Neurol. 2016; 13(1):25-36. DOI: 10.1038/nrneurol.2016.187. View

15.

Pan X, Xue F, Nan X, Tang Z, Wang K, Beckers Y . Illumina Sequencing Approach to Characterize Thiamine Metabolism Related Bacteria and the Impacts of Thiamine Supplementation on Ruminal Microbiota in Dairy Cows Fed High-Grain Diets. Front Microbiol. 2017; 8:1818. PMC: 5611408. DOI: 10.3389/fmicb.2017.01818. View

16.

Tremlett H, Zhu F, Arnold D, Bar-Or A, Bernstein C, Bonner C . The gut microbiota in pediatric multiple sclerosis and demyelinating syndromes. Ann Clin Transl Neurol. 2021; 8(12):2252-2269. PMC: 8670321. DOI: 10.1002/acn3.51476. View

17.

Imai K, Keele L, Tingley D . A general approach to causal mediation analysis. Psychol Methods. 2010; 15(4):309-34. DOI: 10.1037/a0020761. View

18.

Sand I, Levy S, Fitzgerald K, Sorets T, Sumowski J . Mediterranean diet is linked to less objective disability in multiple sclerosis. Mult Scler. 2022; 29(2):248-260. PMC: 9918647. DOI: 10.1177/13524585221127414. View

19.

Sand I . The Role of Diet in Multiple Sclerosis: Mechanistic Connections and Current Evidence. Curr Nutr Rep. 2018; 7(3):150-160. PMC: 6132382. DOI: 10.1007/s13668-018-0236-z. View

20.

Nihiser A, Lee S, Wechsler H, McKenna M, Odom E, Reinold C . Body mass index measurement in schools. J Sch Health. 2007; 77(10):651-71. DOI: 10.1111/j.1746-1561.2007.00249.x. View