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A higher Mediterranean diet score, including unprocessed red meat, is associated with reduced risk of central nervous system demyelination in a case-control study of Australian adults

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Black, LJ, Baker, K, Ponsonby, A-L, van der Mei, I ORCID: 0000-0001-9009-7472, Lucas, RM and Pereira, G 2019 , 'A higher Mediterranean diet score, including unprocessed red meat, is associated with reduced risk of central nervous system demyelination in a case-control study of Australian adults' , Journal of Nutrition, vol. 149, no. 8 , pp. 1385-1392 , doi: 10.1093/jn/nxz089.

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Abstract

Background: The evidence associating diet and risk of multiple sclerosis (MS) is inconclusive.Objectives: The aim of this study was to investigate associations between a Mediterranean diet and risk of a first clinical diagnosis of central nervous system demyelination (FCD), a common precursor to MS.Methods: We used data from the 2003-2006 Ausimmune Study, an Australian multicenter, case-control study examining environmental risk factors for FCD, with participants matched on age, sex, and study region (282 cases, 558 controls; 18-59 y old; 78% female). The alternate Mediterranean diet score (aMED) was calculated based on data from a food-frequency questionnaire. We created a modified version of the aMED (aMED-Red) where ∼1 daily serving (65 g) of unprocessed red meat received 1 point. All other components remained the same as aMED. Conditional logistic regression (254 cases, 451 controls) was used to test associations between aMED and aMED-Red scores and categories and risk of FCD, adjusting for history of infectious mononucleosis, serum 25-hydroxyvitamin D concentrations, smoking, education, total energy intake, and dietary underreporting.Results: There was no statistically significant association between aMED and risk of FCD [per 1-SD increase in aMED score: adjusted odds ratio (aOR): 0.89; 95% CI: 0.75, 1.06; P = 0.181]. There was evidence of a nonlinear relation between aMED-Red and risk of FCD when a quadratic term was used (P = 0.016). Compared with the lowest category of aMED-Red, higher categories were significantly associated with reduced risk of FCD, corresponding to a 37% (aOR: 0.63; 95% CI: 0.41, 0.98; P = 0.039), 52% (aOR: 0.48; 95% CI: 0.28, 0.83; P = 0.009), and 42% (aOR: 0.58; 95% CI: 0.35, 0.96; P = 0.034) reduced risk of FCD in categories 2, 3, and 4, respectively.Conclusions: A Mediterranean diet, including unprocessed red meat, was associated with reduced risk of FCD in this Australian adult population. The addition of unprocessed red meat to a Mediterranean diet may be beneficial for those at high risk of MS.

Item Type: Article
Authors/Creators:Black, LJ and Baker, K and Ponsonby, A-L and van der Mei, I and Lucas, RM and Pereira, G
Keywords: Ausimmune study, Mediterranean diet, multiple sclerosis, nutrition and disease, nutritional epidemiology
Journal or Publication Title: Journal of Nutrition
Publisher: American Society for Nutrition
ISSN: 0022-3166
DOI / ID Number: 10.1093/jn/nxz089
Copyright Information:

Copyright 2019 American Society for Nutrition

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