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Sugary Drinks May Up Disability in MS

— But overall diet quality not associated with disability status

MedpageToday

PHILADELPHIA -- Drinking sugar-sweetened beverages was associated with worsened multiple sclerosis-related disability, researchers in Germany reported.

In an analysis of 135 people with MS, those ranked in the highest quartile for sugar-sweetened beverage (SSB) intake had five-fold higher odds for severe disability versus mild-to-moderate disability (OR 5.01, 95% CI 1.03-24.37, P=0.01 for trend), reported Elisa Meier-Gerdingh, MD, of St. Josef Hospital in Bochum, and colleagues.

However, the overall diet quality -- assessed by score -- wasn't tied to disability status for these patients, according to an early-release abstract from the American Academy of Neurology meeting to be held here in May.

"Diet is an important determinant of metabolic comorbidity in the general population and influences mechanisms implicated in MS (e.g., immune function, oxidative stress, the gut microbiota)," the authors wrote.

"When people with MS are confronted with their diagnosis, they often want to know how they can contribute positively to the course of their disease besides using the medication available," Meier-Gerdingh explained to app. She added how the number of studies looking at diet's influence on MS progression is rather limited.

"Due to the lack of reliable data, people often restrict their diets in multiple ways following guidelines they find on the Internet without having proof for their benefit," Meier-Gerdingh said.

The researchers analyzed cross-sectional data from the participants (73% female; mean age 44.6). Utilizing a 102-item food frequency questionnaire, they computed each of the participants DASH score ranging from 8 (poor quality) up to 40 (high quality).

The questionnaire gathered information on consumption of healthy foods like nuts and legumes, whole-grains and dairy, and weighed it against the intake of unhealthy foods, including intake of sodium, red and processed meats, as well as sugar-sweetened beverages.

The authors found that the highest consumption group consumed around 290 calories per day of soda or other sugar-sweetened beverages, which is the equivalent of about two cans of non-diet soda. The lowest consumption group drank an average of seven calories in sugar-sweetened beverages per day (the equivalent of 1.5 cans of non-diet soda per month).

Each of the adult participants also underwent a neurologic exam to rate disability status ranked on the Expanded Disability Status Scale; 30 of these patients were considered to have severe disability (a score of ≥6).

Meier-Gerdingh said she was surprised by the study results. "In the past, several nutritional components like fish, saturated fatty acids, or vitamin D have been discussed as potential influencing factors in context with MS," she explained, noting that research was done prior to the greater societal focus on potential health issues related to sugar-sweetened beverages.

"Nevertheless, people with MS are at increased risk of metabolic disorders and the consumption of sugar sweetened beverages is -- referring to the DASH score weighting SSBs besides other food components as unfavorable -- a critical aspect of an 'unhealthy diet' contributing to a higher risk of developing chronic diseases like adiposity or hypertension," she said.

The cross-sectional design limited the ability to show causation. Meier-Gerdingh said one question that remains unanswered is if greater intake of sugar-sweetened beverages leads to worse outcomes in MS, or if more severe disease makes it's more difficult for the individual to adhere to a healthier diet.

"So at the moment it is too early to derive nutritional guidelines or recommendations from our results," she stated, adding that "on basis of our results we believe it to be worthy to collect more longitudinal data in the future."

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    Kristen Monaco is a senior staff writer, focusing on endocrinology, psychiatry, and nephrology news. Based out of the New York City office, she’s worked at the company since 2015.

Primary Source

American Academy of Neurology

Meier-Gerdingh E, et al "Dietary Intake and the Effect on Disease Progression in People with Multiple Sclerosis" AAN 2019.