Proinflammatory diets in women may increase their likelihood of a first clinical diagnosis of central nervous system demyelination (FCD), a common precursor to multiple sclerosis (MS), according to a new study published in Multiple Sclerosis and Related Disorders.

The authors found that women who had FCD during the study period (case, n=205) had higher median scores on the Dietary Inflammatory Index (DII) than women in the control group (control, n=394), which indicated a more proinflammatory diet (2.02 vs 1.61; P <.01).

In a multivariate analysis, a higher DII score in women increased the likelihood of FCD and a classic first demyelinating event (FDE). A 17% increase in FCD likelihood was observed for each one-unit increase in DII score.

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“Our results suggest that an anti-inflammatory diet may offer a protective effect against the likelihood of FCD in women. Longitudinal research is needed to explore whether an anti-inflammatory diet might also influence the disease progression of MS,” the authors said.

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The women (n=599) also had much higher median DII scores (1.76 vs 0.25; P <.0001) than men (n=175). Median DII values were not significantly different between case and control groups for men (0.11 vs 0.32; P =.37).

Total energy intake was also estimated for participants and was significantly correlated with DII for both men and women using univariate regressions. However, in a multivariate analysis including FCD, energy intake was no longer significantly related.

Participants were recruited as part of the Australian Ausimmune Study. One to 4 participants in the control group were recruited per case in the study using the Australian Electoral Roll. Participants were asked to complete the Cancer Council Victoria Dietary Questionnaire for Epidemiological Studies version 2 food frequency questionnaire to assess their dietary habits.

FCD included patients with an incident of a classic FDE as well as patients who had a history of past undiagnosed demyelinating events.


Mannino A, Lithander FE, Dunlop E, et al. A proinflammatory diet is associated with an increased likelihood of first clinical diagnosis of central nervous system demyelination in women. Mult Scler Relat Disord. 2021;57. doi:10.1016/j.msard.2021.103428.