The consumption of oily fish and raw vegetables may lower the risk of aquaporin-4 antibody-positive (AQP4+) neuromyelitis optica spectrum disorder (NMOSD), according to a study published in Scientific Reports.

The study utilized a 2-sample Mendelian randomization (MR) design and found that high consumption of oily fish and raw vegetables significantly reduced the risk of AQP4+ NMOSD. Using an inverse variance-weighted MR method resulted in odds ratios (ORs) of 0.006 (95% CI, 4.18×10-5 to 0.885; P =.045) and 5.28×10-6 (95% CI, 4.67×10-11 to 0.598; P =.041) for oily fish and raw vegetables, respectively. 

Read more about NMOSD risk factors

Continue Reading

Horizontal pleiotropy without heterogeneity was identified for oily fish consumption, so MR-Egger analysis was also performed, which yielded an OR of 1.78×10-16 (95% CI, 2.60×10−25 to 1.22×10−7; P =.001). Heterogeneity and pleiotropy were not observed for raw vegetable consumption.

None of the 24 other food intake exposures considered in the study were found to be significantly associated with the risk of AQP4+ NMOSD.

“In conclusion, oily fish and raw vegetable consumption can decrease the risk of AQP4-positive NMOSD,” the authors wrote.

“Further research is needed to determine the exact causal relationship and mechanisms underlying the association between specific food intake and AQP4-positive NMOSD,” the authors added.

The authors hypothesized that the anti-inflammatory effects of the omega-3 polyunsaturated fatty acids found in oily fish, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and improved gut microfloral profiles may play a role in reducing the risk of AQP4+ NMOSD.

The authors also speculated that the high levels of antioxidants could reduce the risk of NMOSD and AQP4 seropositivity for raw vegetables.

The study included 132 patients with NMOSD and 784 control participants. In a previous genome-wide association study, 747 single-nucleotide polymorphisms (SNPs) were associated with 29 lifestyle and dietary factors.


Wang S, Pan L, Wu R, et al. Oily fish and raw vegetable consumption can decrease the risk of AQP4-positive neuromyelitis optica spectrum disorders: a Mendelian-randomization study. Sci Rep. Published online June 9, 2023. doi:10.1038/s41598-023-36372-1