Dietary and Lifestyle Factors in Multiple Sclerosis Progression: Results from a 5-year Longitudinal MRI Study (P5.2-002)

Objective: To assess the effect of lifestyle-based risk factors linked to cardiovascular disease (CVD) on clinical and MRI-derived multiple sclerosis (MS) outcomes. Background: Evidence for the role, if any, of dietary and lifestyle factors in MS pathophysiology is important for clinical patient care, but the relationship remains poorly understood. Design/Methods: This study enrolled 175 clinically isolated syndrome (CIS)/MS patients and 42 age-, sex-matched healthy controls (HCs) who were longitudinally followed for 5.5 years. The 20-year CVD risk was calculated by Healthy Heart Score (HHS) prediction model that included age, smoking, body mass index, dietary intake, exercise, and alcohol consumption. The dietary intake was additionally used in an independent analysis. Baseline and follow-up MRI scans were obtained and cross-sectional and longitudinal changes of T2-lesion volume (LV), whole brain volume (WBV), white matter volume (WMV), gray matter volume (GMV), and lateral ventricular volume (LVV) were measured. Results: The age component of the HHS had the highest individual associations with MRI-derived volumes in both MS patients and HCs. After correcting for disease duration, the baseline HHS values of the MS group were associated with baseline GMV (r=−0.20, p=0.01), and longitudinal LVV change (r=0.19, p=0.01). The diet HHS score was associated with 5-year T2-LV accrual (r=−0.191, p=0.04). In the HC group, the HHS was associated with LVV (r=0.58, p Conclusions: Higher lifestyle risk score was associated with accelerated central brain atrophy in MS patients. In independent analysis, unhealthier diet was associated with lesion accrual. The lower magnitude of associations observed in MS patients, compared to HCs, may be explained by independent MS-specific pathophysiological processes that contribute to additional brain damage. Disclosure: Dr. Hagemeier has nothing to disclose. Dr. Jakimovski has nothing to disclose. Dr. Weinstock-Guttman has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Biogen Idec, EMD Serono, Genentech, Novartis, Mallinckrodt, and Celgene. Dr. Weinstock-Guttman has received research support from Biogen Idec, Novartis, and Genentech. Dr. Gandhi has nothing to disclose. Dr. Guan has nothing to disclose. Dr. Ramasamy has nothing to disclose. Dr. Fuchs has nothing to disclose. Dr. Bergsland has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with EMD Serono. Dr. Dwyer has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Buffalo Neuroimaging Analysis Center. Dr. Dwyer has received research support from Novartis. Dr. Ramanathan has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with EMD Serono, Biogen Idec, Pfizer Inc, the National Multiple Sclerosis Society, the Department of Defense, Jog for the Jake Foundation, the National Institutes of Health and National Science Foundation. Dr. Ramanathan has received personal compensation in an editorial capacity for Editor from the American Association of Pharmaceutical Scientists. Dr. Ramanathan has received research support from EMD Serono, Biogen Idec, Pfizer Inc, the National Multiple Sclerosis Society, the Department of Defense, Jog for the Jake Foundation, the National Institutes of Health and National Science Foundation. Dr. Zivadinov has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with EMD Serono, Genzyme-Sanofi, and Novartis. He received financial support for research activities from Teva Pharmaceuticals, Biogen-Idec, Genzyme-Sanofi, Novartis, Claret Medical, Intekrin-Coherus and IMS Health.