Multiple sclerosis and related disorders · 2025
Diet-dependent acid-base load is not associated with rate of relapse, annualised disability change, FLAIR, and black hole lesion volume on MRI in a prospective cohort study of those with multiple sclerosis.
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Saul A, Taylor B V, Blizzard L, Simpson-Yap S, Probst Y C, Black L J, Ponsonby A L, Broadley S A, Lechner-Scott J, Ausimmune/AusLong Investigators Group, van der Mei I
Аннотация
PURPOSE: A higher diet-dependent acid-base load has been associated with low grade inflammation and selected medical conditions. No study has examined the association between diet-dependent acid-base load and progression or inflammatory activity measures in persons with multiple sclerosis (MS).
METHODS: A prospective cohort, aged 18-59 years at study entry, was followed annually for ten years as part of the AusLong Study. At study entry, participants (n = 223) received a first clinical diagnosis of central nervous system demyelination. Potential Renal Acid Load (PRAL) and Net Endogenous Acid Production (NEAP) were calculated using dietary intake data (previous 12 months) from a food frequency questionnaire measured at the baseline 5- and 10-year AusLong reviews. We examined the association between PRAL and NEAP with measures of MS progression and inflammatory activity, including time to relapse, annualised disability change (Expanded Disability Status Scale [EDSS]), fluid-attenuated inversion recovery (FLAIR) lesion volume, and black hole lesion volume (ml).
RESULTS: We observed no association between PRAL or NEAP with the rate of relapse in the continuous form (p = 0.35). When examining the PRAL and NEAP as categorical variables, the highest PRAL quartile, but not the NEAP, was associated with a lower risk of relapse rather than a higher risk, as hypothesised (Q4 vs Q1: adjusted Hazard Ratio=0.26, 95 %CI=0.10, 0,65, p = 0.004; p for trend 0.06). There was no significant association between PRAL or NEAP, either using the continuous form or when assessed as categorical variables, with annualised EDSS change, FLAIR lesion volume, or black hole lesion volume in any region.
CONCLUSION: Our findings indicate that a higher diet-dependent acid-base load is not associated with a worsening in MS progression and measured inflammatory activity measures.
METHODS: A prospective cohort, aged 18-59 years at study entry, was followed annually for ten years as part of the AusLong Study. At study entry, participants (n = 223) received a first clinical diagnosis of central nervous system demyelination. Potential Renal Acid Load (PRAL) and Net Endogenous Acid Production (NEAP) were calculated using dietary intake data (previous 12 months) from a food frequency questionnaire measured at the baseline 5- and 10-year AusLong reviews. We examined the association between PRAL and NEAP with measures of MS progression and inflammatory activity, including time to relapse, annualised disability change (Expanded Disability Status Scale [EDSS]), fluid-attenuated inversion recovery (FLAIR) lesion volume, and black hole lesion volume (ml).
RESULTS: We observed no association between PRAL or NEAP with the rate of relapse in the continuous form (p = 0.35). When examining the PRAL and NEAP as categorical variables, the highest PRAL quartile, but not the NEAP, was associated with a lower risk of relapse rather than a higher risk, as hypothesised (Q4 vs Q1: adjusted Hazard Ratio=0.26, 95 %CI=0.10, 0,65, p = 0.004; p for trend 0.06). There was no significant association between PRAL or NEAP, either using the continuous form or when assessed as categorical variables, with annualised EDSS change, FLAIR lesion volume, or black hole lesion volume in any region.
CONCLUSION: Our findings indicate that a higher diet-dependent acid-base load is not associated with a worsening in MS progression and measured inflammatory activity measures.