In some cases, MS begins during childhood, but why it can start so early and why some children have more relapses than others is not clear.
Laboratory models of MS have previously shown that a diet high in fats increases the number of immune cells moving into the brain and spinal cord. These immune cells may then cause the inflammation that leads to the symptoms of MS. However, the role of diet, and specifically the amount of fat one eats, on the rate of relapses in children has not been well studied.
In this study published in the Journal of Neurology, Neurosurgery and Psychiatry, researchers from the USA investigated the relationship between diet and relapse rate in children. They found that children eating a diet high in fat were more likely to have a relapse, and that a diet higher in vegetables was linked to fewer relapses.
The researchers examined the diets of 219 children with relapsing remitting MS (RRMS) or clinically isolated syndrome (CIS – the first episode of MS-like symptoms) from 11 centres around the USA. Upon enrolment in the study the children and a caregiver were asked to complete a Block Kids Food Screener (BKFS) survey. This is a food frequency questionnaire designed for children between the ages of 2 to 17. This questionnaire has been validated in other studies as a method for accurately estimating the amount of different types of foods children eat.
The team compared the diets of children that had at least one relapse to those that did not. They found that a 10% increase in energy intake from fat was associated with a 56% increase in the chance of a child having a relapse. The connection with relapses was strongest particularly for the amount of saturated fat in the diet.
They also discovered that a diet high in vegetables was associated with a 50% lower likelihood of having a relapse.
The researchers did not find any association with the intake of fruits, fibre, carbohydrates, sugar, iron, cholesterol and dairy and risk of or protection from a relapse. While this study looked specifically at the risk of relapses in children who already have MS, an [arlier study had shown a link between low iron in children and the risk of developing MS.
It is thought that a high fat diet may contribute to relapses in MS as it causes the release of molecules that promote inflammation in the whole body, thereby increasing the chances of an inflammatory attack in MS.
There are some limitations to this research which will require further study before firm conclusions can be made. Mainly, the diet of the children was compared at the time that they enrolled in the study rather than across the whole period in which relapses were studied. It is possible that the children’s diet may have changed during the study, which may have affected the rate of relapses. A prospective study that follows both diet and relapses over time would help to clarify this.
Other factors such as alcohol, coffee and smoking are not included in the food survey, which could also affect relapse rates, however, they are less likely to be a factor, particularly for the younger children.
This research suggests that a healthy diet may be useful in reducing the frequency of future relapses in children with MS, but more research is required to confirm that making changes to the diet can reduce relapses, whether and how fat affects the immune system and inflammatory responses in children, and how this may be linked to MS.
