Higher fish consumption was associated with a lower risk of disability progression in patients with multiple sclerosis, a recent longitudinal study found.
Published in the Journal of Neurology, Neurosurgery & Psychiatry, researchers reported that greater intake of both lean and oily fish reduced the risk of confirmed disability worsening (CDW) and progression to Expanded Disability Status Scale (EDSS) scores of 3 and 4.
Analyzing data from 2,719 incident cases in the Swedish Epidemiological Investigation of MS (EIMS) cohort, researchers observed that patients with the highest fish consumption at diagnosis (scoring 6 on a frequency scale of 2-6) had a significantly lower risk of CDW (HR, 0.66; 95% CI, 0.51-0.86), EDSS 3 (HR, 0.55; 95% CI, 0.39-0.79), and EDSS 4 (HR, 0.57; 95% CI, 0.33-0.96) compared with those with low fish intake. These associations remained significant after adjusting for age, sex, disease phenotype, disease duration, and disease-modifying therapy use.
Follow-up data up to 15 years post-diagnosis, including a 2021 dietary assessment of 1,719 respondents, revealed that patients who maintained or increased fish intake experienced a stronger protective effect. Those shifting from the lowest to highest intake category had the most pronounced reduction in CDW risk (HR, 0.41; 95% CI, 0.17-0.95).
"Our findings suggest that higher fish consumption is associated with a reduced risk of disability progression in MS, likely due to the anti-inflammatory and neuroprotective properties of nutrients found in fish. These results highlight the potential importance of dietary habits in managing MS," said Eva Johansson from the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Both lean and oily fish intake were linked to lower CDW risk (HR, 0.84; 95% CI, 0.71-1.00 and HR, 0.81; 95% CI, 0.68-0.97, respectively), with the strongest benefits seen in individuals consuming both regularly. Researchers suggest that omega-3 fatty acids, taurine, and dietary influences on gut microbiota may play roles in modulating immune responses in MS. Notably, adjustment for vitamin D levels had minimal impact on the observed associations, suggesting other nutrients in fish may be more important.
Despite the study's large sample and extended follow-up, its observational nature limits causal inference, and self-reported dietary data may introduce recall bias. Researchers emphasize the need for further studies to validate these findings and explore underlying mechanisms.
The study, conducted by Karolinska Institutet and China Agricultural University, was funded by the Swedish Research Council, the Swedish Research Council for Health, Working Life and Welfare, the Swedish Brain Foundation, the Swedish Medical Research Council, Margaretha af Ugglas Foundation, the Swedish Foundation for MS Research, and NEURO Sweden.
Conflict of interest disclosures for this study are outlined in the published article.
