FRIDAY, March 30 (HealthDay News) -- Dietary factors and
cigarette smoking may alter the course of disease in patients with
a milder form of multiple sclerosis, a new study finds.
Out of nearly 900 patients with what is called "relapsing onset"
multiple sclerosis (MS), those who regularly consumed alcohol,
caffeine and fish were less likely to progress to the point that
they needed help walking, which is considered a milestone in the
course of the disease. In contrast, cigarette smoking was
associated with an increased risk of becoming disabled.
One explanation is that dietary factors might have a direct
protective effect on MS patients, said Dr. Marie D'hooghe, a
clinical neurologist in Belgium and lead author of the study.
Caffeine, fish and alcohol at low to moderate levels are all known
to have anti-inflammatory properties, and focal, or localized,
inflammation in the brain and spinal cord is an important aspect of
However, the study did not prove that caffeine and alcohol will
slow MS, an incurable disease of the nervous system, and patients
should not use these findings as a reason to suddenly start brewing
coffee and sipping cocktails.
Also, the study only saw the associations between diet and
smoking and disease progression among patients with
relapsing-remitting MS, and not among those with what is known as
primary progressive MS.
This suggests that progressive MS is a distinct phase of the
disease with different mechanisms, D'hooghe said. "Degeneration [of
nerve cells] is probably more relevant in progressive onset and
inflammation is not as important," she said.
MS affects more than 350,000 people in the United States and
about 2.5 million worldwide. Most patients experience
relapsing-remitting MS, which has a variable disease course
involving alternating attacks and recovery periods, while about 15
percent of patients have primary progressive MS, marked by a steady
worsening of the disease.
The new study is published in the April issue of the
European Journal of Neurology.
For the study, researchers mailed questionnaires to patients
registered with the Flemish MS Society, asking about their
consumption of alcohol, wine, coffee, tea and fish, as well as
about cigarette smoking.
The questionnaires also asked patients about their disease
(relapsing or progressive), and whether they had reached the stage
that they needed a cane or other support to walk about 330 feet,
and if so, how long after disease diagnosis they reached that
The study included almost 1,400 participants, about 900 with
relapsing-remitting MS and almost 500 with primary progressive MS.
They were between 17 and 89 years of age.
Researchers found that the association between delayed disease
progression and consumption of alcohol, caffeine and fish among
relapsing MS patients was stronger for patients with greater
For example, patients who did not consume any alcohol took about
25 years to progress to the stage of disease where they needed
support to walk. However, those who had either less than one drink
or at least one alcoholic drink per week reached this stage at
around 28 and 32 years, respectively.
In contrast, smoking appeared to accelerate disease progression.
Smoking is known to be a risk factor for developing MS, and could
also play a role in disease progression, D'hooghe said.
Still, it remains possible that diet and smoking do not affect
the disease's course, D'hooghe noted. Instead, people who drink
alcohol and caffeine and eat fish might be more likely to make
other lifestyle or diet choices that affect the disease.
Another possibility, D'hooghe added, is that the MS patients who
are able to enjoy a glass of wine or go out to buy fish are also
the ones who have less advanced disease.
But even if dietary factors are not helpful against disease,
this study suggests that low to moderate consumption might also not
be harmful. "At least we have no argument for an adverse effect,"
Another expert said it is tricky to know what the findings mean
Dr. Bianca Weinstock-Guttman, a neurologist at State University
of New York at Buffalo, suggested that patients talk with their
doctors about whether drinking alcohol might interfere with their
medications and about the possibility that drinking caffeine could
aggravate bladder problems that are common in MS.
While these dietary components could help early in the course of
relapsing MS, it is very difficult to have a clear-cut benefit in
the later stages of the disease or in the case of primary
progressive MS, said Weinstock-Guttman.
To learn more about multiple sclerosis, head to the
National MS Society.