Fresh fish consumption is associated with a lower risk of multiple sclerosis independent of serum 25OHD levels
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Background: Oily fish is the best dietary source of both vitamin D and omega-3 polyunsaturated fatty acids (PUFAs), both of which may play a protective role in multiple sclerosis (MS).
Methods: We examined the association between fish consumption and risk of MS using data from the MS Sunshine Study, a multi-ethnic matched case-control study of incident MS or its precursor, clinically isolated syndrome (CIS), conducted in a Southern Californian population. Information on fish consumption over the 12 months prior to symptom onset/index date (567 cases, 618 controls) was collected via 2 questions during a structured in-person questionnaire. We used logistic regression models to test associations been fish consumption and MS/CIS, adjusting for age, sex, race/ethnicity, history of infectious mononucleosis, education, smoking and deseasonalised serum 25-hydroxyvitamin D concentrations.
Results: Compared with consuming fresh fish less than once per month, consuming fresh fish 1-3 times per month (adjusted OR=0.71; 95%CI 0.54, 0.93; p=0.014) or once per week or more was associated with a 29% reduced risk of MS/CIS (adjusted OR=0.71; 95%CI 0.53, 0.95; p=0.022; p=0.017 for trend). There was no statistically significant association between consuming shrimp/canned/dried fish and risk of MS/CIS. No multiplicative interaction of fish consumption with race/ethnicity on risk of MS/CIS was detected.
Conclusions: These results support a protective effect of fresh fish consumption for risk of MS that is independent of vitamin D status and consistent across racial/ethnic groups. Future studies should elucidate whether specific components of fish (namely omega-3 PUFAs) are protective or whether the replacement of other potentially detrimental foods are factors in reducing the risk of MS.