High Iron Intake Associated with Pediatric Multiple Sclerosis

A significant intake of iron may contribute to multiple sclerosis (MS) in children, according to a new report.

Researchers from the University of California, San Francisco examined 312 pediatric MS patients and 456 controls in order to to determine the association between dietary factors and MS in the population. The children were recruited from 16 US centers, and were diagnosed with MS before reaching 18 years old.

The patients and their parents also completed the Block Kids Food Screener questionnaire 2011-2016. The 41-question survey asked about development, environmental exposures, medical history, demographic information, and race.

There are anecdotal reports of amelioration of MS symptoms when a patient adopts a “healthy” diet such as Mediterranean or low-fat/ high fiber, researchers wrote. However, there are currently no dietary guidelines for patients with MS and their at-risk relatives. And so far, dietary studies for MS patients have centered on vitamin D and obesity, but not overall diets.

The researchers observed an average dietary intake of fiber, iron, and dairy was significantly lower in MS patients compared to controls. When the investigators categorized their data by males vs. females, the only average dietary difference was dietary fiber in males.

The mean calorie intake for cases and controls was similar between the groups, and the percentage energy intake from protein, carbohydrates, and fat did not present and differences between MS patients and controls.

However, the data did suggest a presence of lower iron intake among cases of pediatric MS, Dr. Julia Pakpoor told MD Magazine. The study is the first of its kind to examine the diets of pediatric MS patients, researchers wrote, while other studies looked at dietary factors in MS patients, such as fat intake, or fruit and vegetable intake, and gut microbiota modulation.

Pakpoor explained that their findings are of particular note because iron’s role in MS has been discussed for a long time in research circles, but not with respect to the pediatric patient population. The investigators believe their paper will stimulate further research and help more teams investigate whether altered iron levels could contribute to a mediating process in MS.

The researchers also suspected that iron deficiency may influence MS through its effect on the immune system’s overall function. They additionally noted that patients included in the study that were in the 18- to 19-year-old range may have underestimated their caloric consumption due to increased alcohol and coffee intake, which was not included in the study.

“For clinicians, I think the most important aspect of our work was that we observed no evidence of strong associations between most of the investigated dietary factors and pediatric MS,” Pakpoor said. “The role of diet in the MS of a child is a topic of frequent concern and anxiety for relatives of a child with MS."

Pakpoor hoped the results reassure parents of pediatric MS patients and supports current clinical practice, which she noted "does not recommend any particular diet modifications (with the potential exception of vitamin D repletion) for children with MS."

The study, “Dietary factors and pediatric multiple sclerosis: A case-control study,” was published online in Multiple Sclerosis Journal.