Dietary inflammatory index and risk of multiple sclerosis: Findings from a large population-based incident case–control study

Background: Diet and inflammation have been suggested to be important risk factors for multiple sclerosis (MS). Objectives: In this study, we examined the ability of the dietary inflammatory index (DII) to predict MS in a case-control study conducted in Iran. Methods: This study included 68 MS cases and 140 controls hospitalized for acute non-neoplastic diseases. The DII was computed based on dietary intake assessed by a previously validated food frequency questionnaire. Logistic regression models were used to estimate ORs adjusted for age, energy, sex, body mass index, season of birth, rubella history, history of routine exercise before MS, smoking and history of consumption of cow's milk in the first 2 years of life. Results: Subjects with higher DII scores (i.e., with a more pro-inflammatory diet) had a higher risk of MS, with the DII being used both as a continuous variable (ORcontinuous 1.66; 95% CI 1.19-2.31; 1 unit increase corresponding to ≈15% of its range in the current study) and a categorical variable (ORDII (>1.43 vs.≤1.43) 2.68; 95% CI 1.15-6.26). Conclusions: These results indicate that a pro-inflammatory diet is associated with increased risk of MS.

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Waterpipe smoking associated with multiple sclerosis: A population-based incident case–control study

Multiple Sclerosis Journal ◽

10.1177/1352458516677867 ◽

2016 ◽

Vol 23 (10) ◽

pp. 1328-1335 ◽

Cited By ~ 22

Author(s):

Ibrahim Abdollahpour ◽

Saharnaz Nedjat ◽

Mohammad Ali Sahraian ◽

Mohammad Ali Mansournia ◽

Petr Otahal ◽

...

Keyword(s):

Multiple Sclerosis ◽

Passive Smoking ◽

Case Control Study ◽

Population Based ◽

Case Control ◽

Waterpipe Smoking ◽

Incident Case ◽

Global Increase ◽

Incident Cases ◽

Control Study

Background: While cigarette and passive smoking have been identified as modifiable risk factors for multiple sclerosis (MS), there is no report regarding Waterpipe smoking–MS association. Objective: We examined the association of Waterpipe, tobacco, and passive smoking with MS. Methods: Population-based incident case–control study in Iran with 547 incident cases and 1057 general population controls (7 August 2013–17 February 2015). Logistic regression model was used. Multiplicative along with additive interaction was assessed using product term and Synergy Index (SI), respectively, and the population attributable fractions (PAFs) were calculated. Results: Having ever smoked Waterpipe, tobacco, or being exposed to passive smoking were all significantly associated with MS (odds ratio (OR) = 1.77 (1.36–2.31), OR = 1.69 (1.24–2.31), and OR = 1.85 (1.48–2.32), respectively). Clear dose–response associations were observed with the duration exposed ( p < 0.001 for all three) and the amount smoked ( p < 0.001 for Waterpipe and tobacco). Those who had all three types of smoking had an odds that was 4.1 times higher than those without any type. The three types of smoking jointly contributed to 30.9% of the MS incidence. Conclusion: We identified Waterpipe smoking as a novel risk factor for MS. Given the global increase in Waterpipe smoking, especially among young adults, this finding reinforces the need for public health interventional and educational programs to combat this global increase.

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Stress-full life events and multiple sclerosis: A population-based incident case-control study

Multiple Sclerosis and Related Disorders ◽

10.1016/j.msard.2018.09.026 ◽

2018 ◽

Vol 26 ◽

pp. 168-172 ◽

Cited By ~ 2

Author(s):

Ibrahim Abdollahpour ◽

Saharnaz Nedjat ◽

Mohammad Ali Mansournia ◽

Svetlana Eckert ◽

Bianca Weinstock-Guttman

Keyword(s):

Multiple Sclerosis ◽

Life Events ◽

Case Control Study ◽

Population Based ◽

Case Control ◽

Incident Case ◽

Full Life ◽

Control Study

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The role of nutritional factors during adolescence in multiple sclerosis onset: a population-based incident case–control study

Nutritional Neuroscience ◽

10.1080/1028415x.2019.1647689 ◽

2019 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Ibrahim Abdollahpour ◽

Maria Pia Sormani ◽

Saharnaz Nedjat ◽

Mohammad Ali Mansournia ◽

Ingrid van der Mei

Keyword(s):

Multiple Sclerosis ◽

Case Control Study ◽

Population Based ◽

Case Control ◽

Incident Case ◽

Nutritional Factors ◽

Multiple Sclerosis Onset ◽

Control Study

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Estimating the Marginal Causal Effect and Potential Impact of Waterpipe Smoking on Multiple Sclerosis Using Targeted Maximum Likelihood Estimation Method: a Large Population-Based Incident Case-Control Study

American Journal of Epidemiology ◽

10.1093/aje/kwab036 ◽

2021 ◽

Author(s):

Ibrahim Abdollahpour ◽

Saharnaz Nedjat ◽

Amir Almasi-Hashiani ◽

Maryam Nazemipour ◽

Mohammad Ali Mansournia ◽

...

Keyword(s):

Multiple Sclerosis ◽

Maximum Likelihood ◽

Case Control Study ◽

Population Based ◽

Case Control ◽

Waterpipe Smoking ◽

Case Control Studies ◽

Incident Case ◽

Targeted Maximum Likelihood ◽

Control Study

Abstract There are few if any reports regarding the role of lifetime waterpipe smoking in multiple sclerosis (MS) etiology. The authors investigated the association between waterpipe and MS, adjusted for confounders. This was a population-based incident case-control study conducted in Tehran, Iran. Cases (n=547) were 15–50-year-old patients identified from the Iranian Multiple Sclerosis Society between 2013 and 2015. Population-based controls (n=1057) were 15–50-year old recruited by random digit telephone dialing. A double robust estimator method known as targeted maximum likelihood estimator (TMLE) was used to estimate the marginal risk ratio and odds ratio between waterpipe and MS. The both estimated RR and OR was 1.70 (95% CI: 1.34, 2.17). The population attributable fraction was 21.4% (95% CI: 4.0%, 38.8%). Subject to the limitations of case-control studies in interpreting associations causally, this study suggests that waterpipe use, or its strongly related but undetermined factors, increases the risk of MS. Further epidemiological studies including nested case-control studies are needed to confirm these results.

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