The evidence for diet as a risk factor for multiple sclerosis (MS) is inconclusive. We examined the associations between fish consumption and risk of a first clinical diagnosis of central nervous system demyelination (FCD), a common precursor to MS.
The 2003–2006 Ausimmune Study was a case-control study examining environmental risk factors for FCD, with participants recruited from four regions of Australia and matched on age, sex, and study region. Dietary intake data were collected using a food frequency questionnaire. We used conditional logistic regression models to test associations between fish consumption (total, tinned, grilled, and fried) and risk of FCD (249 cases and 438 controls), adjusting for history of infectious mononucleosis, smoking, serum 25-hydroxyvitamin D concentrations, socio-economic status, omega-3 supplement use, dietary under-reporting, and total energy intake.
Higher total fish consumption (per 30 g/day, equivalent to two serves/week) was associated with an 18% reduced risk of FCD (AOR 0.82; 95% CI 0.70, 0.97). While we found no statistically significant associations between grilled and fried fish consumption and risk of FCD, higher tinned fish consumption (per 30 g/day) was associated with a 41% reduced risk of FCD (AOR 0.59; 95% CI 0.39, 0.89).
Tinned fish is predominantly oily, whereas grilled and fried fish are likely to be a combination of oily and white types. Oily fish is high in vitamin D and very long chain polyunsaturated omega-3 fatty acids, both of which may be beneficial in relation to MS.
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We thank the participants of the Ausimmune Study. We would like to acknowledge and thank the physicians who notified case participants to the Ausimmune Study: Jeffrey Blackie FRACP, Richard Bourke FRACGP, John Cameron MD, Ross Carne MD, Ben Clark FRANZCO, Steven Collins MD, Diana Conrad FRANZCO, Michael Coroneos FRACS, Nicholas Downie FRANZCO, David Floate FRACP, Peter Gates FRACP, Kerryn Green FRACP, Erwin Groeneveld FRANZCO, John Harrison FRANZCO, Michael Haybittel FRANZCO, Robert Henderson FRACP, John Henshaw MMed, James Hurley MD, Dean Jones FRACP, Michael Katekar MBBS, Anthony Kemp FRACP, Mark King FRACP, George Kiroff FRACS, Brett Knight FRACP, Thomas Kraemer FRACP, Cecile Lander FRACP, Jeannette Lechner-Scott FRACP, Andre Loiselle FRACP, Paul McCartney FRANZCO, Pamela McCombe PhD, Mark McGree FRANZCO, David McKnight FRANZCO, Daniel McLaughlin PhD, Satish Nagarajah MBBS, Rob Nightingale FRACP, Terence O’Brien MD, John O'Sullivan MD, Gregory Outteridge FRANZCO, Anthony Pane FRANZCO, Mark Parsons FRACP, Melinda Pascoe FRACP, David Prentice PhD, Richard Ralph FRACGP, Stephen Read FRACP, John Richmond FRACP, Ian Routley FRANZCO, Timothy Ruddle FRANZCO, Noel Saines FRACP, Stan Siejka MBBS (dec), Christopher Staples FRACP, Paul Talman FRACP, Don Todman FRACP, Nitin Verma FRANZCO, Brendan Vote FRANZCO, Michael Waldie FRANZCO, Michael Weetch FRACP, Rodney Westmore FRANZCO, Andrew Wong FRACP; and the local research officers: Susan Agland BN, Barbara Alexander BN, Marcia Davis MD, Zoe Dunlop BN, Rosalie Scott BN, Marie Steele RN, Catherine Turner MPH&TM, Brenda Wood RN; and the Ausimmune Study project officers during the course of the study: Jane Gresham MA(Int Law), Camilla Jozwick BSc(Hons), Helen Rodgers RN.
Funding for the Ausimmune Study was provided by the National Multiple Sclerosis Society of the United States of America, the National Health and Medical Research Council of Australia and Multiple Sclerosis Research Australia. LJB is supported by a Multiple Sclerosis Western Australia Postdoctoral Fellowship and a Curtin University Research Fellowship. RML is supported by a National Health and Medical Research Council of Australia Senior Research Fellowship. Funding bodies had no role in the design or conduct of the study; collection, management, analysis, or interpretation of data; or preparation, review, or approval of the paper.
The Ausimmune Investigator Group and LJB designed the study; LJB analysed and interpreted the data and wrote the paper; YCP contributed to data analysis; GP provided statistical support and contributed to data interpretation; JLS, RML, GP, and the Ausimmune Investigator Group provided critical revision of the paper for important intellectual content; LJB had primary responsibility for the final content. All the authors read and approved the final version of the paper.
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Black, L.J., Zhao, Y., Peng, Y.C. et al. Higher fish consumption and lower risk of central nervous system demyelination. Eur J Clin Nutr 74, 818–824 (2020). https://doi.org/10.1038/s41430-019-0476-z