https://orcid.org/0000-0002-1698-6666
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ABSTRACT
Background
Multiple sclerosis (MS) is a common and disabling condition. The importance of healthy lifestyle for this disease is poorly explored.
Objective
To test whether adherence to healthier lifestyle patterns is associated with a lower presence of multiple sclerosis (MS).
Methods
By using a case–control design, we investigated the combined association of four healthy lifestyle-related factors (no current smoking, healthy diet, exercising regularly, body mass index <30 kg/m2) and the prevalence of MS. A logistic regression analysis, adjusted for potential confounders, was used and data reported as odds ratios (ORs) with their 95% confidence intervals (CIs).
Results
728 participants with MS were matched with healthy controls (n = 2,912) using a propensity score approach. In a multivariable analysis, compared to those who scored low in the composite lifestyle score (0–1 healthy lifestyle factors), people who adopted all four low risk lifestyle factors showed a 71% lower odds of having MS (OR = 0.29; 95% CI: 0.15–0.56). Moreover, there was a strong linear trend, suggesting that the higher number of healthy lifestyle behaviors was associated with lower odds of having MS.
Conclusion
Following a healthy lifestyle is associated with a lower prevalence of MS. This association should be explored further in cohort studies.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Data availability statement
The data that support the findings of this study are available at https://www.ukbiobank.ac.uk/, reference number [ID = 41245]. These data were derived from the following resources available in the public domain: https://www.ukbiobank.ac.uk/.
Additional information
Funding
Notes on contributors
Nicola Veronese
Dr. Nicola Veronese was born on 01 February, 1983, in Adria, Rovigo, Italy. During his specialization in Geriatrics, he worked as Research Fellow at the Washington University in Saint Louis, MO, USA. During this period, he attended on several projects regarding the effect of healthy lifestyle, calorie restriction and intermittent fasting on metabolism of obese and overweight subjects. Moreover, he worked as research fellow with Stefania Maggi, Neuroscience Institute, National Research Council, Padua, Italy regarding the positive effects of Mediterranean diet on several medical conditions typical of older people, such as neurodegenerative diseases. After these experiences, he obtained the position of communitybased geriatrician in ULSS 3 Serenissima, Venice, Italy. He actually covers the position of senior researcher in the University of Palermo. His research is mainly epidemiological and focused on the most common diseases present in older people. In particular, areas of his interest are osteoarticular, metabolic (including obesity and diabetes) and cardiovascular diseases, as well as nutrition. He is author of more than 400 articles published in national and international scientific journals and of numerous abstracts accept in national and international congresses.
Lin Yang
Dr. Lin Yang is an epidemiologist scientist in the Alberta Health Services, Canada. Her research primarily focuses on the role of energy balance in cancer prevention and survivorship. She has obtained training in kinesiology, statistics, physical activity promotion, nutritional epidemiology, circadian and sleep epidemiology, and transdisciplinary research in cancer. Her research program integrates methodologies from clinical research, epidemiology, and implementation science to elucidate the biological mechanisms of energy balance and cancer to inform personalized interventions paving the way towards sustainable scaling-up. Dr. Yang's program has established collaborations with clinician, exercise physiologists, engineers, and genetic epidemiologists within and beyond Canada and are currently being funded by the Canadian Institutes of Health Research and the Canadian Cancer Society.
Laura Piccio
Dr. Laura Piccio is a physician scientist known internationally for her work in the field of neuroimmunology and neuroinflammation. She obtained her medical degree and PhD at the University of Milan, Italy, where she trained as a neurologist. Early in her career, she started working on models of central nervous system inflammation such as multiple sclerosis (MS). She joined the Division of Neuroimmunology at Washington University School of Medicine in 2005 after being awarded a post-doctoral fellowship of the National MS Society (NMSS). Dr. Piccio has been on faculty at Washington University since 2008. She was the Harry Weaver Neuroscience Scholar of the NMSS from 2010 until 2015. In 2019 Dr. Piccio took a position as an Associate Professor at the University of Sydney.
Lee Smith
Dr Lee Smith is a Reader in Physical Activity and Public Health and Director of the Cambridge Centre for Sport and Exercise Sciences. His research utilizes epidemiological and meta-research techniques to better understand multiple areas of public health and medicine.
Joseph Firth
Dr. Joseph Firth is a UKRI Future Leaders Fellow at the University of Manchester, U.K. He previously worked as a Research Fellow at Western Sydney University (Australia), after completing his PhD (Medicine) at the University of Manchester before that. His current research focuses primarily on the interface between lifestyle factors with physical and mental health outcomes in people with mental illness. Within this, Dr. Firth is particularly interested in evaluating novel approaches towards reduce behavioural risk factors associated with the comorbidity between physical and mental health conditions.
Wolfgang Marx
Dr Wolfgang Marx is a joint Alfred Deakin and Multiple Sclerosis Research Australia postdoctoral research fellow at the Food & Mood Centre (Deakin University). Wolfgang is also an Accredited Practising Dietitian and an honorary research fellow at The Florey Institute of Neuroscience and Mental Health, La Trobe University, and Bond University. Wolfgang's current research program covers a broad range of projects involving the use nutraceuticals for mental health, fatigue, and cognition. Of particular interest is the role of polyphenols – compounds found abundantly in spices, fruits, and vegetables – in multiple sclerosis and the gut microbiome.
Gianluigi Giannelli
Prof. Gianluigi Giannelli has documented experience in the field of chronic liver disease as in both clinical and research aspects. He has studied the biological aspects of therapies to prevent the development of cirrhosis and hepatocellular carcinoma. In particular HCC represents his main field of interest in both clinical and translational research. He has a proved experience in the clinical studies for the validation of biomarkers for diagnosis and management of patients with HCC. He has a large experience in the molecular mechanisms responsible for the progression of HCC and for the identification of new therapeutic targets in preclinical models.
Maria Gabriella Caruso
Maria Gabriella Caruso 61 years old, born in Cosenza. I am a doctor, specialist in Internal Medicine and in Biochemistry to University Federico II in Naples. I work from 30 years at the IRCCS “S,. de Bellis” in Castellana Grotte in the field of clinical nutrition and experimental research. I love to decline my life in the plural. I love my family and my job. I like traveling, reading, cooking and cycling. I buy and read a lot of books because I think that books make our world a better place.
Anna Maria Cisternino
Anna Maria Cisternino, Dietitian with permanent contract at the Clinical Nutrition Outpatient Clinic of the Institute of Hospitalization and Scientific Care of Castellana Grotte (BA). Specific skills in the outpatient management of patients with problems related to body weight, diet therapy, body composition analysis by bio-impedancemetry and evaluation of basal metabolism by indirect calorimetry. Planning and execution of the in vivo determination of the glycemic index according to the protocol of Jenkins and Wolever. Running trials in multidisciplinary teams. Experience in the field of clinical nutrition and the low glycemic index Mediterranean diet applied to clinical research protocols.
Maria Notarnicola
Dr Maria Notarnicola has documented experience in the study of lipid metabolism in human gastrointestinal cancer. In particular, the genetic and biochemical changes of mevalonate pathway in human colorectal cancer, as well as the molecular mechanisms responsible for cell growth and proliferation in colon cancer, represent her main field of interest. She has a large experience in the study of lipogenic enzymes expression both in vitro and in animal models of colorectal cancer, showing a particular interest in studying the effects of Mediterranean diet components in subjects with metabolic syndrome and intestinal inflammatory diseases. She has a documented experience in cell membrane lipidomic analysis aimed to identify new molecular markers useful for the prevention and therapy of chronic metabolic diseases, including cancer.
Rossella Donghia
Rossella Donghia and I work at IRCCS “S. de Bellis” Castellana Grotte (BA). I've worked for 4 years in the Pharmacological Laboratory, and now I'm the Data Analysis in the same hospital. I graduated from the University of Bari in 2016 with a bachelor's degree in Cellular and Molecular Biology. In 2018 I have achieved a Master (2nd Levels) in Advanced Biostatistic for Clinical Reserch at Padua University. In 2019 I have frequented the Erasmus Medical Center (Rotterdam). Now I'am pursuing the Specialization in Medical Statistical at Milan University, and the 2 Specialization Courses at Harvard T.H. Chan School of Public Health (Boston) and The Johns Hopkins University (Baltimora) in Data Science. I am also a professor of Medical Statistics at the University of Bari for the health professions.
Mario Barbagallo
Prof. Mario Barbagallo, is Professor of Geriatrics and Director of the Geriatric Unit, University Hospital of Palermo, and Director Post-graduate program in Geriatrics, President of IAGG-ER (International association of Geriatrics-European Region) for the years 2019-2023. Member of the Superior Council of the Italian Minister of Health. He is included in the list of the Top Italian Scientists (www.topitalianscientists.org). He worked in Parma and Rome where he obtained the PhD in 1989. From 1989 to 1992, worked at the Cornell University Medical Center, NY, NY, USA, and from 1993 to 1995 as a Fulbright Scholar and Visiting Professor at Wayne State University, Detroit, MI, USA. He is an expert of problems related to the prevention and treatment of diseases associated with aging. Member of numerous national and international scientific societies and appreciated speaker in Italy and abroad. Author of about 500 publications in national and international scientific journals.
Luigi Fontana
Luigi Fontana is an internationally recognized physician scientist and one of the world's leaders in the field of nutrition and healthy longevity in humans. His pioneering studies on the effects of dietary restriction in humans have opened a new area of nutrition-related research that holds tremendous promise for the prevention of age-related chronic diseases and for the understanding of the biology of human aging. Professor Fontana is the Leonard P. Ullmann Chair of Translational Metabolic Health at the Charles Perkins Centre, where he directs the Healthy Longevity Research and Clinical Program. He is also a Professor of Medicine and Nutrition in the Faculty of Medicine and Health at the University of Sydney and a Clinical Academic in the Department of Endocrinology at the Royal Prince Alfred Hospital.