{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T10:03:13Z","timestamp":1789380193787,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005317","name":"Kermanshah University of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005317","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Multiple sclerosis (MS) is a chronic inflammatory disease influenced by genetic and environmental factors. Dietary habits, reproductive characteristics, and physical activity have been proposed as potential contributors to MS susceptibility. This study aimed to investigate the association of dietary intake, supplement use, reproductive factors, and physical activity with MS in Kermanshah Province, Iran.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This case\u2013control study included 600 participants (300 MS patients and 300 matched healthy controls) from Kermanshah. Data were collected using the validated Persian version of the Environmental Exposure and Lifestyle Risk Factors in MS Questionnaire (EnvIMS\u2010Q). Logistic regression analyses were performed to estimate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with controls, participants with MS reported lower consumption of several foods, including fish (adjusted OR\u2009=\u20090.31, 95% CI 0.19\u20130.50), seafood (adjusted OR\u2009=\u20090.31, 95% CI 0.10\u20130.98), nuts (adjusted OR\u2009=\u20090.60, 95% CI 0.39\u20130.93), and dairy products. Fish oil supplementation was less common among patients with MS (adjusted OR\u2009=\u20090.28, 95% CI 0.13\u20130.61). Female patients reported higher frequencies of oral contraceptive use, miscarriage, and assisted reproduction. Vigorous physical activity was significantly lower among patients than controls, whereas mild physical activity did not differ significantly. No significant association was observed for vitamin D supplementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study identified associations between several dietary, reproductive, and lifestyle factors and MS in a high\u2010prevalence region of Iran. Lower consumption of selected nutrient\u2010rich foods, lower fish oil supplement use, certain reproductive factors, and lower levels of vigorous physical activity were associated with higher odds of MS. Prospective studies are needed to clarify temporal relationships and causality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.72773","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T06:30:33Z","timestamp":1782973833000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reproductive, Dietary, and Physical Activity Factors Associated With Multiple Sclerosis: A Case\u2013Control Study"],"prefix":"10.1002","volume":"9","author":[{"given":"Nazanin","family":"Razazian","sequence":"first","affiliation":[{"name":"Neuroscience Research Center, Health Institute Kermanshah University of Medical Sciences Kermanshah Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiva","family":"Bashiri","sequence":"additional","affiliation":[{"name":"Clinical Research Development Center, Imam Reza Hospital Kermanshah University of Medical Sciences Kermanshah Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asma","family":"Aliahmadi","sequence":"additional","affiliation":[{"name":"Clinical Research Development Center, Imam Reza Hospital Kermanshah University of Medical Sciences Kermanshah Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharareh","family":"Eskandarieh","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Research Center, Neuroscience Institute Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Ali","family":"Sahraian","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Research Center, Neuroscience Institute Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5157-8898","authenticated-orcid":false,"given":"Milad","family":"MohamadYari","sequence":"additional","affiliation":[{"name":"Clinical Research Development Center, Imam Reza Hospital Kermanshah University of Medical Sciences Kermanshah Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6446-7289","authenticated-orcid":false,"given":"Mansour","family":"Rezaei","sequence":"additional","affiliation":[{"name":"Social Development and Health Promotion Research Center Kermanshah University of Medical Sciences Kermanshah Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Negin","family":"Fakhri","sequence":"additional","affiliation":[{"name":"Neuroscience Research Center, Health Institute Kermanshah University of Medical Sciences Kermanshah Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13819"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2024.105435"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30481-1"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s44197-025-00353-6"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2019.07.013"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-021-05750-w"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2021.103441"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01473-3"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/CON.0000000000001136"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-025-13248-0"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu14061150"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2018.03.022"},{"issue":"2","key":"e_1_2_12_14_1","first-page":"106","article-title":"Investigation of Pregnancy Tendency, Reproductive Characteristics, and Disability in Women With Multiple Sclerosis: A Secondary Data Analysis of the National Registry in Iran","volume":"23","author":"Ezabadi S. 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