{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:28:16Z","timestamp":1788546496229,"version":"build-2803163510"},"reference-count":30,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2023,5,6]],"date-time":"2023-05-06T00:00:00Z","timestamp":1683331200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,5,6]],"date-time":"2023-05-06T00:00:00Z","timestamp":1683331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Health and Medical Research Council of Australia","award":["APP316901 and 224215"],"award-info":[{"award-number":["APP316901 and 224215"]}]},{"name":"LJB is supported by a Multiple Sclerosis Research Australia Postdoctoral Fellowship and a Curtin University Research Fellowship."},{"name":"AS is supported by a Multiple Sclerosis Research Australia Postgraduate Scholarship."},{"name":"National Multiple Sclerosis Society of the United States of America","award":["RG3364A1\/2"],"award-info":[{"award-number":["RG3364A1\/2"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>A pro-inflammatory diet has been posited to induce chronic inflammation within the central nervous system (CNS), and multiple sclerosis (MS) is an inflammatory disease of the CNS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>\n                      We examined whether Dietary Inflammatory Index (DII\n                      <jats:sup>\u00ae)<\/jats:sup>\n                      ) scores are associated with measures of MS progression and inflammatory activity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A cohort with a first clinical diagnosis of CNS demyelination was followed annually (10\u2009years,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009223). At baseline, 5- and 10-year reviews, DII and energy-adjusted DII (E-DII\n                      <jats:sup>TM<\/jats:sup>\n                      ) scores were calculated (food frequency questionnaire) and assessed as predictors of relapses, annualised change in disability (Expanded Disability Status Scale) and two magnetic resonance imaging measures; fluid-attenuated inversion recovery (FLAIR) lesion volume and black hole lesion volume.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A more pro-inflammatory diet was associated with a higher relapse risk (highest vs. lowest E-DII quartile: hazard ratio\u2009=\u20092.24, 95% confidence interval (CI)\u2009= \u22121.16, 4.33,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.02). When we limited analyses to those assessed on the same manufacturer of scanner and those with a first demyelinating event at study entry (to reduce error and disease heterogeneity), an association between E-DII score and FLAIR lesion volume was evident (\u03b2\u2009=\u20090.38, 95% CI\u2009=\u20090.04, 0.72,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>There is a longitudinal association between a higher DII and a worsening in relapse rate and periventricular FLAIR lesion volume in people with MS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585231167739","type":"journal-article","created":{"date-parts":[[2023,5,6]],"date-time":"2023-05-06T05:44:23Z","timestamp":1683351863000},"page":"1012-1023","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["A pro-inflammatory diet in people with multiple sclerosis is associated with an increased rate of relapse and increased FLAIR lesion volume on MRI in early multiple sclerosis: A prospective cohort study"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0942-0469","authenticated-orcid":false,"given":"Alice M","family":"Saul","sequence":"first","affiliation":[{"name":"Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce V","family":"Taylor","sequence":"additional","affiliation":[{"name":"Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh","family":"Blizzard","sequence":"additional","affiliation":[{"name":"Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6521-3056","authenticated-orcid":false,"given":"Steve","family":"Simpson-Yap","sequence":"additional","affiliation":[{"name":"Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia\/Melbourne School of Population &amp; Global Health, The University of Melbourne, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy H","family":"Oddy","sequence":"additional","affiliation":[{"name":"Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nittin","family":"Shivappa","sequence":"additional","affiliation":[{"name":"Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA\/Arnold School of Public Health, University of South Carolina, Columbia, SC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R","family":"H\u00e9bert","sequence":"additional","affiliation":[{"name":"Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA\/Arnold School of Public Health, University of South Carolina, Columbia, SC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucinda J","family":"Black","sequence":"additional","affiliation":[{"name":"Curtin School of Population Health, Curtin University, Perth, WA, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Louise","family":"Ponsonby","sequence":"additional","affiliation":[{"name":"Murdoch Children\u2019s Research Institute, Royal Children\u2019s Hospital, The University of Melbourne, Melbourne, VIC, Australia\/The Florey Institute of Neuroscience &amp; Mental Health, Parkville, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9429-4307","authenticated-orcid":false,"given":"Simon A","family":"Broadley","sequence":"additional","affiliation":[{"name":"School of Medicine, Griffith University, Gold Coast, QLD, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanette","family":"Lechner-Scott","sequence":"additional","affiliation":[{"name":"Department of Neurology, John Hunter Hospital, Newcastle, NSW, Australia\/Faculty of Medicine and Public Health, Hunter Medical Research Institute, The University of Newcastle, Newcastle, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"van der Mei","sequence":"additional","affiliation":[{"name":"Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn M","family":"Lucas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Dear","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry","family":"Dwyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Broadley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor","family":"Kilpatrick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron","family":"Shaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caron","family":"Chapman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Coulthard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P","family":"Pender","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Valery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,5,6]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-018-0041-4"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.2174\/187152709788680670"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13668-018-0236-z"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/1028415X.2017.1303016"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980013002115"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/advances\/nmaa063"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1017\/S000711451400395X"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/nu11081873"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/advances\/nmab037"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41430-018-0294-8"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-09-0191"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31820af93d"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.1032"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2016-313722"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2016.00576"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2015.05.003"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.518"},{"issue":"1","key":"e_1_3_3_19_2","first-page":"19","article-title":"Development of the Melbourne FFQ: A food frequency questionnaire for use in an Australian prospective study involving an ethnically diverse cohort","volume":"3","author":"Ireland P","year":"1994","unstructured":"Ireland P, Jolley D, Giles G, et al. Development of the Melbourne FFQ: A food frequency questionnaire for use in an Australian prospective study involving an ethnically diverse cohort. Asia Pac J Clin Nutr 1994; 3(1): 19\u201331.","journal-title":"Asia Pac J Clin Nutr"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/advances\/nmy071"},{"key":"e_1_3_3_21_2","volume-title":"A biometric study of basal metabolism in man","author":"Harris J","year":"1919","unstructured":"Harris J, Benedict F. A biometric study of basal metabolism in man. Washington, DC: Carnegie Institute of Washington, 1919."},{"issue":"12","key":"e_1_3_3_22_2","first-page":"569","article-title":"Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut-off limits to identify under-recording","volume":"45","author":"Goldberg GR","year":"1991","unstructured":"Goldberg GR, Black AE, Jebb SA, et al. Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut-off limits to identify under-recording. Eur J Clin Nutr 1991; 45(12): 569\u2013581.","journal-title":"Eur J Clin Nutr"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41430-019-0476-z"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1249\/01.MSS.0000078924.61453.FB"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(67)90010-4"},{"key":"e_1_3_3_26_2","unstructured":"Hern\u00e1n MA Robins JM. Causal inference: What if 2020 https:\/\/cdn1.sph.harvard.edu\/wp-content\/uploads\/sites\/1268\/2021\/03\/ciwhatif_hernanrobins_30mar21.pdf"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1080\/00949655.2017.1397151"},{"key":"e_1_3_3_28_2","first-page":"1887","article-title":"Robust causal inference using directed acyclic graphs: The R package \u2018dagitty\u2019","volume":"45","author":"Textor J","year":"2016","unstructured":"Textor J, Van der Zander B, Gilthorpe MS, et al. Robust causal inference using directed acyclic graphs: The R package \u2018dagitty\u2019. Int J Epidemiol 2016; 45: 1887\u20131894.","journal-title":"Int J Epidemiol"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/155.2.176"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/65.4.1220S"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30470-2"}],"container-title":["Multiple Sclerosis Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585231167739","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13524585231167739","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585231167739","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:11:47Z","timestamp":1777695107000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13524585231167739"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,6]]},"references-count":30,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1177\/13524585231167739"],"URL":"https:\/\/doi.org\/10.1177\/13524585231167739","relation":{},"ISSN":["1352-4585","1477-0970"],"issn-type":[{"value":"1352-4585","type":"print"},{"value":"1477-0970","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,6]]}}}