{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T14:21:42Z","timestamp":1788531702907,"version":"build-2803163510"},"reference-count":86,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000890","name":"National Multiple Sclerosis Society","doi-asserted-by":"publisher","award":["award RG3364A1\/2"],"award-info":[{"award-number":["award RG3364A1\/2"]}],"id":[{"id":"10.13039\/100000890","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"national health and medical research council","doi-asserted-by":"publisher","award":["APP316901 and 224215"],"award-info":[{"award-number":["APP316901 and 224215"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Diet intake has been implicated in multiple sclerosis (MS) risk; however, the mechanisms are unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Investigated whether DNA methylation (DNAm) mediated the associations of diet and MS onset-risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We utilised data from the Ausimmune case\u2013control study, comparing 201 MS cases and 342 matched controls. Diet scores were estimated from food frequency questionnaires. Genotypes and DNAm were measured using the Illumina Global Screening Array and MethylationEPIC BeadChip, respectively. The 2432 top-ranked MS-associated cytosine-guanine pairs (CpGs) were dimension-reduced using Weighted-Gene Correlation Network Analysis (WGCNA) to five (A1-A5) DNAm module scores. Diet\u2013MS associations were evaluated using multivariable logistic regression, and mediation through DNAm modules by counterfactual mediation analysis. We conducted stratified analyses by human leukocyte antigen (\n                      <jats:italic toggle=\"yes\">HLA<\/jats:italic>\n                      ) genotypes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The alternate Mediterranean diet score (aMED) including unprocessed red meat (aMED-Red) (adjusted odds ratio (aOR)\u2009=\u20090.88; 95% confidence interval (CI)\u2009=\u20090.79\u20130.98) and Healthy diet scores (aOR\u2009=\u20090.86; 95% CI\u2009=\u20090.75\u20130.98) were associated with lower MS onset-risk. A5 DNAm module significantly mediated the associations of aMED (30.3%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.027) and aMED-Red (22.1%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.037) scores with MS onset-risk. Stratified by\n                      <jats:italic toggle=\"yes\">HLA<\/jats:italic>\n                      genotypes, no differences in diet\u2013MS associations or A5 DNAm-module mediation were seen.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Up to one-third of the associations of Mediterranean diet scores with MS onset-risk were explained by DNAm in genes involved in immune function. These findings provide a better understanding of the underlying MS pathogenesis and inform future research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585261462517","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T18:28:34Z","timestamp":1784658514000},"page":"1022-1037","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["DNA methylation partially mediates the associations of Mediterranean diet scores with MS onset-risk: Results from the Ausimmune case\u2013control study"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0231-6722","authenticated-orcid":false,"given":"Mehari Woldemariam","family":"Merid","sequence":"first","affiliation":[{"name":"The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia"},{"name":"Department of Epidemiology and Biostatistics, 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V","family":"Taylor","sequence":"additional","affiliation":[{"name":"MS Research Flagship, Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannette","family":"Lechner-Scott","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health, Newcastle University, Callaghan, NSW, Australia"},{"name":"Hunter Medical Research Institute, Newcastle University, Callaghan, NSW, Australia"},{"name":"Department of Neurology, John Hunter Hospital, New Lambton Heights, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney J","family":"Scott","sequence":"additional","affiliation":[{"name":"Hunter Medical Research Institute, Newcastle University, Callaghan, NSW, Australia"},{"name":"School of Biomedical Sciences and Pharmacy, Newcastle University, Callaghan, NSW, 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J","family":"Kilpatrick","sequence":"additional","affiliation":[{"name":"The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6581-3657","authenticated-orcid":false,"given":"Anne-Louise","family":"Ponsonby","sequence":"additional","affiliation":[{"name":"The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia"},{"name":"Murdoch Children\u2019s Research Institute, The University of Melbourne, Parkville, VIC, 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":"The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia"},{"name":"MS Research Flagship, 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