Dataset Information

Association Between Dietary Intake and Function in Amyotrophic Lateral Sclerosis.

ABSTRACT: Importance:There is growing interest in the role of nutrition in the pathogenesis and progression of amyotrophic lateral sclerosis (ALS). Objective:To evaluate the associations between nutrients, individually and in groups, and ALS function and respiratory function at diagnosis. Design, Setting, and Participants:A cross-sectional baseline analysis of the Amyotrophic Lateral Sclerosis Multicenter Cohort Study of Oxidative Stress study was conducted from March 14, 2008, to February 27, 2013, at 16 ALS clinics throughout the United States among 302 patients with ALS symptom duration of 18 months or less. Exposures:Nutrient intake, measured using a modified Block Food Frequency Questionnaire (FFQ). Main Outcomes and Measures:Amyotrophic lateral sclerosis function, measured using the ALS Functional Rating Scale-Revised (ALSFRS-R), and respiratory function, measured using percentage of predicted forced vital capacity (FVC). Results:Baseline data were available on 302 patients with ALS (median age, 63.2 years [interquartile range, 55.5-68.0 years]; 178 men and 124 women). Regression analysis of nutrients found that higher intakes of antioxidants and carotenes from vegetables were associated with higher ALSFRS-R scores or percentage FVC. Empirically weighted indices using the weighted quantile sum regression method of "good" micronutrients and "good" food groups were positively associated with ALSFRS-R scores (? [SE], 2.7 [0.69] and 2.9 [0.9], respectively) and percentage FVC (? [SE], 12.1 [2.8] and 11.5 [3.4], respectively) (all P?

SUBMITTER: Nieves JW

PROVIDER: S-EPMC5370581 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Association Between Dietary Intake and Function in Amyotrophic Lateral Sclerosis.

Nieves Jeri W JW Gennings Chris C Factor-Litvak Pam P Hupf Jonathan J Singleton Jessica J Sharf Valerie V Oskarsson Björn B Fernandes Filho J Americo M JA Sorenson Eric J EJ D'Amico Emanuele E Goetz Ray R Mitsumoto Hiroshi H

JAMA neurology 20161201 12

<h4>Importance</h4>There is growing interest in the role of nutrition in the pathogenesis and progression of amyotrophic lateral sclerosis (ALS).<h4>Objective</h4>To evaluate the associations between nutrients, individually and in groups, and ALS function and respiratory function at diagnosis.<h4>Design, setting, and participants</h4>A cross-sectional baseline analysis of the Amyotrophic Lateral Sclerosis Multicenter Cohort Study of Oxidative Stress study was conducted from March 14, 2008, to Fe ...[more]

PMID: 27775751

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Project description:ImportancePersistent environmental pollutants may represent a modifiable risk factor involved in the gene-time-environment hypothesis in amyotrophic lateral sclerosis (ALS).ObjectiveTo evaluate the association of occupational exposures and environmental toxins on the odds of developing ALS in Michigan.Design, setting, and participantsCase-control study conducted between 2011 and 2014 at a tertiary referral center for ALS. Cases were patients diagnosed as having definitive, probable, probable with laboratory support, or possible ALS by revised El Escorial criteria; controls were excluded if they were diagnosed as having ALS or another neurodegenerative condition or if they had a family history of ALS in a first- or second-degree blood relative. Participants completed a survey assessing occupational and residential exposures. Blood concentrations of 122 persistent environmental pollutants, including organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), and brominated flame retardants (BFRs), were measured using gas chromatography-mass spectrometry. Multivariable models with self-reported occupational exposures in various exposure time windows and environmental toxin blood concentrations were separately fit by logistic regression models. Concordance between the survey data and pollutant measurements was assessed using the nonparametric Kendall τ correlation coefficient.Main outcomes and measuresOccupational and residential exposures to environmental toxins, and blood concentrations of 122 persistent environmental pollutants, including OCPs, PCBs, and BFRs.ResultsParticipants included 156 cases (mean [SD] age, 60.5 [11.1] years; 61.5% male) and 128 controls (mean [SD] age, 60.4 [9.4] years; 57.8% male); among them, 101 cases and 110 controls had complete demographic and pollutant data. Survey data revealed that reported pesticide exposure in the cumulative exposure windows was significantly associated with ALS (odds ratio [OR] = 5.09; 95% CI, 1.85-13.99; P = .002). Military service was also associated with ALS in 2 time windows (exposure ever happened in entire occupational history: OR = 2.31; 95% CI, 1.02-5.25; P = .046; exposure ever happened 10-30 years ago: OR = 2.18; 95% CI, 1.01-4.73; P = .049). A multivariable model of measured persistent environmental pollutants in the blood, representing cumulative occupational and residential exposure, showed increased odds of ALS for 2 OCPs (pentachlorobenzene: OR = 2.21; 95% CI, 1.06-4.60; P = .04; and cis-chlordane: OR = 5.74; 95% CI, 1.80-18.20; P = .005), 2 PCBs (PCB 175: OR = 1.81; 95% CI, 1.20-2.72; P = .005; and PCB 202: OR = 2.11; 95% CI, 1.36-3.27; P = .001), and 1 BFR (polybrominated diphenyl ether 47: OR = 2.69; 95% CI, 1.49-4.85; P = .001). There was modest concordance between survey data and the measurements of persistent environmental pollutants in blood; significant Kendall τ correlation coefficients ranged from -0.18 (Dacthal and "use pesticides to treat home or yard") to 0.24 (trans-nonachlor and "store lawn care products in garage").Conclusions and relevanceIn this study, persistent environmental pollutants measured in blood were significantly associated with ALS and may represent modifiable ALS disease risk factors.

Dataset Information

Association Between Dietary Intake and Function in Amyotrophic Lateral Sclerosis.

Publications

Association Between Dietary Intake and Function in Amyotrophic Lateral Sclerosis.

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