High fish intake linked to slower disability progression in MS

High intake of lean and oily fish appears to slow the progression of disability in multiple sclerosis (MS), researchers reported on Feb. 25, 2025 in the Journal of Neurology Neurosurgery & Psychiatry.

For this analysis, Swedish investigators extracted data on 2,719 newly diagnosed subjects  (average age 38) enrolled in  the Epidemiologic Investigation of Multiple Sclerosis (EIMS) study.

All were enrolled between April 2005 and June 2015.

At baseline, all subjects provided information on environmental exposures and lifestyle habits, including consumption of lean and oily fish. Such consumption was categorized as never or seldom, 1 to 3 times a month, or weekly.

They scored fish consumption from 2 to 6, depending on whether the subjects ate lean or oily fish, or both.

The investigators tracked disease progression for up to 15 years using the Expanded Disability Status Scale (EDSS) and the Swedish MS registry.

They defined MS-related disability worsening as an increase in the EDSS score of at least 1 point from baseline, sustained between two further check-ups, at least 6 months apart.

They reported that the highest level of fish consumption at baseline was associated with a 44% lower risk of disability worsening. They also reported that those subjects in the highest consumption group at baseline achieved a 45% lower risk of progressing to EDSS 3 and a 43% lower risk of progressing to EDSS 4 compared with those who consumed no fish or little fish in their diets.

In 2021, 1,719 subjects completed a questionnaire about changes in their fish consumption over time.

The researchers reported that 412 subjects (24%) had altered their fish consumption, 288 had increased it and 124 had decreased it.

They found that subjects who increased their fish consumption score from 2–3 to 5–6 within 5 years after diagnosis (n=133) had achieved a 20% lower risk of confirmed disability worsening, compared with those who continued to eat little or no fish (n=400).

Sixteen subjects had increased their fish consumption from a baseline score of 2 to a score of 5–6; They achieved a 59% lower risk of disability worsening when compared with subjects who started and stayed at the lowest level of fish consumption (n=101).

“This study provides robust longitudinal evidence that higher total fish consumption (lean and oily fish combined) is associated with a reduced risk of MS disability progression, including confirmed disability worsening (CDW) and progression to Expanded Disability Status Scale (EDSS) 3 and EDSS 4,” the authors concluded.