1. Swedish adults who reported the highest amount of alcohol consumption had a decreased incidence of Multiple Sclerosis (MS).
Evidence grade: Level 3 (Average)
Study Rundown: MS is a chronic neurologic disease which is thought to have both environmental and genetic influences. Alcohol consumption is a modifiable environmental exposure which has, in other studies, been shown to have a protective factor against certain autoimmune diseases, such as autoimmune hypothyroidism, systemic lupus erythematosus, and rheumatoid arthritis. This study was designed to help determine whether a similar relationship exists between alcohol consumption and risk of developing MS. The results of the study demonstrated that participants with MS were less likely to be alcohol consumers compared to those without MS, who were more likely to be alcohol consumers.
Strengths include a large sample size of cases and controls that were randomly selected. The investigators also ensured that only properly filled out questionnaires were included in the final analysis. Weaknesses of the study include the fact that only Swedish people were included in the study. There was also a long list of environmental factors that were included in the questionnaire, which could have confounded the results.
In-Depth [case control study]: The study consisted of two case control studies from Sweden, Epidemiological Investigation of Multiple Sclerosis (EIMS) and Genes and Environment in Multiple Sclerosis (GEMS). While the questionnaires for the two studies were different, they both inquired about the participants’ alcohol consumption over a period of time. EIMS included 745 MS cases and 1761 controls, and GEMS included 5874 MS cases and 5246 controls.
In EIMS, women who reported high alcohol consumption had an OR of 0.6 (95% CI, 0.4-1.0) of developing MS compared to women who did not consume alcohol. Men with high alcohol consumption had an OR of 0.5 (95% CI, 0.2-1.0) compared to men who did not consume alcohol. In GEMS, the OR for women was 0.7 (95% CI, 0.6-0.9) and for men, it was 0.7 (95% CI, 0.5-0.9). Risk reduction was more pronounced in smokers than never smokers in the GEMS group (attributable proportion, 0.2; P=0.01).
By Anees Daud and James Jiang
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