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Previous research has shown that alcohol consumption may be associated with a reduced risk of rheumatoid arthritis, lupus erythematosus, and other autoimmune diseases. There have also been reports that alcohol may lower the risk of multiple sclerosis (MS). The authors of the present paper have used data from two large Swedish case-control studies of MS to evaluate the relation of alcohol consumption to MS. Key results showed that in both of the case-control analyses, there was a dose-response inverse relation between alcohol consumption and the risk of developing MS. In comparison with subjects reporting no alcohol intake in the 5- or 10-year period during which the diagnosis of MS was first made, subjects in the highest alcohol consumption group (> 112 g/week, about 9 drinks per week for women; >168 g/week, about 14 drinks per week for men) had 30% to 50% lower risk of developing MS. A variety of potential confounders were included in the analysis, including smoking, education, and SES.

Forum members who reviewed this paper all thought that it reflected a well-done analysis. The main concerns were that, as are most studies of uncommon diseases, these were case-control comparisons (which may be associated with recall bias, reverse causation, and other potential confounding variables), and that the investigators could not determine if the “non-drinkers,” their referent group, were lifetime abstainers or former drinkers. Also, while earlier research has shown that the polyphenols in wine may provide protection beyond that of alcohol in combating inflammation, there were no data on beverage-specific results.

In general, however, Forum members welcomed this contribution to our knowledge on the subject, and thought that the authors did a good job in discussing the strengths and weaknesses of their study. There was a brief discussion of potential mechanisms by which alcoholic beverages could lower the risk of MS, but no discussion of the potential added effects related to polyphenolic substances. Forum members also thought that serum uric acid (which may increase with alcohol consumption) could play a role in an autoimmune disease, but this was not discussed by the authors.

Based on previous research and the results of this paper, it is probable that moderate alcohol intake, especially of wine, may lower the risk of developing MS, a neurological disease for which no cure is currently available. While MS is too uncommon a condition to use these findings to recommend alcohol consumption for the prevention of the disease, it would be useful if future research could help determine if, for subjects who already have MS, moderate drinking may affect the progression of their disease.

Reference: Hedström AK, Hillert J, Olsson T, Alfredsson L. Alcohol as a modifiable lifestyle factor affecting multiple sclerosis risk. JAMA Neurology 2014; doi:10.1001/jamaneurol.2013.5858; published online January 6, 2014.


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