Vit D and MS

[Guest guest]

- Age of onset of multiple sclerosis was more than two years earlier in

patients who lived in northern latitudes -- with reduced exposure to the sun

in fall and winter -- during childhood, researchers found.

Low intake of vitamin D supplements was also associated with earlier onset,

according to Culpepper, MD, of the University of land School of

Medicine in Baltimore and colleagues.

" This is the first evidence that low sun exposure may be related to early

onset of of MS symptoms, " Culpepper told attendees at the meeting of the

Joint Consortium of Multiple Sclerosis Centers and America's Committee on

Treatment and Research in Multiple Sclerosis.

Low sun exposure has long been linked to the risk of MS, based on geographic

and ethnic patterns in differential MS incidence. To determine if the same

was true for age of onset, Culpepper and colleagues recruited 1,167 men and

women drawn from the Veterans Administration's Multiple Sclerosis

Surveillance Registry for an extensive interview to determine how much time

they spent out in the sun during the fall and winter between the ages of 6

and 15.

Combined with their ZIP code and altitude, this information allowed the

researchers to determine the total UV-B exposure during those months.

Vitamin D supplement intake was determined by participants' recollection of

milk, fish, and cod liver oil consumption.

The group of participants was about half women, and included 948 patients

with relapsing-remitting MS and 219 with primary progressive form of the

disease.

No effect of sun exposure or vitamin D intake was seen in those with primary

progressive disease, and no effect was seen in patients with either form who

lived in areas of the country that got a lot of sunlight in the winter

months. " If you live in a high solar radiation area, such as the deep South,

you are probably getting enough exposure even in the deep winter, " Culpepper

said.

But in those with relapsing-remitting MS who lived in more northern areas,

those in the lowest quartile of exposure, with less than 16 weeks of

cool-season exposure, had an age of onset 2.3 years before those in the

highest three quartiles (*P*=0.01).

Age at onset was delayed by three years for regular users of cod liver oil (

*P*=0.01), a potent source of readily available vitamin D. In a multiple

regression model, that effect was more pronounced in low-solar radiation

areas.

" The link between age of onset and sun exposure is likely through the effect

of sun on vitamin D, " Culpepper said.

Childhood through puberty is a critical period of MS risk, he noted. " We

believe there is a window of susceptibility " up to the early or mid-teens.

" We need to be able to identify the at-risk individuals, and then intervene

in childhood, " he said, but noted that risk is likely to be a combination of

genetic, in utero, and childhood effects.

" This is a big challenge for epidemiologists to work out. "

Intervention would be another challenge, he pointed out, since increasing

sun exposure without protecting against sun burn increases risk of melanoma.

Vitamin D supplementation would be an alternative, Culpepper suggested.

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--

Ortiz, MS, RD

" I plan on living forever - so far so good "

" Cause of obesity, heart disease and cancer: Look at the end of your fork "