Natalie Frank has a Ph.D. in Clinical psychology. She specializes in Pediatric Psychology and Behavioral Medicine.
Alcohol and the Connection to MS
The etiology of multiple sclerosis (MS) involves environmental, behavioral and genetic factors and their interactions. One behavioral risk factor that has been examined is alcohol consumption.
Alcohol exposure has been found to impact all components of the adaptive immune system. While some studies demonstrate that heavy drinking can drastically harm the elements within the immune system, other studies have shown that moderate alcohol intake may be beneficial and positively impact the adaptive immune system.
However, the actual mechanism involved in ethanol’s effect on the adaptive immune system continues to be poorly understood. Additionally, how alcohol exposure relates to the risk of developing MS is unclear.
Results From Previous Studies
Results from a few small studies and meta-analyses have demonstrated inconsistent results. A Danish cohort study indicated that adolescents who drank alcohol had a decreased risk of developing MS later in life in both genders. These findings were not dose-specific for women, with the protective effects occurring for those who drank a little, a moderate amount, or a large amount of alcohol compared to those who didn’t drink at all.
For men, the findings were dose specific, with men who drank a small amount of alcohol having a lower risk of developing MS compared to men who didn’t drink at all, but no effects were found for men who drank a moderate or large amount (Andersen, Sondergaard, Oturai et al., 2018).
In a prospective study conducted with two large cohorts of women, results found that neither the total amount of alcohol consumed nor the type of alcohol consumed (beer, wine or liquor) were associated with an increased risk of developing MS (Massa, O’Reilly, Munger & Ascherio, 2012).
In one meta-analysis, results indicated that there was no evidence that alcohol exposure was related to an increased risk of developing MS (Zhu, Ye, Zhang, Lin, Shi, Wei, Liu, & He, 2015). There was an indication of a possible protective factor of alcohol exposure on rates of MS, but the authors cautioned that this conclusion needed to be validated with additional research. In a larger meta-analysis, results indicated that alcohol consumption was found to have positive outcomes on MS development in some studies and negative outcomes in others (Fragosi & Cardoso. 2016).
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In an investigation conducted in Sweden involving two case-control studies, results indicated a dose-dependent inverse relationship between alcohol consumption and the risk of developing MS (Hedström,Hillert, Olsson, & Alfredsson, 2014). This association was statistically significant in both genders. In one study, women who consumed large amounts of alcohol had an odds ratio of .6 for developing MS compared to non-drinking women, indicating decreased risk compared to women who never drank. Similarly, men who reported consuming a lot of alcohol had an odds ratio of .5, also indicating decreased risk.
In the other study, the odds ratio for both men and women who drank was .7 compared to non-drinkers. A side finding of this investigation was that in both studies, the negative effects of smoking were more significant among non-drinkers, indicating an interaction between these two behavioral variables.
The Current Study
Now, a recent study better determines the effects of alcohol intake and the interaction of alcohol intake and smoking on the subsequent development of MS (Hedstrom, Olsson, & Alfredsson, 2021). Alcohol exposure was related to a 20 percent decrease in the risk of developing MS compared to never drinking.
The findings of this study suggested that not drinking alcohol significantly increased the risk of developing MS, particularly if they’d ever smoked in the past or present. As a characteristic of MS is an overactive immune system, the effects of alcohol which decrease the immune system, may explain the association.
The association between never drinking and the development of MS was stronger for smokers. The interaction was somewhat stronger for current smokers compared to past smokers, and the interaction became significantly stronger with cumulative smoking.
The researchers caution using these findings to dictate treatment recommendations, although they are useful for clinical practice and understanding risk factors for individuals who have a genetic predisposition to develop MS. While they said the results do suggest there is no need to tell patients with MS heritability or who already have MS to abstain from drinking alcohol completely, they also don’t support telling such patients to increase their alcohol consumption.
“Consumption of alcohol has detrimental effects on other disease conditions, and better understanding of the mechanisms behind our findings may help to define ways to achieve protection against MS by other means than alcohol consumption,” the researchers stated.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2021 Natalie Frank