Mediterranean Diet Associated With Lower Disability Risk in MS Study

High adherence to a Mediterranean diet is associated with a lower risk of disability outcomes, as well as reported disease symptoms, in people with multiple sclerosis (MS), a new study shows.

The data provide important information for further studies to guide clinical recommendations in MS.

The study, “Mediterranean diet is linked to less objective disability in multiple sclerosis,” was published in Multiple Sclerosis Journal.

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Diet is known to have an impact on cardio-metabolic complications, with potential effects on the immune and nervous systems. The MS community, in particular, is interested in how diet can potentially protect against disability and help manage disease symptoms.

However, “although experts tend to agree on general healthy eating principles (e.g. limiting processed foods), rigorous clinical research in MS is needed,” the researchers wrote. Furthermore, “research including objectively measured disability outcomes is quite limited.”

The Mediterranean diet is of particular interest in MS research.

In the new study, a team led by researchers at the Icahn School of Medicine at Mount Sinai has now assessed the adherence of people with MS to a Mediterranean diet and its association with disability outcomes.

The study included 563 MS patients, ages 18–65, who completed the Mediterranean Diet Adherence Screener (MEDAS), which scores the consumption of healthy (e.g., olive oil, vegetables) and avoidance of unhealthy (e.g., red meat, butter) foods; the MS Functional Composite (MSFC), which quantifies disability outcomes in MS, including cognition, arm coordination, and walking speed alterations; and patient-reported outcomes, which assesses physical impairment, fatigue, walking/cognitive dysfunction, depression, and anxiety.

‘MEDAS was by far the best health-related predictor’ of disability outcomes

The data showed that the MEDAS scores of MS patients (score of 6.25, ranging from 1 to 12) were similar to those of 402 screened healthy European adults (score of 6.22), and 140 local healthy adults demographically matching the MS group (score of 6.29).

Importantly, by dividing MEDAS scores in different ranges (lower to higher: 1–4, 5–6, 7–8, and 9–12), the team found that higher scores were associated with better MSFC performance (meaning less disability), independent of demographics (age, sex, race, ethnicity, and socioeconomic status) and health-related conditions.

“MEDAS was by far the best health-related predictor of MSFC,” the researchers wrote.

The team also found that each MEDAS point score increase was linked to a 15% lower risk for MSFC impairment. In addition, higher MEDAS attenuated the effects of disease progression and longer disease duration on disability.

Increased MEDAS scores were also related to lower disability across all patient-reported outcomes, regardless of demographic and health-related settings. Among patient-reported outcomes analyzed, depression had the strongest association with MEDAS scores.

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Overall, “higher MEDAS independently predicted better outcomes across MSFC,” its components, and patient-reported outcomes in the MS patients, the researchers wrote, meaning that a higher adherence to the Mediterranean diet predicted better outcomes in terms of disability, and performance/functional capacity.

In more detail, “better MSFC was most associated with higher olive oil consumption, but also to greater consumption of nuts and wine, and lower consumption of pastries and sugary beverages,” the team wrote. “Depression was worse among patients who use butter, drink sugary beverages, and consume less fish.”

Taken together, this study demonstrated a strong association between MS-related disability and the Mediterranean diet in a large group of people with MS.

“We anticipate these results will inform the design of longitudinal studies and interventional clinical trials on this crucially important topic going forward,” the researchers wrote, noting that the findings can also be relevant for the “design of larger interventional studies evaluating the potential of diet as an adjunct to traditional disease-modifying therapy in MS.”