ECTRIMS 2025: Ultra-processed foods may fuel disease in early MS
Increased consumption linked to more frequent relapses, greater lesion activity
Consuming large amounts of ultra-processed foods (UPF) — products high in additives, artificial ingredients, and extensive processing — is associated with increased disease activity in people with clinically isolated syndrome (CIS), which is the first presentation of multiple sclerosis (MS), a study has found.
The analysis used a signature of blood metabolites to estimate a person’s intake of ultra-processed foods. Overall, patients with the highest consumption were 30% more likely to experience a relapse over five years than those with the lowest intake.
A diet high in ultra-processed foods was also associated with greater lesion volume at two years, though no differences were observed in the proportion of patients who converted to clinically definite MS.
Reducing ultra-processed food intake is a low-risk strategy
“Reducing UPF intake may be a safe, low-risk complementary strategy for early MS management alongside established therapies,” said Gloria Dalla Costa, MD, a neurologist and researcher at the Harvard T.H. Chan School of Public Health, who shared the results at the 41st Congress of the European Committee for Treatment and Research in Multiple Sclerosis, held last week in Barcelona, Spain, and online.
Dalla Costa’s presentation was titled “Association of Ultra-Processed Food Intake with Increased MS Disease Activity: Findings from the BENEFIT Trial.”
“Similar to vitamin D supplementation or smoking cessation advice, this is not about replacing established therapies, but about complementing them,” she said in an ECTRIMS press release. “It’s a low-risk, potentially high-benefit intervention.”
MS is caused by a mistaken immune system attack that damages healthy tissue in the brain and spinal cord. Ultra-processed foods have been shown to increase inflammation, with a high intake being associated with an increased risk of death, cancer, and cardiovascular diseases. However, their influence on MS activity remains unclear.
Ultra-processed foods are industrially formulated foods that contain ingredients with little or no culinary use, such as additives, emulsifiers, colorings, and flavorings. These foods include frozen pizzas, instant noodles, flavored yogurts, sweetened milk drinks, and much of what is typically considered junk food, according to Dalla Costa.
In the study, researchers investigated whether ultra-processed food intake was associated with MS activity in people with CIS. They analyzed data from 451 patients who had participated in the BENEFIT trial (NCT00185211), which tested whether Betaseron (interferon beta-1b) could delay the conversion from CIS to clinically definite MS.
At the start of the study, participants provided a blood sample and were then followed for five years. The researchers have now used those blood samples to estimate each participant’s ultra-processed food intake based on a previously validated signature of 39 blood metabolites, or small molecules produced during cellular metabolism.
Over five years, 46.1% of patients were eventually diagnosed with MS. Although UPF scores were not associated with conversion to clinical definite MS, the results showed patients with the top 25% UPF scores experienced significantly more relapses over five years compared with those with the bottom 25% scores.
This difference remained significant after adjusting for factors such as age, sex, treatment allocation (whether patients received Betaseron or a placebo), initial disease burden, body fat, vitamin D levels, and smoking status.
In addition to relapses, patients with the top UPF scores had a greater lesion volume and also a higher rate of new active lesions at two years, regardless of other factors, indicating more severe tissue damage.
Food can act as chronic inflammatory accelerant
“This pattern suggests ultra-processed foods act as a chronic inflammatory accelerant rather than a disease trigger, amplifying existing inflammatory processes in MS rather than determining whether someone develops the disease in the first place,” Dalla Costa said.
Potential biological mechanisms may involve disruption of the gut barrier by additives present in UPFs, and impaired cellular energy metabolism, she noted.
“Elevated ceramides and modified [fats] suggest UPF consumption may also alter membrane composition, making myelin and the cells that produce it more vulnerable to autoimmune attack,” she added.
The team is planning to replicate these results in other groups of people with MS and analyze the microbiome, or the population of microorganisms present in the gut, in those who consume large amounts of ultra-processed foods.
Note: The Multiple Sclerosis News Today team is providing live coverage of the 41st Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Sept. 24-26. Go here to see the latest stories from the conference.
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