Diet rich in plant products linked to fewer symptoms in MS

Diet was found to significantly influence the severity of multiple sclerosis (MS) symptoms among patients living in Denmark in a new real-world study.

A diet rich in plant-based products was generally associated with a lower symptom burden than one high in red and processed meats. The same was true for higher vegetable intake compared with eating fewer veggies.

However, the researchers noted that their findings do not confirm that any specific diet eases MS symptoms. Instead, these results offer insight into a potential relationship between diet and disease severity that warrants further investigation.

“Although the research design limits the possibilities of establishing causal inference, the results indicate that general guidelines for healthy diet may be relevant as a tool in coping with MS symptoms,” the team wrote, though adding that “the results suggested less symptom burden with increased intake of vegetables.”

The study, “Dietary Patterns and Their Associations with Symptom Levels Among People with Multiple Sclerosis: A Real-World Digital Study,” was published in Neurology and Therapy.

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Patients’ ‘real-world’ food intake tracked over 100 days

Diet has been proposed as a modifiable lifestyle factor that can influence MS risk, the severity of symptoms, and disease progression.

Various dietary components have been investigated for their potential effects in the neurodegenerative disease, but large, well-controlled studies to look at the overall effects of diet — rather than individual food items — are lacking.

“High-quality clinical trials are rare within the field of MS and diet, not least due to challenges in maintaining [people with MS] on a specific diet during a long period of time,” the researchers wrote, noting that cognitive issues and fatigue also limit trial participation.

While the few pilot studies and smaller clinical trials that have been conducted suggest that diet does impact MS symptoms, review studies have found that the existing evidence remains uncertain.

High-quality clinical trials are rare within the field of MS and diet, not least due to challenges in maintaining [people with MS] on a specific diet during a long period of time.

To learn more about the impact of diet among MS patients in Denmark, specifically, researchers at the Danish MS Society now systematically collected real-world, long-term data on food intake and disease symptoms from adults across the country.

Patients were asked to digitally record their food intake and symptoms daily over a period of 100 days, or a little longer than three months.

While 550 people initially registered for the study, a total of 163 — about 30% — met the study criteria of completing at least three weeks of digital recordings.

The number of data entries each completed tended to be higher among people with more severe or progressive forms of MS.

“Hence, the study population might be biased towards [patients] with more progressive or severe MS,” the researchers wrote.

Among those eligible participants, the researchers identified three distinct dietary clusters. The first, dubbed the “Western diet” by the team, was distinguished by a high consumption of red meat and processed meat products, whereas the so-called “plant-rich diet” was characterized by a higher intake of vegetables, vegetable oils, and fruits.

The third diet — called the “variable diet” by researchers — fell somewhere in between the others, and was marked by high dairy consumption.

Individuals in the Western and plant-rich groups differed in terms of demographic variables, with those consuming a Western diet being less educated and living in more rural areas, while those eating a plant-rich diet were more highly educated, concentrated in urban population centers, and were younger.

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Eating more veggies led to symptom reduction of up to 74%

In general, the plant-rich diet was associated with a reduced symptom burden. Across nine different MS symptoms, those reductions ranging from 19%-90% relative to the Western diet. These differences were statistically significant for overall symptom burden as well as for pain and bladder symptoms.

When focusing on vegetable consumption, the results showed that patients eating more veggies had a 32%-74% reduction in symptoms compared with those eating fewer vegetables. Significant differences were observed for walking difficulties. In turn, muscle weakness was found to be lowest among people who consumed an intermediate amount of meat.

The findings overall were consistent with several pilot studies indicating that a high-quality or veggie-rich diet may have beneficial effects on MS symptoms.

“The results of the present study add to the growing knowledge concerning the impact of diet on MS symptomatology,” the researchers wrote.

Still, the exploratory and observational design of the study posed certain limitations, including an inability to associate dietary habits with clinical measures of disease severity or with certain MS treatments.

While no cause and effect relationship can be determined from this type of study, the design “strengthened an everyday and real-world perspective on dietary habits,” the team wrote.

Moreover, the use of digital tools for recording data can “offer a valid and valuable way to gain insight into everyday life with MS within real-world settings,” they added.