ACTRIMS 2026: Mediterranean diet may help slow disability worsening in MS
Study: Biological aging processes are potentially modifiable with lifestyle changes
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- Mediterranean diet adherence may slow disability worsening in early MS.
- This effect is linked to slowing biological aging, as indicated by longer telomeres.
- Lifestyle changes and diet interventions are being studied for MS management.
Better adherence to a Mediterranean-like diet may help prevent disability worsening in people with early multiple sclerosis (MS), in part by slowing biological aging, according to data from a new study.
The findings suggest that diet, biological age, and disability are closely connected and that lifestyle changes could potentially influence long-term disease outcomes.
“Biological aging processes are … relevant to MS and, importantly, potentially modifiable with lifestyle changes,” Ilana Katz Sand, MD, a neurologist at Mount Sinai Hospital in New York City, said in an oral presentation at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2026, held last week in San Diego and virtually.
Her talk was titled “Diet, Leukocyte Telomere Length, and Disability in Multiple Sclerosis.”
Study participants reported their adherence to Mediterranean diet
Biological age reflects how old a person’s cells and tissues appear based on markers of aging, which may differ from their chronological age. One commonly used marker is leukocyte telomere length (LTL).
Telomeres are protective caps at the ends of chromosomes that naturally shorten as cells divide. Shorter telomeres in white blood cells have been linked to greater disability and brain changes in people with MS.
Researchers have also found that dietary habits may influence both biological aging and disability, suggesting that lifestyle modifications may help to slow those processes. However, the exact relationships between diet, biological age, and disability remain poorly understood.
To explore this, Katz Sand and colleagues analyzed data from 185 people with relapsing forms of MS who were being followed as part of a large observational study. Participants had been diagnosed within the past five years and were followed for six years.
In addition to undergoing multiple clinical assessments, MRI scans, and blood tests over time, participants also reported how closely they adhered to a Mediterranean diet — which emphasizes olive oil, fruits, and vegetables, while limiting animal fats, red meat, and processed foods — using the 14-point Mediterranean Diet Adherence Screener.
People whose disability worsened had shorter telomeres
Over the six-year follow-up period, people whose disability worsened had lower Mediterranean diet scores and shorter telomeres than those whose disability had remained stable. These results were observed even after adjusting for factors such as age, sex, socioeconomic status, body weight, and physical activity.
The strongest association between diet and telomere length was seen among participants with the lowest diet adherence. Those in the bottom 25% of Mediterranean diet scores had significantly shorter telomeres than others with higher scores.
“It seems that this particular combination of both not meeting some of [the Mediterranean diet] targets like olive oil, fruits, and vegetables, and also having a higher consumption of things like baked goods [and] processed meats, really puts people at a disadvantage when it comes to LTL status,” Katz Sand said.
Statistical analyses then suggested that at least some of the effects of diet on disability were indirect, being mediated by its impact on biological age. Although the results did not reach statistical significance, the data suggested that telomere length accounted for about 16% of the relationship between Mediterranean diet adherence and worsening disability.
We’ve previously shown that we actually can get people to change their diet if we give them the support and resources to do so.
The team now plans to validate these findings using distinct markers of biological aging and different dietary patterns and indices. If data continue to show an association between diet, biological aging, and disability worsening, then it’s possible that dietary changes might help reduce disability worsening in MS.
Katz Sand noted that changing eating habits can be difficult, but specialized interventions may help support these changes.
“We’ve previously shown that we actually can get people to change their diet if we give them the support and resources to do so,” the scientist said.
The researchers are also running a clinical trial (NCT06992115), sponsored by the National MS Society, testing whether a Mediterranean-style diet intervention can improve a range of outcomes in MS. While the trial’s main goal is to assess changes in a biomarker of nerve cell damage, the researchers also aim to measure disability and LTL, which may help determine the impact of diet on biological aging and disability worsening.
The trial has enrolled about 50% of its planned 100 participants, and will follow them for about one year, which is “the minimum amount of time … you need to see an effect on biological aging,” Katz Sand said. “Stay tuned on that.”
The Multiple Sclerosis News Today team is providing virtual coverage of the ACTRIMS Forum 2026 from Feb. 5-7. Go here to see the latest stories from the conference.
