Pilot study compares effects of 2 diet plans on sleep and appetite in MS
Both Mediterranean diet and timed eating aid weight loss in RRMS
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Eating a variety of healthy foods is recommended for people with multiple sclerosis. (Image from iStock)
- A small clinical trial assessed how the Mediterranean diet and time-restricted eating affect body composition and sleep in women with multiple sclerosis.
- Both dietary interventions led to weight loss and reductions in waist and hip circumference in over a 12-week period.
- Only the Mediterranean diet was linked to positive changes in sleep and circadian rhythm questionnaire scores.
Both the Mediterranean diet and time-restricted eating — a dietary intervention in which all daily meals and snacks are consumed within a set time window — may help promote weight loss in people with relapsing-remitting multiple sclerosis (RRMS), according to results from a small clinical trial comparing the two diets.
The pilot study also found that following the Mediterranean diet — which stresses fruits and vegetables, lean meats and seafood, and olive oil as key dietary components — may alter sleep habits in people with this type of multiple sclerosis (MS), which is marked by periods of new or worsening symptoms interspersed with times in which they ease and/or stabilize.
Still, the scientists say more research is needed to determine if these diets can ease the sleep disturbances that are “frequently associated” with MS.
The researchers had been testing the two eating plans in women with RRMS to see whether either would affect the body’s natural sleep-wake cycle, known as the circadian rhythm, and appetite markers. While only the Mediterranean diet was linked to differences in scores on sleep measures, both eating plans helped participants lose weight while increasing protein, fiber, and water intake, the team noted.
“The present findings provide preliminary evidence supporting the potential role of nutritional interventions as complementary approaches in the management of RRMS and may help generate hypotheses for future clinical studies,” the researchers wrote.
The study, “Mediterranean Diet vs. Time-Restricted Eating: Effects on Circadian Rhythm and Appetite Markers in Female Patients with Multiple Sclerosis — A Pilot Study,” was published in the journal Healthcare.
What a person eats can have a profound impact on health, and it’s generally recommended that people with multiple sclerosis (MS) try to eat a well-balanced diet. To date, however, there is not enough data to support any one diet plan as the best for people with MS. As such, several specific types of diets are being explored by researchers.
One of these is the Mediterranean diet. Structured to follow eating habits similar to those of people living near the Mediterranean Sea, this diet includes lots of lean meats, seafood, fruits, veggies, and olive oil. Another diet strategy that’s been investigated for MS is time-restricted eating or TRE, where people eat only during certain hours of the day — often within a consistent eight-hour daily window — and fast the rest of the time.
Evidence links MS to sleep problems
Now, a team of scientists in Turkey sought to compare the effects of these two dietary plans. To that end, the team conducted a small pilot study (NCT06546033) testing the Mediterranean diet versus TRE in 34 women with RRMS. All participants received individualized dietary guidance, with half following a Mediterranean diet and half following a TRE strategy for about three months.
One key endpoint, or goal, was assessing the impact of diet on sleep patterns.
“There is increasing evidence that MS is associated with the disruption of circadian rhythms, which represent physical, mental, and behavioral patterns that oscillate repeatedly every 24 [hours],” the researchers wrote.
Here, the team investigated whether sleep disturbances and “circadian disruption” are potentially a result of MS or “a contributing factor to [the] disease,” according to the researchers.
At the beginning and end of the 12-week dietary period, the researchers tested various metrics related to body composition, blood biomarkers, and sleep.
“This study is among the first to directly compare the effects of MedDiet [the Mediterranean diet] and TRE on [body composition], [and] biochemical, sleep, and appetite-related outcomes in females with RRMS,” the researchers noted.
Those on Mediterranean diet saw higher sleep scores
The results showed that both diets led patients to lose weight, along with reductions seen in waist and hip circumference, which typically reflect a drop in abdominal fat. Data also indicated that cholesterol levels decreased among patients who followed the Mediterranean diet, but these changes weren’t statistically meaningful in analyses that accounted for other variables.
The Mediterranean diet group, but not the TRE group, also reported significant increases in scores on the Morningness and Eveningness Sleep Questionnaire (MEQ), a standardized assessment that measures when a person prefers to be awake and active. Higher scores basically mean that someone tends to be more of a morning person.
The findings suggest that diet may help modulate the body’s natural processes for keeping time, known as the circadian clock, although this relationship warrants further study, according to the authors.
Both interventions were associated with changes in [body composition] measures, whereas modest favorable changes in [cholesterol] parameters and higher [sleep-related] scores were observed in the [Mediterranean diet] group.
Other sleep-related measures did not significantly change with either diet plan. Levels of hunger-related hormones were also unchanged with both diets, the data showed.
“Both interventions were associated with changes in [body composition] measures, whereas modest favorable changes in [cholesterol] parameters and higher MEQ scores were observed in the MedDiet group,” the researchers wrote.
The scientists stressed that this study was limited to a small number of female patients followed for only a few months, so more research is essential to further evaluate the impact of different diets in MS.
“Given the pilot nature of the study, the absence of a non-intervention control group, and the relatively small sample size, further trials with longer follow-up periods and objective circadian and metabolic measures are needed to clarify the long-term effects of these dietary interventions,” the team concluded.
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