Published research illustrating the impact of diet found in Jan 2024 in a project with student G H Alzanbaqi and Dr Jonathan White.


DIET AND MULTIPLE SCLEROSIS


Fruits and vegetables


Paper: Dietary patterns and associations with health outcomes in Australian people with multiple sclerosis

Journal: European Journal of Clinical Nutrition, 75(10), 1506–1514. 2021

Key insights: Higher scores (‘healthier’) on subscales for fibre, fruit and vegetable were associated with better quality of life scores.

Description: This cross-sectional study aimed to investigate the dietary habits and associations with health outcomes in Australians with multiple sclerosis (MS). The analysis was based on 2016 survey data from the Australian MS Longitudinal Study, involving 1490 participants. Among them, 94.3% reported making efforts to eat healthy, with 21.2% following specific diets. Notably, those adhering to diets often did so less strictly. Results indicated that a healthier overall diet score, along with higher scores for fibre, fruit, vegetable, and healthy fat intake, were associated with better mental, physical, and total quality of life. Additionally, participants avoiding dairy and meat or following specific MS diets were less prevalent than previously reported. The study underscores the need for prospective dietary research to explore the feasibility and long-term effects of dietary changes on the health outcomes of individuals with MS.


Diet and health-related quality of life


Paper: Higher diet quality is associated with short and long-term benefits on SF-6D health state utilities: a 5-year cohort study in an international sample of people with multiple sclerosis

Journal: Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 32(7), 1883–1896. 2023

Key insights: Each 10-unit increase in the total diet score was associated with a 0.8% to 1.2% higher Health-Related Quality of Life (HRQoL). Higher fat, fibre, and fruit/vegetable intake were consistently associated with approximately 1.0% or more improvement in HRQoL.However, higher meat and dairy consumption at baseline were linked to approximately 1.0% to 2.0% lower HRQoL at subsequent follow-up

Description: This study explored the connection between diet and health-related quality of life (HRQoL) in individuals with multiple sclerosis (MS). Using a large international cohort, researchers found that higher-quality diets were associated with increased HSU (health state utilities) over 2.5- and 5-year periods. Specifically, improvements in fat, fiber, and fruit/vegetable intake were consistently linked to better HRQoL outcomes, while baseline meat and dairy consumption were associated with lower HRQoL at subsequent follow-up. These findings suggest that interventions to enhance diet quality may effectively improve HRQoL in people living with MS


Plant-based diet


Paper: Diet and disease-related outcomes in multiple sclerosis: A systematic review of clinical trials

Journal: Current Journal of Neurology. 2022

Key insights: Plant-based diets (low-fat and low-calorie) showed 60-70% improvement in fatigue compared to a regular diet. Low-protein plant-based diet demonstrated a moderate to large improvement in disability and relapse rate (RR) compared to a Western diet. The ketogenic diet (KD) exhibited clinically meaningful improvement in quality of life (QOL) and disability compared to a regular diet. Fish oil (FO) had a 10-30% improvement in disability compared to a placebo. Evening primrose oil and hemp seed oil showed 70-150% improvement in RR compared to olive oil. High flavonoid cocoa had a 40% improvement in fatigue and a 4% improvement in QOL.

Description: In this systematic review of clinical trials investigating the impact of diet on multiple sclerosis (MS) patients, 15 trials involving 669 participants were analysed. Plant-based diets, specifically low-fat and low-calorie variations, demonstrated significant positive effects on fatigue compared to regular diets. Another plant-based diet, low in protein, showed moderate to large effects on disability and relapse rate compared to a Western diet. The ketogenic diet (KD) exhibited clinically meaningful effects on quality of life (QOL) and disability. Fish oil (FO) demonstrated a small effect on disability. Evening primrose oil and hemp seed oil had medium to large effects on relapse rate compared to olive oil. High-flavonoid cocoa had a moderate effect on fatigue and a small effect on QOL compared to low-flavonoid cocoa. The conclusion suggests that a plant-based diet is foundational for dietary recommendations in MS patients, while low-fat, low-calorie, and KD diets, along with the addition of fish oil, vegetable oil, and flavonoids, could also be beneficial.


Fish and seafood


Paper: Dietary fish intake and the risk of multiple sclerosis: a systematic review and meta-analysis of observational studies

Journal: Nutritional Neuroscience, 25(4), 681–689. 2020

Key insights: Consuming 0.5 servings of fish weekly during adolescence and beyond may lower MS risk, but additional studies are needed for conclusive evidence of this preventive effect.

Description: In a systematic review conducted to examine the association between dietary fish intake and the risk of multiple sclerosis (MS), six relevant articles were analysed. The study found that the consumption of fish appears to decrease the risk of MS when compared to controls, with an odds ratio of 0.77 (95% confidence intervals: 0.64, 0.92; p-value = 0.004; I2 = 54.7%). The findings suggest that maintaining a dietary intake of at least 0.5 servings of fish per week during adolescence and beyond may potentially reduce the risk of MS. However, the authors emphasize the need for further studies to substantiate this preventive effect.


Healthy dietary pattern


Paper: Adherence to healthy dietary pattern is associated with lower risk of multiple sclerosis

Journal: Journal of Central Nervous System Disease, 14, 117957352210925. 2022

Key insights: The study found that a higher adherence to the Healthy dietary pattern was associated with a 74% reduced risk of MS, while the Unhealthy dietary pattern was linked to a three-fold increased risk.

Description: This study investigated the relationship between dietary patterns and the risk of Multiple Sclerosis (MS). Conducted in Mashhad, Iran, with 197 MS patients and 200 matched control subjects, the study identified four major dietary patterns: Unhealthy, Western, Healthy, and Traditional. After adjusting for various factors, the study found that a higher adherence to the Healthy dietary pattern was associated with a 74% reduced risk of MS, while the Unhealthy dietary pattern was linked to a three-fold increased risk. No significant correlation was observed with the Western and Traditional dietary patterns. The findings suggest that a healthy diet may contribute to lowering the risk of MS, while an unhealthy diet may increase it.

 


Mediterranean diet


Paper: Effects of different dietary interventions in multiple sclerosis: a systematic review of evidence from 2018 to 2022

Journal: Nutritional Neuroscience, 1–13. 2022

Key insights: Positive health outcomes were reported for energy-restricted/intermittent fasting diets, ketogenic diet, and modified paleolithic diet. Lack of evidence for low-fat diets, gluten-free diet, and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet in individuals with MS. The Mediterranean diet is more recommendable based on positive long-term results and minimal side effects, though further studies are needed for a definitive conclusion.

Description:

Objective: Conducting a systematic review between February and March 2022, we aimed to assess the impact of various dietary interventions on individuals with Multiple Sclerosis (MS) and identify the most suitable dietary model for this population.

Methods: A search across 'PubMed,' 'Web of Science,' and 'The Cochrane Library' yielded 269 studies from 2018 to 2022. Of these, only 17 met the inclusion criteria.

Results and Conclusion: While certain diets like energy-restricted/intermittent fasting, ketogenic, and modified paleolithic show positive outcomes, potential long-term nutrient deficiencies raise concerns. No current studies were found for low-fat, gluten-free, and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets in MS patients. The Mediterranean diet, supported by positive long-term results and minimal side effects, appears promising. However, further research is needed for a conclusive recommendation.


Paper: Adherence to Mediterranean Diet Is Associated with Multiple Sclerosis Severity

Journal: Nutrients, 2023

Key insights: Higher adherence to the Mediterranean Diet was associated with 6.18 times (518%) higher probability of having a mild-to-moderate MS. It remains uncertain whether specific dietary components in the MedDiet affect health at disease onset or slow down disease progression, requiring further research for confirmation

Description: This study aimed to explore the potential impact of adherence to the Mediterranean Diet (MedDiet) on the severity of Multiple Sclerosis (MS) in a group of Italian patients. The research involved 106 patients categorized based on their MedDiet adherence. Results indicated that higher adherence was associated with a 6.18 higher probability of having mild-to-moderate MS. However, the study did not identify specific constituents of the MedDiet that individually influenced MS severity. The authors suggested that further research is necessary to replicate these findings and address whether specific dietary components in the MedDiet could affect health status at disease onset or slow down disease progression.


There are also many references in the main book by Professor George Jelinek. The Diet section is covered on pages 71-147 of the book and includes a total of 150 scientific evidence-based research articles.