Diet & Clinical Outcomes in Multiple Sclerosis

Research Summary: A pro-inflammatory diet in people with multiple sclerosis is associated with an increased rate of relapse and increased FLAIR lesion volume on MRI in early multiple sclerosis: A prospective cohort study

While it is now widely accepted that dietary modifications can be an important part of disease management in multiple sclerosis, there is limited amounts of data about whether it can directly impact on disease progression.  In this research article, we summarise a publication that has investigated this topic.

What?

This article looks at whether a pro-inflammatory diet is linked to greater disease activity and worse clinical outcomes in people living with multiple sclerosis.

Who?

This research was conducted by a team at the Menzies Institute of Medical Research in Tasmania, Australia.

Where?

The article was published in the Multiple Sclerosis Journal.  The full text publication is available here.

When?

The study was first published online on May 6, 2023.

BACKGROUND #1:  Dietary modifications are discussed as an important lifestyle factor that people living with multiple sclerosis can control to help manage their disease.  While a number of ‘MS diets’ have been proposed, the current advice is for people to follow a healthy, balanced diet.

BACKGROUND #2:  One of the reasons that diet is an important focus is that it can reduce the risk of several comorbidities, such as cardiovascular disease, that are known to be increased in people living with multiple sclerosis.

BACKGROUND #3:  There is a limited amount of data that shows how diet impacts on clinical outcomes in people living with multiple sclerosis.

FINDING #1:  Participants answered questionnaires related to their food intake, so that a dietary inflammatory index (DII) score could be determined.  A basic explanation of the DII can be found here.  Essentially, a negative score indicates an anti-inflammatory diet and a positive score indicates a pro-inflammatory diet.  The average score for participants in the study was +1.68 at 5 years and +1.91 at 10 years. 

FINDING #2:  A higher DII score was associated with an increased relapse rate – that is, those who had a more pro-inflammatory diet had a greater risk of relapse than those on an anti-inflammatory diet.

FINDING #3: There was also a suggestion that a more pro-inflammatory diet might be linked with a higher lesion volume observed on MRI scans.  This finding wasn’t as conclusive and may need further analysis.

THOUGHT #1:  The findings of this study suggest that following a healthy diet may have direct impacts on the clinical outcomes of multiple sclerosis. This evidence, as well as the fact that a healthy diet can help promote weight-loss and reduce the risk of comorbidities, provides really strong reasoning for why a focus should be placed on dietary modifications in people living with multiple sclerosis.

THOUGHT #2:  There are many factors that influence the diet that a person follows, such as income, socio-economic status, food access and time availability.  Therefore, we need to have an understanding that just knowing that following a healthy diet is a good idea may not be enough to initiate lifestyle modifications.  Open and honest conversations that allow for discussion of all of these contributing factors are important for helping to create positive and sustainable change.

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Other articles we have published on the topic of diet and multiple sclerosis can be found here.