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Low-fat, plant-based diet in multiple sclerosis: A randomized controlled trial.

Vijayshree Yadav1, Gail Marracci1, Edward Kim1

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A plant-based diet improved fatigue, BMI, and metabolic markers in multiple sclerosis (MS) patients but did not significantly impact MRI outcomes or disability. Further research is needed for long-term benefits.

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Area of Science:

  • Neurology
  • Nutrition Science
  • Clinical Research

Background:

  • Dietary interventions are of interest for multiple sclerosis (MS) management, but robust data are limited.
  • The impact of a very-low-fat, plant-based diet on MS progression, disease activity, and symptoms requires evaluation in a randomized-controlled trial.
  • Fatigue significantly impacts quality of life (QOL) in MS patients, with limited effective treatment options.

Purpose of the Study:

  • To assess the adherence, safety, and effects of a very-low-fat, plant-based diet on brain MRI, clinical outcomes (relapses, disability, BMI), metabolic markers (lipids, insulin), QOL, and fatigue in relapsing-remitting MS (RRMS).

Main Methods:

  • A one-year, randomized-controlled, assessor-blinded study involving 61 participants with RRMS.
  • Participants were assigned to either a very-low-fat, plant-based diet (N=32) or a wait-listed control group (N=29).
  • Outcomes included brain MRI, clinical assessments, SF-36 for QOL, and FSS/MFIS for fatigue.

Main Results:

  • Adherence to the plant-based diet was excellent, with significantly lower total fat intake compared to controls.
  • No significant differences were observed between groups in brain MRI outcomes, MS relapses, or disability (EDSS scores) at 12 months.
  • The diet group showed significant improvements in fatigue (FSS, MFIS), BMI, LDL cholesterol, total cholesterol, and insulin levels by six months.

Conclusions:

  • A very-low-fat, plant-based diet is well-tolerated in RRMS patients and improves fatigue, BMI, and metabolic biomarkers.
  • The diet did not demonstrate significant effects on brain MRI, relapse rates, or disability over one year.
  • While beneficial for self-reported fatigue and metabolic health, larger, longer studies are needed to confirm long-term benefits and rule out smaller effects.