Dietary interventions for multiple sclerosis-related outcomes

Area of Science:

• Neurology
• Immunology
• Nutritional Science

Background:

• Multiple sclerosis (MS) is a central nervous system demyelinating disease, likely caused by immune dysregulation.
• Disease-modifying therapies modulate the immune system, and dietary interventions are being explored for their potential impact on MS outcomes.

Purpose of the Study:

• To assess the effects of various dietary interventions on health outcomes in individuals with MS.
• This review updates previous Cochrane reviews on dietary interventions for multiple sclerosis.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) and controlled clinical trials (CCTs) comparing dietary interventions to placebo or other interventions.
• Searched multiple databases including CENTRAL, MEDLINE, Embase, and Web of Science up to May 2019.
• Primary outcomes included relapse rates and disability progression; secondary outcomes included MRI activity and safety.

Main Results:

• Thirty trials involving adults with MS were included, with significant risk of bias noted in most.
• Polyunsaturated fatty acid (PUFA) supplementation showed uncertain effects on relapses and disability progression compared to monounsaturated fatty acids (MUFAs) or other PUFAs.
• Antioxidant supplementation and other dietary interventions demonstrated insufficient evidence to determine impact on MS-related outcomes, with low to very low certainty evidence.

Conclusions:

• Current evidence suggests polyunsaturated fatty acid (PUFA) administration may not differ from alternatives in affecting MS relapse rates or disability.
• There is insufficient evidence to conclude whether antioxidant supplementation or other dietary interventions impact MS-related outcomes.
• Further high-quality research is needed to clarify the role of dietary interventions in managing multiple sclerosis.