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Updated: Dec 21, 2025

Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination
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Dietary interventions for multiple sclerosis-related outcomes.

Natalie E Parks1, Caitlin S Jackson-Tarlton1, Laura Vacchi2

  • 1Department of Medicine, Division of Neurology, Dalhousie University, Halifax, Canada.

The Cochrane Database of Systematic Reviews
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Dietary interventions for multiple sclerosis (MS) show uncertain effects. Polyunsaturated fatty acid (PUFA) supplementation and antioxidant use do not appear to significantly alter MS relapse rates or disability progression, with limited evidence available.

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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.