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Published on: February 23, 2024
Mediterranean diet is linked to less objective disability in multiple sclerosis
Ilana Katz Sand1, Sarah Levy1, Kathryn Fitzgerald2
1Department of Neurology, Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Background:
The multiple sclerosis (MS) community is highly interested in diet as a potential protective factor against disability, but empirical evidence remains limited.
Objective:
Evaluate associations between patient-reported Mediterranean diet alignment and objective disability in a real-world MS cohort.
Methods:
Data were analyzed from persons with MS, aged 18-65, who completed the Mediterranean Diet Adherence Screener (MEDAS), MS Functional Composite (MSFC; primary disability metric), and patient-reported outcomes (PROs; disability, gait disturbance, fatigue, anxiety, and depression) as part of our Comprehensive Annual Assessment Program. Multiple regression predicted MSFC (and PROs) with MEDAS after adjusting for demographic (age, sex, race, ethnicity, and socioeconomic status) and health-related (body mass index (BMI), exercise, sleep disturbance, hypertension, diabetes, hyperlipidemia, and smoking) covariates.
Results:
Higher MEDAS independently predicted better outcomes across MSFC (z-score, B = 0.10 (95% confidence interval (CI): 0.06, 0.13), β = 0.18, p < 0.001), MSFC components, and PROs in 563 consecutive patients. Each MEDAS point was associated with 15.0% lower risk for MSFC impairment (⩽ 5th percentile on ⩾ 2 tasks; odds ratio (OR) = 0.850; 95% CI: 0.779, 0.928). Higher MEDAS attenuated effects of progressive disease and longer disease duration on disability.
Conclusion:
With robust control for potential confounds, higher Mediterranean diet alignment predicted lower objective and patient-reported disability. Findings lay the necessary groundwork for longitudinal and interventional studies to guide clinical recommendations in MS.
Insights
Adhering to the Mediterranean diet is linked to better physical function and reduced disability in people with multiple sclerosis (MS). This dietary pattern may help slow disease progression and lessen its impact.
Area of Science:
- Neurology
- Nutritional Science
- Clinical Research
Background:
- The multiple sclerosis (MS) community shows significant interest in diet's role in managing disability.
- Empirical evidence linking diet to MS disability outcomes is currently limited.
Purpose of the Study:
- To investigate the association between adherence to the Mediterranean diet and objective disability markers in a real-world cohort of individuals with MS.
- To evaluate patient-reported outcomes related to disability and well-being in relation to Mediterranean diet alignment.
Main Methods:
- Analysis of data from 563 individuals with MS (aged 18-65) using the Mediterranean Diet Adherence Screener (MEDAS).
- Objective disability was assessed using the MS Functional Composite (MSFC) and its components.
- Patient-reported outcomes (PROs) including disability, gait disturbance, fatigue, anxiety, and depression were collected.
- Multiple regression models were employed to predict MSFC and PROs based on MEDAS scores, adjusting for demographic and health-related covariates.
Main Results:
- Higher adherence to the Mediterranean diet (higher MEDAS scores) was independently associated with better outcomes on the MSFC and PROs.
- Each point increase in MEDAS score correlated with a 15.0% reduced risk of MSFC impairment.
- Greater Mediterranean diet adherence was found to mitigate the negative effects of progressive disease and longer disease duration on disability.
Conclusions:
- Higher alignment with the Mediterranean diet predicts reduced objective and patient-reported disability in individuals with MS, even after controlling for confounding factors.
- These findings provide a foundation for future longitudinal and interventional studies to inform clinical dietary recommendations for MS management.
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