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Published on: February 23, 2024
Mediterranean-like diets in multiple sclerosis: A systematic review
H Abbasi1, F Shakouri1, R Mosaddeghi-Heris2
1Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
Background:
Mediterranean-like diet is an anti-inflammatory diet with high-fiber consumption and lower intake of saturated fatty acids which is proposed to have beneficial effects in patients with multiple sclerosis (MS). This investigation aims to explore the impacts of this style of diet on people living with MS, based on clinical evidence.
Methods:
This study was conducted following the 2020 version of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Both interventional and observational clinical studies which evaluated the effects of Mediterranean-like diets on MS patients were considered for inclusion. Review articles, letters, commentaries, case reports, non-English papers, and conference abstracts were excluded. PubMed, Web of Science, Scopus, and EMBASE databases were searched until March 23rd, 2023, and risk of bias in randomized-controlled trials (RCTs) was evaluated based on the second version of the Cochrane RoB assessment tool (RoB.2). In addition, for the observational studies, Joanna Briggs Institute (JBI)'s critical appraisal tools were utilized.
Results:
Of 161 records that were screened in the title/abstract stage, 13 reports of 11 studies were included in the systematic review. Three RCTs (including one pilot RCT), and eight observational studies reported the effects of Mediterranean-like diets on people living with MS. The sample sizes in clinical trials varied between 36 and 147 and for observational studies between 30 and 563 patients. Evidence suggested positive effects of a Mediterranean-like diet on inflammatory status and MS-related symptoms such as fatigue, quality of life, attack rate, and cognitive dysfunction.
Discussion:
This systematic review pointed out possible beneficial effects of Mediterranean-like diets for MS patients. The limited number of well-designed RCTs was the main limitation of this study; therefore, large-scale multiple-center interventional studies are suggested. Variety in the assessed outcomes, study designs, and groups of the studies prevented meta-analysis which was the other limitation of this study.
Insights
A Mediterranean-like diet may benefit patients with multiple sclerosis (MS) by reducing inflammation and improving symptoms like fatigue and cognitive dysfunction. Further large-scale studies are needed to confirm these positive effects.
Area of Science:
- Neurology
- Nutritional Science
- Public Health
Background:
- The Mediterranean-like diet, characterized by high fiber and low saturated fat, is recognized for its anti-inflammatory properties.
- Existing evidence suggests potential benefits for individuals with multiple sclerosis (MS).
Conclusions:
- This systematic review suggests potential benefits of a Mediterranean-like diet for individuals with multiple sclerosis (MS).
- The primary limitation is the scarcity of well-designed randomized controlled trials (RCTs).
- Recommendations include conducting large-scale, multi-center interventional studies to further validate these findings.
