Dietary habits and advanced imaging/laboratory markers in multiple sclerosis: An exploratory cross-sectional study

Diet is increasingly recognized as a potential factor influencing MS pathophysiology.

To examine associations between diet and clinical/imaging/laboratory biomarkers of MS-related burden.

In this cross-sectional study, daily nutrient intake was quantified in 112 MS patients using the French MetaCardis food frequency questionnaire. Participants underwent matched serum and 3T brain magnetic resonance imaging (MRI), including brain volumetrics, brain-predicted age, cortical lesions (CL), central vein sign (CVS), paramagnetic rim lesions (PRLs), and enlarged perivascular space (EPVS) assessments. p-values were false discovery rate corrected (pFDR), and regression models adjusted for energy intake and potential confounders.

Participants (66% women, 72% relapsing-remitting MS) had a median age of 42 years (interquartile range (IQR) = 20), disease duration of 9 years (20), body mass index (BMI) of 22.8 (5.3) kg/m², and expanded disability status scale (EDSS) of 2 (2.5). Saturated and trans-fatty acids intake were positively associated with anxiety symptoms (β = 0.39, pFDR = 0.02; β = 13.09, pFDR = 0.03, respectively).Alcohol intake was positively associated with EPVS score (β = 0.02, pFDR = 0.01), whereas trans-fatty acid intake was positively associated with CL count (β = 17.50, pFDR = 0.04) and PRL volume (β = 3251.37, pFDR = 0.04).

Higher intake of saturated and trans-fatty acids and alcohol was associated with biomarkers of chronic inflammation and neurovascular dysfunction, suggesting a potential role in MS progression. Longitudinal and interventional studies are needed to establish causality.