Dietary adherence and disability evolution in multiple sclerosis: An exploratory 12-month prospective cohort study

Area of Science:

• Neurology
• Nutrition Science
• Metabolic Research

Background:

• Lifestyle factors, including diet, may impact multiple sclerosis (MS) disability.
• Limited prospective data link dietary adherence to objective clinical outcomes in MS.
• Homocysteine, a metabolite, is a potential mediator between nutrition and neurodegeneration, but its role in MS is unclear.

Purpose of the Study:

• To investigate the association between adherence to a structured dietary intervention and longitudinal changes in plasma homocysteine levels.
• To examine the relationship between dietary adherence and disability progression in patients with MS over 12 months.

Main Methods:

• Prospective cohort study of 41 MS patients over 12 months.
• Dietary adherence assessed using a structured follow-up scale.
• Plasma homocysteine and Expanded Disability Status Scale (EDSS) measured at baseline, 6, and 12 months.
• Statistical analyses included correlation and multivariate linear regression.

Main Results:

• Plasma homocysteine levels decreased significantly over 12 months.
• While overall EDSS showed slight increase, high dietary adherence was linked to a decrease in EDSS scores (-0.56).
• Low adherence correlated with EDSS increase (+0.53).
• Dietary adherence was inversely correlated with EDSS change (r = -0.57, p = 0.0006) and remained independently associated in multivariate analysis (β = -0.45, p = 0.0005).

Conclusions:

• Higher adherence to dietary counseling was associated with a more favorable short-term disability trajectory in MS patients.
• Causality cannot be inferred, and clinical significance of observed changes requires further investigation.
• Exploratory findings need confirmation in larger controlled studies with validated dietary assessment tools.