Dietary regimens and cognitive function in multiple sclerosis: a systematic review

Area of Science:

• Neurology
• Nutrition Science
• Dietary Interventions

Background:

• Cognitive impairment is a significant complication of multiple sclerosis (MS).
• Non-pharmacological strategies, particularly diet, for managing MS-related cognitive decline are underexplored.
• Existing research on diet's impact on MS cognition requires synthesis.

Purpose of the Study:

• To review and synthesize current evidence on the relationship between various dietary patterns and cognitive outcomes in individuals with MS.
• To evaluate the effectiveness of specific diets, including Mediterranean, Paleolithic/Wahls, Swank, ketogenic, and time-restricted eating, on cognitive function in MS.

Main Methods:

• Systematic review of clinical interventional and observational studies.
• Analysis of studies investigating specific diets (Mediterranean, Wahls/Paleolithic, Swank, ketogenic, time-restricted eating) and general dietary quality in MS patients.
• Evaluation of cognitive outcomes reported in the included studies.

Main Results:

• Mediterranean diet trials generally showed no significant cognitive improvements, but some studies indicated benefits in processing speed and reduced cognitive complaints.
• Wahls/Paleolithic and Swank diets demonstrated comparable improvements in processing speed and mental cognition.
• Limited evidence suggests potential benefits of ketogenic and time-restricted diets; findings for general healthy or high-fiber diets were inconsistent.

Conclusions:

• Dietary interventions may serve as promising adjunctive strategies for supporting cognitive health in multiple sclerosis.
• Inconsistencies in study design, cognitive assessments, and intervention duration, along with limited high-quality evidence, necessitate further rigorous research.
• Strong recommendations for specific dietary interventions in MS cognitive health cannot be made without additional high-quality evaluations.