Diet and MS
New Directions in MS Research
A diet consisting primarily of vegetables, whole grains, berries, poultry, fish, and olive oil was associated with larger thalamic volume – a measure of brain health and function – in a study examining how eating habits correlated with MRI findings in 185 people with MS.
Study participants were an average age of 34 years, and on average, had been diagnosed with MS a little more than two years before study entry. Two-thirds were female, and the participants’ median Expanded Disability Status Scale (EDSS) was 1.0, indicating that most study subjects had no disability and only minimal symptoms in one functional area.
The participants underwent MRI assessment and completed a detailed questionnaire about their eating habits. They were then divided into four groups based on their reported dietary practices. Investigators examined how various MRI parameters differed across groups once adjustments had been made for patient demographics and markers of fitness.
The researchers found that people who followed the Mediterranean-DASH Intervention for Neurodegenerative Delay, or MIND, diet, which emphasizes the food described at the start of this section, tended to have larger thalamic volume than people in other groups. The thalamus is a grey-matter area of the brain that processes and relays sensory information, while also helping to regulate sleep and wakefulness.
Study findings showed that dairy intake was associated with smaller T2-weighted lesions and greater cortical thickness, while higher intake of polyunsaturated fatty acids, such as omega-3, was associated with increased microstructural integrity in normal-appearing white matter.
The researchers concluded that their findings showing an association between dietary factors and MRI metrics in people in the early stages of MS warranted similar studies in MS patients with longer disease duration.79
People in Italy embraced the so-called “Mediterranean diet” long before that heart-healthy style of eating gained popularity, and its name, in America. So what better place than Italy to assess the impact that the diet – which emphasizes vegetables, fruits, whole grains, fish and poultry, with moderate use of dairy and limited red meat – has on MS?
Italian researchers recently enrolled 301 people with MS in a study to look at how diet, smoking, body mass index (BMI), waist-hip ratio (WHR), and other factors affect the course of MS. Two-thirds of the patients were women. Study participants’ average age was 43 years. Their median Expanded Disability Status Scale (EDSS) score was 2, indicating that most had minimal disability.
Based on their responses to extensive diet questionnaires, the participants were divided into two groups. The first group (64.8% of all subjects) was composed of people who were totally adherent to a Mediterranean diet. The second group consisted of people deemed to be “sufficiently” adherent to the diet, meaning that they followed it less often than people in the other group.
Perhaps surprisingly, the investigators did not find an association between greater adherence to the Mediterranean diet and measures of MS disease severity, such as EDSS score or Fatigue Severity Scale (FFS) score. Rather, they found that people with higher BMI had worse EDSS and FFS scores. Similarly, they found a direct and statistically significant relationship between waist-hip ratio and higher (meaning worse) EDSS and FFS values. Not surprisingly, higher smoking intensity was associated with higher EDSS scores, while people who were more physically active had less impairment as measured on the EDSS and reported less fatigue.80