A close up of a hand reaching for a glass of water on a table full of foods typical of a Mediterranean diet such as olives and fishShare on Pinterest
The Mediterranean diet may also have cognitive benefits. Vera Lair/Stocksy
  • Researchers analyzed the effects of a Mediterranean diet on cognitive impairment among patients with MS.
  • They found that closer adherence to the Mediterranean diet was linked to a lower risk of cognitive impairment.
  • Further studies are needed to confirm the results.

Multiple sclerosis (MS) is a chronic autoimmune condition that affects the brain and central nervous system. Symptoms include fatigue, mobility problems, and numbness.

Around 2.8 million people live with MS worldwide, and females are twice as likely than men to have the condition.

Studies show that certain diets and other lifestyle factors may improve the quality of life for patients with MS. One study, for example, found that the Mediterranean diet may have a neuroprotective effect against disability in MS.

The cause of MS is unknown, and there is currently no cure. Treatments typically focus on symptom relief and slowing progression.

The Mediterranean diet is a varied diet that contains minimally-processed foods, limited amounts of red meat, and moderate amounts of dairy and poultry. It is high in:

  • fish
  • vegetables
  • whole grains
  • legumes
  • fruits
  • mono- or polyunsaturated fatty acids such as olive oil

Further research into how dietary factors affect MS could improve quality of life among patients with the condition.

Recently, researchers investigated the effects of the Mediterranean diet on cognition among patients with MS.

They found that stronger adherence to the Mediterranean diet was linked to a lower risk for cognitive impairment.

“Cognitive impairment may affect over 50% of persons with MS and there are currently no effective pharmacologic treatments,” Barbara Giesser, neurologist and MS specialist at Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, California, not involved in the study, told Medical News Today.

“A lifestyle strategy that could help protect or maintain normal cognitive function would be very important in helping people with MS to live their best lives,” she added.

The study was presented at the American Academy of Neurology’s 75th Annual Meeting.

For the study, the researchers recruited 563 people with MS. Each completed a questionnaire to record how closely they followed the Mediterranean diet. Scores ranged from 0–14. Participants were split into various groups: those who scored 0–4 adhered least to the Mediterranean diet, whereas those who scored nine and above adhered to the diet most.

Participants also underwent three tests assessing their thinking and memory skills. From these tests, they found that 108 participants, or 19.2%, had cognitive impairment.

After analyzing the results, the researchers found that patients who most closely followed the Mediterranean diet had a 20% lower risk for cognitive impairment than those who adhered to it least.

The relationship remained after controlling for confounders including demographic factors and health factors including sleep disturbances, diabetes, and hypertension.

“Among health-related factors, the level of dietary alignment with the Mediterranean pattern was by far the strongest predictor of people’s cognitive scores and whether they met the study criteria for cognitive impairment,” said study author Dr. Ilana Katz Sand, of the Icahn School of Medicine at Mount Sinai in New York, New York, and a member of the American Academy of Neurology, in a press release.

“This way of eating provides a high-quality diet that contains not only essential nutrients, but also a diversity of naturally occurring bio-actives that are increasingly under investigation for their role in protecting against cognitive decline,” Meghan Pendleton, RD, not involved in the study, told MNT.

“Oxidative stress is suggested to play a major role in MS, causing cellular damage and neurodegeneration. [Hypotheses suggest] that the Mediterranean diet provides bio-actives that may protect against oxidative stress, or offer other protective mechanisms,” she said.

“The mechanisms whereby the [Mediterranean] diet might help protect cognition include possible anti-inflammatory and or anti-oxidant effects, reduction in co-morbidities that might affect cognition such as hypertension, and substitution of healthier foods for foods that may contribute to co-morbidities or adversely impact cognition e.g. ultra processed foods,” Dr. Giesser added.

“This type of study design gives insights into associations, but not exact mechanism of how [the] diet may confer benefits,” noted Pendleton.

Pendleton said that observational studies were important in this regard, “for helping to create hypotheses to test [but] future interventional clinical trials will help clarify our understanding and strengthen our ability to make specific recommendations.”

“There is currently a lack of long-term intervention trials when it comes to nutrition approaches for various brain health outcomes, including MS. We know in other areas of brain health research where nutrition is used as an intervention, such as for dementia, there are often inconsistencies between findings from observational and interventional studies,” she added.

“So, while this study certainly does contribute to our current understanding of how diet may be associated with MS, we must be patient and take caution in extrapolating meaning or clinical significance,” she said.

Pendleton noted that research in nutrition and MS is still in its infancy, meaning further studies are needed before conclusions can be made.

“[I] don’t see any downside for someone adopting the Mediterranean diet anyway— it is a very health-promoting way of eating, and can be helpful for risk reduction and management of other conditions.”
— Meghan Pendleton, RD

However, she noted that there is still no clear definition of what a Mediterranean diet is, and that the diet is less about specific foods, and more so about general food patterns.

“This is an important point because the diet should be culturally flexible to incorporate traditional foods from all kinds of cuisines. Sometimes I think providers really miss the mark with this, and inadvertently provide ethnocentric recommendations that may end up not being culturally sensitive and useful for patients,” she concluded.