Impact of Mediterranean Diet Adherence on Quality of Life in Patients with Multiple Sclerosis: A Prospective Study.
Multiple sclerosis (MS) is a chronic neuroinflammatory disease that significantly impairs quality of life (QoL). Emerging evidence suggests that dietary patterns, particularly the Mediterranean diet (MD), may offer neuroprotective and anti-inflammatory benefits. However, data on the effect of MD adherence on QoL in MS patients remain limited. This study aims to assess the impact of adherence to the MD adherence on the QoL of patients with MS following a three-month nutritional counselling program.
This prospective study included 50 adult MS patients recruited from the National Institute of Neurology in Tunis. Participants received individualized nutritional counselling based on the MD and were followed for three months. MD adherence was assessed using the 14-item PREDIMED score, and QoL was measured using the SF-36 questionnaire. Anthropometric and dietary data were collected at baseline and at three months.
Mean PREDIMED scores increased significantly from 7.12 ± 1.96 to 12.68 ± 3.20 (p=0.035), indicating improved MD adherence. QoL also improved significantly (SF-36 global score: 47.72 ± 21.48 to 52.99 ± 38.94; p=0.014), especially in mental health, vitality, role-emotional, and social functioning subscales. A positive correlation was observed between the changes in PREDIMED and SF-36 scores. Multivariate analysis identified increased intakes of vitamins C, D, E, B6, B9, B12 and minerals such as magnesium, selenium, and iron as independent factors associated with QoL improvement, whereas the significant increase in omega-3 fatty acid intake was not identified as a predictor. Significant reductions in body weight, body mass index, and waist circumference were also noted.
Improved MD adherence was associated with better QoL and nutritional status in patients with MS. These findings support the potential inclusion of nutritional counselling in the overall management of MS. Further randomized controlled trials are needed to confirm these results and establish causality.
This prospective study included 50 adult MS patients recruited from the National Institute of Neurology in Tunis. Participants received individualized nutritional counselling based on the MD and were followed for three months. MD adherence was assessed using the 14-item PREDIMED score, and QoL was measured using the SF-36 questionnaire. Anthropometric and dietary data were collected at baseline and at three months.
Mean PREDIMED scores increased significantly from 7.12 ± 1.96 to 12.68 ± 3.20 (p=0.035), indicating improved MD adherence. QoL also improved significantly (SF-36 global score: 47.72 ± 21.48 to 52.99 ± 38.94; p=0.014), especially in mental health, vitality, role-emotional, and social functioning subscales. A positive correlation was observed between the changes in PREDIMED and SF-36 scores. Multivariate analysis identified increased intakes of vitamins C, D, E, B6, B9, B12 and minerals such as magnesium, selenium, and iron as independent factors associated with QoL improvement, whereas the significant increase in omega-3 fatty acid intake was not identified as a predictor. Significant reductions in body weight, body mass index, and waist circumference were also noted.
Improved MD adherence was associated with better QoL and nutritional status in patients with MS. These findings support the potential inclusion of nutritional counselling in the overall management of MS. Further randomized controlled trials are needed to confirm these results and establish causality.
Authors
Hedfi Hedfi, Baradhi Baradhi, Ayed Ayed, Jemai Jemai, Mami Mami, Ali Ali, Laajili Laajili, Zouari Zouari, Ben Sassi Ben Sassi, Htira Htira
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