Diet quality and patient health outcomes over 10 years in people with MS

Dr Simpson-Yap and his team used information from the UK MS Register to better understand whether diet quality is linked with health and wellbeing outcomes for people living with MS. The project was strengthened by expanding the dataset to include repeated follow-up information from 2016 to 2024, covering more than 26,000 observations from 2,379 participants. This allowed the team to look at diet and MS outcomes over time, rather than relying only on one or two snapshots.

Across the project, the team found encouraging evidence that healthier eating patterns may be linked with better outcomes for people living with MS. In particular, stronger alignment with a Mediterranean-style diet was associated with better mental quality of life and lower risk of depression and anxiety over seven years of follow-up, although this finding was restricted to females. The Mediterranean diet generally includes plenty of vegetables, fruit, wholegrains and legumes, healthy fats such as olive oil and nuts, and more fish and poultry than red meat.

The research also found that people whose eating patterns were closer to Mediterranean and MIND diets tended to perform better on some thinking and memory tasks. The MIND diet combines features of the Mediterranean diet and the DASH diet and was designed to support brain health. The team also found that greater adherence to the MIND diet was linked with lower walking-related disability and lower fatigue in people living with MS. Importantly, the results also suggested that fatigue may affect dietary choices. More research is needed to understand whether diet affects fatigue, fatigue affects diet, or whether both are happening.

Another important finding was that higher intake of ultra-processed foods was linked with greater walking-related disability, even after accounting for overall diet quality.

A review of existing studies found that people whose diets included more foods linked with inflammation may have been more likely to develop MS or similar demyelinating conditions. This suggests that inflammation related to diet could play a role in MS risk, although more research is needed to better understand this connection.

Together, the results of this study suggest that diet may play a role in MS symptoms and quality of life, particularly mental health, fatigue, cognition and disability. While firm conclusions from the current study cannot be drawn yet, these preliminary findings provide support for further studies examining whether a Mediterranean-style diet can help improve health outcomes for people living with MS. They also highlight the need to consider gender differences in dietary analysis.

The team is undertaking further analysis of the UK MS Register data to better understand the links between diet and MS outcomes over time.

Over the course of the study, the team developed international collaborations with clinicians and researchers in the UK, including experts in neurology, diet, the gut microbiome and cognition. These collaborations helped support interpretation of the findings and opened opportunities for future research into how diet may relate to MS symptoms and brain health.

Based on their findings, the team produced four articles for publication in peer-reviewed journals and presented their findings at several domestic and international conferences.