Mediterranean Diet May Help Preserve Cognition in MS

Following a Mediterranean diet may help sharpen the cognitive skills of people with multiple sclerosis (MS), according to a preliminary study presented at the American Academy of Neurology’s 75th Annual Meeting in Boston. 

Inspired by the way people in places like Spain, Italy, and Greece eat, the diet puts an emphasis on vegetables, fruits, whole grains, beans and legumes, plus liberal consumption of fish and other low fat proteins, olive oil and other non-tropical vegetable oils, nuts, and low fat dairy. It also sets limits on sugar, sodium, highly processed foods, refined carbohydrates, and saturated fats. 

Already considered one of the best diets to follow for overall health benefits, U.S. News & World Report’s Best Diets has named Mediterranean style eating plans their top choice for several years running, giving it high marks for promoting weight loss and cardiometabolic health. Nearly 70 years of research backs up claims that the largely plant-based diet can help lower the risk of numerous chronic diseases and promote greater longevity.

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The latest study, performed at the Icahn School of Medicine at Mount Sinai in New York, scored 563 people with MS from zero to 14, depending on how they answered a questionnaire to determine how closely they followed the Mediterranean diet. Researchers then divided participants into four groups based on their diet scores, with the lowest group having scores of zero to four and the highest group having scores of nine or higher. 

Participants also took three tests to evaluate their thinking and memory skills, with cognitive impairment defined as scoring in less than the fifth percentile on two or three of the tests.

A total of 108 people, or 19 percent, fell into the cognitive impairment category. Those who stuck closest to a Mediterranean diet had a 20 percent lower risk for cognitive impairment than people who did not eat this way. Of the group who didn’t follow the diet at all, 34 percent had scores at the cognitive impairment level.  

The relationship between diet and cognitive skills was strongest among people with progressive MS, where the disease steadily worsens, compared to those with relapsing-remitting MS, where the disease flares up and then goes into periods of remission.

“It’s exciting to see that we may be able to help people living with MS maintain better cognition by eating a Mediterranean diet,” said study author Ilana Katz Sand, MD, who practices at Icahn and who is also a member of the American Academy of Neurology. 

When researchers rigorously adjusted for other variables that could affect the risk of cognitive impairment, such as socioeconomic status, smoking, body mass index, high blood pressure and exercise, the results held, Katz Sand said. 

“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,” Katz Sand said.

Nearly 1 million people in the United States live with MS. Neurological difficulties are very common with this disease, and they often get worse over time, even with aggressive treatment. Katz Sand said that people living with MS are very interested in ways they can be proactive from a lifestyle perspective to help improve their outcomes.