Koukach Dalya, Aljumaily Maryam, Al-Attiyah Noora, Al-Amer Rawdhah, Attia Yasmine, Tayyem Reema
Department of Nutrition Sciences, College of Health Science, Qatar University, Doha, 2713, Qatar.
Transl Neurosci. 2025 May 14;16(1):20250371. doi: 10.1515/tnsci-2025-0371. eCollection 2025 Jan 1.
Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system characterized by neuroinflammation and progressive neurodegeneration. Growing evidence suggests that dietary interventions may influence MS progression and symptom management by modulating inflammation, oxidative stress, and gut microbiota composition. This narrative review examines the effects of the Mediterranean, plant-based, ketogenic, Wahls, Swank, intermittent fasting, and gluten-free diets, alongside key nutrients such as omega-3 fatty acids, vitamin D, polyphenols, and antioxidants. Among these, Mediterranean and plant-based diets have shown the most consistent benefits, including reductions in fatigue, improved quality of life, and modulation of inflammatory markers. The Wahls and Swank diets show promise but are primarily supported by studies from their respective research groups, raising concerns about long-term adherence and nutritional adequacy. The ketogenic diet and intermittent fasting have yielded mixed findings, with some studies suggesting benefits for fatigue and neuroprotection, while others highlight potential metabolic risks. The gluten-free diet and omega-3 supplementation lack robust evidence, with inconsistent findings across studies. Additionally, ultra-processed foods and diets high in saturated fats have been associated with increased inflammation and greater MS severity. Despite promising findings, limitations such as small sample sizes, short follow-up durations, and study design inconsistencies prevent definitive conclusions. Future research should prioritize large-scale, long-term randomized controlled trials to establish the efficacy, safety, and sustainability of dietary interventions in MS management. Mechanistic studies and standardized dietary protocols are also needed to better understand the role of diet in MS progression and symptom control.
多发性硬化症（MS）是一种慢性免疫介导的中枢神经系统疾病，其特征为神经炎症和进行性神经退行性变。越来越多的证据表明，饮食干预可能通过调节炎症、氧化应激和肠道微生物群组成来影响MS的进展和症状管理。这篇叙述性综述探讨了地中海饮食、植物性饮食、生酮饮食、瓦尔兹饮食、斯旺克饮食、间歇性禁食和无麸质饮食的效果，以及ω-3脂肪酸、维生素D、多酚和抗氧化剂等关键营养素的作用。其中，地中海饮食和植物性饮食显示出最一致的益处，包括减轻疲劳、改善生活质量和调节炎症标志物。瓦尔兹饮食和斯旺克饮食显示出一定前景，但主要得到各自研究团队的研究支持，这引发了对长期依从性和营养充足性的担忧。生酮饮食和间歇性禁食的研究结果不一，一些研究表明对疲劳和神经保护有益，而另一些研究则强调了潜在的代谢风险。无麸质饮食和补充ω-3脂肪酸缺乏有力证据，各项研究结果不一致。此外，超加工食品和高饱和脂肪饮食与炎症增加和MS严重程度加剧有关。尽管有一些有前景的发现，但样本量小、随访时间短和研究设计不一致等局限性阻碍了得出明确结论。未来的研究应优先进行大规模、长期的随机对照试验，以确定饮食干预在MS管理中的疗效、安全性和可持续性。还需要进行机制研究和标准化饮食方案，以更好地了解饮食在MS进展和症状控制中的作用。
