Food as medicine: Study finds specialized diet lowers depression in MS patients

06 Mar 2023 --- Multiple sclerosis (MS) patients that followed an overcoming MS (OMS) diet for 2.5 years had a 20% lower risk of depression than those that did not and a 30% lower depression risk than people that stopped following the diet, according to a new study. The researchers note that diet modification and maintenance may help to manage MS symptoms, but patients need support for ongoing adherence.

People that continued the OMS diet also had a 29% lower risk of fatigue and a 57% lower risk of severe disability than patients that stopped following the diet. 

Of the study participants, 33% of people followed an OMS diet for 2.5 years. This mostly plant-based diet focuses on whole food and low-saturated fat with seafood. 

The research team notes that diet is unlikely the only factor contributing to better outcomes, as people who stopped following the diet did not sustain the benefits of lower fatigue and disability. 

They concluded that further analysis is needed to confirm the causality between following an OMS diet and improving MS outcomes.

Study set up The authors note that healthy lifestyle behaviors in participants may have influenced the study’s outcomes.
Australian researchers analyzed data for 671 people from 33 countries from a longitudinal observational study. The results are published in Frontiers in Nutrition.

Participants completed online surveys and followed up with surveys at 2.5, 5 and 7.5 years to check adherence to MS diets. 

The researchers compared non-adherence to diets with partial (either ceased or commenced at the 7.5-year time point) and ongoing adherence (at both 5 and 7.5-year time points).

The researchers measured depression through health questionnaires at baseline, 5- and 7.5-year time points and calculated disability status with patient-determined disease steps. 

The study relied on self-assessment, which limits data accuracy. It did not assess whether diets were adhered to for the 2.5-year interval. 

Implications for MS patients 
The authors suggest that healthcare producers consider strategies and tools tailored to an individual’s needs so that people with MS can maintain their diet. 

The study found that adhering to an OMS or high-quality diet, which includes fruits, vegetables, whole grains and fish while low in refined sugars, processed meat and saturated fat, for over 2.5 years was possible for people with MS, even with depression symptoms. 

However, fatigue and disability have been reported by MS patients as barriers to modifying their lifestyle, especially in continuing an MS diet. 

The study had a healthy participant bias, with a relatively low prevalence of disability in the study’s participants, who were also more likely to follow multimodal healthy lifestyle behaviors. 

Food for health  
Continuing a high-quality diet was associated with a 22% lower risk of depression than following the diet. 

The authors note that the diet’s potential benefits require ongoing efforts, as partial adherence did not have better outcomes than non-adherence. 

Earlier studies also found associations between other MS diets and improved health outcomes. However, the current study needed more data to analyze other diets’ effects on MS symptoms, such as Swank, Ashton Embry Best Bet, McDougall, Paleo and Wahls. High-quality diets are high in fruits, vegetables, whole grains and fish while low in refined sugars, processed meat and saturated fat.

These diets are similar in intake of fruit and vegetables and limited intake of processed foods but differ in eliminating certain foods. 

Further research needed
The authors note that the study’s outcomes may not represent the broader population of people with MS.  

They add that further research should also assess individual and additive impacts of lifestyle behaviors on health outcomes and adherence to diets and duration. 

Notably, the study’s outcomes may result from participants adopting multiple healthy lifestyle behaviors. 

Compared to people who left the study during the 7.5-year time frame, participants who completed the study had adopted healthy behaviors and followed a multimodal lifestyle program for people with MS. 

In another project, researchers at the University of Copenhagen are developing personalized dietary profiles applicable to inflammatory diseases such as MS, which could tell individuals what is good or bad for them to eat. 

By Jolanda van Hal