A new study published in the European Journal of Neurology found that a higher quality diet was associated with lower disability progression in patients with multiple sclerosis (MS). In contrast, meat consumption was found to be associated with higher disability progression.

According to the authors, “Modifiable lifestyle factors, including diet, affect clinical outcomes in multiple sclerosis.”

The study analyzed information from 1346 patients with MS who were participating in the Health Outcomes and Lifestyle In a Sample of people with MS (HOLISM) international cohort. The patients were evaluated over 2.5 years period, during which their diet, disability, fatigue, and depression risk were assessed.

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A modified Diet Habits Questionnaire (DHQ) was used to obtain dietary data, and the Patient-determined MS Severity Score (P-MSSS) was used to calculate disability. Fatigue and depression risk were obtained using the Fatigue Severity Scale and the Patient Health Questionnaire-2, respectively. Participants also reported if they were experiencing any symptoms related to a recent MS relapse.

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The study’s results cross-sectionally showed a significant dose-dependent relationship between higher DHQ scores and a reduced frequency of fatigue, depression risk, and severe disability. When the data was analyzed prospectively, higher DHQ scores at baseline were associated with a lower risk of disability progression. Patients with DHQ scores in the top 2 quartiles had 41% and 36% lower risks of increasing disability and P-MSSS values that were 0.30 points lower.

The data did not show a prospective relationship between baseline DHQ scores and fatigue or depression risk, however.

A separate cross-sectional analysis showed that the consumption of meat increased P-MSSS values by 0.22 points. Prospective analysis showed that baseline meat consumption elevated the risk of increasing disability by 76% and was associated with an increase of 0.18 P-MSSS points. Dairy consumption was also analyzed cross-sectionally and prospectively but the results were mixed.

“These results show that better quality of the diet, as well as not consuming meat, were associated with reduced disability progression in people with MS,” the authors wrote. “Substantiation of these findings in other settings may inform opportunities to manage disability progression in people with MS using dietary modifications.” 


Simpson-Yap S, Nag N, Probst Y, Jelinek G, Neate S. Higher quality diet and non-consumption of meat are associated with less self-determined disability progression in people with multiple sclerosis: a longitudinal cohort study. Eur J Neurol. Published online August 14, 2021. doi:10.1111/ene.15066

The HOLISM study. The University of Melbourne. Accessed August 26, 2021.