The following is a summary of “Mediterranean Diet is Associated with Cognition in Multiple Sclerosis,” published by Sand, et al.

This study assesses the links between the Mediterranean diet score and mental health outcomes in multiple sclerosis (MS). The relationship between food choices and health consequences is of great concern to people with multiple sclerosis. Researchers have previously observed associations between thalamic volume in early MS and objectively documented MS-related disability and adherence to a Mediterranean diet (Multiple Sclerosis Functional Composite). Thus, in a representative clinical MS cohort, researchers looked at the correlation between the Mediterranean diet score and mental performance.

Patients with Multiple Sclerosis (n=563, 71% female; mean age 44.2±11.3 years) took the Mediterranean Diet Adherence Screener (MEDAS, scores 0-14) and a version of the Symbol Digit Modalities Test, the Hopkins Verbal Learning Test, Revised, and the CANTAB Paired Associate Learning to mimic the BICAMS cognitive battery. 

A normalized score was calculated by adding up the individuals’ cognitive z-scores. After controlling for age, sex, race/ethnicity, SES, and health-related (body mass index, exercise, sleep disturbance, high blood pressure, high cholesterol, and smoking) factors, researchers examined the independent contribution of MEDAS to cognition using multiple regression. Logistic regression predicted the risk of cognitive impairment (<5th percentile on 2-3 tasks) after controlling for the aforementioned factors using MEDAS. The average z-score for cognitive ability was -0.67 (0.95). Improvements in cognitive performance might be attributed to a higher MEDAS score on their own (B=0.08 [95%CI: 0.05, 0.11], β =0.20, P<0.001]). One hundred and eight individuals (19.2%) were found to have cognitive impairment. 

A decreased likelihood of cognitive impairment was associated with a higher MEDAS score (Odds Ratio=0.80 [95% CI: 0.73, 0.89], P< 0.001). Regarding health-related predictors of cognitive z-score and cognitive impairment, MEDAS was by far the most accurate. According to effect modifications, stronger associations were found between nutrition and cognition (z-score and impairment) among people with progressive (as opposed to relapsing) disease. After accounting for relevant potential variables, researchers find a substantial correlation between the Mediterranean diet score and cognitive function in a broadly-representative sample of persons with MS. As the disease progresses, the strength of the correlation raises the potential of a neuroprotective mechanism. Clinical trials, including interventions and longer-term investigations, are required.