Journal article
The Effect of Dietary Interventions on Peripheral Markers of Inflammation Among People with Multiple Sclerosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Multiple sclerosis and related disorders, Vol.106, 106913
02/2026
DOI: 10.1016/j.msard.2025.106913
PMID: 41422672
Abstract
•Dietary interventions reduce serum CRP levels in people with multiple sclerosis.•Effects on leptin and adiponectin were inconsistent across trials.•Intervention duration explained CRP variability across studies.•Findings suggest a potential role of diet in modulating systemic inflammation in MS. .
Multiple sclerosis (MS) is characterized by neuroinflammation and peripheral immune dysregulation, with circulating cytokines and systemic markers implicated in disease activity and progression. Emerging evidence suggests that diet influences inflammation, yet the impact of diet on inflammatory markers in MS remains unclear.
PubMed, Web of Science, Scopus, Embase, and Cochrane library (Central) were searched for randomized controlled trials (RCTs) evaluating dietary interventions versus control on peripheral inflammatory biomarkers, from inception through February 2025. Pooled effects were estimated using random-effects meta-analysis. The certainty of the evidence was assessed using the NutriGRADE scoring system. The study was registered in PROSPERO (CRD42023425961).
Thirteen RCTs (n = 891) met inclusion criteria. Seven assessed dietary effects on C-reactive protein (CRP), with five showing reductions, particularly in Mediterranean, plant-based, and calorie-restricted diets, and two showing no between-group differences. The largest improvements occurred in trials lasting six months or longer. Meta-analyses of leptin (WMD: 0.95; 95% CI: –2.80 to 4.69) and adiponectin (WMD: 480; 95% CI: –152 to 1112) revealed no significant effects of calorie restriction. Data for other markers were insufficient for pooling. NutriGRADE evidence was rated low due to small sample sizes, and studies with a high or some concerns risk of bias.
Several dietary interventions may reduce systemic inflammation in PwMS, with greater effects in longer-duration interventions. Calorie-restricted diets did not significantly alter adipokines. Given the limited number and heterogeneity of studies, larger and longer RCTs using comparable dietary interventions are needed to confirm these findings.
Details
- Title: Subtitle
- The Effect of Dietary Interventions on Peripheral Markers of Inflammation Among People with Multiple Sclerosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- Creators
- Wade R. Pingel - University of IowaTyler J. Titcomb - University of IowaSolange M. Saxby - Department of Internal Medicine, University of Iowa, Iowa City, IA, USAFarshad Arsalandeh - Iran University of Medical SciencesAsma Salari-Moghaddam - Medical University of IlamAshutosh Mangalam - University of IowaLinda G. Snetselaar - University of IowaTerry L. Wahls - University of IowaFarnoosh Shemirani - Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
- Resource Type
- Journal article
- Publication Details
- Multiple sclerosis and related disorders, Vol.106, 106913
- DOI
- 10.1016/j.msard.2025.106913
- PMID
- 41422672
- NLM abbreviation
- Mult Scler Relat Disord
- ISSN
- 2211-0348
- eISSN
- 2211-0356
- Publisher
- Elsevier B.V
- Language
- English
- Electronic publication date
- 12/09/2025
- Date published
- 02/2026
- Academic Unit
- Neurology; Epidemiology; Pathology; Iowa Neuroscience Institute; Orthopedics and Rehabilitation; Fraternal Order of Eagles Diabetes Research Center; General Internal Medicine; Internal Medicine
- Record Identifier
- 9985090592302771
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