Adherence to the Mediterranean diet is associated with improved fatigue, sleep quality, quality of life, and MRI findings in patients with multiple sclerosis

Multiple sclerosis (MS) is a chronic neurodegenerative disease causing fatigue, sleep disturbances, and reduced quality of life (QoL). The Mediterranean diet (MeD), with anti-inflammatory and neuroprotective effects, may benefit MS symptoms. Eighty-four MS patients diagnosed at least one year prior, without other chronic diseases, were included. MeD adherence was measured by the 14-item Mediterranean Diet Adherence Screener (MEDAS). Fatigue was assessed using the Fatigue Severity Scale (FSS), sleep quality with the Pittsburgh Sleep Quality Index (PSQI), QoL with the Short Form-36 Health Survey (SF-36), and disability by the Expanded Disability Status Scale (EDSS). Cranial and cervical MRI lesions were evaluated. Data analysis used Mann-Whitney U, Spearman’s rho, and chi-square tests. Mean age was 36.3±9.45 years; 61.9% were female. Mean scores: EDSS 1.63, FSS 4.55, MEDAS 6.53, PSQI 6.28. Higher MEDAS scores correlated with lower fatigue and better sleep. Males reported higher energy (p=0.009); females had worse sleep (p=0.011). Cervical lesions were associated with poor sleep (p=0.022). QoL negatively correlated with poor sleep (r=-0.97). Lower adherence to the MeD may relate to increased fatigue, poor sleep, reduced QoL, and cervical lesions in MS patients. Diet and lesion location appear to influence clinical outcomes.