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Mediterranean and MIND dietary patterns and cognitive performance in multiple sclerosis: A cross-sectional analysis of the UK Multiple Sclerosis Register
Multiple sclerosis (MS) is a chronic auto-immune neuroinflammatory disorder characterized by a spectrum of systemic and neurological symptoms, including cognitive impairment. Recent research indicates that diets promoting brain health, particularly the Mediterranean (MED) and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets, may enhance cognitive function. However, investigations focusing on their impact within MS populations remain scarce.
This study analyzed cross-sectional associations between dietary patterns and cognitive performance using data from 967 participants in the United Kingdom Multiple Sclerosis Register (UKMSR). Dietary pattern scores, specifically alternate Mediterranean (aMED) and MIND, were derived from a 130-item food frequency questionnaire (EPIC-Norfolk). Cognitive assessments were conducted using the Cognitron-MS (C-MS) battery, which evaluates overall cognition and four specific domains: object memory, problem solving, information processing speed (IPS), and words memory. Cognitive outcomes were measured as Deviation-from-Expected (DfE) scores, adjusted for demographic and device characteristics via external regression-based norms. Linear models accounted for total energy intake, MS phenotype, disease duration, and current disease-modifying therapy (DMT) use. Additionally, interactions were explored concerning MS phenotype and DMT usage.
The results indicated that higher alignment with aMED and MIND dietary patterns correlated with improved performance in specific cognitive domains; however, no significant association with overall cognition was observed. Notably, aMED scores consistently correlated with enhanced IPS, while MIND scores were linked to improved words memory. In categorical analyses, participants in the middle or highest tertiles of aMED or MIND scores performed approximately 0.4 standard deviations better on various cognitive tasks compared to those in the lowest tertile. These associations were robust across sensitivity analyses, with stratified analyses revealing variations in cognitive performance and diet-cognition relationships based on MS phenotype and DMT use.
Mediterranean and MIND dietary patterns exhibit modest cross-sectional associations with specific cognitive domains in individuals with MS, with variations in performance observed across different subgroups. While causal inferences cannot be established, these findings underscore the necessity for future longitudinal and randomized controlled trials to further explore the impact of dietary interventions on cognitive function across diverse MS populations. [NPID: multiple sclerosis, cognitive performance, Mediterranean diet, MIND diet]
Year: 2025
