No major differences seen in diets of patients who did or didn’t attain NEDA-3
by Marisa Wexler, MS | January 3, 2024
An analysis of data covering nearly 200 people with multiple sclerosis (MS) found no association between dairy or gluten consumption and MS disease activity.
While some specific diets for MS tend to restrict gluten and/or daily, this study found that people who ate these dietary products were as likely to show no evidence of disease activity (NEDA-3) over a two-year period as those who avoided these foods. NEDA-3 is defined as no relapses, no new or enlarging lesions, and no disability progression.
The study, “Dairy and gluten in disease activity in multiple sclerosis,” was published in Multiple Sclerosis Journal – Experimental, Translational and Clinical.
An MS diet ideally avoids foods that could promote inflammation
Diet can have profound effects on health, and eating a well-balanced and nutritious diet can be an important part of managing chronic diseases such as MS.
While no single diet is recommended widely for people with MS, several dietary strategies have been developed that generally aim to provide for a patient’s nutritional needs while avoiding foods that could worsen inflammation.
Some proposed MS diets recommend limiting intake of dairy and/or gluten, based on the idea that these foods may trigger disease worsening. However, supporting evidence is limited.
Scientists in Australia evaluated the relationship between dairy and gluten consumption and MS disease activity in 187 patients: 159 with relapsing-remitting MS, 23 with secondary progressive MS, three with primary progressive MS, and one person defined as having progressive relapsing MS. All completed dietary screeners to assess their intake of dairy and gluten over the previous two years, including the frequency and quantity of foods containing them eaten at each meal.
The researchers used statistical models to compare intake among patients with and without disease activity over these two years. Specifically, they assessed their NEDA-3 status, meaning patients have no relapses, no worsening of disability, and no new activity seen on MRI scans.
Likely best approach: A diet that’s healthy and balanced
Among these patients, 87 people (47%) retained NEDA-3 status over the study’s years, while the others experienced some form of disease activity.
Overall, dietary consumption for NEDA-3 group patients was about 21% higher for dairy products and 7% lesser for gluten products than among the group with disease activity. However, results showed no significant differences in dairy or gluten intake between the two groups during the two years analyzed.
Individual measures of relapse rates, disability progression, MRI activity, and quality of life also showed no significant differences based on gluten or dairy intake.
As this study was in a relatively small group, its researchers highlighted that it might lack the statistical power to detect small effects of dairy or gluten that might be statistically meaningful in larger groups. Still, these findings show with fair certainty that neither dairy nor gluten has a substantial impact on MS disease activity, they added.
“Detection of more modest effects will require larger sample sizes, however, it remains to be determined whether such effects will translate to clinically important differences in disease activity,” the scientists concluded. “Therefore, recommending a healthy, balanced diet for [people with] MS may be the best approach.”
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