Mediterranean-like diets in multiple sclerosis: A systematic review

IF 2.8 4区医学 Q2 CLINICAL NEUROLOGY Revue neurologique Pub Date : 2024-12-01 DOI:10.1016/j.neurol.2023.07.017

H. Abbasi , F. Shakouri , R. Mosaddeghi-Heris , E. Gholipour-Khalili , F. Jahanshahlou , S. Sanaie , A. Naseri , M. Talebi

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Abstract

Background

Mediterranean-like diet is an anti-inflammatory diet with high-fiber consumption and lower intake of saturated fatty acids which is proposed to have beneficial effects in patients with multiple sclerosis (MS). This investigation aims to explore the impacts of this style of diet on people living with MS, based on clinical evidence.

Methods

This study was conducted following the 2020 version of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Both interventional and observational clinical studies which evaluated the effects of Mediterranean-like diets on MS patients were considered for inclusion. Review articles, letters, commentaries, case reports, non-English papers, and conference abstracts were excluded. PubMed, Web of Science, Scopus, and EMBASE databases were searched until March 23rd, 2023, and risk of bias in randomized-controlled trials (RCTs) was evaluated based on the second version of the Cochrane RoB assessment tool (RoB.2). In addition, for the observational studies, Joanna Briggs Institute (JBI)’s critical appraisal tools were utilized.

Results

Of 161 records that were screened in the title/abstract stage, 13 reports of 11 studies were included in the systematic review. Three RCTs (including one pilot RCT), and eight observational studies reported the effects of Mediterranean-like diets on people living with MS. The sample sizes in clinical trials varied between 36 and 147 and for observational studies between 30 and 563 patients. Evidence suggested positive effects of a Mediterranean-like diet on inflammatory status and MS-related symptoms such as fatigue, quality of life, attack rate, and cognitive dysfunction.

Discussion

This systematic review pointed out possible beneficial effects of Mediterranean-like diets for MS patients. The limited number of well-designed RCTs was the main limitation of this study; therefore, large-scale multiple-center interventional studies are suggested. Variety in the assessed outcomes, study designs, and groups of the studies prevented meta-analysis which was the other limitation of this study.

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地中海式饮食对多发性硬化症的影响:一项系统综述

地中海式饮食是一种高纤维饮食和低饱和脂肪酸摄入的抗炎饮食，被认为对多发性硬化症(MS)患者有益。本研究旨在根据临床证据，探讨这种饮食方式对多发性硬化症患者的影响。本研究遵循2020年版本的系统评价和荟萃分析首选报告项目(PRISMA)声明进行。评估地中海式饮食对多发性硬化症患者影响的干预性和观察性临床研究均被纳入考虑。综述文章、信函、评论、病例报告、非英文论文和会议摘要被排除在外。检索PubMed、Web of Science、Scopus和EMBASE数据库至2023年3月23日，基于Cochrane第二版RoB评估工具(rob2)评估随机对照试验(RCTs)的偏倚风险。此外，在观察性研究中，使用了乔安娜布里格斯研究所(JBI)的批判性评估工具。在标题/摘要阶段筛选的161份记录中，11项研究的13份报告被纳入系统评价。3项随机对照试验(包括1项试点随机对照试验)和8项观察性研究报告了地中海式饮食对ms患者的影响。临床试验的样本量在36 ~ 147例之间，观察性研究的样本量在30 ~ 563例之间。有证据表明，地中海式饮食对炎症状态和ms相关症状(如疲劳、生活质量、发病率和认知功能障碍)有积极影响。本系统综述指出地中海式饮食对多发性硬化症患者可能有益。设计良好的随机对照试验数量有限是本研究的主要局限性;因此，建议开展大规模的多中心介入研究。评估结果、研究设计和研究分组的多样性阻碍了meta分析，这是本研究的另一个局限性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revue neurologique 医学-临床神经学

CiteScore

4.80

自引率

0.00%

发文量

598

审稿时长

55 days

期刊介绍： The first issue of the Revue Neurologique, featuring an original article by Jean-Martin Charcot, was published on February 28th, 1893. Six years later, the French Society of Neurology (SFN) adopted this journal as its official publication in the year of its foundation, 1899. The Revue Neurologique was published throughout the 20th century without interruption and is indexed in all international databases (including Current Contents, Pubmed, Scopus). Ten annual issues provide original peer-reviewed clinical and research articles, and review articles giving up-to-date insights in all areas of neurology. The Revue Neurologique also publishes guidelines and recommendations. The Revue Neurologique publishes original articles, brief reports, general reviews, editorials, and letters to the editor as well as correspondence concerning articles previously published in the journal in the correspondence column.

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