To explore the effect of a modified Mediterranean dietary intervention (MMDI) on neurofilament light chain (NfL) in people with Multiple Sclerosis (MS).

Recent research demonstrates links between diet and MS clinical outcomes. NfL is an emerging biomarker for MS disease worsening and is being explored as a clinical trial outcome measure. Here we evaluate the effect of a MMDI on NfL in people with MS, utilizing samples collected from a pilot randomized clinical trial. 

36 women with MS were randomly assigned to follow a MMDI or continue their usual diet for 6 months. NfL was measured at baseline and 6 months using next generation automated enzyme-linked immunosorbent assay. We performed a secondary analysis of change in plasma NfL over time between diet groups using a Mann Whitney U test. Wilcoxon signed rank tests were used to assess change in NfL stratified by diet groups. We assessed differences in change in NfL between diet groups adjusting for age and body mass index (BMI) using a constrained longitudinal data analysis model (cDLA.)

32 participants had complete NfL data (intervention n=18, control n=14). There was no significant age difference between treatment groups. Mean NfL for the intervention group decreased significantly from 18.54±7.14 pg/mL to 15.43±6.29 pg/mL over the 6 month period (p=0.004). Mean NfL for the control group increased from 14.93±5.89 pg/mL to 16.16±12.89 pg/mL over the 6 month period, though this change was not significant (p=0.61). There was a trend toward a greater decrease in NfL in the intervention group in formal tests for interaction; however, this difference was not statistically significant (p=0.13). In cDLA models adjusting for age and BMI, findings were similar (p=0.13.)

In this pilot randomized clinical trial, a MMDI was associated with a significant decrease in NfL over time. Future larger studies are needed to confirm these findings.