Meta-analysisindependent cross-checkabstract checked★ key study I-AUTO-104 standard review
Diet and inflammation markers in MS
The effect of dietary interventions on peripheral markers of inflammation among people with multiple sclerosis: A systematic review and meta-analysis of randomized controlled trials.
Overview
Pingel WR et al.. Mult Scler Relat Disord 2026 · PMID 41422672 · DOI 10.1016/j.msard.2025.106913
Some diets may lower inflammation markers in MS, but the evidence is weak and does not show effects on relapses or disability.
Does the study support the specific claim? Partly · Methodological quality: low
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Test diet effects on inflammation in MS.
- How was the study done?
Meta-analysis of 13 RCTs.
- How many people, animals or samples were studied?
891 people with MS.
- What was actually found?
CRP reduced in 5 of 7 trials.
- How large was the observed effect?
Adipokines not changed.
- What do the results mean in everyday life?
Healthy eating may be a useful addition to MS care, not a replacement.
- What are the study's limitations?
Surrogate outcomes; low certainty.
- What does it say about Elawady's specific claim?
Partly supports a role of diet in inflammation; not a cure.
- Do the results apply to Germany and Europe?
Applies; same physiology.
- What can explicitly not be concluded from this study?
Effect on relapses or disability.
Scientific in-depth review
1. Full reference
- Authors
- Pingel WR et al.
- Journal
- Mult Scler Relat Disord
- Year
- 2026
- Identifier
- PMID 41422672 DOI 10.1016/j.msard.2025.106913
- Verification
- verified – PubMed efetch 2026-10-26; Crossref update-to/updated-by check
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
One author reports equity in companies selling an MS diet programme (Wahls) (stated).
2. Research question
Do dietary interventions change peripheral inflammatory markers in people with MS?
3. Study design and population
- Study design
- Meta-analysis – Systematic review and meta-analysis of RCTs (NutriGRADE)
- Population
People with MS
- Country
International
- Period
Search to Feb 2025
- Sample size
13 RCTs, 891 participants
- Inclusion and exclusion criteria
not stated in abstract
4. Methods and endpoints
- Exposure / intervention
Mediterranean, plant-based, calorie-restricted and other diets
- Comparator
Control diets
- Endpoints
CRP, cytokines, leptin, adiponectin
- Statistical methods
Random effects WMD; NutriGRADE
5. Actual results
- Results
7 RCTs assessed CRP: 5 showed reductions (notably Mediterranean, plant-based, calorie-restricted diets), 2 no difference; larger improvements in trials >=6 months. Calorie restriction: leptin WMD 0.95 (-2.80 to 4.69), adiponectin WMD 480 (-152 to 1112), not significant. NutriGRADE certainty low.
- Absolute risks
not reported
- Authors' conclusion
Several dietary interventions may reduce systemic inflammation in MS; larger, longer RCTs needed.
6. Strengths
- RCTs only
7. Weaknesses
- Surrogate markers only; no relapse or disability outcomes
- Small trials; COI
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Low NutriGRADE; COI.
9. Assessment of the statistical interpretation
Mostly narrative for CRP; pooled adipokine effects null.
10. Relevance to the specific claim
Fair acknowledgement: diet can modestly influence inflammation markers in MS - but surrogate markers are not disease control.
11. Independent contrary findings
12. Transferability to Germany and Europe
Universal biology; applies in Europe and Egypt.
13. Overall methodological judgement
Supports 'diet matters somewhat for inflammation'; does not support diet as treatment of MS.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | low |
| Risk of bias | some concerns |
| Precision of results | low |
| Directness | indirect |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | mixed |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |