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Dietary interventions for multiple sclerosis

  • Review
  • Intervention




Clinical and experimental data suggest that certain dietary regimens, particularly those including polyunsaturated fatty acids (PUFAs) and vitamins might improve outcomes in people with multiple sclerosis (MS). Diets and dietary supplements are much used by people with MS in the belief that they might improve disease outcomes.


To answer MS consumers' questions regarding the efficacy and safety of dietary regimens for MS.

Search methods

We searched the Cochrane MS Group trial register (February 2006), Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Library, Issue 1, 2006, MEDLINE (PubMed) (1966 to March 2006), EMBASE (1974 to March 2006) and the bibliographies of papers found.

Selection criteria

All randomised controlled trials comparing a specific dietary intervention, diet plan or dietary supplementation, with no dietary modification or placebo, were eligible.

Data collection and analysis

Two reviewers independently selected articles, assessed trial quality and extracted data.

Main results

Trial quality was poor, particularly as regards descriptions of randomisation, blinding and adverse event reporting. Some studies had large numbers of drop-outs; dropouts were never included in the analyses. PUFAs did not have a significant effect on disease progression, measured as worsening of Disability Status Scale. Omega-6 fatty acids (11-23 g/day linoleic acid) had no benefit in 75 relapsing remitting (RR) MS patients (progression at two years: relative risk (RR)=0.78, 95% CI [0.45 to 1.36]) or in 69 chronic progressive (CP) MS patients (RR=1.67, 95% CI [0.75 to 3.72]. Linoleic acid (2.9-3.4 g/day) had no benefit in CPMS (progression at two years: RR=0.78, 95% CI [0.43 to 1.42]). Slight decreases in relapse rate and relapse severity were associated with omega-6 fatty acids in some small studies, however these findings are limited by the limited validity of the endpoints.
Omega-3 fatty acids had no benefit on progression at 12 months in 14 RRMS patients or at 24 months in 292 RRMS patients (RR=0.15, 95% CI [0.01 to 3.11], p= 0.22 at 12 months, and 0.82 95% CI [0.65 to 1.03], p=0.08, at 24 months).
The low frequency of reported adverse events suggests no major toxicity associated with PUFA administration.
No studies on vitamin supplementation and allergen-free diets were analysed as none met the eligibility criteria.

Authors' conclusions

PUFAs seem to have no major effect on the main clinical outcome in MS (disease progression), and does not substantially affect the risk of clinical relapses over 2 years. However, the data available are insufficient to assess any potential benefit or harm from PUFA supplementation. Evidence bearing on the possible benefits and risks of vitamin supplementation and antioxidant supplements in MS is lacking. More research is required to assess the effectiveness of diets interventions in MS.




臨床及實驗資料顯示某些飲食, 特別是那些含有未飽和脂肪酸及維他命, 可以改善多發性硬化症病患的預後,飲食及補充劑用在越來越多的多發性硬化病人身上,我們相信它可能改善疾病預後。










若以失能狀態的惡化來評估,PUFA並無對病程有顯著的影響。Ω6脂肪酸(11 – 23 g/day亞油酸)使用在75位RRMS病人身上無益處(在2年時惡化的RR = 0.78, 95% CI [0.45 to 1.36]),或使用在69位CPMS病人身上亦然RR = 1.67, 95% CI [0.75 to 3.72]。亞油酸(2.9 – 3.4 g/day)對於CPMS無益處(在2年時惡化的RR = 0.78, 95% CI [0.43 to 1.42])。 在某些研究顯示Ω6脂肪酸能稍微降低復發機率及復發的嚴重程度,不過效度有限。Ω3脂肪酸的使用療效評估方面,則是在12個月時評估14位RRMS病人及在24個月時評估292位RRMS病人,都沒有益處(12個月時RR = 0.15, 95% CI [0.01 to 3.11], p = 0.22, 24個月時RR = 0.82, 95% CI [0.65 to 1.03], p = 0.08,)。PUFA的嚴重副作用不多,沒有關於補充維他命的研究,研究不含致敏物的飲食則不符合選擇標準。





此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。


由於目前已知傳統的多發性硬化症治療只有部分效果,大部分病人選擇附加的或替代的療法,常是飲食和食物補充品,事實上在網路用“多發性硬化”及“飲食”作搜尋會得到超過6百萬篇參考資料,表示這樣的治療被廣泛使用並且得到多發性硬化病人的認同,最常被使用的飲食療法為補充多元不飽和脂肪酸、不含致敏物(麥麩及牛奶)的飲食、微量營養素以及抗氧化物例如硒、銀杏萃取、輔脢Q10。這篇作者希望能評估何種飲食的改變能對多發性硬化預後有較佳的影響,雖然這方面有許多相關文獻,但是符合選擇標準的只有6篇,是研究多元不飽和脂肪酸療法,一共699位病人;並沒有關於維他命及抗氧化物補充的研究能符合收錄標準,也沒有找到其他多發性硬化建議的飲食療法的相關文獻。以目前有限的資料無法提供多元不飽和脂肪酸對多發性硬化的影響是好或壞,可惜約50 – 75%的多發性硬化病人都有使用飲食療法。

Plain language summary

Dietary interventions as complementary therapies for MS

Because available conventional treatments are only partially effective and may produce side effects, most patients with MS use therapies proposed by complementary and alternative medicine - usually diets and dietary supplements. In fact, an Internet search using the terms "multiple sclerosis" and "diet" produces over 6 million references, indicating that these treatments are widely used and believed in by the MS consumer community. The most common dietary interventions are supplementation with polyunsaturated fatty acids, allergen (gluten and milk)-free diets, vitamins, and micronutrients and antioxidants such as selenium, Gingko biloba extracts, coenzyme Q10.
The authors of this review tried to assess whether changes in dietary habits could favourably influence the prognosis of people with MS.
Although a massive amount of data has been published in this area, only 6 studies on polyunsaturated fatty acids (PUFA), studying a total of 699 patients, met the minimal inclusion criteria in terms of methodological quality, for inclusion in this review. No studies on vitamins and antioxidant supplements were found that met our criteria. No papers on any other proposed dietary intervention for MS were found after extensive searching of the scientific databases.
The data available are insufficient to assess any potential benefit or harm that might result from PUFA supplementation. This is unfortunate since 50-75% of people with MS make use of such diets and dietary supplementations.