The Mediterranean diet and multiple sclerosis: a case-control study in The Republic of Cyprus

Abstract

Background: It has been suggested that dietary habits are associated with multiple sclerosis. Some eating patterns have been considered protective while others harmful. Objectives: A case–control study was used to examine the association between multiple sclerosis and the Mediterranean diet, food groups and individual foods. Methods: A total of 127 multiple sclerosis cases and 718 controls from across The Republic of Cyprus completed a self-reported questionnaire which included lifestyle and food questions. A 9-unit Mediterranean diet score (MDS) was calculated. Logistic regression was used to assess associations. An age-matched analysis of 119 cases and 119 controls was evaluated using conditional regression. Results: In the logistic regression analysis adjusted for age, a higher MDS (OR=0.96, 95% CI: 0.93-1.00, p: 0.04) was inversely associated with being a multiple sclerosis case. Significant inverse associations were found in the following groups: vegetables (OR=0.83, 95% CI: 0.70-0.98, p: 0.03) alcohol (OR=0.87, 95% CI: 0.80-0.95, p: 0.001) legumes (OR=0.78, 95% CI: 0.64-0.95, p: 0.01) non-refined cereals (OR=0.81, 95% CI: 0.66-0.98, p: 0.03) while significant associations were found with dairy products (OR=1.24, 95% CI: 1.05- 1.46, p: 0.01). Similar results were seen in the age-matched conditional regression analysis. Conclusions: There was found to be a statistically significant association between a Mediterranean type diet and multiple sclerosis. There was an inverse association of being a multiple sclerosis case, with an increase in the MDS. Certain food groups and individual foods may also be associated with an increased or decreased association of being a multiple sclerosis case. This study may have significant effects on health planning in The Republic of Cyprus. When interpreting the results, there is always the possibility of reverse causality. That is, the disease itself, or the diagnosis of the disease, may lead to a change in eating habits. It is recommended that a Mediterranean type diet type be considered as a prevention measure to investigate in future intervention studies.