Anti-aging and Anti-inflammatory Dietary Interventions in Multiple Sclerosis: A Narrative Review

Multiple sclerosis (MS) is a chronic sex-biased (3♀:1♂) immune-mediated demyelinating disease of the central nervous system (CNS). Disease-modifying therapies targeting the peripheral immune cells efficiently limit relapses in early MS but cannot abrogate the chronic progressive component of the disease. The exact cause of MS remains elusive but interactions between predisposing genetic and environmental risk factors result in aberrant activation of pro-inflammatory immune cells targeting the CNS, leading to the formation of multifocal demyelinating lesions in the brain and spinal cord. MS-related genetic polymorphisms and viral triggers are currently not amenable to intervention. In contrast, obesity and gut dysbiosis represent potential modifiable risk factors contributing to MS pathogenesis and disease course. Diet influences obesity and metabolic diseases, shapes gut microbiota composition, modulates oxidative stress, and affects biological aging and inflammatory processes. Dietary patterns have emerged as factors modifying MS risk, disease activity, and progression. Therapeutic dietary interventions represent a promising avenue to promote healthy aging and regulate neuroinflammatory and neurodegenerative processes in MS. Here we describe the impact of diet on MS course and review the nutritional interventions investigated in MS and its animal models, with a focus on the mechanisms implicated including the impact on the gut microbiota.