title: Anti-inflammatory nutritional intervention in patients with relapsing-remitting and primary-progressive multiple sclerosis: A pilot study.
abstract: The aim of this work was to assess the influence of nutritional intervention on inflammatory status and wellness in people with multiple sclerosis. To this end, in a seven-month pilot study we investigated the effects of a calorie-restricted, semi-vegetarian diet and administration of vitamin D and other dietary supplements (fish oil, lipoic acid, omega-3 polyunsaturated fatty acids, resveratrol and multivitamin complex) in 33 patients with relapsing-remitting multiple sclerosis and 10 patients with primary-progressive multiple sclerosis. At 0/3/6 months, patients had neurological examination, filled questionnaires and underwent anthropometric measurements and biochemical analyses. Serum fatty acids and vitamin D levels were measured as markers of dietary compliance and nutritional efficacy of treatment, whereas serum gelatinase levels were analyzed as markers of inflammatory status. All patients had insufficient levels of vitamin D at baseline, but their values did not ameliorate following a weekly administration of 5000  IU, and rather decreased over time. Conversely, omega-3 polyunsaturated fatty acids increased already after three months, even under dietary restriction only. Co-treatment with interferon-beta in relapsing-remitting multiple sclerosis was irrelevant to vitamin D levels. After six months nutritional treatment, no significant changes in neurological signs were observed in any group. However, serum levels of the activated isoforms of gelatinase matrix metalloproteinase-9 decreased by 59% in primary-progressive multiple sclerosis and by 51% in relapsing-remitting multiple sclerosis patients under nutritional intervention, including dietary supplements. This study indicates that a healthy nutritional intervention is well accepted by people with multiple sclerosis and may ameliorate their physical and inflammatory status.
authors.affiliation: Department of Sciences, University of Basilicata, 85100 Potenza, Italy paoloxriccio@gmail.com.
authors.forename: Paolo
authors.initials: P
authors.lastname: Riccio
authors.affiliation: Department of Sciences, University of Basilicata, 85100 Potenza, Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: Rossano
authors.affiliation: Department of Sciences, University of Basilicata, 85100 Potenza, Italy.
authors.forename: Marilena
authors.initials: M
authors.lastname: Larocca
authors.affiliation: Department of Sciences, University of Basilicata, 85100 Potenza, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Trotta
authors.affiliation: Department of Agricultural and Food Science, University of Naples "Federico II", 80055 Portici, Napoli, Italy.
authors.forename: Ilario
authors.initials: I
authors.lastname: Mennella
authors.affiliation: Department of Agricultural and Food Science, University of Naples "Federico II", 80055 Portici, Napoli, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Vitaglione
authors.affiliation: Center for Applied Nutrition, 74010 Statte, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Ettorre
authors.affiliation: O.T.I. Officine Terapie Innovative S.r.l., 67061 Carsoli, Aquila, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Graverini
authors.affiliation: O.T.I. Officine Terapie Innovative S.r.l., 67061 Carsoli, Aquila, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: De Santis
authors.affiliation: Center for Multiple Sclerosis, Hospital ASL 4 "Madonna Delle Grazie", 75100 Matera, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Di Monte
authors.affiliation: Center for Multiple Sclerosis, Hospital ASL 4 "Madonna Delle Grazie", 75100 Matera, Italy.
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Coniglio
mesh_terms: D000328:Adult; D000886:Anthropometry; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000032:analysis; D004032:Diet / Q000379:methods*; D005227:Fatty Acids / Q000097:blood; D005260:Female; D018093:Gelatinases / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000473:pathology / Q000628:therapy*; D009460:Neurologic Examination; D010865:Pilot Projects; D012008:Recurrence; D044967:Serum / Q000737:chemistry; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014807:Vitamin D / Q000097:blood; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D005227:Fatty Acids; D014807:Vitamin D; D018093:Gelatinases
keywords: Multiple sclerosis; complementary and alternative medicine; diet; gelatinases; inflammation; interferon-β; quality of life; vitamin D