Adapted Mediterranean Diet Impact on the Symptoms of Chronic Fatigue, Serum Levels of Omega-3 Polyunsaturated Fatty Acids (Pufas) and Interleukin 17 (Il-17) in Patients With Relapsing-Remitting Multiple Sclerosis Undergoing Disease-Modifying Therapy: A Pilot Study

Abstract

Purpose: This pilot study was designed to investigate the impact of a moderate-calorie Mediterranean diet compared to a regular diet with omega-3 PUFAs (eicosapentaenoic and docosahexaenoic acids) supplementation on fatigue symptoms in patients with relapsing-remitting multiple sclerosis (RRMS) and to assess the optional benefit of the diet on their quality of life. Material/Methods: This 12-month pilot study was conducted in 2021 at the Department of Neurology, Medical University – Pleven, Bulgaria. A total of 60 patients with RRMS aged 18-64 were selected from the database of the Neurology Clinic at the University Hospital "Dr Georgi Stranski" – Pleven. From the selected patients, only 30 were included in the pilot phase and respectively assigned to the nutritional arms. Blood samples were collected twice – at the first and second visit in 3 months, for metabolic and dietary parameters analysis. Symptoms of fatigue were assessed with Fatigue Scale for Motor and Cognitive Functions (FSMC) and Modified Fatigue Impact Scale (MFIS). Results: From the 30 participants included in the study, 17 patients attended the clinic centre for complete follow-up; the remaining 13 were only partially observed. The dynamics of the followed-up parameters showed a statistically significant change in the body mass index (BMI), the fatigue symptoms in the FSMC and MFIS scales, total cholesterol and triglycerides levels, and the serum concentrations of IL17A, EPA and DHA. The metabolic caloric values were also found to be significantly changed. Conclusions: Despite the small study size limitation, this pilot study might be of benefit for further extensive research on the potential favorable impact of diet and lifestyle modifications on the symptoms of fatigue in multiple sclerosis patients.