Table 2.

Main findings on dietary approach and/or supplement in MS.

Dietary Approach and/or Supplement	Study Population	Main Findings	Reference
Adherence to the ketogenic diet	99 MS subjects	Amelioration of fatigue and depression accompanied by weight loss and reduction in pro-inflammatory cytokines	[136]
Adherence to the OMS diet	Data from an international population of MS followed over 7.5 years	Lower depression rate	[140]
High intake of grain or meat, fat, and milk from animals (elevate content of phytic acid)	75 MS women and 75 healthy controls	Positive correlation with the prevalence of MS	[166]
Omega-3 fatty acid and fish oils supplementation	Systematic review of 5554 studies	Beneficial effects on reducing relapsing rate, inflammatory markers, and improving quality of life	[142]
Diets enriched in PUFAs	80,920 women from Nurses’ Health Study and 94,511 women from Nurses’ Health Study II	Lower incidence of MS. Among the specific types of PUFA, only α-linolenic acid was inversely associated with MS risk	[144]
Omega-3 PUFAs supplementation	10 MS patients	Improvement in quality of life by decreasing relapse rates	[148]
Vitamin D deficiency	92,253 women from the Nurses’ Health Study (NHS) and 95,310 women from the Nurses’ Health Study II (NHS II)	Higher risk of MS incidence	[155]
Low vitamin D intake	Review of literature data	Increased incidence of MS, but the risk–benefit profile of dosage and duration or supplementation needs to be clarified	[156]
Vitamin D supplementation	172 MS patients were randomized: low-dose vitamin D3–high-dose vitamin D3	Lack of significant effects	[157]
Low levels of vitamin A	31 MS patients and 29 matched controls	Lack of correlation with the incidence of MS	[159]
Vitamin A supplementation	101 MS patients in a placebo randomized clinical trial	Significant improvement in fatigue and depression. Improvement also in psychiatric outcomes during interferon therapy	[160]
Probiotics supplementation	40 MS patients	Significant improvement in inflammatory markers, oxidative stress indicators, pain, fatigue, and quality of life	[171]
Probiotics supplementation	60 MS patients	Significant improvements in disability scores and mental health parameters, such as reduced depressive symptoms, anxiety, and stress	[172]