Research
Nutrition and Multiple Sclerosis: The gut is key
by Magdalena Wallkamm1 and Nicole Jankovic1,2
1Institute for Integrative Health Care and Health Promotion, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany
2Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, 33098 Paderborn, Germany
Cite as: Wallkamm, M. & Jankovic, N. (2025). Nutrition and Multiple Sclerosis: The gut is key. THE MIND Bulletin on Mind-Body Medicine Research, 7, 32-33. https://doi.org/10.61936/themind/2024121231
XXX
XXX
Keywords: XXX
References
Akimbekov, N. S., Digel, I., Sherelkhan, D. K., Lutfor, A. B., & Razzaque, M. S. (2020). Vitamin D and the Host-Gut Microbiome: A Brief Overview. Acta Histochemica Et Cytochemica, 53(3), 33–42. https://doi.org/10.1267/ahc.20011.
Alexy, U., Jankovic, N., Schmitting, S., & Buyken, A. (2021). Chronobiologie und Ernährung. Aktuelle Ernährungsmedizin, 46, 95–104. https://doi.org/10.1055/a-1219-7355.
Altowaijri, G., Fryman, A., & Yadav, V. (2017). Dietary Interventions and Multiple Sclerosis. Current Neurology and Neuroscience Reports, 17(3), 28. https://doi.org/10.1007/s11910-017-0732-3.
Boziki, M. K., Kesidou, E., Theotokis, P., Mentis, A.‑F. A., Karafoulidou, E., Melnikov, M., Sviridova, A., Rogovski, V., Boyko, A., & Grigoriadis, N. (2020). Microbiome in Multiple Sclerosis; Where Are We, What We Know and Do Not Know. Brain Sciences, 10(4). https://doi.org/10.3390/brainsci10040234.
Brown, J., Quattrochi, B., Everett, C., Hong, B.‑Y., & Cervantes, J. (2020). Gut commensals, dysbiosis, and immune response imbalance in the pathogenesis of multiple sclerosis. Multiple Sclerosis Journal, 27(6), 807–811. https://doi.org/10.1177/1352458520928301.
Buga, A. M., Padureanu, V., Riza, A.‑L., Oancea, C. N., Albu, C. V., & Nica, A. D. (2023). The Gut-Brain Axis as a Therapeutic Target in Multiple Sclerosis. Cells, 12(14). https://doi.org/10.3390/cells12141872.
Campagnoli, L. I. M., Marchesi, N., Varesi, A., Morozzi, M., Mascione, L., Ricevuti, G., Esposito, C., Galeotti, N., & Pascale, A. (2024). New therapeutic avenues in multiple sclerosis: Is there a place for gut microbiota-based treatments? Pharmacological Research, 209, 107456. https://doi.org/10.1016/j.phrs.2024.107456.
Chunder, R., Heider, T., & Kuerten, S. (2023). The prevalence of IgG antibodies against milk and milk antigens in patients with multiple sclerosis. Frontiers in Immunology, 14, 1202006. https://doi.org/10.3389/fimmu.2023.1202006.
Clemente-Suárez, V. J., Beltrán-Velasco, A. I., Redondo-Flórez, L., Martín-Rodríguez, A., & Tornero-Aguilera, J. F. (2023). Global Impacts of Western Diet and Its Effects on Metabolism and Health: A Narrative Review. Nutrients, 15(12). https://doi.org/10.3390/nu15122749.
Crayton, H. J., & Rossman, H. S. (2006). Managing the symptoms of multiple sclerosis: A multimodal approach. Clinical Therapeutics, 28(4), 445–460. https://doi.org/10.1016/j.clinthera.2006.04.005.
Dakanalis, A., Tryfonos, C., Pavlidou, E., Vadikolias, K., Papadopoulou, S. K., Alexatou, O., Vorvolakos, T., Chrysafi, M., Fotiou, D., Mentzelou, M., Serdari, A., Chatzidimitriou, M., Dimoliani, S., Tsourouflis, G., & Giaginis, C. (2024). Associations between Mediterranean Diet Adherence, Quality of Life, and Mental Health in Patients with Multiple Sclerosis: A Cross-Sectional Study. Journal of Personalized Medicine, 14(2). https://doi.org/10.3390/jpm14020199.
Diaz-Marugan, L., Kantsjö, J. B., Rutsch, A., & Ronchi, F. (2023). Microbiota, diet, and the gut-brain axis in multiple sclerosis and stroke. European journal of immunology, 53(11), e2250229. https://doi.org/10.1002/eji.202250229.
Di Majo, D., Cacciabaudo, F., Accardi, G., Gambino, G., Giglia, G., Ferraro, G., Candore, G., & Sardo, P. (2022). Ketogenic and Modified Mediterranean Diet as a Tool to Counteract Neuroinflammation in Multiple Sclerosis: Nutritional Suggestions. Nutrients, 14(12). https://doi.org/10.3390/nu14122384.
Dobson, R [R.], & Giovannoni, G [G.] (2019). Multiple sclerosis - a review. European Journal of Neurology, 26(1), 27–40. https://doi.org/10.1111/ene.13819.
Dobson, R [Ruth], Cock, H. R., Brex, P., & Giovannoni, G [Gavin] (2018). Vitamin D supplementation. Practical Neurology, 18(1), 35–42. https://doi.org/10.1136/practneurol-2017-001720.
Duscha, A., Gisevius, B., Hirschberg, S., Yissachar, N., Stangl, G. I., Dawin, E., Bader, V., Haase, S., Kaisler, J., David, C., Schneider, R., Troisi, R., Zent, D., Hegelmaier, T., Dokalis, N., Gerstein, S., Del Mare-Roumani, S., Amidror, S., Staszewski, O., . . . Haghikia, A. (2020). Propionic Acid Shapes the Multiple Sclerosis Disease Course by an Immunomodulatory Mechanism. Cell, 180(6), 1067-1080.e16. https://doi.org/10.1016/j.cell.2020.02.035.
Esch, T., Stefano, G. B., Fricchione, G. L., & Benson, H. (2002). The role of stress in neurodegenerative diseases and mental disorders. Neuro endocrinology letters, 23(3), 199–208. PMID: 12080279.
Esch, T., Kim, J. W., & Stefano, G. B. (2006). Neurobiological implications of eating healthy. Neuro endocrinology letters, 27(1-2), 21–33. PMID: 16648819.
Felicetti, F., Tommasin, S., Petracca, M., Giglio, L. de, Gurreri, F., Ianniello, A., Nistri, R., Pozzilli, C., & Ruggieri, S. (2022). Eating Hubs in Multiple Sclerosis: Exploring the Relationship Between Mediterranean Diet and Disability Status in Italy. Frontiers in Nutrition, 9, 882426. https://doi.org/10.3389/fnut.2022.882426.
García-Montero, C., Fraile-Martínez, O., Gómez-Lahoz, A. M., Pekarek, L., Castellanos, A. J., Noguerales-Fraguas, F., Coca, S., Guijarro, L. G., García-Honduvilla, N., Asúnsolo, A., Sanchez-Trujillo, L., Lahera, G., Bujan, J., Monserrat, J., Álvarez-Mon, M., Álvarez-Mon, M. A., & Ortega, M. A. (2021). Nutritional Components in Western Diet Versus Mediterranean Diet at the Gut Microbiota-Immune System Interplay. Implications for Health and Disease. Nutrients, 13(2). https://doi.org/10.3390/nu13020699.
Ghasemi, N., Razavi, S., & Nikzad, E. (2017). Multiple Sclerosis: Pathogenesis, Symptoms, Diagnoses and Cell-Based Therapy. Cell Journal, 19(1), 1–10. https://doi.org/10.22074/cellj.2016.4867.
Gisevius, B., Duscha, A., Poschmann, G., Stühler, K., Motte, J., Fisse, A. L., Augustyniak, S., Rehm, A., Renk, P., Böse, C., Hubert, D., Peters, K., Jagst, M., Gömer, A., Todt, D., Bader, V., Tokic, M., Hirschberg, S., Krogias, C., . . . Haghikia, A. (2024). Propionic acid promotes neurite recovery in damaged multiple sclerosis neurons. Brain Communications, 6(3), fcae182. https://doi.org/10.1093/braincomms/fcae182.
Jellinger, K. A. (2024). Depression and anxiety in multiple sclerosis. Review of a fatal combination. Journal of Neural Transmission (Vienna, Austria: 1996), 131(8), 847–869. https://doi.org/10.1007/s00702-024-02792-0.
Johansson, E., Guo, J., Wu, J., Olsson, T., Alfredsson, L., & Hedström, A. K. (2025). Impact of fish consumption on disability progression in multiple sclerosis. Journal of Neurology, Neurosurgery & Psychiatry, jnnp-2024-335200. https://doi.org/10.1136/jnnp-2024-335200.
Johnson, A. J., Vangay, P., Al-Ghalith, G. A., Hillmann, B. M., Ward, T. L., Shields-Cutler, R. R., Kim, A. D., Shmagel, A. K., Syed, A. N., Walter, J., Menon, R., Koecher, K., & Knights, D. (2019). Daily Sampling Reveals Personalized Diet-Microbiome Associations in Humans. Cell Host & Microbe, 25(6), 789-802.e5. https://doi.org/10.1016/j.chom.2019.05.005.
Kozhieva, M., Naumova, N., Alikina, T., Boyko, A., Vlassov, V., & Kabilov, M. R. (2019). Primary progressive multiple sclerosis in a Russian cohort: Relationship with gut bacterial diversity. BMC Microbiology, 19(1), 309. https://doi.org/10.1186/s12866-019-1685-2
Ladakis, D. C., & Bhargava, P. (2023). The Role of Gut Dysbiosis and Potential Approaches to Target the Gut Microbiota in Multiple Sclerosis. CNS Drugs, 37(2), 117–132. https://doi.org/10.1007/s40263-023-00986-w.
Linseisen, J., Renner, B., Gedrich, K., Wirsam, J., Holzapfel, C., Lorkowski, S., Watzl, B., Daniel, H., & Leitzmann, M. (2025). Data in Personalized Nutrition: Bridging Biomedical, Psycho-behavioral, and Food Environment Approaches for Population-wide Impact. Advances in Nutrition, 100377. https://doi.org/10.1016/j.advnut.2025.100377.
Lorefice, L., & Zoledziewska, M. (2024). Propionic Acid Impact on Multiple Sclerosis: Evidence and Challenges. Nutrients, 16(22). https://doi.org/10.3390/nu16223887.
McGinley, M. P., Goldschmidt, C. H., & Rae-Grant, A. D. (2021). Diagnosis and Treatment of Multiple Sclerosis: A Review. JAMA, 325(8), 765–779. https://doi.org/10.1001/jama.2020.26858.
Moles, L., & Otaegui, D. (2020). The Impact of Diet on Microbiota Evolution and Human Health. Is Diet an Adequate Tool for Microbiota Modulation? Nutrients, 12(6). https://doi.org/10.3390/nu12061654.
Moravejolahkami, A. R., Shakibaei, M., Sharma, M., Mohammadnezhad, M., & Devarakonda, S. L. S. (2024). Effect of Mediterranean diet on body mass index and fatigue severity in patients with multiple sclerosis: A systematic review and meta-analysis of clinical trials. Heliyon, 10(18), e37705. https://doi.org/10.1016/j.heliyon.2024.e37705.
Murdaca, G., Gerosa, A., Paladin, F., Petrocchi, L., Banchero, S., & Gangemi, S. (2021). Vitamin D and Microbiota: Is There a Link with Allergies? International Journal of Molecular Sciences, 22(8). https://doi.org/10.3390/ijms22084288.
Nitzan, Z., Staun-Ram, E., Volkowich, A., & Miller, A. (2023). Multiple Sclerosis-Associated Gut Microbiome in the Israeli Diverse Populations: Associations with Ethnicity, Gender, Disability Status, Vitamin D Levels, and Mediterranean Diet. International Journal of Molecular Sciences, 24(19). https://doi.org/10.3390/ijms241915024.
Olsson, T., Barcellos, L. F., & Alfredsson, L. (2017). Interactions between genetic, lifestyle and environmental risk factors for multiple sclerosis. Nature Reviews Neurology, 13(1), 25–36. https://doi.org/10.1038/nrneurol.2016.187.
Ordoñez-Rodriguez, A., Roman, P., Rueda-Ruzafa, L., Campos-Rios, A., & Cardona, D. (2023). Changes in Gut Microbiota and Multiple Sclerosis: A Systematic Review. International Journal of Environmental Research and Public Health, 20(5). https://doi.org/10.3390/ijerph20054624.
Parodi, B., & Kerlero de Rosbo, N. (2021). The Gut-Brain Axis in Multiple Sclerosis. Is Its Dysfunction a Pathological Trigger or a Consequence of the Disease? Frontiers in Immunology, 12, 718220. https://doi.org/10.3389/fimmu.2021.718220.
Perler, B. K., Friedman, E. S., & Wu, G. D. (2023). The Role of the Gut Microbiota in the Relationship Between Diet and Human Health. Annual Review of Physiology, 85, 449–468. https://doi.org/10.1146/annurev-physiol-031522-092054.
Qian Z, Li Y, Guan Z, Guo P, Zheng K, Du Y, Yin S, Chen B, Wang H, Jiang J, Qiu K and Zhang M (2023) Global, regional, and national burden of multiple sclerosis from 1990 to 2019: Findings of global burden of disease study 2019. Front. Public Health 11:1073278. https://doi: 10.3389/fpubh.2023.1073278.
Riccio, P., & Rossano, R. (2015). Nutrition facts in multiple sclerosis. ASN Neuro, 7(1). https://doi.org/10.1177/1759091414568185.
Ross, F. C., Patangia, D., Grimaud, G., Lavelle, A., Dempsey, E. M., Ross, R. P., & Stanton, C. (2024). The interplay between diet and the gut microbiome: Implications for health and disease. Nature Reviews. Microbiology, 22(11), 671–686. https://doi.org/10.1038/s41579-024-01068-4.
Rutsch, A., Kantsjö, J. B., & Ronchi, F. (2020). The Gut-Brain Axis: How Microbiota and Host Inflammasome Influence Brain Physiology and Pathology. Frontiers in Immunology, 11, 604179. https://doi.org/10.3389/fimmu.2020.604179.
Sadeghi-Bahmani, D., Esmaeili, L., Mokhtari, F., Sadeghi Bahmani, L., Afsharzadeh, M., Shaygannejad, V., Mirmosayyeb, O., Goldstein-Piekarski, A. N., & Gross, J. J. (2022). Effects of Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Stress Reduction (MBSR) on symptoms and emotional competencies in individuals with multiple sclerosis. Multiple Sclerosis and Related Disorders, 67, 104029. https://doi.org/10.1016/j.msard.2022.104029.
Sand, I. K., Levy, S., Fitzgerals, K., & Sorets, Tali, Sumowski, James, F (2018). The Role of Diet in Multiple Sclerosis: Mechanistic Connections and Current Evidence. Current Nutrition Reports, 7(3), 150–160. https://doi.org/10.1007/s13668-018-0236-z.
Schneider, E., O’Riordan, K. J., Clarke, G., & Cryan, J. F. (2024). Feeding gut microbes to nourish the brain: Unravelling the diet-microbiota-gut-brain axis. Nature Metabolism, 6(8), 1454–1478. https://doi.org/10.1038/s42255-024-01108-6.
Sharifa, M., Ghosh, T., Daher, O. A., Bhusal, P., Alaameri, Y. A., Naz, J., Ekhator, C., Bellegarde, S. B., Bisharat, P., Vaghani, V., & Hussain, A. (2023). Unraveling the Gut-Brain Axis in Multiple Sclerosis: Exploring Dysbiosis, Oxidative Stress, and Therapeutic Insights. Cureus, 15(10), e47058. https://doi.org/10.7759/cureus.47058.
Stoiloudis, P., Kesidou, E., Bakirtzis, C., Sintila, S.‑A., Konstantinidou, N., Boziki, M., & Grigoriadis, N. (2022). The Role of Diet and Interventions on Multiple Sclerosis: A Review. Nutrients, 14(6). https://doi.org/10.3390/nu14061150.
Thornton, A. E., & Raz, N. (1997). Memory impairment in multiple sclerosis: A quantitative review. Neuropsychology, 11(3), 357–366. https://doi.org/10.1037//0894-4105.11.3.357
Tryfonos, C., Chrysafi, M., Vadikolias, K., Berberoglou, L., Vorvolakos, T., Dimoliani, S., Tsourouflis, G., Kontogiorgis, C., Antasouras, G., & Giaginis, C. (2024). Nutritional interventional studies in patients with multiple sclerosis: A scoping review of the current clinical evidence. Journal of Neurology, 271(4), 1536–1570. https://doi.org/10.1007/s00415-023-12140-z.
Ullah, H., Arbab, S., Tian, Y., Liu, C.‑Q., Chen, Y., Qijie, L., Khan, M. I. U., Hassan, I. U., & Li, K. (2023). The gut microbiota-brain axis in neurological disorder. Frontiers in Neuroscience, 17, 1225875. https://doi.org/10.3389/fnins.2023.1225875.
Waterhouse, M., Hope, B., Krause, L., Morrison, M., Protani, M. M., Zakrzewski, M., & Neale, R. E. (2019). Vitamin D and the gut microbiome: A systematic review of in vivo studies. European Journal of Nutrition, 58(7), 2895–2910. https://doi.org/10.1007/s00394-018-1842-7.