Abstract

Multiple sclerosis (MS) is a chronic neurodegenerative disease causing fatigue, sleep disturbances, and reduced quality of life (QoL). The Mediterranean diet (MeD), with anti-inflammatory and neuroprotective effects, may benefit MS symptoms. Eighty-four MS patients diagnosed at least one year prior, without other chronic diseases, were included. MeD adherence was measured by the 14-item Mediterranean Diet Adherence Screener (MEDAS). Fatigue was assessed using the Fatigue Severity Scale (FSS), sleep quality with the Pittsburgh Sleep Quality Index (PSQI), QoL with the Short Form-36 Health Survey (SF-36), and disability by the Expanded Disability Status Scale (EDSS). Cranial and cervical MRI lesions were evaluated. Data analysis used Mann-Whitney U, Spearman’s rho, and chi-square tests. Mean age was 36.3±9.45 years; 61.9% were female. Mean scores: EDSS 1.63, FSS 4.55, MEDAS 6.53, PSQI 6.28. Higher MEDAS scores correlated with lower fatigue and better sleep. Males reported higher energy (p=0.009); females had worse sleep (p=0.011). Cervical lesions were associated with poor sleep (p=0.022). QoL negatively correlated with poor sleep (r=-0.97). Lower adherence to the MeD may relate to increased fatigue, poor sleep, reduced QoL, and cervical lesions in MS patients. Diet and lesion location appear to influence clinical outcomes.

Key words: Mediterranean diet, multiple sclerosis, cervical magnetic resonance imaging, fatigue and sleep quality, quality of life