Multiple sclerosis and related disorders · 2025
Effect of a gluten-free diet on serum lipopolysaccharide levels and disease progression in multiple sclerosis patients: A 6-month longitudinal study.
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Karataş Ezgi, Uçar Aslı, Yüceyar Ayşe Nur, Taşkıran Dilek, Baklan Meltem
Аннотация
BACKGROUND: Multiple Sclerosis (MS) is a chronic autoimmune and inflammatory disease of the central nervous system, and recent evidence suggests a potential role for gluten in its pathogenesis.
OBJECTIVES: This study aimed to evaluate the effects of a gluten-free diet (GFD) on disease-related disability, anthropometric parameters, and serum lipopolysaccharide (LPS) levels in patients with Relapsing-Remitting Multiple Sclerosis (RRMS).
METHODS: Fifty-four female RRMS patients were followed for six months. The GFD group (n = 27) adhered to a structured gluten-free diet, while the gluten-containing diet (GD) group (n = 27) received general healthy eating advice. Anthropometric measurements, 24-hour dietary recalls, and blood samples were collected at baseline, 3 months, and 6 months.
RESULTS: After six months, energy and carbohydrate intakes significantly decreased in the GFD group (p < 0.05), accompanied by a marked reduction in serum LPS levels (ΔLPS = -377.93 ± 975.41 vs. 207.00 ± 288.81 pg/mL; p < 0.001). The GFD group also showed significant improvement in EDSS scores (ΔEDSS = -0.24 ± 0.61 vs. 0.00 ± 0.39; p = 0.042). Body weight, BMI, waist and hip circumferences, and body fat mass decreased significantly compared with the GD group (all p < 0.05). Regression analysis identified "group" as a significant predictor of ΔLPS, ΔEDSS, and Δwaist circumference (p < 0.05), independent of age, disease duration, and HEI changes.
CONCLUSIONS: A six-month gluten-free diet improved disability, reduced systemic endotoxemia, and favorably altered body composition in RRMS patients, supporting its potential as a complementary nutritional therapy in multiple sclerosis management.
OBJECTIVES: This study aimed to evaluate the effects of a gluten-free diet (GFD) on disease-related disability, anthropometric parameters, and serum lipopolysaccharide (LPS) levels in patients with Relapsing-Remitting Multiple Sclerosis (RRMS).
METHODS: Fifty-four female RRMS patients were followed for six months. The GFD group (n = 27) adhered to a structured gluten-free diet, while the gluten-containing diet (GD) group (n = 27) received general healthy eating advice. Anthropometric measurements, 24-hour dietary recalls, and blood samples were collected at baseline, 3 months, and 6 months.
RESULTS: After six months, energy and carbohydrate intakes significantly decreased in the GFD group (p < 0.05), accompanied by a marked reduction in serum LPS levels (ΔLPS = -377.93 ± 975.41 vs. 207.00 ± 288.81 pg/mL; p < 0.001). The GFD group also showed significant improvement in EDSS scores (ΔEDSS = -0.24 ± 0.61 vs. 0.00 ± 0.39; p = 0.042). Body weight, BMI, waist and hip circumferences, and body fat mass decreased significantly compared with the GD group (all p < 0.05). Regression analysis identified "group" as a significant predictor of ΔLPS, ΔEDSS, and Δwaist circumference (p < 0.05), independent of age, disease duration, and HEI changes.
CONCLUSIONS: A six-month gluten-free diet improved disability, reduced systemic endotoxemia, and favorably altered body composition in RRMS patients, supporting its potential as a complementary nutritional therapy in multiple sclerosis management.