Research Information System
MULTIPLE SCLEROSIS AND RELATED DISORDERS, vol.104, 2025 (SCI-Expanded, Scopus)
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 (Delta LPS =-377.93 f 975.41 vs. 207.00 f 288.81 pg/ mL; p < 0.001). The GFD group also showed significant improvement in EDSS scores (Delta EDSS =-0.24 f 0.61 vs. 0.00 f 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 Delta LPS, Delta EDSS, and Delta waist 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.