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This study analyzed 41,428 participants from the Swedish National March Cohort, assessing diet at baseline in 1997 via a Food Frequency Questionnaire. MS incidence was tracked through national registries and HRs were estimated with multivariable Cox models.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/mediterranean-diet-and-risk-of-multiple-sclerosis-a-prospective-cohort-study/414416/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/mediterranean-diet-and-risk-of-multiple-sclerosis-a-prospective-cohort-study/414416.png","ImageObject",300,407,{"name":92,"@type":93},"Oliver","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the main objective of the study?","Question",{"text":112,"@type":113},"To determine whether adherence to the Mediterranean diet is associated with lower risk of developing multiple sclerosis (MS).","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was dietary intake measured?",{"text":117,"@type":113},"Dietary intake was assessed at baseline in 1997 using a Food Frequency Questionnaire and summarized as a Mediterranean Diet Score (0–9), analyzed numerically and categorically (low, medium, high).",{"name":119,"@type":110,"acceptedAnswer":120},"What were the study findings on MS risk?",{"text":121,"@type":113},"An increase of one point in the Mediterranean Diet Score was associated with a 14% lower MS risk. The association was stronger among non-smokers and in participants aged ⩽45 years, with no clear risk reduction observed among smokers or those aged >45 years.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},414416,1790767551,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46,"preview_page_count":4},8796095461610,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","MULTIPLE SCLEROSIS JOURNAL  \nMSJ  \nOriginal Research Paper  \nMediterranean diet and risk of multiple sclerosis: A prospective cohort study  \nSara Ratti, Helén Eke, Anna Cantarutti, Stephanie E Bonn, Hans-Olov Adami, Weimin Ye, Marta Ponzano, Alessandra Grotta and Ylva Trolle Lagerros  \nAbstract  \nBackground and Objectives: Although adherence to the Mediterranean diet has been reported to be inversely associated with risk of neurodegenerative disease, it is uncertain if this dietary pattern also reduces multiple sclerosis (MS) risk.  \nMethods: We analyzed data from 41,428 participants in the Swedish National March Cohort. Dietary intake was assessed at baseline in 1997 using a Food Frequency Questionnaire. The Mediterranean Diet Score was analyzed numerically (range: 0–9) and categorically (low, medium, high adherence) . Participants were followed using national registries to identify MS cases. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards models.  \nResults: During a mean follow-up of 17.6 years, we identified 89 incident MS cases. Each one-point increase in the Mediterranean Diet Score was associated with a 14% lower MS risk (HR = 0.86, 95% CI: 0.75–0.99) . When stratified by smoking, we found a 26% lower risk among non-smokers (HR = 0.74, 95% CI: 0.61–0.90), while no risk reduction was seen among smokers. In age-stratified analyses, inverse associations were observed in participants aged ⩽ 45 years (HR = 0.77, 95% CI: 0.64–0.93), but not in those aged >45 years.  \nConclusions: Adherence to the Mediterranean diet was inversely associated with MS risk, supporting its potential neuroprotective role.  \nKeywords: Mediterranean diet, multiple sclerosis, epidemiology, cohort study, nutrition  \nDate received: 23 July 2025; revised: 6 October 2025; accepted: 14 October 2025  \nIntroduction  \nMultiple sclerosis (MS) is a chronic disease of the central nervous system, characterized by myelin loss, inflammation, and neurodegeneration.1 Common symptoms include visual impairment, sensorimotor dysfunction, fatigue, and cognitive deficits.1 Onset is usually at ages 20–45 years, and there is a higher incidence in females.1 Sweden has one of the highest global prevalence rates of MS (215 per 100,000) .2 Established and suspected causes of MS include genetic and environmental factors, such as Vitamin D deficiency,3 Epstein–Barr virus infection,4 smoking,5 obesity,5 and potentially also diet.6 Although the influence of diet remains under examination, the Mediterranean dietary pattern might be protective.7,8 This dietary pattern, characterized by a high consumption of fruits, vegetables, olive oil, and omega-3 fatty acids, has previously been associated with a reduced risk of Alzheimer’s and Parkinson’s disease,9,10  \npotentially due to its antioxidant and anti-inflammatory effects. Current evidence, although still limited in scope, suggests that individuals adhering to the Mediterranean diet may have a lower risk of developing MS, pointing to a potentially beneficial role for this dietary pattern.7,8 To expand the limited knowledge, we examined the association between Mediterranean diet adherence and MS incidence in a large Swedish prospective cohort.  \nMethods  \nStudy population  \nThe Swedish National March Cohort was established in 1997 during a nationwide fundraising campaign by the Swedish Cancer Society. This 4-day event took place in nearly 3,600 cities and villages across  \nMultiple Sclerosis Journal 2026, Vol. 32(1) 61–68 DOI: 10. 1177/ 13524585251396408 © The Author(s), 2025.  \nArticle reuse guidelines: [sagepub.com/journals](sagepub.com/journals)permissions  \nCorrespondence to:  \nS Ratti  \nDepartment of Statistics and Quantitative Methods, University of MilanoBicocca, Via Bicocca degli Arcimboldi, 8 (Building U7), Milan, 20126, Italy.  \n[s.ratti15@campus.unimib.it](s.ratti15@campus.unimib.it)  \nSara Ratti  \nAnna Cantarutti  \nDepartment of Statistics and Quantitative M","cbCaiu3TE3Vm8McT","https://ap.wps.com/l/cbCaiu3TE3Vm8McT","pdf",820041,"English","# Abstract\n# Introduction\n# Methods\n## Study population\n# Results\n# Conclusions","[{\"question\":\"What was the main objective of the study?\",\"answer\":\"To determine whether adherence to the Mediterranean diet is associated with lower risk of developing multiple sclerosis (MS).\"},{\"question\":\"How was dietary intake measured?\",\"answer\":\"Dietary intake was assessed at baseline in 1997 using a Food Frequency Questionnaire and summarized as a Mediterranean Diet Score (0–9), analyzed numerically and categorically (low, medium, high).\"},{\"question\":\"What were the study findings on MS risk?\",\"answer\":\"An increase of one point in the Mediterranean Diet Score was associated with a 14% lower MS risk. The association was stronger among non-smokers and in participants aged ⩽45 years, with no clear risk reduction observed among smokers or those aged \\u003e45 years.\"}]","Mediterranean diet and risk of multiple sclerosis - A prospective cohort study | PDF",1790597492]