Researchers looked at seven studies involving over 1,100 people with relapsing-remitting multiple sclerosis (RRMS) who were taking a medication called dimethyl fumarate. They wanted to see if eating a Mediterranean diet—which focuses on vegetables, fruits, fish, and olive oil—could help alongside the medication. The analysis found that people who followed this diet had fewer disease relapses and less disability progression. However, the studies didn’t show clear improvements in overall quality of life. This suggests that diet might be a helpful addition to MS treatment, but more research is needed to fully understand all the benefits.

The Quick Take

  • What they studied: Whether eating a Mediterranean diet helps people with relapsing-remitting multiple sclerosis (a type of MS where symptoms come and go) who are already taking a standard MS medication
  • Who participated: Over 1,100 people with RRMS who were being treated with dimethyl fumarate, a common MS medication. The research combined data from seven different studies
  • Key finding: People who followed a Mediterranean diet had about 31% fewer disease relapses and showed less disability progression compared to those who didn’t follow the diet. These improvements were statistically significant, meaning they’re unlikely to be due to chance
  • What it means for you: If you have RRMS and take dimethyl fumarate, adding a Mediterranean diet to your treatment plan may help reduce how often you experience relapses and slow disability progression. However, this should be done alongside your prescribed medication, not instead of it. Talk to your doctor before making major dietary changes

The Research Details

This was a meta-analysis, which means researchers searched through scientific databases to find all published studies about the Mediterranean diet and MS. They looked for studies published up until September 2025 across six major medical databases. They included only studies that measured specific outcomes: how often MS relapses occurred, disability levels (measured by a standard scale), and quality of life. The researchers combined the results from seven studies that met their criteria, involving 1,118 people total.

To combine the studies fairly, they used statistical methods that account for differences between studies. They also checked each study for potential problems or bias that might affect the results. They followed strict guidelines called PRISMA to make sure they did the review properly and reported everything clearly.

This approach is important because individual studies can sometimes give conflicting results or involve small numbers of people. By combining multiple studies together, researchers can see the bigger picture and get stronger evidence. This meta-analysis approach helps doctors and patients understand whether the Mediterranean diet is truly helpful for MS, not just in one study but across many different research projects

The researchers used established tools to check how reliable each study was and whether the overall evidence was strong. They looked for publication bias (the tendency for positive results to be published more often than negative ones). The studies included were all about people with RRMS taking the same medication, which makes the comparison fair. However, the overall quality of evidence was moderate, meaning while the findings are promising, more high-quality studies would make the evidence even stronger

What the Results Show

The analysis found strong evidence that the Mediterranean diet combined with dimethyl fumarate treatment reduced relapse rates. People following the diet had a 31% lower chance of experiencing a relapse compared to those not following the diet. This difference was highly statistically significant, meaning there’s very little chance this happened by random luck.

The second major finding involved disability progression. People on the Mediterranean diet showed less worsening of their disability symptoms, with an average improvement of about 0.53 points on the disability scale. While this might sound small, on the scale used to measure MS disability, this represents a meaningful difference that patients can notice in their daily functioning.

These improvements suggest that diet may work together with the medication to help control MS symptoms. The Mediterranean diet’s anti-inflammatory properties—it’s rich in foods that reduce inflammation in the body—may complement how the medication works to manage the disease.

The researchers also looked at quality of life measures, which ask patients about their physical health and mental health. Interestingly, while the diet improved relapses and disability, the studies didn’t show clear improvements in overall quality of life scores. This doesn’t mean the diet doesn’t help with quality of life—it may mean that the studies weren’t designed to measure these benefits well, or that improvements in relapses and disability take time to translate into noticeable quality of life changes

This research builds on earlier evidence suggesting that diet plays a role in MS management. The Mediterranean diet has been studied for many other health conditions and consistently shows anti-inflammatory benefits. This meta-analysis is one of the first to specifically combine multiple studies about this diet in RRMS patients taking a specific medication. The findings align with the growing understanding that combining lifestyle changes (like diet) with medical treatment may be more effective than medication alone

The studies included were relatively small and varied in how they measured outcomes, which can affect the strength of conclusions. The research only looked at people with RRMS taking one specific medication, so results may not apply to people with other types of MS or taking different medications. The studies didn’t clearly measure quality of life improvements, so we can’t be sure about that benefit. Additionally, people who choose to follow a Mediterranean diet may differ in other healthy habits, which could affect the results. More large, well-designed studies are needed to confirm these findings

The Bottom Line

If you have RRMS and are taking dimethyl fumarate, discussing a Mediterranean diet with your healthcare team is reasonable. The evidence suggests it may help reduce relapses and slow disability progression. Confidence level: Moderate. The diet should be used as a complement to, not a replacement for, your prescribed MS medication. Start by incorporating more vegetables, fruits, whole grains, fish, and olive oil into your meals

This research is most relevant for people with relapsing-remitting MS who are taking dimethyl fumarate. It may also be worth discussing with doctors if you have other types of MS or take different medications, though the evidence is strongest for this specific combination. People without MS can still benefit from a Mediterranean diet for general health. If you’re pregnant, have certain food allergies, or have other health conditions, talk to your doctor before making dietary changes

Based on the studies reviewed, improvements in relapse rates and disability may take several months to become apparent. Don’t expect immediate changes—think of dietary changes as a long-term strategy to work alongside your medication. Most benefits appeared in studies lasting 6 months or longer

Want to Apply This Research?

  • Track weekly adherence to Mediterranean diet principles (servings of vegetables, fish, whole grains, olive oil use) and monthly relapse occurrences or symptom changes. Use a simple scoring system: 0-3 relapses per month is the target to monitor
  • Start by adding one Mediterranean diet element per week: Week 1 add olive oil to meals, Week 2 add fish twice, Week 3 increase vegetables to 5+ servings daily. Use the app to log these changes and set reminders for meal planning
  • Create a monthly dashboard showing: (1) diet adherence percentage, (2) relapse frequency, (3) disability symptom tracking, and (4) medication compliance. Compare month-to-month trends over 3-6 months to see if dietary changes correlate with symptom improvements

This research suggests the Mediterranean diet may help manage RRMS symptoms when combined with medication, but it is not a substitute for medical treatment. Always consult with your neurologist or healthcare provider before making significant dietary changes or adjusting your MS medication. The findings apply specifically to people with RRMS taking dimethyl fumarate and may not apply to other MS types or medications. Individual results vary, and diet should be part of a comprehensive treatment plan that includes prescribed medications and regular medical monitoring.