{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:55:36Z","timestamp":1791186936952,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:00:00Z","timestamp":1788048000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:00:00Z","timestamp":1788048000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004748","name":"Mashhad University of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004748","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multiple sclerosis (MS) is a chronic autoimmune and neurodegenerative disease influenced by environmental factors, including diet. The Mediterranean Diet (MeDi), rich in anti\u2010inflammatory and antioxidant compounds, and micronutrient adequacy may reduce MS risk and progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aims to examine the associations between the Mediterranean Diet Score (MDS), Mean Adequacy Ratio (MAR), and MS risk in a case\u2010control setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This case\u2010control study included 197 newly diagnosed relapsing\u2010remitting MS patients (aged 18\u201365 years) from Iran, and 200 matched controls without neurological diseases. Dietary intake was assessed using a validated semi\u2010quantitative food frequency questionnaire. MDS was calculated based on nine dietary components, and MAR was computed as the average Nutrient Adequacy Ratio for seven micronutrients. Adjusted binary logistic regression estimated odds ratios (ORs) for MS risk across MDS and MAR tertiles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Higher MDS and MAR were associated with significantly reduced MS risk. Individuals in the highest MDS tertile had 47% lower odds of MS (OR: 0.53, 95% CI: 0.29\u20130.98,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04), and those in the highest MAR tertile had 75% lower odds (OR: 0.25, 95% CI: 0.10\u20130.62,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) compared to the lowest tertiles after adjustments. No significant differences in total energy or macronutrient intake were observed between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Higher adherence to the Mediterranean Diet and better micronutrient adequacy are associated with a reduced risk of MS. These findings highlight the potential of dietary interventions as a cost\u2010effective strategy for MS prevention, warranting further longitudinal and interventional studies to establish causality and inform public health strategies.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      The Mashhad University of Medical Sciences approved the study with numbers IR.MUMS.REC.1393.182.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73139","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T06:36:51Z","timestamp":1788158211000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mediterranean Diet and Micronutrient Adequacy in Relation to Relapsing\u2010Remitting Multiple Sclerosis Risk: A Case\u2010Control Study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0850-6934","authenticated-orcid":false,"given":"Maryam","family":"Ahmadi\u2010Khorram","sequence":"first","affiliation":[{"name":"Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences Tehran Iran"},{"name":"Students' Scientific Research Center (SSRC) Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8712-0165","authenticated-orcid":false,"given":"Alireza","family":"Hatami","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center Isfahan University of Medical Sciences Isfahan Iran"},{"name":"Students' Research Committee Isfahan University of Medical Sciences Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6526-8712","authenticated-orcid":false,"given":"Mostafa","family":"Shahraki Jazinaki","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran"},{"name":"Student Research Committee Mashhad University of Medical Sciences Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8320-6300","authenticated-orcid":false,"given":"Yasaman","family":"Aali","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran"},{"name":"Student Research Committee Mashhad University of Medical Sciences Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7494-7895","authenticated-orcid":false,"given":"Maedeh","family":"Nojoumi","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran"},{"name":"Student Research Committee Mashhad University of Medical Sciences Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Keykhaei","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran"},{"name":"Student Research Committee Mashhad University of Medical Sciences Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4185-2694","authenticated-orcid":false,"given":"Ali","family":"Jafarzadeh Esfehani","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran"},{"name":"Metabolic Syndrome Research Center Mashhad University of Medical Sciences Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3202-2709","authenticated-orcid":false,"given":"Mohsen","family":"Nematy","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran"},{"name":"Metabolic Syndrome Research Center Mashhad University of Medical Sciences Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,30]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458520970841"},{"key":"e_1_2_13_3_1","unstructured":"World Health Organization 2023. 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