{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T15:11:50Z","timestamp":1783609910901,"version":"3.55.0"},"reference-count":17,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rtLungfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018893","name":"Scania","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018893","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Strategic Research Area in Health Care Sciences"},{"name":"ICA AB"},{"name":"Werlabs"},{"DOI":"10.13039\/501100002794","name":"Cancerfonden","doi-asserted-by":"publisher","award":["Grant CAN 2012\/591"],"award-info":[{"award-number":["Grant CAN 2012\/591"]}],"id":[{"id":"10.13039\/501100002794","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100018177","name":"Telefonaktiebolaget LM Ericsson","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018177","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Region Stockholm"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Objectives:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>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\u20139) 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>During a mean follow-up of 17.6\u2009years, we identified 89 incident MS cases. Each one-point increase in the Mediterranean Diet Score was associated with a 14% lower MS risk (HR\u2009=\u20090.86, 95% CI: 0.75\u20130.99). When stratified by smoking, we found a 26% lower risk among non-smokers (HR\u2009=\u20090.74, 95% CI: 0.61\u20130.90), while no risk reduction was seen among smokers. In age-stratified analyses, inverse associations were observed in participants aged\u2009\u2a7d\u200945\u2009years (HR\u2009=\u20090.77, 95% CI: 0.64\u20130.93), but not in those aged &gt;45\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Adherence to the Mediterranean diet was inversely associated with MS risk, supporting its potential neuroprotective role.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585251396408","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T07:30:30Z","timestamp":1765870230000},"page":"61-68","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Mediterranean diet and risk of multiple sclerosis: A prospective cohort study"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4102-5808","authenticated-orcid":false,"given":"Sara","family":"Ratti","sequence":"first","affiliation":[{"name":"Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5218-3628","authenticated-orcid":false,"given":"Hel\u00e9n","family":"Eke","sequence":"additional","affiliation":[{"name":"Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3700-780X","authenticated-orcid":false,"given":"Anna","family":"Cantarutti","sequence":"additional","affiliation":[{"name":"Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2219-7970","authenticated-orcid":false,"given":"Stephanie E","family":"Bonn","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9592-5791","authenticated-orcid":false,"given":"Hans-Olov","family":"Adami","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Clinical Effectiveness Group, Institute of Health and Society, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6859-4648","authenticated-orcid":false,"given":"Weimin","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4091-4686","authenticated-orcid":false,"given":"Marta","family":"Ponzano","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Genoa, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5116-7180","authenticated-orcid":false,"given":"Alessandra","family":"Grotta","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies, Stockholm University\/Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6816-7577","authenticated-orcid":false,"given":"Ylva","family":"Trolle Lagerros","sequence":"additional","affiliation":[{"name":"Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"1935","article-title":"Diagnosis and management of multiple sclerosis","volume":"7010","author":"Calabresi PA","year":"2004","unstructured":"Calabresi PA. Diagnosis and management of multiple sclerosis. Am Family Phys 2004; 7010: 1935\u20131944.","journal-title":"Am Family Phys"},{"key":"e_1_3_3_3_2","unstructured":"The Multiple Sclerosis International Federation Atlas of MS 3rd ed September 2020 https:\/\/www.atlasofms.org (accessed 8 September 2025)."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.296.23.2832"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.24.3083"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2016.187"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13668-018-0236-z"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/13524585231181841"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s43856-024-00565-0"},{"key":"e_1_3_3_10_2","first-page":"337","article-title":"Adherence to Mediterranean diet and health status: Meta-analysis","author":"Sofi F","year":"2008","unstructured":"Sofi F, Cesari F, Abbate R, et al. Adherence to Mediterranean diet and health status: Meta-analysis. BMJ 2008; 337.","journal-title":"BMJ"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.20854"},{"key":"e_1_3_3_12_2","article-title":"Cohort profile: The Swedish national March cohort","volume":"463","author":"Trolle Lagerros Y","year":"2017","unstructured":"Trolle Lagerros Y, Hantikainen E, Mariosa D, et al. Cohort profile: The Swedish national March cohort. Int J Epidemiol 2017; 463: 795\u2013795e.","journal-title":"Int J Epidemiol"},{"key":"e_1_3_3_13_2","volume-title":"Nutritional epidemiology","author":"Willet W","year":"2013","unstructured":"Willet W. Nutritional epidemiology. 3rd edn. Oxford: Oxford University Press, 2013.","edition":"3"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/134.7.1800"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38415.644155.8F"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12031-020-01672-y"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.3390\/nu16111746"},{"key":"e_1_3_3_18_2","unstructured":"World Health Organization Multiple Sclerosis International Federation. Atlas: Multiple sclerosis resources in the world 2008. World Health Organization https:\/\/iris.who.int\/handle\/10665\/43968"}],"container-title":["Multiple Sclerosis Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585251396408","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13524585251396408","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585251396408","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T03:34:12Z","timestamp":1782963252000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13524585251396408"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,15]]},"references-count":17,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1177\/13524585251396408"],"URL":"https:\/\/doi.org\/10.1177\/13524585251396408","relation":{},"ISSN":["1352-4585","1477-0970"],"issn-type":[{"value":"1352-4585","type":"print"},{"value":"1477-0970","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,15]]}}}