{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T04:11:14Z","timestamp":1788667874496,"version":"build-2803163510"},"reference-count":67,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"abstract":"<jats:p>Ultra-processed foods are increasingly recognised as drivers of adverse health outcomes, yet their implications for multiple sclerosis remain underexamined. Emerging evidence suggests that ultra-processed food\u2013rich dietary patterns are associated with greater central adiposity, pro-inflammatory metabolic signatures, microbiota disruption and adverse neuroimmune profiles relevant to multiple sclerosis. Major conceptual pitfalls, including the heterogeneity of ultra-processed foods and the scarcity of longitudinal or interventional studies addressing neuroimmune outcomes, continue to limit interpretation. Ultra-processed food\u2013driven comorbidities, such as obesity, hypertension, dyslipidaemia, insulin resistance and depression, may further accelerate disability accumulation and reduce treatment efficacy in multiple sclerosis, underscoring the need for integrated dietary\u2013immune models. This review integrates evidence from epidemiology, mechanistic studies, microbiome research and exposome science to provide a coherent framework for interpreting ultra-processed food\u2013multiple sclerosis interactions. Recognising ultra-processed food exposure as a potentially modifiable contributor to multiple sclerosis activity may inform future preventive and therapeutic strategies.<\/jats:p>","DOI":"10.1177\/13524585261481479","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:47:20Z","timestamp":1788504440000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultra-processed foods and multiple sclerosis: Evidence, pitfalls and perspectives"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2050-2908","authenticated-orcid":false,"given":"Lorena","family":"Lorefice","sequence":"first","affiliation":[{"name":"Multiple Sclerosis Center, Binaghi Hospital, ASL Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Fenu","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, ARNAS G. Brotzu, Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4223-905X","authenticated-orcid":false,"given":"Giovanni","family":"Fantola","sequence":"additional","affiliation":[{"name":"Metabolic and Obesity Unit, ARNAS G. Brotzu, Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3033-6133","authenticated-orcid":false,"given":"Magdalena","family":"Zoledziewska","sequence":"additional","affiliation":[{"name":"Institute of Genetic and Biomedical Research (IRGB), Italian National Research Council (CNR), Monserrato, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","unstructured":"Belbasis L Bellou V Evangelou E et al. Environmental risk factors and multiple sclerosis: an umbrella review of systematic reviews and meta-analyses. 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