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To this end, in a seven-month pilot study we investigated the effects of a calorie-restricted, semi-vegetarian diet and administration of vitamin D and other dietary supplements (fish oil, lipoic acid, omega-3 polyunsaturated fatty acids, resveratrol and multivitamin complex) in 33 patients with relapsing-remitting multiple sclerosis and 10 patients with primary-progressive multiple sclerosis. At 0\/3\/6 months, patients had neurological examination, filled questionnaires and underwent anthropometric measurements and biochemical analyses. Serum fatty acids and vitamin D levels were measured as markers of dietary compliance and nutritional efficacy of treatment, whereas serum gelatinase levels were analyzed as markers of inflammatory status. All patients had insufficient levels of vitamin D at baseline, but their values did not ameliorate following a weekly administration of 5000\u2009\u2009IU, and rather decreased over time. Conversely, omega-3 polyunsaturated fatty acids increased already after three months, even under dietary restriction only. Co-treatment with interferon-beta in relapsing-remitting multiple sclerosis was irrelevant to vitamin D levels. After six months nutritional treatment, no significant changes in neurological signs were observed in any group. However, serum levels of the activated isoforms of gelatinase matrix metalloproteinase-9 decreased by 59% in primary-progressive multiple sclerosis and by 51% in relapsing-remitting multiple sclerosis patients under nutritional intervention, including dietary supplements. This study indicates that a healthy nutritional intervention is well accepted by people with multiple sclerosis and may ameliorate their physical and inflammatory status.<\/jats:p>","DOI":"10.1177\/1535370215618462","type":"journal-article","created":{"date-parts":[[2016,1,19]],"date-time":"2016-01-19T20:13:23Z","timestamp":1453234403000},"page":"620-635","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":83,"title":["Anti-inflammatory nutritional intervention in patients with relapsing-remitting and primary-progressive multiple sclerosis: A pilot study"],"prefix":"10.3389","volume":"241","author":[{"given":"Paolo","family":"Riccio","sequence":"first","affiliation":[{"name":"Department of Sciences, University of Basilicata, 85100 Potenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Rossano","sequence":"additional","affiliation":[{"name":"Department of Sciences, University of Basilicata, 85100 Potenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilena","family":"Larocca","sequence":"additional","affiliation":[{"name":"Department of Sciences, University of Basilicata, 85100 Potenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Trotta","sequence":"additional","affiliation":[{"name":"Department of Sciences, University of Basilicata, 85100 Potenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilario","family":"Mennella","sequence":"additional","affiliation":[{"name":"Department of Agricultural and Food Science, University of Naples \u201cFederico II\u201d, 80055 Portici, Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Vitaglione","sequence":"additional","affiliation":[{"name":"Department of Agricultural and Food Science, University of Naples \u201cFederico II\u201d, 80055 Portici, Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Ettorre","sequence":"additional","affiliation":[{"name":"Center for Applied Nutrition, 74010 Statte, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Graverini","sequence":"additional","affiliation":[{"name":"O.T.I. 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