{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T03:35:38Z","timestamp":1790566538242,"version":"4.1.0"},"reference-count":83,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,2,11]],"date-time":"2024-02-11T00:00:00Z","timestamp":1707609600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"YPATIA","award":["5472\/16"],"award-info":[{"award-number":["5472\/16"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: The Mediterranean diet (MD) is well-known as a diet which may exert a protective effect against neurodegenerative diseases, including multiple sclerosis (MS). To date, only a few clinical surveys have assessed the potential effects of the MD in patients with MS. The purpose of the present study is to evaluate the potential effects of MD compliance on disease disability, quality of life, physical activity, depressive symptomatology, and blood biochemical parameters related to nutritional status in MS patients, considering several socio-demographic, anthropometric, and lifestyle characteristics. Methods: This is a cross-sectional study conducted on 558 adults with MS aged 18\u201364 years. Relevant questionnaires were utilized to evaluate socio-demographic and anthropometric parameters, disease disability (Expanded Disability Status Scale, EDSS), multidimensional health-related quality (MS Quality of Life-54, MSQOL-54), physical activity levels (International Physical Activity Questionnaire, IPAQ), depression (Beck Depression Inventory II, BDI-II), and MD adherence (MedDietScore), while several blood biochemical parameters were retrieved from the patients\u2019 medical records. Results: Enhanced MD compliance was independently associated with a decreased frequency of overweight\/obesity, as well as abdominal obesity, in patients suffering from MS. Elevated MD compliance was also independently associated with a decreased incidence of advanced disease disability, a higher prevalence of elevated physical activity, an improved quality of life, and lower depressive symptoms, as well as higher levels of certain blood biochemical parameters, which are effective indicators of iron deficiency and malnutrition. Conclusions: The present study found that higher MD adherence may slow down disease disability, promoting a better quality of life and mental health in adults with MS. Future prospective surveys are required to obtain conclusive results.<\/jats:p>","DOI":"10.3390\/jpm14020199","type":"journal-article","created":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T03:50:27Z","timestamp":1707709827000},"page":"199","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Associations between Mediterranean Diet Adherence, Quality of Life, and Mental Health in Patients with Multiple Sclerosis: A Cross-Sectional Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2328-3862","authenticated-orcid":false,"given":"Antonios","family":"Dakanalis","sequence":"first","affiliation":[{"name":"Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy"},{"name":"Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Tryfonos","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7764-3544","authenticated-orcid":false,"given":"Eleni","family":"Pavlidou","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Vadikolias","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sousana K.","family":"Papadopoulou","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Alexatou","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theofanis","family":"Vorvolakos","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Chrysafi","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Fotiou","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, Aristoteleio University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Mentzelou","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aspasia","family":"Serdari","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Chatzidimitriou","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Dimoliani","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerasimos","family":"Tsourouflis","sequence":"additional","affiliation":[{"name":"Second Department of Surgery, Propedeutic, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2878-4831","authenticated-orcid":false,"given":"Constantinos","family":"Giaginis","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,11]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Multiple sclerosis: Pathogenesis, symptoms, diagnoses and cell-based therapy","volume":"19","author":"Ghasemi","year":"2017","journal-title":"Cell J."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Khan, Z., Gupta, G.D., and Mehan, S. 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