{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T21:18:50Z","timestamp":1788297530073,"version":"build-2803163510"},"reference-count":65,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"MULTIPLE SCLEROSIS AUSTRALIA","award":["MSA #222089"],"award-info":[{"award-number":["MSA #222089"]}]},{"name":"UK Research and Innovation Centre","award":["EP\/S023283\/1"],"award-info":[{"award-number":["EP\/S023283\/1"]}]},{"DOI":"10.13039\/100013376","name":"Institute of Psychiatry, Psychology & Neuroscience at King\u2019s College London","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100013376","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Multiple sclerosis (MS) is a chronic auto-immune neuroinflammatory disorder presenting as a range of systemic and neurological symptoms, including cognitive impairment. Emerging evidence suggests that diets targeting brain health\u2014such as the Mediterranean (MED) and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets\u2014may improve cognitive function; however, studies examining their role in people living with MS are limited. Methods: We examined cross-sectional associations between diet and cognition data from 967 participants in the United Kingdom Multiple Sclerosis Register (UKMSR). Dietary pattern scores (alternate Mediterranean; aMED, and MIND) were derived from the 130-item EPIC-Norfolk food frequency questionnaire. Cognition was assessed using the MS-specific Cognitron-MS (C-MS) battery (13 tasks) and summarised as overall cognition (global G factor) and four domains (object memory, problem solving, information processing speed [IPS], and words memory). Cognitive outcomes were expressed as Deviation-from-Expected (DfE) scores standardised to demographic and device characteristics using external regression-based norms. Linear models were adjusted for total energy intake, MS phenotype, disease duration since diagnosis, and current disease-modifying therapy (DMT) use. Interactions tested moderation by MS phenotype (relapsing vs. progressive MS) and current DMT use (yes vs. no). Sensitivity analyses included within-domain multiple-comparison control, rank-based inverse-normal transformation, and winsorisation. Results: Greater alignment with aMED and MIND dietary patterns were associated with higher scores in specific cognitive domains but not in overall cognition. Higher aMED scores were associated most consistently with better IPS, while higher MIND scores were additionally associated with better words memory. In categorical models, participants with the middle or highest tertiles of aMED or MIND scores performed up to ~0.4 SD better on tasks of Verbal Analogies, Word Definitions, Simple Reaction Time, Words Memory Immediate, or Words Memory Delays compared with those in the lowest tertile. These findings were robust across sensitivity analyses. Stratified analyses showed differential cognitive performance and diet-cognition associations by MS phenotype and DMT use. Conclusions: Mediterranean and MIND dietary patterns showed modest cross-sectional associations with specific cognition domains, with differential cognitive performance in different subgroups according to MS phenotype and DMT use. Although causal inference is not possible, our findings indicate future MS-related dietary studies (longitudinal and\/or randomised controlled trials) examining cognitive function domains across different MS subgroups are warranted.<\/jats:p>","DOI":"10.3390\/nu17213326","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T02:03:48Z","timestamp":1761185028000},"page":"3326","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Mediterranean and MIND Dietary Patterns and Cognitive Performance in Multiple Sclerosis: A Cross-Sectional Analysis of the UK Multiple Sclerosis Register"],"prefix":"10.3390","volume":"17","author":[{"given":"Maggie","family":"Yu","sequence":"first","affiliation":[{"name":"Neuroepidemiology Unit, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Simpson-Yap","sequence":"additional","affiliation":[{"name":"Neuroepidemiology Unit, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia"},{"name":"MS Research Flagship, Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia"},{"name":"Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0903-8606","authenticated-orcid":false,"given":"Annalaura","family":"Lerede","sequence":"additional","affiliation":[{"name":"Department of Brain Sciences, Faculty of Medicine, Imperial College London, London W12 0NN, UK"},{"name":"Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroscience, King\u2019s College London, London SE5 8AF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Nicholas","sequence":"additional","affiliation":[{"name":"Department of Brain Sciences, Faculty of Medicine, Imperial College London, London W12 0NN, UK"},{"name":"Population Data Science, Swansea University Medical School, Swansea SA2 8PP, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0508-7507","authenticated-orcid":false,"given":"Shelly","family":"Coe","sequence":"additional","affiliation":[{"name":"School of Sport, Nutrition and Allied Health Professions, Oxford Institute for Applied Health Research, Oxford Brookes University, Oxford OX3 0BP, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9655-1389","authenticated-orcid":false,"given":"Thanasis G.","family":"Tektonidis","sequence":"additional","affiliation":[{"name":"School of Sport, Nutrition and Allied Health Professions, Oxford Institute for Applied Health Research, Oxford Brookes University, Oxford OX3 0BP, UK"},{"name":"Co-Centre for Sustainable Food Systems and The Institute for Global Food Security, Queen\u2019s University Belfast, Northern Ireland, Belfast BT9 5DL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard Martinez","family":"Solsona","sequence":"additional","affiliation":[{"name":"School of Sport, Nutrition and Allied Health Professions, Oxford Institute for Applied Health Research, Oxford Brookes University, Oxford OX3 0BP, UK"},{"name":"Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC 3125, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rod","family":"Middleton","sequence":"additional","affiliation":[{"name":"Population Data Science, Swansea University Medical School, Swansea SA2 8PP, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1971-173X","authenticated-orcid":false,"given":"Yasmine","family":"Probst","sequence":"additional","affiliation":[{"name":"School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW 2522, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Hampshire","sequence":"additional","affiliation":[{"name":"Department of Brain Sciences, Faculty of Medicine, Imperial College London, London W12 0NN, UK"},{"name":"Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroscience, King\u2019s College London, London SE5 8AF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elasma","family":"Milanzi","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangqin","family":"Cui","sequence":"additional","affiliation":[{"name":"Neuroepidemiology Unit, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0426-2158","authenticated-orcid":false,"given":"Rebekah Allison","family":"Davenport","sequence":"additional","affiliation":[{"name":"Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Neate","sequence":"additional","affiliation":[{"name":"Neuroepidemiology Unit, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mia","family":"Pisano","sequence":"additional","affiliation":[{"name":"Neuroepidemiology Unit, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry","family":"Kirkland","sequence":"additional","affiliation":[{"name":"Neuroepidemiology Unit, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2897-0271","authenticated-orcid":false,"given":"Jeanette","family":"Reece","sequence":"additional","affiliation":[{"name":"Neuroepidemiology Unit, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, 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