| خلاصه مقاله | Background: It is suggested that people with multiple sclerosis (MS) benefit from following a Mediterranean-style diet (MSD). This study aims to systematically review the evidence regarding the effects of a MSD in improving fatigue, which is the most common and debilitating MS-related symptom (1).
Methods: This study was conducted following the 2020 version of the PRISMA statement. Both interventional and observational clinical studies which evaluated the effects of MSD on fatigue in MS patients were considered for inclusion. Review articles, letters, commentaries, case reports, non-English papers, and conference abstracts were excluded. PubMed, Web of Science, Scopus, and EMBASE databases were searched until March 23rd, 2023, and risk of bias in randomized-controlled trials (RCTs) was evaluated based on the second version of the Cochrane RoB assessment tool (RoB.2). In addition, for the observational studies, Joanna Briggs Institute (JBI)'s critical appraisal tools were utilized.
Results: Of 161 records that were screened in the title/abstract stage, 6 studies and 8 report of these studies, were included in this systematic review. Two single-blind RCTs, emphasized the higher protective effects of the 1-yeat adherence to a MSD against MS-related fatigue, based on Modified Fatigue Impact Scale (MFIS), and Fatigue Severity Scale (FSS), but not in Visual Analog Fatigue Scale (VASF) (2-5), which also reported in a pilot study, based on Neurological Fatigue Index-MS (NFI-MS), too (6). Also, adherence to MSD was found to be associated with a reduction in fatigue in observational studies (7-9).
Discussion: This study pointed out possible beneficial effects of Mediterranean-like diets on MS-related fatigue. High level of risk of bias was found in the included RCT studies; however, the findings of the observational studies do not seem to greatly affected by risk of bias.
Funding: The research protocol was approved and supported by the Student Research Committee, Tabriz University of Medical Sciences (grant number: 71635).
Registration: PROSPERO ID: CRD42023411742 |