A discussion of the role of diet in disease course in pediatric multiple sclerosis and additional considerations relevant to the design and conduct of observational nutritional epidemiology studies.

The prognosis of multiple sclerosis (MS) is generally quite heterogeneous. Several environmental influences like vitamin D status and smoking have been consistently linked with disease course; however, despite these findings, much of the variability remains unexplained. Interest in diet as an additional environmental disease modifying agent for MS is rapidly rising. Many dietary components modulate mechanisms (eg, immune/mitochondrial function and gut microbiota diversity) hypothesised to influence disease evolution over time. Recently, the Wellness Research Group sponsored by the National MS Society concluded that the state of knowledge concerning diet in people with MS is suboptimal. The panel suggests that while anecdotal support regarding the role diet may play in influencing disease course or symptoms is positive, there is …