Role of Diet and Supplementation with Omega-3 Polyunsaturated Fatty Acids for Managing Chronic Fatigue in Patients with Relapsing-Remitting Multiple Sclerosis

Summary Multiple sclerosis (MS) is a chronic autoimmune demyelinating disease of the central nervous system (CNS) with unclear and multifactorial etiology, variable clinical symptoms with different severity, and treatment with limited efficacy. Authors conclude that the immune system has a role in pathogenesis, and many modern therapies target the immune system. Among clinicians, it is accepted that not every patient will progress in the same way, and there is high variability between clinical courses of MS in different patients. Modern therapies have shown to reduce new lesions and clinical relapses but lack effectiveness at halting underlying neurodegeneration at lesions, the localized inflammation on a small scale, chronic demyelination, and axonal and neuronal damage. Dietary metabolites have far-reaching and systemic effects. It has been suggested that diet can play an essential role in helping to modify immune system function to promote regulation as opposed to inflammation. Polyunsaturated fatty acids decrease inflammation through conversion into anti-inflammatory prostaglandins E1 and E2, which affect cytokine production, leukocyte migration, and other immune system components. The Mediterranean style diet is a diet low in saturated fats, high in polyunsaturated and monounsaturated fats, rich in fruits and vegetables, and low in processed foods (low salt content). Eating a Mediterranean-style diet can help reduce fatigue (as reported by patients) and change the clinical course favorably.