Effect of a gluten-free diet on serum lipopolysaccharide levels and disease progression in multiple sclerosis patients: A 6-month longitudinal study.
Level 3 - non-randomized controlled study
Non-randomized or unstated-allocation prospective controlled longitudinal study
PubMed 41205557 · doi:10.1016/j.msard.2025.106811
What was done
Fifty-four female patients with relapsing-remitting multiple sclerosis (RRMS) were followed in a 6-month controlled longitudinal study. Participants were allocated to either a structured gluten-free diet (GFD, n = 27) or a control group receiving general healthy eating advice while continuing a gluten-containing diet (GD, n = 27). Anthropometric measurements, 24-hour dietary recalls, and blood samples were collected at baseline, 3 months, and 6 months to evaluate serum lipopolysaccharide (LPS) levels, disability using the Expanded Disability Status Scale (EDSS), and body composition.
What was found
At 6 months, the GFD group showed significant reductions in energy and carbohydrate intake (p < 0.05). Serum LPS levels decreased in the GFD group while increasing in the GD group (ΔLPS = -377.93 ± 975.41 vs. 207.00 ± 288.81 pg/mL; p < 0.001). Disability scores improved in the GFD group relative to controls (ΔEDSS = -0.24 ± 0.61 vs. 0.00 ± 0.39; p = 0.042). Body weight, BMI, waist circumference, hip circumference, and body fat mass also significantly decreased compared to controls (all p < 0.05). In regression models, group assignment independently predicted changes in LPS, EDSS, and waist circumference after adjusting for age, disease duration, and dietary quality changes (p < 0.05).
Why it matters
This study provides preliminary evidence that a gluten-free diet may reduce circulating endotoxemia and slightly improve functional disability in RRMS, suggesting a potential role for dietary modification in managing systemic inflammation.
Limits
The sample was small (54 participants) and restricted to females. Randomization and blinding methods were not described in the abstract. Caloric intake and body fat decreased significantly in the intervention group, confounding whether benefits derived specifically from gluten exclusion or from weight loss and energy restriction.
Cited by
- supports Elevated circulating levels of lipopolysaccharide (LPS) and anti-LPS antibodies correlate with Parkinson's disease, Alzheimer's disease, and multiple sclerosis.