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Mediterranean diet is associated with a shift toward a more morning-oriented chronotype in female patients with relapsing-remitting multiple sclerosis

In a 12-week randomized pilot trial, 34 female patients with relapsing-remitting MS were assigned to either a Mediterranean diet (MedDiet) or time-restricted eating (TRE). MEQ scores increased only in the MedDiet group (p = 0.035), suggesting a shift toward morningness, while PSQI scores improved over time in both groups without a diet-specific effect. No significant changes were observed in appetite-related hormones (leptin, ghrelin).

Last updated: Aug 15, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score44/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Mediterranean Diet vs. Time-Restricted Eating: Effects on Circadian Rhythm and Appetite Markers in Female Patients with Multiple Sclerosis-A Pilot Study.

observational

İnbaşı EG, Çakır Biçer N, İşcan D, Bayram E, Türker PF · Healthcare (Basel, Switzerland) (2026)

Participants: N/A
Duration: 12 weeks
Intervention: Mediterranean diet (eucaloric) vs. time-restricted eating (16:8 protocol) for 12 weeks
Outcome: Chronotype (MEQ score), sleep quality (PSQI), appetite hormones (leptin, ghrelin), lipid profile, anthropometrics
Effect Size: N/A (only p-values reported; MEQ increase p=0.035)
Population: 34 female patients with relapsing-remitting multiple sclerosis

Result:

PubMed: 42588234DOI: 10.3390/healthcare14152266

Mechanism Graph

MedDiet may influence circadian rhythm via nutrient timing and composition
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Improved dietary patterns may affect clock gene expression or light-dark entrainment
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Reduced inflammation or metabolic improvements may support circadian alignment
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Result: Shift toward morning-oriented chronotype (higher MEQ score)

Limitations

  • ⚠Small sample size (n=17 per group) and pilot design
  • ⚠No correction for multiple comparisons for MEQ and lipid findings; lipid changes did not survive correction
  • ⚠No significant changes in sleep quality or appetite hormones, limiting overall conclusions
  • ⚠Short duration (12 weeks) may not capture long-term effects

Frequently Asked Questions

Did the Mediterranean diet improve sleep quality in MS patients?▼

No significant improvement in sleep quality (PSQI) was attributed to the Mediterranean diet; PSQI improved over time in both groups, but the effect was not diet-specific.

What is the 16:8 time-restricted eating protocol?▼

It involves eating all meals within an 8-hour window and fasting for the remaining 16 hours each day. In this study, it was eucaloric to maintain baseline weight.

Did either diet affect appetite hormones?▼

No significant changes in leptin or ghrelin levels were observed in either group after 12 weeks.

What does a higher MEQ score indicate?▼

A higher MEQ score indicates a more morning-oriented chronotype (i.e., preferring to be active earlier in the day). The Mediterranean diet group showed a significant increase in MEQ scores.

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References

  1. 1.İnbaşı EG, Çakır Biçer N, İşcan D, Bayram E, Türker PF. "Mediterranean Diet vs. Time-Restricted Eating: Effects on Circadian Rhythm and Appetite Markers in Female Patients with Multiple Sclerosis-A Pilot Study.." Healthcare (Basel, Switzerland), 2026. PMID: 42588234 DOI: 10.3390/healthcare14152266
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.