Targeting Lifestyle in CNS Inflammatory Demyelinating Diseases: Insights from Diet and Exercise as Potential Disease Modifiers

Virgilio, Eleonora; Abate Daga, Federico; Bronzini, Matteo; Morra, Marta; Rosso, Rachele; Maglione, Alessandro; Matta, Manuela; Masuzzo, Federica; Rolla, Simona

doi:10.3390/brainsci16010057

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Targeting Lifestyle in CNS Inflammatory Demyelinating Diseases: Insights from Diet and Exercise as Potential Disease Modifiers

by

Eleonora Virgilio

^1,2,*

,

Federico Abate Daga

^1,†

,

Matteo Bronzini

^2,†,

Marta Morra

^2,†,

Rachele Rosso

¹

,

Alessandro Maglione

^1,3

,

Manuela Matta

²,

Federica Masuzzo

² and

Simona Rolla

¹

Department of Clinical and Biological Sciences, University of Turin, 10043 Orbassano, Italy

²

Neurology Unit, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy

³

Department of Computer Science, University of Turin, Corso Svizzera 185, 10149 Turin, Italy

^*

Author to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

Brain Sci. 2026, 16(1), 57; https://doi.org/10.3390/brainsci16010057 (registering DOI)

Submission received: 6 November 2025 / Revised: 18 December 2025 / Accepted: 29 December 2025 / Published: 30 December 2025

(This article belongs to the Special Issue Lifestyle and Risk Factors for Multiple Sclerosis)

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Abstract

This narrative review explores the impact of diet and physical exercise both as a risk factor of central nervous system inflammatory diseases, but more importantly as potential adjunctive disease modifiers in Multiple Sclerosis (MS), Neuromyelitis Optica Spectrum Disorders (NMOSD), and Myelin Oligodendrocyte Glycoprotein (MOG) antibody-associated disease (MOGAD). The majority of evidence relies on MS preclinical and clinical studies, but preclinical studies also support the benefit of lifestyle intervention in NMOSD and MOGAD. In MS, adherence to healthy diets (particularly Mediterranean and MIND diets) could lead to a milder disease course with reduced relapse rates, while structured exercise from early disease stages promotes neuroprotection by upregulating neurotrophic factors and preserving brain volume, possibly impacting disease progression. The ketogenic diet and intermittent caloric restriction also showed promising results. Physical activity, including both aerobic training and resistance training, emerges as a potential disease-modifying strategy by promoting neuroprotection, reducing inflammation, and supporting functional and cognitive outcomes, particularly when implemented early in the disease course. A synergistic approach alongside disease-modifying treatments (DMTs) would further positively modulate core pathological processes. Evidence for NMOSD and MOGAD warrants further investigation. We highlight that integrating personalized lifestyle strategies would be beneficial from the early stages. However, future large-scale, standardized trials are required to fully confirm the neuroprotective potential of diet and exercise across the entire spectrum of CNS disorders.

Keywords: multiple sclerosis; NMOSD; MOGAD; diet; exercise; lifestyle; environmental factors; risk factors; disease progression

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MDPI and ACS Style

Virgilio, E.; Abate Daga, F.; Bronzini, M.; Morra, M.; Rosso, R.; Maglione, A.; Matta, M.; Masuzzo, F.; Rolla, S. Targeting Lifestyle in CNS Inflammatory Demyelinating Diseases: Insights from Diet and Exercise as Potential Disease Modifiers. Brain Sci. 2026, 16, 57. https://doi.org/10.3390/brainsci16010057

AMA Style

Virgilio E, Abate Daga F, Bronzini M, Morra M, Rosso R, Maglione A, Matta M, Masuzzo F, Rolla S. Targeting Lifestyle in CNS Inflammatory Demyelinating Diseases: Insights from Diet and Exercise as Potential Disease Modifiers. Brain Sciences. 2026; 16(1):57. https://doi.org/10.3390/brainsci16010057

Chicago/Turabian Style

Virgilio, Eleonora, Federico Abate Daga, Matteo Bronzini, Marta Morra, Rachele Rosso, Alessandro Maglione, Manuela Matta, Federica Masuzzo, and Simona Rolla. 2026. "Targeting Lifestyle in CNS Inflammatory Demyelinating Diseases: Insights from Diet and Exercise as Potential Disease Modifiers" Brain Sciences 16, no. 1: 57. https://doi.org/10.3390/brainsci16010057

APA Style

Virgilio, E., Abate Daga, F., Bronzini, M., Morra, M., Rosso, R., Maglione, A., Matta, M., Masuzzo, F., & Rolla, S. (2026). Targeting Lifestyle in CNS Inflammatory Demyelinating Diseases: Insights from Diet and Exercise as Potential Disease Modifiers. Brain Sciences, 16(1), 57. https://doi.org/10.3390/brainsci16010057

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

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Targeting Lifestyle in CNS Inflammatory Demyelinating Diseases: Insights from Diet and Exercise as Potential Disease Modifiers

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