The Influence of Socioeconomic Status and Diet on Multiple Sclerosis Outcomes: Sarah Levy, PhD

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“We found that socioeconomic status is a really important factor that clinicians should be aware of in terms of understanding outcomes in their patients with MS. Although socioeconomic status is difficult to change, what we found were modifiable factors that seem to be really important—diet being maybe the most important modifiable factor.”

A recent study examined disparities in cognitive and physical disease severity between Black and White individuals with multiple sclerosis (MS) in the MS-diverseCITY cohort in New York.¹ In the study, researchers conducted a retrospective chart review of 150 Black and 150 White patients with MS, matched by age and sex, to explore differences in disease outcomes and the role of socioeconomic status (SES). Despite similar disease duration, MS phenotype, and use of high-efficacy treatments, findings revealed that Black patients with MS had significantly lower SES scores, lower educational attainment, and worse performance on cognitive and physical function assessments, including gait disturbance.

Among the key findings, results showed that SES mediated 37% of the variance in disease severity between racial groups, emphasizing the critical role of social determinants in MS outcomes. This highlighted that, even among highly educated patients with access to modern treatments, disparities persist, likely influenced by socioeconomic factors. By incorporating a comprehensive SES index—which includes neighborhood deprivation, education, and literacy—the study provided novel insights into the underlying contributors to these disparities and suggested that further research could explore additional modifiable factors to improve outcomes for Black individuals with MS.

These findings were recently presented by senior author Sarah Levy, PhD, clinical neuropsychologist and assistant professor at Mount Sinai, at the 2025 Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum, held February 27 to March 1, in West Palm Beach, Florida. During the Forum, Levy sat down for an interview with NeurologyLive^®, where she discussed the research on disparities in MS outcomes between Black and White patients, particularly focusing on physical and cognitive disability. She emphasized the importance of socioeconomic status and diet as influential factors, with particular attention to the role of diet in mitigating these disparities. Levy also highlighted research by a colleague suggesting that the Mediterranean-style diet may offer protective benefits for patients with MS.

Click here for coverage of 2025 ACTRIMS Forum.

REFERENCES
1. Klineova S, Sumowski JF, Williams M et al. Disparities in Cognitive and Physical Disease Severity in Black and White People with Multiple Sclerosis in New York. Presented at ACTRIMS Forum 2025; February 27 to March 1; West Palm Beach, Florida. P398.