Multiple Sclerosis Society of Canada

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Is the quality of diet related to level of disability and symptom severity in MS?

Background: Is diet related to progression in MS?

Some MS worsens and some does not. Some MS worsens rapidly -- and some stays stable for years. The reasons why remain unknown which is deeply frustrating to everyone concerned with this disease. Everyone, healthy or ill, can modify their diet. But, is diet a potential modifiable factor to slow progression in MS? While many diets have become popular because they seem to result in reduced symptoms of MS, few studies have actually tested the impact of these diets in people living with MS.

The research team led by Dr. Kathryn Fitzgerald which included MS Society-funded neurologist, Dr. Ruth Ann Marrie, published a report in Neurologyexamining the association of diet quality/ intake of specific food to disability and symptom severity in MS.

Study: People in the NARCOMS registry participated in a dietary questionnaire and reported disability status. The research team correlated the responses.

The study surveyed respondents through the North American Research Committee on MS (NARCOMS) registry who completed a dietary questionnaire. The research group used the questionnaire which captured the participants' intake of fruit, vegetables and legumes, grains, sugars and red/processed meat to establish a “diet quality score” for each individual. To assess how diet and other lifestyle factors, such as physical activity and smoking, were linked to disease severity, the team also used the Patient-Determined Disease Steps (PDDS) questionnaire.

Results: Individuals with MS with a healthier diet had a better outcome

A total of 6,989 respondents diagnosed with MS provided dietary information and were hence included in the analysis. Individuals who reported a high diet quality score—meaning a diet that was rich in fruits, vegetables and legumes, and grains and lower in sugars and red meat—were 20% less likely to have severe disability as well as severe depression. Furthermore, the analysis also revealed that people with a healthier lifestyle, which included a healthy diet, routine physical activity and no smoking, were 30% less likely to have fatigue and 40% less likely to experience pain compared to those who did not have a healthy lifestyle.

Comment:

This article sheds new light on the importance of diet in MS. However, the results still need to be interpreted with caution due to the limitations of the questionnaire. There was little information on the types of fats people consumed and no way to distinguish between types of diary foods. Moreover, the participants in the study tended to be older and Caucasian and had been diagnosed with MS for nearly 20 years; therefore the results may not be applicable to everyone with MS. Additional studies are still needed to better understand the associations that diet and healthy lifestyles has on disease outcomes and answer key questions like if a healthy lifestyle can actually promote a better outcome in MS or does poor outcomes encourage a decline in healthy habits.

Source:

Fitzgerald K et al. (2017) Diet quality is associated with disability and symptom severity in multiple sclerosis. Neurology. 90(1): e1-e11.