Writing in the journal Multiple Sclerosis and Related Disorders, Australian researchers suggested that dietary modifications should be considered in the management of MS. They indicated that few studies have reported on long-term implications of fatigue and disability and how diet may influence disease symptoms.
“Understanding predictors of health outcome trajectories may provide insight to potential interventions,” the researchers wrote. “While high-level evidence for specific dietary recommendations for people with MS (pwMS) are limited, we and others have reported high-quality diet, and non-consumption of meat, are positively associated with lower frequencies of fatigue and lower severe disability.”
Dietary behaviors
Multiple sclerosis is a chronic disease that affects the central nervous system which then impacts the brain and spinal cord. Fatigue and disability are signs of MS progression, leading to a reduced quality of life.
Although large studies have identified trajectories of fatigue and disability in people with MS, the researchers indicated that no study has explored how modifying lifestyle behaviors can influence these paths.
Existing studies reveal discrepancies in results, which the scientists suggest may be attributed to factors such as participant bias, different measures of diet and co-contribution of participant’s adherence to additional healthy lifestyle behaviors.
Vitamin D consumption among people with MS show varying results.
“Mixed prospective associations have been reported for vitamin D supplementation with fatigue and disability, with positive associations limited to pwMS with vitamin D deficiency and in those supplementing with doses of ≥5,000IU daily,” the researchers explained.
Study details
A group of 839 participants was recruited internationally via web-based platforms for the five-year study and were asked to complete an online survey to capture demographic, clinical and health information at 2.5-year intervals. Most of the participants, who were a mean age of 46, were females, had a normal BMI and had a non-progressive MS phenotype. The volunteers were diagnosed with MS for an average of 7 to 12 years prior to beginning the study.
A significant number of the participants were not using anti-fatigue medication and were taking omega-3 supplements.
Scientists assessed diet based on a modified Dietary Habits Questionnaire (DHQ), which documents broad consumption of diet and food preparation. Items were calculated on a Likert scale from 1 to 5, with 1 indicating poor and 5 being healthy. The analyses also included meat and dairy consumption components documented through survey questions.
For omega-3 supplementation, participants ticked a box on the survey indicating consumption of fish oil, high-potency fish oil, flaxseed oil, or other.
The participants answered yes or no as to whether their average daily dose of vitamin D was greater or equal to 5,000 IU.
To determine fatigue, the scientists implemented the Fatigue Severity Scale to define clinically significant fatigue. They assessed disability using the validated Patient-Determined Disease Steps.
“Two severe disability trajectories were identified; low-disability (85%) had a stable trajectory while high-disability (15%) had a 30% increase in probability of severe disability over five years,” the researchers wrote. “Baseline high-quality diet, and omega-3 and vitamin D supplement use, were associated with reduced risk of being in the worse clinical trajectories, while meat and dairy consumption were associated with increased risk.”
Source: Multiple Sclerosis and Related Disorders
doi: 10.1016/j.msard.2024.105615
“Diet and omega-3 and vitamin D supplement use predict five-year fatigue and disability trajectories in people with multiple sclerosis”
Authors: Xin Lin et al.
