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Neurology. 2018 Jan 2;90(1):e1-e11. doi: 10.1212/WNL.0000000000004768. Epub 2017 Dec 6.

Diet quality is associated with disability and symptom severity in multiple sclerosis.

Author information

1
From the Department of Neurology (K.C.F.), Johns Hopkins School of Medicine, Baltimore, MD; Dignity Health (T.T.), St. Joseph's Hospital and Medical Center, Phoenix, AZ; Division of Biostatistics (A.S.), Washington University in St. Louis School of Medicine, MO; Department of Biostatistics (S.S.C., G.C.), School of Public Health, University of Alabama at Birmingham; Mellen Center (R.F.), Cleveland Clinic Foundation, OH; and Departments of Internal Medicine and Community Health Sciences (R.A.M.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. fitzgerald@jhmi.edu.
2
From the Department of Neurology (K.C.F.), Johns Hopkins School of Medicine, Baltimore, MD; Dignity Health (T.T.), St. Joseph's Hospital and Medical Center, Phoenix, AZ; Division of Biostatistics (A.S.), Washington University in St. Louis School of Medicine, MO; Department of Biostatistics (S.S.C., G.C.), School of Public Health, University of Alabama at Birmingham; Mellen Center (R.F.), Cleveland Clinic Foundation, OH; and Departments of Internal Medicine and Community Health Sciences (R.A.M.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

Abstract

OBJECTIVE:

To assess the association between diet quality and intake of specific foods with disability and symptom severity in people with multiple sclerosis (MS).

METHODS:

In 2015, participants in the North American Research Committee on MS (NARCOMS) Registry completed a dietary screener questionnaire that estimates intake of fruits, vegetables and legumes, whole grains, added sugars, and red/processed meats. We constructed an overall diet quality score for each individual based on these food groups; higher scores denoted a healthier diet. We assessed the association between diet quality and disability status as measured using Patient-Determined Disease Steps (PDDS) and symptom severity using proportional odds models, adjusting for age, sex, income, body mass index, smoking status, and disease duration. We assessed whether a composite healthy lifestyle measure, a healthier diet, healthy weight (body mass index <25), routine physical activity, and abstinence from smoking was associated with symptom severity.

RESULTS:

Of the 7,639 (68%) responders, 6,989 reported physician-diagnosed MS and provided dietary information. Participants with diet quality scores in the highest quintile had lower levels of disability (PDDS; proportional odds ratio [OR] for Q5 vs Q1 0.80; 95% confidence interval [CI] 0.69-0.93) and lower depression scores (proportional OR for Q5 vs Q1 0.82; 95% CI 0.70-0.97). Individuals reporting a composite healthy lifestyle had lower odds of reporting severe fatigue (0.69; 95% CI 0.59-0.81), depression (0.53; 95% CI 0.43-0.66), pain (0.56; 95% CI 0.48-0.67), or cognitive impairment (0.67; 95% CI 0.55-0.79).

CONCLUSIONS:

Our large cross-sectional survey suggests a healthy diet and a composite healthy lifestyle are associated with lesser disability and symptom burden in MS.

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