Dietary Intake and the Effect on Disease Progression in People with Multiple Sclerosis

Elisa Meier-Gerdingh 1
Kathryn Fitzgerald 2
Ralf Gold 3
Kerstin Hellwig 1

1 St. Josef Hospital Bochum
2 Johns Hopkins School of Medicine
3 Neurologische Universitaetsklinik

Objective: To evaluate the association between diet and disability in people with MS.

Background: People with multiple sclerosis (MS) are at increased risk of metabolic disorders. Diet is an important determinant of metabolic comorbidity in the general population and influences mechanisms implicated in MS (e.g. immune function, oxidative stress, the gut microbiota). However, studies investigating the effects of diet on disease progression is limited.

Design/Methods: We conducted a cross-sectional study of people with MS who completed a 102-item food frequency questionnaire and received a neurologic exam. For each individual, we calculated the DietaryApproaches-to-Stop-Hypertension (DASH) score, which is a composite measure of dietary quality favorably weighting an individualís intake of fruits, vegetables, nuts and legumes, whole-grains and dairy, and unfavorably weighting intake of sodium, sugar-sweetened beverages (SSBs) and red and processed meats. Scores ranged from 8 (poorest quality) to 40 (highest quality). We assessed the association between overall DASH scores and DASH-component foods/nutrients and disability status (via Expanded Disability Status Scale [EDSS]) categorized as mild-to-moderate (EDSS:<6) and severe (EDSS:≥6) using logistic regression models adjusting for age, sex, body-mass index (BMI), smoking and symptom duration.

Results: We analyzed cross-sectional data from 135 participants (73% female, mean age: 44.6y [standard deviation; SD:13.9y], mean BMI: 24.5[SD:5.3]) who underwent dietary assessments and a neurologic exam; 30 individuals had severe disability. Overall DASH scores were not associated with disability status. With respect to individual DASH-score components, individuals in the highest quartile of SSB intake had higher risk of severe vs.
mild-to-moderate disability (OR: 5.01; 95% CI: 1.03-24.37; P for trend=0.01). Other components were not associated with disability status.

Conclusions: While overall diet quality was not associated with disability status in this preliminary study, we observed potential association between SSBs and higher disability status in MS patients. Longitudinal studies are needed to evaluate if diet impacts future disability.