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More sprouts or another mince pie? Examining the link between a healthy diet and disability in MS

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Summary

As we go into the festive season, what scientific evidence is there to help you decide between sprout or mince pie? To shed more light on the impact of what we eat on the course of MS, this study investigated the link between diet and disability in people with MS.

Nearly 7,000 people took part in this North American study. They were asked to complete a dietary questionnaire and score the severity of their symptoms. They also answered questions about aspects of lifestyle linked to health such whether they smoked, took regular exercise and maintained a healthy weight.

People were divided into five groups based on the healthiness of their diet. The healthiest diet had the highest amounts of fruits, vegetables, pulses and whole grains and lowest amounts of added sugars and red or processed meat. Researchers analysed associations between the diet groups and MS symptoms. 

The study found that a healthy diet and lifestyle was associated with lower levels of disability and MS symptom severity. However, the results do not necessarily confirm that what you eat has a direct impact on your MS symptoms. The results could be interpreted as showing that it's easier to eat well and have a healthy lifestyle when you have lower levels of disability.

We need more research to get a better understanding of the influence of a healthy lifestyle on the course of MS. In the meantime, it is recognised that a healthy, balanced diet, high in fruit and veg and low in fats, is important for everyone to maintain general health. So, on balance, it is probably better to help yourself to more sprouts and resist the offer of another mince pie.


Background

Many people are interested in the potential to manage their MS through diet. As we go into the festive season, what scientific evidence is there to help you decide between sprout or mince pie? In an effort to shed more light on the impact of what we eat on the course of MS, this study investigated the link between diet and disability in people with MS.

How this study was carried out

Participants were recruited from a North American register of people with MS. 6,989 people completed a dietary questionnaire. Participants reported whether they had experienced a relapse or gradual worsening of symptoms in the previous 6 months and scored the severity of their MS symptoms, including mobility, hand function, vision, fatigue, cognition, bladder/bowel problems, pain and spasticity. They were also asked if they were following a specific diet (for example Swank diet, Paleo diet) and asked whether they smoked, their alcohol intake, level of exercise, household income, height and weight.

People were divided into five groups based on the healthiness of their diet. The healthiest diet had the highest amounts of fruits, vegetables, pulses and whole grains and lowest amounts of added sugars and red or processed meat.

Associations between the five diet groups and severity of MS symptoms and disability were analysed. The researchers also analysed associations between a healthy lifestyle (better than average diet plus healthy weight, regular exercise and no smoking) and MS symptom severity and disability.

What was found

Participants with the healthiest diet were 20% less likely to have severe disability and 20% less likely to have severe depression than those with the least healthy diet. Diet quality was not associated with severity of fatigue, pain or cognitive symptoms.

People with a healthier lifestyle were 50% less likely to experience depression, 30% less likely to have severe fatigue, 40% less likely to have pain and 55% less likely to have severe disability than people who had a less healthy lifestyle.

What does it mean?

The study found that a healthy diet and lifestyle was associated with lower levels of disability and MS symptom severity. On the whole, this backs up the advice to help yourself to more sprouts and resist the offer of another mince pie.

However, the results do not necessarily confirm that what you eat has a direct impact on your MS symptoms. The results could equally well be interpreted as showing that it's easier to eat well and have a healthy lifestyle when you have lower levels of disability. When you're more severely affected by MS, it will be harder to shop for and prepare healthy meals. The financial consequences of having more severe MS may also make it harder to buy healthier foods.

A major strength of the study is the large number of people who took part, adding weight to the results. However, as with any survey, participants are self-selecting and in this study tended to be older (average age 60 years), mainly white and had been diagnosed with MS for an average of nearly 20 years. This may have biased the results.

Finally, as this a one-off survey, it can't shed further light on whether people with healthy diet continue to have lower levels of disability in the long term.

We need more research to get a better understanding of the influence of a healthy lifestyle on the course of MS. In the meantime, it is recognised that a healthy, balanced diet, high in fruit and veg and low in fats, is important for everyone to maintain general health and reduce the risk of conditions such as heart disease, stroke and diabetes. So, on balance, it is probably better to help yourself to more sprouts and resist the offer of another mince pie.

Fitzgerald KC, et al.
Diet quality is associated with disability and symptom severity in multiple sclerosis
Neurology 2017 Dec 6. [Epub ahead of print]
Abstract 

More about diet

Our A-Z page gives a comprehensive overview of diet and MS and includes tips on preparing and eating meals.

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Causes of MS

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CCSVI

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Co-existing conditions

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Diagnosis

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Disease modifying drugs

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Zimmer A, Coslovsky M, Abraham I, et al.
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Cohen M, Brochet B, Clavelou P, et al.
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Havrdova E, Cohen JA, Horakova D, et al.
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Comi G, Patti F, Rocca MA, et al.
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J Neurol. 2017 Dec;264(12):2436-2449.
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Drugs in development

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Vidal-Jordana A.
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Neurol Clin. 2018 Feb;36(1):173-183.
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Stangel M, Kuhlmann T, Matthews PM, et al.
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Agius MA, Klodowska-Duda G, Maciejowski M, et al.
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Mult Scler. 2017 Nov 1:1352458517740641. [Epub ahead of print]
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Birnbaum G, Stulc J.
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Gajofatto A.
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Other treatments

Abboud H, Hill E, Siddiqui J, et al.
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Raknes G, Småbrekke L.
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PLoS One. 2017 Nov 3;12(11):e0187423.
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Schimrigk S, Marziniak M, Neubauer C, et al.
Dronabinol Is a Safe Long-Term Treatment Option for Neuropathic Pain Patients.
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Fleming J, Hernandez G, Hartman L, et al.
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Paediatric MS

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Lavery AM, Waldman AT, Charles Casper T, et al.
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Brenton JN, Engel CE, Sohn MW, et al.
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Pediatr Neurol. 2017 Dec;77:67-72.
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Pathophysiology

Lemus HN, Warrington AE, Rodriguez M.
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Neurol Clin. 2018 Feb;36(1):1-11.
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Wybrecht D, Reuter F, Pariollaud F, et al.
New brain lesions with no impact on physical disability can impact cognition in early multiple sclerosis: A ten-year longitudinal study.
PLoS One. 2017 Nov 17;12(11):e0184650.
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Prognosis

Rabadi MH, Aston CE.
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Int J MS Care. 2017 Sep-Oct;19(5):265-273.
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Provision of care

Costello J.
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Psychological aspects

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Parton C, Katz T, Ussher JM.
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Nery-Hurwit M, Yun J, Ebbeck V.
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Arch Clin Neuropsychol. 2017 Oct 27:1-11. [Epub ahead of print]
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Rehabilitation

Bradshaw MJ, Farrow S, Motl RW, et al.
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Devasahayam AJ, Downer MB, Ploughman M.
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abstract
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Chaseling GK, Filingeri D, Barnett M, et al.
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Med Sci Sports Exerc. 2017 Nov 15. [Epub ahead of print]
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Gilbertson RM, Klatt MD.
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Stem cells

Mancardi G, Sormani MP, Muraro PA, et al.
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Symptoms and symptom management

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Bsteh G, Hegen H, Ladstätter F, et al.
Change of olfactory function as a marker of inflammatory activity and disability progression in MS.
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Fritz NE, Eloyan A, Baynes M, et al.
Distinguishing among multiple sclerosis fallers, near-fallers and non-fallers.
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Ceruti S.
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Crabtree-Hartman E.
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Nathoo N, Mackie A.
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Miller E, Morel A, Redlicka J, et al.
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Flachenecker P, Meissner H, Frey R, et al.
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Work

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