Self-reported ongoing adherence to diet is associated with lower depression, fatigue, and disability, in people with multiple sclerosis

Maggie Yu; George Jelinek; Steve Simpson-Yap; Sandra Neate; Nupur Nag

doi:10.3389/fnut.2023.979380

Self-reported ongoing adherence to diet is associated with lower depression, fatigue, and disability, in people with multiple sclerosis

Front Nutr. 2023 Mar 1:10:979380. doi: 10.3389/fnut.2023.979380. eCollection 2023.

Authors

Maggie Yu¹, George Jelinek¹, Steve Simpson-Yap^{1

2

3}, Sandra Neate¹, Nupur Nag¹

Affiliations

¹ Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
² Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
³ Clinical Research Outcomes Unit, The Royal Melbourne Hospital, Melbourne, VIC, Australia.

Abstract

Introduction: Increasingly, dietary improvements have been shown to have positive associations with health outcomes in people with multiple sclerosis (pwMS). However, adhering to a MS-specific or high-quality diet may be a challenge. We therefore assessed the level of diet-adherence necessary to improve health outcomes of depression, fatigue, and disability.

Methods: Data from an international population of pwMS followed over 7.5 years (n = 671) were analyzed. Self-reported diet quality via diet habits questionnaire (DHQ), and adherence to six MS-diets [Ashton Embry Best Bet, McDougall, Overcoming MS (OMS), Paleolithic (Paleo), Swank, and Wahls] were queried at two timepoints. Four levels of diet adherence were assessed: non-adherence at either timepoint; ceased at second timepoint; commenced at second timepoint; and ongoing at both timepoints. Associations between adherence to OMS and high-quality diet (DHQ score > median) with depression, fatigue, and disability, were assessed by log-binomial regression models adjusted for confounders.

Results: Forty-two percent of pwMS reported ongoing-adherence to a MS-diet at both timepoints, OMS (33%), Swank (4%), Wahls (1.5%), other (<1%). Of these, only OMS-diet adherence was analyzed for associations due to data availability. Ongoing-adherence to the OMS-diet or a high-quality diet, was associated with lower depression compared to non-adherence [OMS: Risk ratios (RR) = 0.80, p = 0.021; DHQ: RR = 0.78, p = 0.009] and ceased-adherence (OMS: RR = 0.70, p = 0.008; DHQ: RR = 0.70, p = 0.010), respectively. Ongoing-adherence to OMS-diet was associated with lower fatigue (RR = 0.71, p = 0.031) and lower severe disability (RR = 0.43, p = 0.033) compared to ceased-adherence.

Conclusion: Results suggest potential benefits of adherence to the OMS- or a high-quality diet on MS health outcomes, with ongoing-adherence likely best. Diet modification and maintenance may serve as a point of intervention to manage MS symptoms, especially depression, in pwMS.

Keywords: depression; diet adherence; disability; fatigue; health outcomes; multiple sclerosis; prospective observational study.

Grants and funding

Research funding by philanthropic gifts to the Neuroepidemiology Unit from Mr. Wal Pisciotta and anonymous donors. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.