A new study published in Multiple Sclerosis and Related Disorders reported that 48.8% of participants in a large international cohort with multiple sclerosis (MS) followed an MS-specific diet program for at least 12 months. The most common programs in this cohort were Overcoming MS (38.1%), Swank (6.3%), and Wahls (3.1%).

Data were collected from 952 participants recruited online from the international Health Outcomes and Lifestyle In a Sample of people with Multiple sclerosis (HOLISM) study in Australia. Participants completed a self-reported survey that included sociodemographic, clinical, and lifestyle data at the time they entered the study and at 2.5-year intervals thereafter.

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Greater adherence to any of the MS-specific diets was associated with higher-than-average socioeconomic status, and higher physical and mental quality of life (QoL). Males and patients with longer disease duration were also found to be more adherent. Participants with higher disability, more clinically significant fatigue, greater depression risk, and more comorbidities were less likely to follow an MS-specific diet program.

Age, education, MS type, number of relapses in the past 12 months, and immunomodulatory medication use were not associated with Overcoming MS diet program adherence. The characteristics associated with adherence to the Wahls diet program included having progressive MS and longer disease duration. No characteristics were independently or consistently associated with adherence to the Swank diet program.

Participants who followed any diet program experienced higher overall diet quality; those adhering to the Overcoming MS diet, in particular, had the highest diet quality. Participants who were following a diet program for their MS had a 12.2% higher score on the Diet Habits Questionnaire (DHQ) and were 2.9 times more likely to have a DHQ score greater than the median.

The authors of this study note that based on concerns regarding the size and design of past studies, “some neurologists are hesitant to recommend these diet programs to their patients and may be awaiting demonstration of clinical efficacy through RCTs and other high-level evidence.”

These results are important because modifiable lifestyle behaviors, including diet, may be effective points of intervention, playing a role in symptom management and slowing MS progression, and might be associated with improved QoL. Replication of these results in other cohorts could inform health professionals seeking to advise their patients on the potential benefits of following such diet programs.

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Simpson-Yap S, Nag N, Jakaria M, Jelinek GA, Neate S. Sociodemographic and clinical characteristics of diet adherence and relationship with diet quality in an international cohort of people with multiple sclerosis. Mult Scler Relat Disord. 2021;56:103307. doi:10.1016/j.msard.2021.103307