Despite featuring a survey that produced interesting insight into how MS patients respond to their condition through dietary behaviors, researchers considered much of the existing research on the subject inefficient and thus had difficulty creating a program to educate patients.
Despite a wide, systematic literature review, researchers behind a new study cited a “poor evidence base” as an obstacle in trying to find a teachable, beneficial dietary plan for patients with multiple sclerosis (MS). Led by Karin Riemann-Lorenz of the University Medical Center Hamburg-Eppendorf, the team’s report of their attempt to educate MS patients on diet and the disease was published recently in PLOS.
Their review of existing information included a German study of over 1,500 patients that showed 41% of people with MS attempted dietary modification, and an Australian study of over 400 people had found that 63% reported using dietary supplements or following special recommendations. Though they cited studies that examined polyunsaturated fatty acids in MS which “do not seem to have major clinical effects on disease progression, but may be associated with a tendency in reduction of frequency of relapses over two years”, and also small studies that evaluated vitamin D supplementation, they deemed most existing evidence insufficient to draw conclusions.
The researchers conducted a survey of 337 people with MS and 136 controls to determine knowledge, attitudes, and dietary habits among the population, combined with socioeconomic information and disease status. Though socioeconomic factors were similar between the afflicted and the controls, those with MS were typically older.
About 60% of those with MS believed diet could play a major role in their disease course. Among them, the Mediterranean Diet, high in fish and fruits and low in fats, was significantly more popular than in the control group (29% to 14%). 73% of respondents hoped to use a better diet to slow MS progression. Three quarters of those with MS reported use of of one or more of a host of dietary supplements, including multivitamins, vitamins C, D, E, folate, and various B vitamins. Vitamin D and omega-3 fatty acids were markedly more prevalent among those with MS than controls (62% to 40% and 67% to 31%, respectively).
With the limited background they’d gathered and the results of their survey, the team attempted to formulate a 2-hour pilot educational program, but the outcome was disappointing. Very little of the information was believed by the small group of 13 participants to be new, though they found it comprehensible. “The absence of controlled studies for broad dietary approaches leaves patients and caregivers largely clueless and might also have added to the lack of satisfaction with the education program,” the authors wrote.
Previous studies have attempted to gauge the use of the Mediterranean diet or “fasting-like” diets to mitigate MS progression. A small study out of the University of Southern California earlier this year put forth the idea that drastically reducing calories for short periods of time could reduce symptoms of MS. Others have examined the results of high-salt diets and the differences in MS patients’ gut microbiota.
The authors of this study conclude with a nod to all of this work: “Dietary counselling is considered highly relevant by patients…Hence, an additional aim should be to enhance patients´ ability to critically appraise the evidence."