The nutritional status of relapsing-remitting multiple sclerosis (RRMS) patients compared to that of healthy people: a Turkish hospital-based study

ABSTRACT

Objective

This study compares the nutritional status and physical activity levels of relapsing-remitting multiple sclerosis (RRMS) patients and healthy people.

Method

The study included 120 participants: 60 multiple sclerosis (MS) patients and 60 controls. RRMS diagnoses were made based on the 2017 McDonald criteria. The food intake frequency questionnaire was administered to the participants, their threeday food intake records were collected, their activity levels were determined, and anthropometric measurements were made. The differences between the groups were analyzed using the Mann–Whitney U test and Pearson's exact chi-squared test.

Results

The participants with MS (46.7%) had a significantly lower rate of shopping for their own food compared to the control group (68.3%) (p = 0.002). The MS group (3.3%) had a lower rate of intake of green leafy vegetables 5 times weekly or more frequently than the control group (20.0%) (p < 0.05); and the control group (35.0%) had a higher consumption rate of pastry more than 1 to 2 times monthly than the MS group (13.3%) (p < 0.05). The participants with MS had a higher intake of fiber, insoluble fiber, and omega 3 fatty acid than the control group (p < 0.05). Expanded Disability Status Scale (EDSS) scores indicates that a positive correlation was found between daily intake of fiber and insoluble fiber (p < 0.05). The patients with MS in the inactive group had a higher EDSS median [2.00(0.00 –5.00)] than the minimal active group [1.25(0.00 –4.00)] (p = 0.034).

Conclusion

With the increase in disability in MS patients, their physical activity levels decrease and it becomes difficult for them to shop on their own. In addition, the consumption frequency of green leafy vegetables, which take time to prepare and a source of fiber, is also decreasing. It has been shown that fiber intake decreases when the disability increase. Therefore, preventing the progression of disability in MS patients is very important in ensuring diversity in food consumption.

KEYWORDS:

• Disability
• food intake
• multiple sclerosis
• physical activity

Acknowledgements

We would like to thank healthcare personnel working in the neurology outpatient clinic of Gevher Nesibe Hospital of Erciyes University’s Faculty of Medicine for their support and Assoc. Prof. Dr. Ferhan Elmalı for carrying out the statistical analyses.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, [Y,M.], upon reasonable request.

Additional information

Notes on contributors

Tutku Atuk Kahraman

Tutku Atuk Kahraman graduated from Erciyes University, Department of Nutrition and Dietetics in 2016. Currently, she is continuing his doctorate education at Erciyes University, Department of Nutrition and Dietetics, and is working as a Research Assistant.

Müge Yılmaz

Müge Yılmaz graduated from Hacettepe University, Department of Nutrition and Dietetics in 1995. He completed his doctorate education at Erciyes University, Department of Public Health in 2014 and is working as an Assistant Professor. He is a member of the Turkish Dietetic Association.

Mehmet Fatih Yetkin

Mehmet Fatih Yetkin graduated from Istanbul University Cerrahpaşa Faculty of Medicine in 2008. Between 2008-2014, he received specialization training at Erciyes University, Department of Neurology. He has been working as an Associate Professor since March 2021. He is a member of the Turkish Neurological Society Multiple Sclerosis Working Group.

Meral Mirza

Meral Mirza received specialization training at Erciyes University, Department of Neurology between 1980-1984. He has been working as a Professor at Erciyes University since 1997. He is a member of the Turkish Neurological Society Multiple Sclerosis Working Group.