Role of diet in male veterans with Multiple Sclerosis, The

Abstract

Multiple Sclerosis (MS) is a chronic, autoimmune disease affecting over 400,000 Americans, in which recurrent inflammation destroys myelin forming cells (oligodendroglia), axons, neurons and astrocytes resulting in a variety of symptoms and neurological disability. Although disease-modifying therapies for MS have significantly improved, their use may result in adverse effects, as well as considerable financial burden. Male Veterans with MS face poorer outcomes and lower socioeconomic status, putting them at high risk for unhealthy eating patterns. Nutritional interventions may reduce the disease burden. Omega-3 fatty acids are implicated in the reduction of inflammation and in remyelination; however, trials among those with MS have failed to show efficacy. These results may in part be associated with methodological challenges. The primary aim of this study was to describe the dietary attitudes and behaviors of male Veterans with MS using qualitative and cross-sectional quantitative methods. Additional aims were to investigate: the association between dietary omega-3s and physical health-related quality of life (secondary); the association between dietary omega-3s and mental health-related quality of life, disease severity, and relapse rate (tertiary); and associations between the dietary omega-6:omega-3 ratio, as well as blood levels and ratio of omega fatty acids with clinical outcomes (exploratory). Participants included 90 male Veterans. Results suggested that participants consumed within recommended daily intakes for most food groups, macronutrients, and micronutrients per the Dietary Guidelines for Americans and International Society for the Study of Fatty Acids and Lipids recommendations. Exceptions primarily included two food group categories: cereals, breads, and starches were consumed at much greater than, and fish at much less than recommended amounts. This was reflected in linoleic acid omega-6, and eicosapentaenoic acid and docosapentaenoic acid omega-3 consumption, respectively. Most individuals reported believing that diet was very important to their health, but faced financial, adherence-related, and nutrition literacy barriers to healthy eating. No statistically significant associations were found between either dietary or blood levels of omega-3 fatty acids or omega-6:omega-3 ratios and MS-related outcomes. Further exploration of evidence-based nutritional strategies aimed at improving quality of life, and reducing comorbidity and overall disease burden for those with MS is warranted.