ECTRIMS eLearning

Multiple sclerosis and diet: systematic review, internet-based survey and pilot-testing of an evidence based patient education programme
Author(s): ,
K Riemann-Lorenz
Affiliations:
Institute of Neuroimmunology and MS
,
M Eilers
Affiliations:
Institute of Neuroimmunology and MS
,
K.-H Schulz
Affiliations:
Clinic for Medical Psychology, UMC, Hamburg, Germany
,
G von Geldern
Affiliations:
UW MS Center, University of Washington, Seattle, WA, United States
,
A Rahn
Affiliations:
Institute of Neuroimmunology and MS
,
S Köpke
Affiliations:
Social Science in Medicine, UKSH, Lübeck, Germany
C Heesen
Affiliations:
Institute of Neuroimmunology and MS
ECTRIMS Learn. Heesen C. 09/15/16; 146621; P781
Christoph Heesen
Christoph Heesen
Contributions
Abstract

Abstract: P781

Type: Poster

Abstract Category: RIMS - Multi-disciplinary rehabilitation

Background: Dietary factors have been discussed to influence risk or disease course of multiple sclerosis (MS) and specific diets and dietary supplements are widely used among people with MS (PwMS). Therefore, we aimed to assess PwMS" dietary habits and information needs in order to develop and pilot-test an evidence based patient education programme on nutrition in MS.

Methods: We performed a systematic literature search in 9/2010 with an update in 6/2015 on the effectiveness of dietary interventions in PwMS. In a next step, a web-based survey among n=337 PwMS and n=136 healthy controls assessed knowledge, dietary habits and information needs using a self-developed questionnaire. Based on the results an interactive group education programme was developed and piloted.

Results: Fifteen randomised-controlled trials (RCTs) were included in the systematic review of which nine studies assessed fatty acid intake and six vitamin D supplementation. Overall, quality of evidence was low and no clear benefit could be seen for either treatment. Of the 337 PwMS who completed the survey, 143 (42%) had tried special diets for PwMS. Main reasons were: improving overall wellbeing (78%) and slowing down disease progression (73%). 30% of PwMS reported to adhere to a `Mediterranean Diet` compared to 14% of healthy controls (p< 0.001), but less often to a `Mixed Diet´ (PwMS: 42%, controls: 60%, p< 0.001). PwMS" most important information needs addressed effectiveness of MS diets (44%) and relation between nutrition and MS (43%). The newly developed evidence-based patient education programme comprised basic knowledge on research methodology, relevant outcome measures of MS studies, information on widespread MS-diets and results of RCTs on diet and MS. A pilot test with 13 participants showed very good comprehensibility. Participants rated the amount of information as adequate and the MS-specific content as very important. However, the poor evidence base for MS diets was perceived as disappointing.

Conclusions: There is no conclusive evidence on dietary interventions for PwMS. Nevertheless many PwMS use special diets which are widely advertised. The weak evidence base is disappointing for PwMS, but is acknowledged as important information. Based on the results of the pilot study, a, easy-accessible possibly web-based intervention should be developed and evaluated.

Disclosure:

K. Riemann-Lorenz has nothing to disclose.

M. Eilers has nothing to disclose.

S. Köpke has nothing to disclose.

G. van Geldern has nothing to discölose.

A. Rahn has nothing to disclose.

K.H. Schulz has nothing to disclose.

C. Heesen has received grants from, Biogen, Genzyme, Novartis.

Abstract: P781

Type: Poster

Abstract Category: RIMS - Multi-disciplinary rehabilitation

Background: Dietary factors have been discussed to influence risk or disease course of multiple sclerosis (MS) and specific diets and dietary supplements are widely used among people with MS (PwMS). Therefore, we aimed to assess PwMS" dietary habits and information needs in order to develop and pilot-test an evidence based patient education programme on nutrition in MS.

Methods: We performed a systematic literature search in 9/2010 with an update in 6/2015 on the effectiveness of dietary interventions in PwMS. In a next step, a web-based survey among n=337 PwMS and n=136 healthy controls assessed knowledge, dietary habits and information needs using a self-developed questionnaire. Based on the results an interactive group education programme was developed and piloted.

Results: Fifteen randomised-controlled trials (RCTs) were included in the systematic review of which nine studies assessed fatty acid intake and six vitamin D supplementation. Overall, quality of evidence was low and no clear benefit could be seen for either treatment. Of the 337 PwMS who completed the survey, 143 (42%) had tried special diets for PwMS. Main reasons were: improving overall wellbeing (78%) and slowing down disease progression (73%). 30% of PwMS reported to adhere to a `Mediterranean Diet` compared to 14% of healthy controls (p< 0.001), but less often to a `Mixed Diet´ (PwMS: 42%, controls: 60%, p< 0.001). PwMS" most important information needs addressed effectiveness of MS diets (44%) and relation between nutrition and MS (43%). The newly developed evidence-based patient education programme comprised basic knowledge on research methodology, relevant outcome measures of MS studies, information on widespread MS-diets and results of RCTs on diet and MS. A pilot test with 13 participants showed very good comprehensibility. Participants rated the amount of information as adequate and the MS-specific content as very important. However, the poor evidence base for MS diets was perceived as disappointing.

Conclusions: There is no conclusive evidence on dietary interventions for PwMS. Nevertheless many PwMS use special diets which are widely advertised. The weak evidence base is disappointing for PwMS, but is acknowledged as important information. Based on the results of the pilot study, a, easy-accessible possibly web-based intervention should be developed and evaluated.

Disclosure:

K. Riemann-Lorenz has nothing to disclose.

M. Eilers has nothing to disclose.

S. Köpke has nothing to disclose.

G. van Geldern has nothing to discölose.

A. Rahn has nothing to disclose.

K.H. Schulz has nothing to disclose.

C. Heesen has received grants from, Biogen, Genzyme, Novartis.

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