ECTRIMS eLearning

A modified Mediterranean dietary intervention for multiple sclerosis: results of a pilot study and lessons learned for future dietary research in MS
Author(s): ,
I. Katz Sand
Affiliations:
Icahn School of Medicine at Mount Sinai | Neurology | Corinne Goldsmith Dickinson Center for MS, Mount Sinai, New York, NY
,
E. Digga
Affiliations:
Icahn School of Medicine at Mount Sinai | Neurology | Corinne Goldsmith Dickinson Center for MS, Mount Sinai, New York, NY
,
E. Benn
Affiliations:
Icahn School of Medicine at Mount Sinai | Neurology | Corinne Goldsmith Dickinson Center for MS, Mount Sinai, New York, NY
,
R. Deshpande
Affiliations:
Icahn School of Medicine at Mount Sinai | Neurology | Corinne Goldsmith Dickinson Center for MS, Mount Sinai, New York, NY
,
S. Gallo
Affiliations:
Icahn School of Medicine at Mount Sinai | Neurology | Corinne Goldsmith Dickinson Center for MS, Mount Sinai, New York, NY
,
M. Fabian
Affiliations:
Icahn School of Medicine at Mount Sinai | Neurology | Corinne Goldsmith Dickinson Center for MS, Mount Sinai, New York, NY
,
A. Miller
Affiliations:
Icahn School of Medicine at Mount Sinai | Neurology | Corinne Goldsmith Dickinson Center for MS, Mount Sinai, New York, NY
L. Arab
Affiliations:
UCLA, Los Angeles, CA, United States
ECTRIMS Learn. Katz Sand I. 10/10/18; 228487; P643
Dr. Ilana Katz Sand
Dr. Ilana Katz Sand
Contributions
Abstract

Abstract: P643

Type: Poster Sessions

Abstract Category: Therapy - Others

Introduction: Interest in the role of diet among MS patients is quite high. At the same time, there is increasing scientific evidence for the importance of dietary factors in MS incidence and disease course. Major barriers to conducting large clinical trials include lack of data on 1) which type of diet should be studied and 2) clinical trial feasibility. Based on available literature, we developed a rationally-designed dietary intervention (restrictive, modified Mediterranean diet) and conducted a randomized pilot study in women with MS for 6 months.
Objective: Main aims relate to clinical trial feasibility and adherence. Additional aims relate to general health and wellness effects on MS symptoms and quality of life.
Methods: Participants were randomly assigned to the modified Mediterranean dietary intervention or control arm (educational seminars). The intervention group received training with the study nutritionist and attended monthly meetings to assess and promote adherence. Formal assessments were completed at baseline and 6 months. Monthly self-assessments were also completed by the intervention arm.
Results: We screened 131 patients between December 2016 and October 2017. Of these, 36 (27.5%) were eligible and willing to commit to the study. At this time,18/18 assigned to the diet group and 14/18 “controls” are complete; an additional 3 are expected to complete in the coming weeks, with only 1 anticipated dropout. Analyses will be updated accordingly. Self-reported adherence was excellent (mean at 6 months= 90.3%). Additional adherence data utilizing food frequency questionnaires and other measures will be reported. 16/18 participants reported some benefit to their overall health and 14/18 reported specific benefits regarding MS symptoms. Mean change on the Neurological Fatigue Index-MS was -2.5±5.4 compared to +1.5±2.9 for controls (p=0.015) and mean change on Multiple Sclerosis Impact Scale-29 after exclusion of 1 outlier was -5.3±9.5 vs +2±9.3 (p=0.04).
Conclusions: It is feasible to enroll MS patients into a rigorous dietary intervention study requiring significant commitment and randomization and reasonable to expect high adherence to this type of dietary program utilizing educational methods to promote adherence. Preliminarily, this diet may improve fatigue and quality of life. Larger scale clinical trials to assess the role of diet for symptom management and even as a disease-modifier in MS are feasible and warranted.
Disclosure: Ilana Katz Sand: nothing to disclose
Elise Digga: nothing to disclose
Emma Benn: nothing to disclose
Richa Deshpande: nothing to disclose
Samantha Gallo: nothing to disclose
Michelle Fabian: nothing to disclose
Aaron Miller:
Lenore Arab: nothing to disclose

Abstract: P643

Type: Poster Sessions

Abstract Category: Therapy - Others

Introduction: Interest in the role of diet among MS patients is quite high. At the same time, there is increasing scientific evidence for the importance of dietary factors in MS incidence and disease course. Major barriers to conducting large clinical trials include lack of data on 1) which type of diet should be studied and 2) clinical trial feasibility. Based on available literature, we developed a rationally-designed dietary intervention (restrictive, modified Mediterranean diet) and conducted a randomized pilot study in women with MS for 6 months.
Objective: Main aims relate to clinical trial feasibility and adherence. Additional aims relate to general health and wellness effects on MS symptoms and quality of life.
Methods: Participants were randomly assigned to the modified Mediterranean dietary intervention or control arm (educational seminars). The intervention group received training with the study nutritionist and attended monthly meetings to assess and promote adherence. Formal assessments were completed at baseline and 6 months. Monthly self-assessments were also completed by the intervention arm.
Results: We screened 131 patients between December 2016 and October 2017. Of these, 36 (27.5%) were eligible and willing to commit to the study. At this time,18/18 assigned to the diet group and 14/18 “controls” are complete; an additional 3 are expected to complete in the coming weeks, with only 1 anticipated dropout. Analyses will be updated accordingly. Self-reported adherence was excellent (mean at 6 months= 90.3%). Additional adherence data utilizing food frequency questionnaires and other measures will be reported. 16/18 participants reported some benefit to their overall health and 14/18 reported specific benefits regarding MS symptoms. Mean change on the Neurological Fatigue Index-MS was -2.5±5.4 compared to +1.5±2.9 for controls (p=0.015) and mean change on Multiple Sclerosis Impact Scale-29 after exclusion of 1 outlier was -5.3±9.5 vs +2±9.3 (p=0.04).
Conclusions: It is feasible to enroll MS patients into a rigorous dietary intervention study requiring significant commitment and randomization and reasonable to expect high adherence to this type of dietary program utilizing educational methods to promote adherence. Preliminarily, this diet may improve fatigue and quality of life. Larger scale clinical trials to assess the role of diet for symptom management and even as a disease-modifier in MS are feasible and warranted.
Disclosure: Ilana Katz Sand: nothing to disclose
Elise Digga: nothing to disclose
Emma Benn: nothing to disclose
Richa Deshpande: nothing to disclose
Samantha Gallo: nothing to disclose
Michelle Fabian: nothing to disclose
Aaron Miller:
Lenore Arab: nothing to disclose

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