Impact of Nutrition on Quality of Life, Fatigue and Functional Mobility in Ms; A Case Series Analysis

BACKGROUND:Multiple Sclerosis (MS) an immune modulated disease can lead to functional disability, fatigue and decreased quality of life. Since disease modifying therapies to control the progression of MS are only moderately efficacious and have multiple side effects many patients seek alternative therapies.  Dietary intervention is one of the alternative therapies proposed to have an effect on both etiology and progression. The process by which nutrients influence cell metabolism and inflammation in MS has been established on the molecular level, however studies examining the role of nutrition in MS are lacking.  Anti-inflammatory diets, emphasizing plant-based nutrition, high in omega-3 fats, vegetables, fruits, beans and legumes, have been used to decrease the effects of inflammation in a variety of other disease states. These diets avoid many trademarks of the “American diet” which is high in beef, eggs and dairy as well as omega-6 fatty acid found in processed foods. The Therapeutic Lifestyle Change (TLC), created by the National Institute of Health (NIH) is a dietary guideline that emphasizes reducing dietary cholesterol, total fat, saturated fat, and trans fats.  Complementing the diet with soluble fibers and fish while monitoring sodium intake is also suggested in the TLC protocol.  The TLC diet has many components of an anti-inflammatory diet and has been shown to enhance T cell-mediated immune functions. OBJECTIVES:  To assess the change of self-reported measures of quality of life, fatigue and functional mobility in a group of subjects living with MS who follow the TLC diet METHODS:This is a case series of 6 subjects living with MS over the age of 20 years with an EDSS between 2.0 and 6.5. Education regarding the TLC diet and sample menus are provided to each subject.  Diet is monitored over 3 months using computer based dietary logs and assessed using 3-day food diaries and the MEDFICTS questionnaire which is 87.5% sensitive in identifying adherence the TLC diet.  Primary outcome measures include the Modified Fatigue Impact Scale, Twelve Item MS Walking Scale and Short Form Health Survey, which are assessed at baseline, 4, 8 and 12 weeks. RESULTS:  This is an on going study; preliminary results will be reported at the conference. CONCLUSION:  It is anticipated that changes in fatigue and components of functional mobility will be observed with the dietary intervention establishing the need for randomized control studies.