Abstract
Introduction:Previous research into the relationship between nutrition and Multiple Sclerosis (MS) has tended to focus on the role of nutrition in the aetiology of the disease. By comparison, there has been little research into nutritional status in MS. The purpose of this study therefore, was to investigate nutritional status in MS and, given the progressive disability that may occur in the disease, also examine the relationship between nutritional status and level of disability in MS.
Methods:
The study included 105 subjects diagnosed with MS who were attending neurological outpatient clinics at two hospitals. A questionnaire was used to collect social and demographic information for the sample. Nutritional status was assessed using anthropometric measures and blood micronutrient levels. A dietary questionnaire and nutrition screening tool were also completed (Hickson and Hill 1997). Dietetic and Speech and Language Therapy input were also recorded. Level of disability was measured using the Kurtzke Expanded Disability Rating Scale (EDSS) (Kurtzke 1983). General health status was measured using the Short Form 36 (SF36) Health Survey Questionnaire (Ware and Sherbourne 1992; Brazier et al 1992).
Results:
Nutritional status was found to be normal in the majority of subjects however individuals were found to have a range of previously unidentified nutritional problems. Although 2.9% of subjects were underweight, overweight and obesity were more common in the study sample with 39.1% of the study sample being overweight or obese. Over 21% of subjects were assessed as being at nutritional risk using a nutrition screening tool. Upper arm anthropometry identified both fat and muscle mass depletion in differing proportions of the study sample with males being significantly more likely to have muscle mass depletion than females (p< 0.05). Blood nutrient analysis identified individuals with low micronutrient levels and deficiencies in a range of nutrients but at the other extreme, high micronutrient levels and in some cases potentially toxic micronutrient levels were also found. The use of special diets and nutrition supplements was also common in the study sample. Whilst this did not have any significant relationship with anthropometric measurements in the study sample, several significant relationships (p < 0.05) were identified between supplement use and micronutrient levels, with supplement users tending to have higher blood micronutrient levels than non supplement users. Despite the nutritional problems identified in the study sample few patients had been referred to a Dietitian since being diagnosed with MS. An investigation of the relationship between nutritional status and level of disability found little evidence of such a relationship in the study sample although some results were interesting enough to warrant further research.
Conclusion:
Patients with MS may have a range of unidentified nutritional problems that could have a negative impact on both physical and mental health. There is a need for improvements in the nutritional care and advice provided to patients with MS.
| Date of Award | 2010 |
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| Original language | English |
| Awarding Institution |
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| Supervisor | Lorna Paul (Supervisor) |