Online dietary advice for the symptomatic management of multiple sclerosis: a scoping review protocol

The relationship of indoor radon gas concentration with multiple sclerosis: a case-control study

This case-control study aimed to investigate the relationship of indoor radon gas concentration and residential building characteristics with mental health with multiple sclerosis (MS) in Yazd City, Iran. The participants included 45 patients with MS and 100 healthy individuals. The participants' socio-economic status and residential building characteristics were investigated using a questionnaire. The radon gas concentration was also measured by CR-39 detectors over a 6-month period. Furthermore, the participants' mental health data were collected using General Health Questionnaire (GHQ-28). The mean concentrations of radon gas were 66.77 and 65.33 Bq/m³ in the homes of patients with MS and healthy individuals, respectively, but the difference was not significant (p = 0.882). However, the radon gas concentration had a significant relationship with the building's age (p = 0.038), ventilation (p = 0.053), and cooling system (p = 0.021). A significant difference was observed between the two study groups in terms of the mental health (p = 0.018), depression (p = 0.037), somatic symptoms (p ≤ 0.001), and physical activity (p = 0.030). Since the indoor radon gas concentration did not have any significant relationship with MS prevalence, more studies are required in this regard, especially in long-term exposure.

Diet and Multiple Sclerosis: Scoping Review of Web-Based Recommendations

Background

There is currently no scientific evidence supporting the use of specific diets in the management of multiple sclerosis (MS); the strongest dietary associations are observed with vitamin D and omega-3 fatty acid supplementation. Despite this, there are many websites that provide advice or suggestions about using various dietary approaches to control symptoms or disease progression.

Objective

The objective of this study was to assess the dietary advice for the symptomatic management of MS available on the internet.

Methods

This study was a systematic review of webpages that provided dietary advice for the management of MS. Webpages were selected from an internet search conducted in November 2016 using Google, Yahoo, and Bing search engines and the search term “MS diet.” The first two pages of results from each search engine were included for the initial assessment. Duplicates were removed. Data extracted from websites included specific advice relating to diet and its rationale and the citation of supporting scientific literature. Authorship and credential information were reviewed to assess webpage quality.

Results

We included 32 webpages in the final assessment. The webpages made a wide variety of specific recommendations regarding dietary patterns and individual foods to help manage MS. The most common dietary pattern advised on these webpages was the low-fat, high-fiber balanced diet, followed by the low-saturated fat diet, near-vegetarian Swank diet, and the Paleo diet. The main categories of individual foods or nutrients suggested for addition to the diet were: supplements (especially omega-3 and vitamin D), fruits, vegetables, and lean protein. In contrast, the most commonly recommended for removal were saturated fats, dairy, gluten-containing grains, and refined sugar. These recommendations were often accompanied by rationale relating to how the particular food or nutrient may affect the development, prevalence and symptoms of MS; however, very little of this information is supported by the current scientific evidence between diet and MS. Only 9 webpages provided full authorship including credential information.

Conclusions

There is a wide variety of Web-based dietary advice, which in some cases is contradictory. In most cases, this advice is the result of peoples’ individual experiences and has not been scientifically tested. How people living with MS use this information is not known. These findings highlight the important role health professionals can play in assisting people living with MS in their health information-seeking behaviors.

Dietary responses to a multiple sclerosis diagnosis: a qualitative study

BACKGROUND/OBJECTIVES

Multiple sclerosis (MS) is an immune-mediated disease with no known cure and insufficient evidence to support a special therapeutic diet to alter symptom management or disease progression. Several studies have reported dietary changes made by people with MS, but there has been limited investigation into experiences surrounding diet in those recently diagnosed. This study explored responses to diet after a recent diagnosis of MS in people living in Western Australia.

SUBJECTS/METHODS

Eleven adults with MS (mean time since diagnosis 8 months) participated in semi-structured interviews focusing on responses to diet since MS diagnosis. Interviews were transcribed, coded and analysed using grounded theory principles.

RESULTS

Three theme responses emerged; (1) the perceived incompatibility of lack of/or generalised dietary advice with disease seriousness at the time of diagnosis; (2) extensive personal research and information seeking with difficulty judging credibility, and (3) self-experimentation with diet to either control MS symptoms or to cure MS.

CONCLUSIONS

Given the seriousness of the disease, there is a perceived gap in dietary information provided at the time of diagnosis. Healthcare professionals should address concerns with alternative therapeutic diets advertised to treat or cure MS, and clearly convey the reasoning for the general healthy dietary recommendations. This would better align advice with the perceptions about the role of diet in MS, assist people with MS in need of information and minimise dietary self-experimentation. Future research should explore the importance of diet for those who have had MS for a longer period of time.