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Huang R, Huang X, Wang Y, Xie Y, Chen K, Ma S, Zhou X, Li W, Tan S, Yang L. The nutritional risk in patients with neuromyelitis optica spectrum disorder. Mult Scler Relat Disord 2023; 77:104900. [PMID: 37487344 DOI: 10.1016/j.msard.2023.104900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/18/2023] [Accepted: 07/16/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND The effect of nutrition on chronic autoimmune diseases is well known. This study is the first to assess the nutritional status of patients with neuromyelitis optica spectrum disorder (NMOSD) by administering the Mini Nutritional Assessment (MNA), to explore the impacts of nutrition on patients' quality of life and to identify the factors associated with the nutritional status of NMOSD patients. METHODS Our study enrolled 70 NMOSD patients and 66 healthy controls. The following data were assessed: demographic information, disease features, and composite evaluations of life status, including nutrition, sleep, anxiety/depression, fatigue, and quality of life. Then, statistical analysis was performed. RESULTS The MNA score of NMOSD patients was 20.4 ± 3.3, which was significantly lower than that of HCs (23.3 ± 2.5, P = 0.002), especially for the dimensions of global evaluation and anthropometric assessment. Nearly 85% of patients were at risk of malnutrition or had definite malnutrition. The total MNA score was positively correlated with the patient's quality of life (P<0.01). Lower MNA scores were correlated with gender (P = 0.02), longer disease duration (P<0.001), more severe anxiety (P = 0.004), more severe depression (P = 0.003), more severe sleep disturbances (P<0.001), and more severe fatigue (P = 0.01). Sleep disturbance was revealed to be a significant independent factor for the NMOSD patients' malnutritional risk (P = 0.001). CONCLUSIONS These results suggest that the risk of malnutrition is very high in NMOSD patients and that malnutrition is closely related to their quality of life. Malnutrition among NMOSD patients is caused by a combination of various physiological and psychological factors. A multifaceted and personalized intervention is required to improve the prognosis of NMOSD.
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Affiliation(s)
- Rui Huang
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West Second Section of First Ring Road, Chengdu 611731, China
| | - Xinyue Huang
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West Second Section of First Ring Road, Chengdu 611731, China
| | - Yuan Wang
- Department of Clinical Nutrition, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yan Xie
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West Second Section of First Ring Road, Chengdu 611731, China
| | - Kai Chen
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West Second Section of First Ring Road, Chengdu 611731, China
| | - Shuai Ma
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West Second Section of First Ring Road, Chengdu 611731, China
| | - Xiaobo Zhou
- Department of Psychosomatic, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Wenjing Li
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West Second Section of First Ring Road, Chengdu 611731, China
| | - Song Tan
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West Second Section of First Ring Road, Chengdu 611731, China; Sichuan Provincial Key Laboratory for Human Disease Gene Study, Chengdu, China; Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, Sichuan, China.
| | - Lili Yang
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West Second Section of First Ring Road, Chengdu 611731, China.
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Mandato C, Colucci A, Lanzillo R, Staiano A, Scarpato E, Schiavo L, Operto FF, Serra MR, Di Monaco C, Napoli JS, Massa G, Vajro P. Multiple Sclerosis-Related Dietary and Nutritional Issues: An Updated Scoping Review with a Focus on Pediatrics. Children (Basel) 2023; 10:1022. [PMID: 37371254 DOI: 10.3390/children10061022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/03/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE Lifestyle/dietetic habits play an important role in the development and progression of multiple sclerosis (MS) disease. Here, we examine the basic pathomechanisms underlying intestinal and brain barrier modifications in MS and consider diets and dietary supplementations proposed over time to complement pharmacological therapies for improving disease outcome both in adults and in children. METHODS Scoping literature search about evidence-based findings in MS-related gut-brain axis (GBA) pathophysiology and nutritional issues at all ages. FINDINGS Data show that (1) no universal best diet exists, (2) healthy/balanced diets are, however, necessary to safeguard the adequate intake of all essential nutrients, (3) diets with high intakes of fruits, vegetables, whole grains, and lean proteins that limit processed foods, sugar, and saturated fat appear beneficial for their antioxidant and anti-inflammatory properties and their ability to shape a gut microbiota that respects the gut and brain barriers, (4) obesity may trigger MS onset and/or its less favorable course, especially in pediatric-onset MS. Vitamin D and polyunsaturated fatty acids are the most studied supplements for reducing MS-associated inflammation. CONCLUSIONS Pending results from other and/or newer approaches targeting the GBA (e.g., pre- and probiotics, engineered probiotics, fecal-microbiota transplantation), accurate counseling in choosing adequate diet and maintaining physical activity remains recommended for MS prevention and management both in adults and children.
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Affiliation(s)
- Claudia Mandato
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, 84081 Baronissi, Salerno, Italy
| | - Angelo Colucci
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, 84081 Baronissi, Salerno, Italy
| | - Roberta Lanzillo
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, 80138 Naples, Naples, Italy
| | - Annamaria Staiano
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, 80138 Naples, Naples, Italy
| | - Elena Scarpato
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, 80138 Naples, Naples, Italy
| | - Luigi Schiavo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Nutrition Section, University of Salerno, 84081 Baronissi, Salerno, Italy
| | - Francesca Felicia Operto
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatric Psychiatry Section, University of Salerno, 84081 Baronissi, Salerno, Italy
| | - Maria Rosaria Serra
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, 80138 Naples, Naples, Italy
| | - Cristina Di Monaco
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, 80138 Naples, Naples, Italy
| | - Julia Sara Napoli
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, 84081 Baronissi, Salerno, Italy
| | - Grazia Massa
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, 84081 Baronissi, Salerno, Italy
| | - Pietro Vajro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, 84081 Baronissi, Salerno, Italy
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