Beckett Jeffrey M, Bird Marie-Louise, Pittaway Jane K, Ahuja Kiran Dk
School of Health Sciences, University of Tasmania, Launceston, Australia.
GF Strong Rehabilitation Research Program, Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
Interact J Med Res. 2019 Jan 9;8(1):e10050. doi: 10.2196/10050.
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.
The objective of this study was to assess the dietary advice for the symptomatic management of MS available on the internet.
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.
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.
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.
目前尚无科学证据支持在多发性硬化症（MS）的管理中使用特定饮食；与维生素D和ω-3脂肪酸补充剂的饮食关联最为显著。尽管如此，仍有许多网站提供关于使用各种饮食方法来控制症状或疾病进展的建议。
本研究的目的是评估互联网上提供的针对MS症状管理的饮食建议。
本研究是对提供MS管理饮食建议的网页进行的系统评价。网页选自2016年11月使用谷歌、雅虎和必应搜索引擎进行的互联网搜索，搜索词为“MS饮食”。每个搜索引擎的前两页结果纳入初始评估。去除重复项。从网站提取的数据包括与饮食相关的具体建议及其原理以及支持性科学文献的引用。审查作者身份和资质信息以评估网页质量。
我们在最终评估中纳入了32个网页。这些网页针对饮食模式和个别食物提出了各种各样的具体建议，以帮助管理MS。这些网页上建议的最常见饮食模式是低脂、高纤维均衡饮食，其次是低饱和脂肪饮食、近乎素食的斯旺克饮食和古饮食。建议添加到饮食中的个别食物或营养素的主要类别包括：补充剂（尤其是ω-3和维生素D）、水果、蔬菜和瘦肉蛋白。相比之下，最常建议去除的是饱和脂肪、乳制品、含麸质谷物和精制糖。这些建议通常伴随着关于特定食物或营养素可能如何影响MS的发展、患病率和症状的原理；然而，目前饮食与MS之间的科学证据很少支持这些信息。只有9个网页提供了包括资质信息在内的完整作者信息。
有各种各样基于网络的饮食建议，在某些情况下这些建议相互矛盾。在大多数情况下，这些建议是人们个人经验的结果，尚未经过科学检验。MS患者如何使用这些信息尚不清楚。这些发现凸显了健康专业人员在协助MS患者进行健康信息寻求行为方面可以发挥的重要作用。
