Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Mult Scler Relat Disord. 2022 Oct;66:104060. doi: 10.1016/j.msard.2022.104060. Epub 2022 Jul 23.
One of the important challenges in the treatment of patients with multiple sclerosis (MS) is determining the effective factors in the treatment of MS, including dietary adherence. The aim of this study was to investigate the relationship between adherence to the Mediterranean diet with anthropometric indices and the expanded disability status scale (EDSS) scores in patients with MS.
The present multicenter and cross-sectional study was conducted on patients with clinically definite MS (according to the 2017 revised McDonald criteria) who were referred to the MS clinics at medical centers affiliated to Shiraz and Tehran Universities of Medical Sciences during 2019. Disease phenotype, EDSS, waist circumference (WC), body mass index (BMI), and comorbidities were assessed. Adherence to the Mediterranean diet was measured with a 14-item modified Mediterranean Diet Adherence Questionnaire. In this questionnaire, a score of 0-5 indicates low adherence, a score of 6-9 shows moderate adherence, and a score of 10 and above demonstrates high adherence (healthy eating pattern).
This study was performed on 478 patients with a mean age of 37.99 ± 9.60 years, out of which 352 patients (73.6%) were female. The percentage of low, medium, and high adherence to the Mediterranean diet in patients with MS was 26.4%, 64%, and 9.6%, respectively. The difference in the level of education between the groups based on adherence to the Mediterranean diet was statistically significant. Low adherence to the Mediterranean diet in underweight, normal, and overweight patients was, respectively, 1.31, 1.32, and 2.29 times higher than in obese patients. This increased risk was only significant in overweight patients (P = 0.019). The results revealed that the score of adherence to the Mediterranean diet had no significant relationship with mild (2.86 ± 2.18), moderate (2.76 ± 2.16), and severe (2.70 ± 2.02) levels of disability.
The level of adherence to the Mediterranean diet in Iranian patients with MS was moderate. This level was associated with BMI, such that low adherence to the Mediterranean diet was higher in overweight patients than obese patients.
多发性硬化症（MS）患者治疗的一个重要挑战是确定治疗 MS 的有效因素，包括饮食依从性。本研究的目的是调查多发性硬化症患者地中海饮食依从性与人体测量指数和扩展残疾状况量表（EDSS）评分之间的关系。
本研究为多中心、横断面研究，纳入 2019 年在 Shiraz 和德黑兰医科大学附属医院 MS 诊所就诊的经临床确诊的多发性硬化症患者（根据 2017 年修订的 McDonald 标准）。评估疾病表型、EDSS、腰围（WC）、体重指数（BMI）和合并症。采用 14 项改良地中海饮食依从性问卷评估地中海饮食的依从性。在这个问卷中，0-5 分表示低依从性，6-9 分表示中度依从性，10 分及以上表示高度依从性（健康饮食模式）。
本研究纳入 478 例患者，平均年龄 37.99±9.60 岁，其中 352 例（73.6%）为女性。MS 患者中地中海饮食低、中、高依从性的比例分别为 26.4%、64%和 9.6%。根据地中海饮食依从性，患者的教育水平存在差异，差异有统计学意义。与肥胖患者相比，体重不足、正常体重和超重患者对地中海饮食的低依从性分别高出 1.31、1.32 和 2.29 倍。这种风险增加仅在超重患者中具有统计学意义（P=0.019）。结果显示，地中海饮食依从性评分与轻度（2.86±2.18）、中度（2.76±2.16）和重度（2.70±2.02）残疾程度无显著相关性。
伊朗多发性硬化症患者的地中海饮食依从水平为中等。该水平与 BMI 相关，即与肥胖患者相比，超重患者对地中海饮食的依从性较低。
