基线期参与健康生活方式及其与参加在线多模式生活方式课程的多发性硬化症患者健康结局的关联。
Baseline engagement with healthy lifestyles and their associations with health outcomes in people with multiple sclerosis enrolled in an online multimodal lifestyle course.
机构信息
Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
出版信息
Eur J Neurol. 2024 Oct;31(10):e16429. doi: 10.1111/ene.16429. Epub 2024 Aug 7.
BACKGROUND AND PURPOSE
Healthy lifestyle behaviour modification may improve health outcomes in people with multiple sclerosis (pwMS), but empirical evidence is needed to confirm prior study findings. We developed an online multimodal lifestyle intervention (Multiple Sclerosis Online Course) to examine the impact of lifestyle modification on health outcomes in pwMS via a randomized control trial (RCT). However, the present study specifically analyses baseline data to assess engagement with healthy lifestyles by RCT participants and cross-sectional associations with health outcomes.
METHODS
Baseline engagement with six "healthy lifestyle behaviours" of the intervention course (high-quality, plant-based diet; ≥5000 IU/day vitamin D; omega-3 supplementation; ≥30 min physical activity 5 times/week; ≥30 min/week meditation; and nonsmoking) was examined. Associations between individual versus collective behaviours (individual behaviours summated) and health outcomes (quality of life [QoL]/fatigue/disability) were evaluated using multivariate modelling (linear/log-binomial/multinomial).
RESULTS
At baseline, 33.7% and 30.0% of participants (n = 857) engaged in one or two healthy behaviours, respectively. In total, engagement with healthy lifestyles by participants was as follows: nonsmoking, 90.7%; omega-3 supplementation, 34.5%; vitamin D supplementation, 29.8%; physical activity, 29.4%; diet, 10.7%; and meditation, 10.5%. Individual behaviours (nonsmoking/physical activity/diet) were independently associated with better health outcomes. Engagement with multiple behaviours, especially diet and physical activity, was associated with better outcomes; engaging with ≥4 behaviours was associated with a 9.0-point higher mental QoL and a 9.5-point higher physical QoL, as well as 23% and 56% lower prevalence of fatigue and moderate disability, respectively.
CONCLUSIONS
Baseline engagement with ≥4 healthy behaviours, including diet and physical activity, was associated with better health outcomes.
背景与目的
健康的生活方式行为改变可能会改善多发性硬化症（pwMS）患者的健康结果，但需要实证证据来证实先前的研究发现。我们开发了一种在线多模式生活方式干预（多发性硬化症在线课程），通过随机对照试验（RCT）来研究生活方式改变对 pwMS 健康结果的影响。然而，本研究专门分析了基线数据，以评估 RCT 参与者对健康生活方式的参与度，以及与健康结果的横断面关联。
方法
本研究检查了干预课程中六种“健康生活方式行为”的基线参与情况（高质量植物性饮食；≥5000IU/天维生素 D；ω-3 补充剂；每周≥5 次、每次≥30 分钟的身体活动；每周≥30 分钟的冥想；不吸烟）。使用多元建模（线性/对数二项式/多项）评估个体行为与集体行为（个体行为总和）与健康结果（生活质量[QoL]/疲劳/残疾）之间的关联。
结果
在基线时，33.7%和 30.0%的参与者（n=857）分别参与了一种或两种健康行为。总的来说，参与者参与健康生活方式的情况如下：不吸烟，90.7%；ω-3 补充剂，34.5%；维生素 D 补充剂，29.8%；身体活动，29.4%；饮食，10.7%；冥想，10.5%。个体行为（不吸烟/身体活动/饮食）与更好的健康结果独立相关。参与多种行为，尤其是饮食和身体活动，与更好的结果相关；参与≥4 种行为与心理 QoL 高出 9.0 分、身体 QoL 高出 9.5 分、疲劳患病率降低 23%、中度残疾患病率降低 56%相关。
结论
基线时参与≥4 种健康行为，包括饮食和身体活动，与更好的健康结果相关。
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