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14 March 2022

Latest NEU Paper Shows Diet Quality Predicts Long-Term Quality of Life in MS

Dr Jonathan White writes about the latest research from the NEU on the relationship between a person’s diet and how it relates to their health in the coming years.

If you have heard anything about Overcoming MS, it is probably “the OMS diet”. Our recommendations for those with MS to eat a wholefood, plant-based diet with seafood are now very well known within the MS community. The evidence-base behind them continues to grow, and the role of diet is increasingly being investigated and accepted by healthcare professionals.

That being said, however, there is still more to be done. The case for diet in MS will not be closed any time soon, and it is highly unlikely that one study will prove definitive. So the only option is to continue to slowly chip away at the bedrock, hoping to unearth a diamond in the rough (enough of the tortured metaphors, I promise!). 

New paper on diet and MS from the NEU

The latest paper from our friends in the Neuroepidemiology Unit at the University of Melbourne certainly helps our cause.  Soon to be published in the journal “Multiple Sclerosis and Related Disorders”, their paper entitled Prospective associations of better quality of the diet with improved quality of life over 7.5 years in people with multiple sclerosis examines the relationship between a person’s diet and how it relates to their health in the coming years. Make no mistake, this is a very important piece of work, even if it sounds like you might have already heard this story before. 

MS studies don’t often focus on quality of life

The connection between diet and MS is well described, with evidence to show that the quality of a person’s diet directly impacts relapse rates and disability progression. But there are very few studies to show how diet quality relates to someone’s quality of life (even if us OMSers already know the answer!). 

There is a huge focus on relapse rates and disability, and rightly so, they are of course extremely important.  But while these quantitative measures may be very useful to scientists, they don’t always relate that closely to a person’s lived experience with MS. Quality of life measures then, are actually some of the most important for those of us with MS. After all, it is how well you feel physically and mentally that matters most when living with a chronic illness. 

The fact that this data was collected prospectively is also very significant, as it means that the researchers set out to test a specific variable, with the outcomes assessed during the study period. This is generally considered preferable to retrospective studies (where information is collected about events that have already occurred) as the risks of bias and confounding factors are less.

Latest NEU study linking diet and quality of life for people with MS

So down to business then. 948 people with MS who participated in the HOLISM Study were followed over 7.5 years, providing self-reported data about their eating habits. They completed the widely-used Diet Habits Questionnaire (DHQ), which was modified to include questions on dairy and meat consumption. This then gave a diet quality score ranging from 20 (poorer) to 100 (healthier), which was then grouped into quartiles for all analyses. 

Quality of life (QoL) was assessed using the MSQOL-54, a validated statistical tool for measuring physical and mental quality of life in people with MS. Physical quality of life comprised physical function, health perceptions, energy/fatigue, role limitations due to physical issues, pain, sexual function, social function, and health distress sub-domains. Mental quality of life comprised health distress, overall QoL, emotional wellbeing, role limitations due to emotional issues, and cognitive function subdomains. 

NEU findings around quality of life

The results showed that those with a higher quality of diet had higher physical and mental quality of life scores. This was a dose-dependent positive association, meaning that the better the diet quality score, the better the QoL score. The results were statistically significant across all the DHQ sub-scores, and interestingly revealed that meat and dairy consumption were each associated with lower QoL scores. 

In those participants in the top two quartiles for diet quality at the beginning of the study, their physical and mental QoL scores increased over the 7.5 years of follow-up. This is highly significant, remember that the traditional teaching on MS is one of a gradual decline and loss of function over time, not often one of improvement and a sense of well-being. 

Study limitations

There were of course some limitations with the study, not least of which was that over 50% of the original study cohort (n = 2466) dropped out over the 7.5 year follow-up, leaving behind a group with healthier lifestyles and less clinical severity. But the investigators used statistical methods to control for this effect, thereby ensuring the accuracy of the results.   

Final thoughts

So here we have research that shows a robust positive relationship between how well you eat and how well you feel physically and mentally more than 7 years later. There will always be those who need bigger and better studies to prove the point, but I for one am very happy to keep eating a delicious OMS-friendly diet in the meantime! 

Further details of the study can be found via the open access link below.