AUTHOR=Fiorella Sandrine , Agherbi Hanane , El Houjeiry Emilia , Castelnovo Giovanni , Renard Dimitri , Privat Pauline , Santamaria Elodie , Vallayer Virginie , Alonso Sandrine , Chevallier Thierry , Bancal Candice , Laurent-Chabalier Sabine , Thouvenot Eric 

TITLE=Personalized dietary advices provided by a dietitian increase calcium intake in outpatients with multiple sclerosis—Results from a randomized, controlled, single-blind trial

JOURNAL=Frontiers in Nutrition

VOLUME=9

YEAR=2023

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.919336

DOI=10.3389/fnut.2022.919336

ISSN=2296-861X

ABSTRACT=<sec><title>Background and aims</title><p>Multiple sclerosis (MS) is associated with osteoporosis, possibly due to neurological disability and decreased calcium intake. The objective of this study was to evaluate the efficacy of a personalized nutritional advice program by a dietitian compared to the delivery of a standard advice form to optimize dietary calcium intake in outpatients with MS.</p></sec><sec><title>Methods</title><p>We performed a randomized, controlled, parallel trial comparing the efficacy of a personalized dietary advice (PDA) program to standard advice form (SAF) to increase daily calcium intake in MS patients. The study population was composed by patients with relapsing-remitting MS aged 18–69 years old. PDA program consisted in dietary advice delivered by a dietitian at baseline, 1 month, and 3 months. Calcium and nutrient intake in patients from both groups was evaluated at baseline and 6 months using a dietary survey.</p></sec><sec><title>Results</title><p>Of the 194 patients screened for inclusion, 182 patients were included (79% female, median age of 42 years, and median EDSS of 2.0), and randomized to SAF (<italic>n</italic> = 92) or PDA (<italic>n</italic> = 90). At 6 months, median calcium intake increased by 241 mg/day in the PDA group and decreased by 120 mg/day in the SAF group (<italic>p</italic> &lt; 0.0001). However, the median calcium intake was 947 mg/day in the SAF group and 778 mg/day in the PDA group at baseline (<italic>p</italic> = 0.0077), potentially favoring the effect of dietary advice. Complementary analyses focusing on patients with insufficient calcium intakes at baseline revealed comparable values in both groups (<italic>p</italic> = 0.69). Of those, patients included in the PDA group obtained significantly higher calcium intakes at 6 months than patients from the SAF group (<italic>p</italic> = 0.0086) independently of EDSS, PASAT, HADS and EQ-5D scores.</p></sec><sec><title>Conclusion</title><p>This work shows the efficacy of dietary management based on personalized advice program over 3 months to durably increase calcium consumption in MS patients with insufficient calcium intake.</p></sec><sec><title>Clinical trial registration</title><p><ext-link ext-link-type="uri" xlink:href="http://clinicaltrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">clinicaltrials.gov</ext-link>, identifier NCT02664623.</p></sec>