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ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition, Psychology and Brain Health
Volume 11 - 2024 |
doi: 10.3389/fnut.2024.1369700
This article is part of the Research Topic Objective Dietary Assessment in Nutrition Epidemiology Studies - Volume II View all 10 articles
Feasibility and assessment of self-reported dietary recalls among newly diagnosed multiple sclerosis: a quasi-experimental pilot study
Provisionally accepted- 1 The University of Iowa, Iowa City, United States
- 2 Dartmouth Health, Lebanon, Illinois, United States
Background: Individuals who are newly diagnosed with clinically isolated syndrome (CIS) or relapsing-remitting multiple sclerosis (RRMS) may choose not to undergo disease-modifying therapies (DMTs) due to concerns about expenses or potential adverse effects. Thus, many individuals will opt for alternative therapies, such as dietary modifications. Among these dietary approaches, the modified Paleolithic elimination diet has shown promise for improving MS-related symptoms; however, restriction of certain food groups can lead to inadequate intake of nutrients. Methods: Three-day self-reported 24-hour dietary recalls using the Automated Self-Administered 24-hour (ASA24) Dietary Assessment Tool were assessed during a 12-month quasi-experimental (i.e., non-randomized) trial among individuals who either voluntarily declined DMTs and received health behavior (HB) intervention, (n=29) or included DMTs and opted for the standard of care (SOC; n=15). Participants in the HB group received a multimodal intervention that included dietary modifications, a walking program, and breathing exercises. Usual intake of each micronutrient was estimated and then evaluated with the estimated average requirement (EAR)-cut point method. Results: At 12 months, >80% of both HB and SOC groups completed 3 days of the self-reported 24-hour recalls, indicating the potential feasibility of ASA24. From baseline to 12 months, the HB group had a decreased mean ratio in total grains (0.64; 95% CI 0.43-0.93; p=0.02) and added sugars (0.52; 95% CI 0.35-0.75; p ≤ 0.001), and an increased mean ratio intake of cured meats (1.74; 95% CI 1.05-2.90; p=0.04); whereas, the SOC group had a decreased mean ratio intake for beef, veal, pork, lamb, and game meat (0.60; 95% CI 0.40-0.90; p=0.01). At baseline, both groups had high proportions with inadequate intake of vitamin E and calcium. The SOC group also had a high proportion with inadequate intake of vitamin D. By 12-months, the HB group exhibited severe proportions of nutrient inadequacies (>20% of the group) for vitamin D (43.5%), vitamin E (29.1%), calcium (69.9%), and copper (27.8%). The SOC group, following their own diet, had inadequacies for all the same micronutrients, except for copper, as the HB group.
Keywords: Multiple Sclerosis, modified Paleolithic diet, physical activity, mindfulness-based breathing, quasi-experimental Trial registration: clinicaltrials.gov identifier: NCT04009005
Received: 12 Jan 2024; Accepted: 09 Sep 2024.
Copyright: © 2024 Saxby, Ehlinger, Brooks, TITCOMB, Ten Eyck, Rubenstein, Bisht, Shemirani, Gill, Kamholz, Snetselaar and Wahls. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Terry L. Wahls, The University of Iowa, Iowa City, United States
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