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Nutrients
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Nutrition and Lifestyle Behaviours for the Prevention and Management of...
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Nutrition and Lifestyle Behaviours for the Prevention and Management of Multiple Sclerosis

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: closed (15 February 2025) | Viewed by 4477

Special Issue Editors

Dr. Yasmine Probst

E-Mail Website
Guest Editor
School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
Interests: multiple sclerosis; diet; nutrition; dietary methodology; health behaviours; clinical trial; consumer engagement; food composition; dietary patterns; food choice; lifestyle; lived experience; supplementation; alcohol; quality of life
Special Issues, Collections and Topics in MDPI journals
Dr. Tyler J. Titcomb

E-Mail Website
Guest Editor
Department of Internal Medicine, University of Iowa, Iowa City, IA 52340, USA
Interests: multiple sclerosis; neurodegeneration; diet; nutrition; dietetics; randomized controlled trials; nutritional epidemiology; comorbidity burden; dietary assessment; nutrition screening; dietary patterns; quality of life; fatigue

Special Issue Information

Dear Colleagues,

Multiple sclerosis (MS) is a chronic, immune-mediated, neurodegenerative disease that affects over 2.9 million people worldwide. In recent years, lifestyle behaviours have gained much interest in the MS community for their role in improving wellness and managing symptoms. However, given the current inconsistency in this emerging field, many questions remain, including the role of lifestyle behaviours in the prevention of MS, the impact of lifestyle behaviours on disease progression, the mechanisms by which lifestyle behaviours improve outcomes, and the role of lifestyle behaviours in the clinical management of MS, among others.

This Special Issue seeks to advance our knowledge regarding lifestyle behaviours and MS. Particularly, studies are sought related to the identification or implementation of health behaviour management approaches, including but not limited to diet, supplementation, physical activity, stress management, sleep, and smoking avoidance. Original research (including trials, observational studies, qualitative studies, animal models, etc.) and reviews (systematic, scoping, narrative, etc.) are eligible for submissions.

Dr. Yasmine Probst
Dr. Tyler J. Titcomb
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • multiple sclerosis
  • nutrition
  • diet
  • exercise
  • physical activity
  • sleep
  • stress management
  • comorbidities
  • malnutrition
  • microbiome
  • health behaviour

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Published Papers (5 papers)

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Research

17 pages, 322 KiB  
Article
The Erythrocyte Fatty Acid Profile in Multiple Sclerosis Is Linked to the Disease Course, Lipid Peroxidation, and Dietary Influence
by Ljiljana Stojkovic, Slavica Rankovic, Evica Dincic, Maja Boskovic, Ana Kolakovic, Mariana Seke, Marija Takić and Maja Zivkovic
Nutrients 2025, 17(6), 974; https://doi.org/10.3390/nu17060974 - 11 Mar 2025
Viewed by 190
Abstract
Background/Objectives: Dietary lifestyle, particularly the intake of fatty acids (FAs), may be useful in alleviating the key pathogenic processes in multiple sclerosis (MS); however, the data are still scarce, particularly with regard to the course of disease. Therefore, the objectives of this study [...] Read more.
Background/Objectives: Dietary lifestyle, particularly the intake of fatty acids (FAs), may be useful in alleviating the key pathogenic processes in multiple sclerosis (MS); however, the data are still scarce, particularly with regard to the course of disease. Therefore, the objectives of this study were to investigate the erythrocyte profile of FAs in patients with relapsing-remitting (RR)MS and progressive (P)MS, and to examine whether dietary supplementation with n-3 PUFAs could influence the FA profile, according to the course of disease. Methods: The FA profile was determined in erythrocytes by gas–liquid chromatography, in 153 patients with RRMS and 69 with PMS, whereas the group on dietary supplementation with n-3 PUFAs consisted of 36 RRMS and 17 PMS patients. Individual FAs were quantified as a percentage of the total identified FAs and analyzed in relation to the demographic and clinical parameters. Results: Compared to RRMS, the PMS patients had higher saturated (S)FAs, n-7 mono-unsaturated (MU)FAs, and n-3 polyunsaturated (PU)FAs, and lower n-6 PUFAs. In the group on omega-3 supplementation, the only difference in FA profile was higher MUFA 16:1n-7 (POA) in PMS than RRMS patients. In PMS patients, there was a positive correlation of disability (EDSS) with the total SFA levels, whereby 16:0 (PA) correlated positively with EDSS and MS severity (MSSS). Also, in PMS, the MSSS correlated negatively with the total and individual n-6, and positively with the total and individual n-3 PUFAs. In PMS patients on n-3 supplementation, there was a negative correlation between MSSS and total n-6/n-3 ratio, and a positive one between MSSS and 22:6n-3 (DHA). The observed decrease in levels of circulating lipid peroxidation product 4-HNE in PMS patients was not found in the n-3 PUFA supplementation group. Conclusions: The present findings suggest that the changes in the levels of FAs and their correlations are specific for the course of MS. Detected FA profile differences can be influenced by n-3 supplementation, primarily in regard to SFAs and PUFAs, supporting an option for the use of dietary supplements in managing the clinical course and progression of MS. Full article
(This article belongs to the Special Issue Nutrition and Lifestyle Behaviours for the Prevention and Management of Multiple Sclerosis)
13 pages, 503 KiB  
Article
Correlates of Inaccuracy in Reporting of Energy Intake Among Persons with Multiple Sclerosis
by Stephanie L. Silveira, Brenda Jeng, Barbara A. Gower, Gary R. Cutter and Robert W. Motl
Nutrients 2025, 17(3), 438; https://doi.org/10.3390/nu17030438 - 25 Jan 2025
Viewed by 627
Abstract
Background/Objectives: Persons with multiple sclerosis (MS) are interested in diet as a second-line approach for disease management. This study examined potential variables that correlate with inaccuracy of self-reported energy intake (EI) in adults with MS. Methods: Twenty-eight participants completed two assessment appointments within [...] Read more.
Background/Objectives: Persons with multiple sclerosis (MS) are interested in diet as a second-line approach for disease management. This study examined potential variables that correlate with inaccuracy of self-reported energy intake (EI) in adults with MS. Methods: Twenty-eight participants completed two assessment appointments within a 14-day period that included a standard doubly labeled water (DLW) protocol for estimating total energy expenditure (TEE). The participants reported their EI using the Automated Self-Administered 24 h (ASA24) Dietary Assessment Tool. The primary variables of interest for explaining the discrepancy between TEE and ASA24 EI (i.e., inaccuracy) included cognition (processing speed, visuospatial memory, and verbal memory), hydration status (total body water), and device-measured physical activity. Pearson’s correlations assessed the association between absolute and percent inaccuracy in reporting of EI with outcomes of interest, followed by linear regression analyses for identifying independent correlates. Results: California Verbal Learning Test—Second Edition (CVLT-II) z-scores and light physical activity (LPA) were significantly associated with mean absolute difference in EI (r = –0.53 and r = 0.46, respectively). CVLT-II z-scores and LPA were the only variables significantly associated with mean percent difference in EI (r = –0.48 and r = 0.42, respectively). The regression analyses indicated that both CVLT-II and LPA significantly explained variance in mean absolute difference in EI, and only CVLT-II explained variance for percent difference in EI. Conclusions: The results from this study indicate that verbal learning and memory and LPA are associated with inaccuracy of self-reported EI in adults with MS. This may guide timely research identifying appropriate protocols for assessment of diet in MS. Full article
(This article belongs to the Special Issue Nutrition and Lifestyle Behaviours for the Prevention and Management of Multiple Sclerosis)
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11 pages, 551 KiB  
Article
Perceptions and Utilization of Registered Dietitian Nutritionists in Multiple Sclerosis Care: A Pilot Survey of Multidisciplinary Providers
by Olivia Wills, Alaina Bradford, Mona Bostick, Yasmine Probst and Tyler J. Titcomb
Nutrients 2025, 17(3), 385; https://doi.org/10.3390/nu17030385 - 22 Jan 2025
Viewed by 672
Abstract
Background/Objectives: Registered dietitian nutritionists (RDNs) are allied healthcare professionals who can help people with multiple sclerosis (MS) incorporate healthy eating, but little is known about their involvement in MS care. Thus, the objective of this survey was to investigate the perceptions and utilization [...] Read more.
Background/Objectives: Registered dietitian nutritionists (RDNs) are allied healthcare professionals who can help people with multiple sclerosis (MS) incorporate healthy eating, but little is known about their involvement in MS care. Thus, the objective of this survey was to investigate the perceptions and utilization of RDNs in MS care among multidisciplinary MS providers in the United States and Canada. Methods: An online survey was disseminated via the Consortium of MS Centers email listserv and MS-specific scientific conferences. The survey queried practitioner type, RDN referrals, the perceived benefits of RDNs in MS care, and the proportion of their patients who follow ‘MS diets’ or have nutrition-related issues. Reasons for or against RDN referral and beneficial resources were also queried. Results: Of the 60 completed surveys, respondents were primarily neurologists (n = 27, 45.0%). Most (n = 43, 71.7%) indicated that half or more of their patients inquire about diet, but n = 32 (53.3%) indicated that very few follow an ‘MS diet’ and n = 47 (78.3%) indicated that very few decline disease-modifying therapies to follow an ‘MS diet’. Most (n = 45, 77.6%) respondents indicated referring their patients to a RDN with lack of nutrition knowledge/general healthy eating advice (n = 34, 73.9%) and overweight/obesity (n = 31, 67.4%) as being the most common reasons for referral. RDNs were reported as being helpful or extremely helpful by n = 38 (84.4%) of respondents who reported referring to RDNs. Most (n = 46, 79.3%) indicated that their patients would benefit from having an RDN with MS-specialized training as a member of staff. Conclusions: MS care providers support the need for RDNs with specialized training in MS care. Full article
(This article belongs to the Special Issue Nutrition and Lifestyle Behaviours for the Prevention and Management of Multiple Sclerosis)
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14 pages, 250 KiB  
Article
Nutrition Knowledge and Food Literacy Among Persons with Multiple Sclerosis—Development and Validation of Patient-Reported Outcome Measures
by Karin Riemann-Lorenz, Susan Seddiq Zai, Anne Daubmann, Jana Pöttgen and Christoph Heesen
Nutrients 2024, 16(23), 4043; https://doi.org/10.3390/nu16234043 - 26 Nov 2024
Viewed by 811
Abstract
Background/Objectives: Persons with MS (pwMSs) are often confronted with contradictory dietary advice, which is not always based on sound scientific evidence. This may lead to poor MS-specific nutrition knowledge (MSNK) and food literacy (MSFL). To date, no studies have assessed MSNK and MSFL [...] Read more.
Background/Objectives: Persons with MS (pwMSs) are often confronted with contradictory dietary advice, which is not always based on sound scientific evidence. This may lead to poor MS-specific nutrition knowledge (MSNK) and food literacy (MSFL). To date, no studies have assessed MSNK and MSFL among pwMSs. Moreover, no validated tools to measure the effects of educational interventions are available. The aim of this study was to develop and validate MS-specific instruments to measure MSNK and MSFL among pwMSs. Methods: Based on a validated food literacy (FL) screener for the general population and prior research about the information needs of pwMSs, we developed 14 MSFL items and 11 MS-specific nutrition knowledge questions. Cognitive debriefing was conducted with 10 pwMSs and resulted in a 12-item MS food literacy questionnaire (MSFLQ) and an 11-item MS nutrition knowledge questionnaire (MSNKQ). After refinement, both questionnaires were pilot tested in an online survey to explore their comprehensibility. The MSNKQ was analyzed descriptively (mean and percentage of correctly answered questions). For MSFLQ item difficulty, the discriminatory power of the items, internal consistency and convergent/divergent validity were assessed. Results: In total, 148 pwMSs (age: 47.1 years (SD = 12.5); 102 women (69%)) completed the online survey. On average, participants answered 3.51/11 MSNK questions correctly (31.9%). The MSFLQ showed good internal consistency (Cronbach’s alpha = 0.85), item difficulty was good and the discriminatory power of the items was satisfactory. Correlations between the MSFLQ and a general food literacy questionnaire was high (r = 0.626, p < 0.001), but only small with the MSNKQ (r = 0.180; p = 0.029), underlining the different constructs. Conclusions: MSNK among pwMSs in Germany is low. The MSNKQ and MSFLQ appear to be suitable instruments to assess MSNK and MSFL and might serve as outcome measures for educational interventions. Full article
(This article belongs to the Special Issue Nutrition and Lifestyle Behaviours for the Prevention and Management of Multiple Sclerosis)
13 pages, 1519 KiB  
Article
Nuclear-Magnetic-Resonance-Spectroscopy-Derived Serum Biomarkers of Metabolic Vulnerability Are Associated with Disability and Neurodegeneration in Multiple Sclerosis
by Taylor R. Wicks, Irina Shalaurova, Richard W. Browne, Anna Wolska, Bianca Weinstock-Guttman, Robert Zivadinov, Alan T. Remaley, James D. Otvos and Murali Ramanathan
Nutrients 2024, 16(17), 2866; https://doi.org/10.3390/nu16172866 - 27 Aug 2024
Viewed by 1500
Abstract
Purpose: Metabolic vulnerabilities can exacerbate inflammatory injury and inhibit repair in multiple sclerosis (MS). The purpose was to evaluate whether blood biomarkers of inflammatory and metabolic vulnerability are associated with MS disability and neurodegeneration. Methods: Proton nuclear magnetic resonance spectra were obtained from [...] Read more.
Purpose: Metabolic vulnerabilities can exacerbate inflammatory injury and inhibit repair in multiple sclerosis (MS). The purpose was to evaluate whether blood biomarkers of inflammatory and metabolic vulnerability are associated with MS disability and neurodegeneration. Methods: Proton nuclear magnetic resonance spectra were obtained from serum samples from 153 healthy controls, 187 relapsing–remitting, and 91 progressive MS patients. The spectra were analyzed to obtain concentrations of lipoprotein sub-classes, glycated acute-phase proteins, and small-molecule metabolites, including leucine, valine, isoleucine, alanine, and citrate. Composite indices for inflammatory vulnerability, metabolic malnutrition, and metabolic vulnerability were computed. MS disability was measured on the Expanded Disability Status Scale. MRI measures of lesions and whole-brain and tissue-specific volumes were acquired. Results: Valine, leucine, isoleucine, alanine, the Inflammatory Vulnerability Index, the Metabolic Malnutrition Index, and the Metabolic Vulnerability Index differed between healthy control and MS groups in regression analyses adjusted for age, sex, and body mass index. The Expanded Disability Status Scale was associated with small HDL particle levels, inflammatory vulnerability, and metabolic vulnerability. Timed ambulation was associated with inflammatory vulnerability and metabolic vulnerability. Greater metabolic vulnerability and inflammatory vulnerability were associated with lower gray matter, deep gray matter volumes, and greater lateral ventricle volume. Conclusions: Serum-biomarker-derived indices of inflammatory and metabolic vulnerability are associated with disability and neurodegeneration in MS. Full article
(This article belongs to the Special Issue Nutrition and Lifestyle Behaviours for the Prevention and Management of Multiple Sclerosis)
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