Highlights
- •Iranian patients with multiple sclerosis (MS) showed moderate compliance with the Mediterranean diet.
- •The score of adherence to the Mediterranean diet did not show significant relationship with varied levels of disability.
- •Low adherence to the Mediterranean diet in underweight, normal, and overweight patients was significantly higher than in obese patients.
Abstract
Background
One of the important challenges in the treatment of patients with multiple sclerosis
(MS) is determining the effective factors in the treatment of MS, including dietary
adherence. The aim of this study was to investigate the relationship between adherence
to the Mediterranean diet with anthropometric indices and the expanded disability
status scale (EDSS) scores in patients with MS.
Material and methods
The present multicenter and cross-sectional study was conducted on patients with clinically
definite MS (according to the 2017 revised McDonald criteria) who were referred to
the MS clinics at medical centers affiliated to Shiraz and Tehran Universities of
Medical Sciences during 2019. Disease phenotype, EDSS, waist circumference (WC), body mass index (BMI), and comorbidities
were assessed. Adherence to the Mediterranean diet was measured with a 14-item modified
Mediterranean Diet Adherence Questionnaire. In this questionnaire, a score of 0–5
indicates low adherence, a score of 6–9 shows moderate adherence, and a score of 10
and above demonstrates high adherence (healthy eating pattern).
Results
This study was performed on 478 patients with a mean age of 37.99 ± 9.60 years, out
of which 352 patients (73.6%) were female. The percentage of low, medium, and high
adherence to the Mediterranean diet in patients with MS was 26.4%, 64%, and 9.6%,
respectively. The difference in the level of education between the groups based on
adherence to the Mediterranean diet was statistically significant. Low adherence to
the Mediterranean diet in underweight, normal, and overweight patients was, respectively,
1.31, 1.32, and 2.29 times higher than in obese patients. This increased risk was
only significant in overweight patients (P = 0.019). The results revealed that the score of adherence to the Mediterranean diet
had no significant relationship with mild (2.86 ± 2.18), moderate (2.76 ± 2.16), and
severe (2.70 ± 2.02) levels of disability.
Conclusion
The level of adherence to the Mediterranean diet in Iranian patients with MS was moderate.
This level was associated with BMI, such that low adherence to the Mediterranean diet
was higher in overweight patients than obese patients.
Keywords
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Article info
Publication history
Published online: July 23, 2022
Accepted:
July 15,
2022
Received in revised form:
June 28,
2022
Received:
January 4,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
