Individual and Co-occurring SNAP Risk Factors: Investigation of Smoking, Nutrition, Alcohol Consumption, and Physical Activity in Persons with Multiple Sclerosis

Julia M. Balto , BS; Ipek Ensari , PhD; Elizabeth A. Hubbard MS; Naiman Khan , PhD, RD; Jennifer L. Barnes , PhD, RD; Robert W. Motl , PhD

Correspondence: Robert W. Motl, PhD, Department of Physical Therapy, University of Alabama at Birmingham, School of Health Professions 336, Birmingham, AL; e-mail: robmotl@uab.edu.

Background: Smoking, poor nutrition, excess alcohol consumption, and insufficient physical activity underlie most preventable causes of morbidity in the general population and are possibly associated with co-morbidities and health outcomes in MS. However, the frequency of co-occurrence of these risk factors among people with MS remains unclear.

Methods: Sixty-nine participants with MS completed self-report measures of smoking status, nutrition, alcohol use, physical activity levels, and sociodemographic and clinical characteristics. The data were analyzed using ttests and χ² analyses in SPSS Statistics 22.0.

Results: Poor diet was the most common risk factor, with 85.5% of the sample not meeting dietary guidelines. Of participants with two or more risk factors, 90.3% were not meeting dietary and physical activity guidelines. There were differential rates of meeting physical activity guidelines between men and women (χ² = 7.5, P = .01) such that 73% of women were not meeting physical activity guidelines compared with 38% of men. There were further differential rates of the most commonly co-occurring risk factors, insufficient physical activity and poor nutrition by sex (χ² = 4.2, P = .05), such that 65% of women reported the co-occurrence of insufficient physical activity and poor diet compared with 38% of men.

Conclusion: Our results indicate that: a) an overwhelming 85.5% of the sample was not meeting nutrition guidelines; b) 90.3% of participants with two or more risk factors reported the co-occurrence of poor diet and insufficient levels of physical activity; and c) physical activity levels and the total number of SNAP risk factors varied across sex.