March 03, 2023
SAN DIEGO — Physicians should emphasize the importance of
diet and lifestyle change in patients with MS and consider home environment,
cultural challenges and other factors when making recommendations, a presenter
noted at ACTRIMS 2023.
“There’s a sense among people diagnosed with MS of a loss of
control over one’s body,” Ilana B. Katz Sand, MD, associate professor of
neurology at the Icahn School of Medicine at Mount Sinai, told attendees. “But
this is something people who are living with this disease can do for themselves
to be proactive.”
Diet and other environmental, cultural, socioeconomic and
personal health factors are key to improving outcomes in patients with MS.
Image: Adobe Stock
People with MS want evidence-based answers to questions
relating to disease progression and nonpharmaceutical solutions that complement
traditional disease-modifying therapies, Katz Sand said. Clinicians should
recognize that environmental factors, such as diet, play an important role in
disease outcomes, and should advocate for resources to help their patients.
It is important for those with MS to take an active role in
their diet since indirect effects like obesity, cholesterol levels and other
vascular risk factors, as well as direct effects such as metabolism and health
gut microbiota, can influence disease course, she noted.
According to Katz Sand, several dietary patterns, including
low saturated fat, plant-based, low fat, caloric restriction/intermittent
fasting, modified paleolithic, ketogenic and Mediterranean diets, are being
investigated for their efficacy in boosting overall health.
Katz Sand singled out the Mediterranean diet, as evidence of
its health benefits is well-established and hard data supports its beneficial
effects on cognitive aging. Plus, she said, long-term adherence is feasible due
to its budget-friendly nature, possibility for whole household involvement and
benefit as a lifestyle change, rather than just a dietary modification.
Katz Sand made several practical recommendations for
patients with MS and their families, including preparing meals at home, adding
fruits and vegetables on a daily basis, selecting whole grains over refined
grains, and avoiding processed foods and added sugars when possible. She added
that a nurse practitioner or other dietary-trained clinician could aid the
process if a patient does not have access to a dietitian.
Physicians should remember to start small and offer
constructive feedback and positive reinforcement, emphasizing the idea of a
lifestyle change, she noted.