Multiple Sclerosis (MS) is known to be a multifactorial disease in which genetic, immunological components and environmental influences, contribute to its development. Nonetheless several MS-associated risk factors make the involvement of dietary habits strongly appealing in contributing to the development and progression of MS. Adverse health activities including being overweight or obese, sedentary lifestyle and smoking habits which are known risk factors for worse health outcomes, are also common in MS population and negatively affect the progression of the disease.
Hence there is a growing interest in understanding the dietary habits and lifestyle factors of patients with MS, if they differ from general population and how these could influence specific disability outcomes as well perception of fatigue at baseline and along clinical follow-up.
Thus, in this observational prospective 24-month study, we will consecutively recruit MS patients referring to MS center according to specific inclusion and exclusion criteria. We will parallelly involve a matched population of healthy subject. We will investigate all subjects' dietary practices, level of physical activities and smoking habits through the use of specific questionnaires. All subjects will undergo a nutritional assessment during which anthropometrics variables as body weight, heights, waist circumference and waist-hip ratio will be evaluated. Patients with MS will undergo a neurological examination at baseline and follow up to measure disability and fatigue level. We will explore differences between patients and controls, we will investigate which dietary and lifestyle factors correlate with disability impairment and fatigue perception and among them which are more predictive of disability progression if occurred.
During the last twenty year a growing body of evidences have pointed out that diet, physical activity, hygienic conditions, sedentary life as well metabolic diseases play an important role in MS. Some data has supported Paleolithic and Mediterranean diets, but the understanding on how food is relative to MS is extremely limited especially in Mediterranean countries. Until better research is gathered, a generally healthy diet is what physicians tend to suggest to their patients. Moreover, BMI can have significant effects on the metabolism of disease-modifying therapies used in MS and on treatment-associated adverse effects. An analysis of interferon-beta-treated patients found that BMI influenced treatment response J Neuroimmunol. 2015 Nov 15;288:92-7]. Thus, there is an unmet need of better characterize diet profile in MS patients and how it interplays with other lifestyle factors in order to correctly drive patients¿ counseling from MS healthcare provider.