Authors
Leena Ahmad, Omar A. Alhaj, Nour A. Elsahoryi, Iman F. Mahmoud, Haitham Jahrami, Abdallah M. Younes, Maha M. Al Rasheed, and Nicola L. Bragazzi
Journal Name
International Journal of Biomolecules and Biomedicine | IJBB
Publisher Name
International Network For Natural Sciences | INNSpub
Abstract
No previous research has assessed the nongenetic factors, especially the nutrition status of MS patients in Arab countries. Hence, this study aims to assess the nutritional status of MS patients among Arab adults. This study is a nationally representative cross-sectional study using a structured, online self-administered, validated quantitative food frequency questionnaire (FFQ) from 13 Arab countries. All data analyses were performed using STATA 16.0 and R for statistical computing version 4.0.4. A total of 813 participants were surveyed, most of the MS participants were female (68.4%), married (58.5%), non-smoker (72.6%) and 53.3% were diagnosed with MS for up to five years. MS participants did not consume the DRI of both the macro and the micronutrients including the energy requirements, except the dietary intake of the sodium which was insignificantly different from the DRI. Results also showed that most participants rarely consumed the main food items including bread, cereals, and most types of meat. While, more than 50% of the participants consumed fruit, vegetables, all types of chicken, fish, fresh soup, rice, and egg up to 3 times per month. On the other hand, milk and milkshake were consumed rarely; while, tea and herbal teas were the most common beverages. Nutrient deficiencies are very common among MS Arab patients. The finding of this study can establish a base for the development of a nutritional program for MS patients in accordance with the recommended DRI.
Introduction
Multiple sclerosis (MS) is defined as a chronic inflammatory condition of the central nervous system (CNS) that is considered as one of the most prevalent causes of non-traumatic disability in young and middle-aged adults. There are four main phenotypes of MS and they are clinically isolated syndrome (CIS); Relapsing-remitting MS (RRMS); Secondary progressive MS (SPMS); Primary progressive MS (PPMS). The RRMS account for 90% of the cases in Jordan (El-Salem et al., 2006).
In addition to its adverse health effects, MS-related health care costs burden numerous countries around the world leading to losses estimated by billions of dollars annually. The effect of MS on the CNS is primarily characterized by the degradation of the myelin sheath, which results in electrical nerve impulses transmission impairment. MS is encountered in many areas of the optic nerves, spinal cord, and brain, whereby myelin is replaced by sclera or scar tissue that causes motor and cognitive symptoms. No single diagnostic test to date can decide whether a patient has MS or not; instead, physicians rely on several diagnostic criteria for its detection (Polman et al., 2011).
The signs and symptoms of MS are easy to distinguish and can recur through the course of this disease naturally. In the advance and severe stages, MS patients can lose the ability to speak, write or walk and eventually succumb to death due to the disease’s complications. To date, there is no validated medication to alter the path of MS, avoid future incidents, or stop the deterioration of the myelin sheet. It is possible to achieve initial recovery from relapses, but over time, neurologic deficits can continue to manifest (van der Vuurst de Vries et al., 2018).
The prevalence of MS differs by geographic location and remains unclear whether it is due to environmental influence, genetic difference, or other variable reasons (Moss, Rensel and Hersh, 2017). MS is thought to be the outcome of a combination of genetic susceptibility and environmental influences (Hedström, Alfredsson and Olsson, 2016), such as low vitamin D levels (Munger et al., 2006), sun exposure (van der Mei, 2003), smoking (Hedström, Olsson and Alfredsson, 2016) and viral exposures (Thacker, Mirzaei and Ascherio, 2006). Other important factors such as obesity have been reported as a risk factor for MS during adolescence (Hedstrom et al., 2014). Besides their potential impact on the MS onset, these various environmental factors may further influence the clinical disease course that significantly varies among MS patients. These findings have resulted in the exploration of adaptive environmental factors that can be adjusted to relieve MS symptoms, delay progression, and increase recovery rate (van der Vuurst de Vries et al., 2018).
Diet appears to be a possible co-factor in the inflammatory process, influencing molecular pathways and gut microbiota (Esposito et al., 2018). The European Society for Clinical Nutrition and Metabolism (ESPEN) recommends a diet low in saturated fatty acids and high in polyunsaturated fatty acids, as well as adequate vitamin D intake and sunlight exposure, to prevent MS. However, n-3 fatty acid, vitamin C, and B12 supplements are not suggested to reduce the frequency and number of relapses in people with MS. (Burgos et al., 2018).
Numerous MS reports showed conflicting findings among different populations, implying the need for more confirmation studies (Moss, Rensel and Hersh, 2017; Pakdel et al., 2019). Most of these reports also did not investigate MS patients’ dietary intake to suggest the optimal daily intakes required for the prevention and/or the management of MS disease. Moreover, literature evidence assessing the relationship between the macro and micronutrient intakes and MS disease in Arab Countries is limited. Hence the current study aims to assess the nutritional status of MS patients among Arab adults. Check out more by following the link Nutritional assessment status of adult patients with multiple sclerosis
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