‘Eating Well with MS’ program improves dietary behavior: Study
Online program deemed valuable, practical to complete for patients
An online education program called “Eating Well with MS” improved the dietary behavior of adults with multiple sclerosis (MS), and was deemed in a study to be practical to complete, interesting, and valuable for patients.
“Our study completion rates highlight the practicality of the intervention,” the researchers evaluating the Australia-based Eating Well program wrote.
Co-created with the MS community, the six-week program is designed to provide individuals living with MS with the knowledge to manage their symptoms through healthy eating. It aims to help MS patients to assess the quality of their eating habits, and to select, prepare, and cook healthy meals. The Eating Well program also helps judge the credibility of special diets marketed to people with the condition and explains how researchers develop evidence in nutrition and MS.
“There’s so much contradictory information out there and it can be hard to make the right choices,” Michelle Evans, a mother of two in Australia who was diagnosed with MS six years ago, said in a news story from Curtin University in Perth, where the study was conducted.
“The Eating Well with MS program helps give a clearer understanding of how diet can play a role in the management of my symptoms,” Evans said.
The study assessing the program, titled “Feasibility of a co-designed online nutrition education program for people with multiple sclerosis,” was published in the journal Multiple Sclerosis and Related Disorders.
Researchers tested education program in 70 people with MS
Emerging evidence suggests that diet may influence the development and progression of MS, a disease marked by immune-mediated attacks on parts of the brain and spinal cord. However, online MS-related dietary information can be conflicting and confusing, according to the researchers.
“Making dietary changes can give people with MS a sense of control over the disease, but there’s a lot of conflicting information online. This program was developed to fill the gap in accessible, evidence-based nutrition advice,” said Rebecca Russell, PhD, the study’s first author and a researcher at the Curtin School of Population Health.
To assess the education program, the researchers conducted a feasibility study (ACTRN12622000276752) that recruited 70 people with MS, most of whom were women (94.3%). The median time since their MS diagnosis was 8.7 years.
We enlisted 70 people with MS to evaluate the program’s effectiveness and participants rated it 6 out of 7 for usefulness, reporting significant improvements in diet quality, meal planning and the ability to critically assess nutrition claims.
The participants were first provided a posted package containing hardcopy recipe booklets, the Eating Well with MS Activity Book, and a brochure and poster on healthy eating.
The Eating Well with MS program consisted of seven modules: an initial welcome module, modules 2-6 forming the core program, and a final summary module. These core modules covered topics such as the importance of healthy eating for MS patients, personalizing eating habits, and making changes in eating habits. They also aimed to help participants to better understand the diets that are marketed to MS patients, and research on multiple sclerosis and diet.
The program was self-paced, with a module released each week for seven weeks and two additional weeks for program completion. Before the program, or at the study’s baseline, the researchers collected data on demographics, disease characteristics, and current dietary habits. Participants also received online surveys before and after the program.
The trial’s feasibility outcomes included demand, assessed by using participant recruitment and time needed to reach full enrollment; practicality, determined by the proportion of patients who completed each module and the total program; and acceptability, assessed with the Intrinsic Motivation Inventory (IMI) subscales of interest/enjoyment and value/usefulness.
From one round of recruitment notices, 108 participants completed the screening questionnaire within six weeks, the data showed. Among them, 96 were eligible and 73 consented to enroll. A total of 70 participants completed the baseline questionnaire.
Importantly, the researchers noted that their goal was to recruit at least 48 participants. These results demonstrate “there was sufficient demand to meet the recruitment target,” they wrote.
Of the initial 70 patients, 84% completed at least one module, 63% finished more than half, and 54% completed all five core modules within nine weeks. The median interest/enjoyment score was 5 of 7, with 7 meaning very true, while the median usefulness rating was 6 of 7.
“We enlisted 70 people with MS to evaluate the program’s effectiveness and participants rated it 6 out of 7 for usefulness, reporting significant improvements in diet quality, meal planning and the ability to critically assess nutrition claims,” Russell noted.
Significantly higher scores seen for patients with improved dietary behavior
Efficacy was then assessed with three questionnaires. One, the Diet Habits Questionnaire or DHQ, measured changes in dietary habits, with subscales on cereals, fruits and vegetables, omega-3 fatty acids, food choices, preparation, takeouts, snacks, fat, and fiber. Total DHQ scores and all subscores, except for food preparation, were significantly higher than baseline after the program, indicating better dietary habits.
Other questionnaires, specifically the Critical Nutrition Literacy Tool and the Food Literacy Behaviour Checklist, were used to measure changes in nutrition and food literacy. Scores for both scales were significantly higher after the program, indicating an improvement.
No differences were noted in other measures, including disability levels, depression, anxiety, or fatigue symptoms. Still, when both fatigue and depression scores were high, there was a significant association with worse DHQ scores. Fatigue symptoms alone, however, were not associated with lower DHQ.
“As people with MS continue to seek out ways to manage their condition through lifestyle changes, ‘Eating Well with MS’ offers a promising resource for improving their overall diet quality which can impact their quality of life,” Russell said. “Our next step is a larger national trial, with the ultimate goal of making this program accessible to all Australians living with MS.”
The research was supported by MSWA, a nonprofit supporting people with neurological conditions in Western Australia, as well as by an incubator grant from MS Australia.
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