Effectiveness of modified dietary habits on body composition and fatigue-associated symptoms in relapsing-remitting multiple sclerosis patients.

Objective To assess the effectiveness of appropriate dietary changes on body composition and fatigue in patients with RRMS. Background The most common symptoms associated with the reduced quality of life of patients suffering from relapsing remitting multiple sclerosis (RRMS) may be exacerbated by an altered nutritional status and consequent modifications of body composition. Fatigue is one of the most disabling symptoms among patients and might be induced, at least in part, both by weakness and deconditioning of the muscle mass and by chronic inflammatory process sustained by adipose tissue. Methods Seventeen patients (mean age 37.4±2.3 years; mean duration of the disease: 9.7±1.7 years, mean EDSS score 1.3±0.2) underwent detailed evaluation of body composition by means of direct segmental multi-frequency bioelectrical impedance analysis and evaluation of fatigue symptoms by the modified fatigue impact scale (MFIS) before and after the 6-week specific diet treatment consisting in low saturated fatty acids of animal origin, high antioxidant foods, and adequacy to caloric expenditure of each patient. Results Adherence to diet treatment led to a decrease (P<0.01) in percent body fat [%: 30.8±1.8 vs. 32.5 ±2.0]; in body fat mass [Kg: 22.7± 2.3 vs. 20.7±1.9] and in visceral fat mass [cm2: 88.9±8.7 vs. 96.02±10.4]. No significant modifications were observed in skeletal muscle mass [Kg: 24.6±0.8 vs.24.5±0.9]. Significant improvement (P<0.001) was observed in MFIS score [25.0±4.9 vs. 43.3±5.6]. A significant improvement of all subscale scores for physical, cognitive, and psychosocial functioning was also observed (P<0.001). Conclusions Compliance to appropriate dietary modifications, even for a short time, is sufficient to promote a significant improvement of those body regions were adipose tissue shows active pro-inflammatory properties. Moreover, it reduces the burden of fatigue on the activities of daily living and in the self-care management of RRMS patients.