Author Of 3 Presentations
P0463 - Healthy-lifestyle-scores associated with lower subsequent fatigue risk in multiple sclerosis using inverse probability treatment weighting (ID 290)
Abstract
Background
Several lifestyle factors, including smoking, diet, physical activity, BMI, and smoking, have been associated with the onset and progression of multiple sclerosis (MS). Combining these lifestyle factors into scoring indices is an efficient way to assess their collective relationship with clinical outcomes.
Objectives
To examine the association of two lifestyle scores with clinically significant fatigue and change thereof over two years’ follow-up.
Methods
Data on sociodemographic, lifestyle and clinical characteristics surveyed from the international HOLISM cohort of people with MS at baseline and 2.5-year follow-up. Fatigue was defined by Fatigue Severity Scale (FSS), and healthy lifestyle by the Healthy Lifestyle Index Score (HLIS), and SNAP (Smoking, Nutrition, Alcohol, Physical Activity) score. Analyses by standard logistic and inverse probability treatment weighting (IPTW) models adjusted for age, sex, MS type, disability, comorbidity number, immunomodulatory medication use, prescription antifatigue medication use, and ongoing relapse symptoms; change in fatigue models also adjusted for baseline fatigue.
Results
1,160 participants completed the FSS questionnaire at both timepoints, and roughly 62% had fatigue at each timepoint. By logistic regression, baseline HLIS and SNAP were each associated with lower risk of being fatigued at follow-up, persisting on adjustment. Using doubly-robust IPTW these associations were attenuated but high (>11) HLIS (OR=0.91, 95% CI=0.83-1.00) and high (>3) SNAP (OR=0.82, 95% CI=0.74-0.91) were each associated with lower risk of fatigue at follow-up. Evaluating change in fatigue, while higher SNAP score was associated with lower risk of change in fatigue (OR=0.89, 95% CI=0.80-0.97), HLIS was not associated (OR=0.97, 95% CI=0.89-1.06).
Conclusions
In this sample of people with MS, healthy lifestyle scores were consistenyl associated with less fatigue 2.5 years later, though only SNAP score was associated with change in fatigue over this interval.
P0512 - Vitamin-D-supplement use but not sun exposure associated with higher quality of life in multiple sclerosis (ID 208)
Abstract
Background
Multiple sclerosis (MS) is an autoimmune condition of the central nervous system. Sun exposure and vitamin D are associated with MS onset and progression and may affect quality of life (QoL).
Objectives
To investigate the prospective relationship of sun exposure and vitamin D supplement use with QoL and change thereof from baseline to 2.5 years follow-up in an international cohort of people with MS.
Methods
Sun exposure and vitamin D supplement use were queried at both timepoints. QoL was assessed by MSQOL-54, estimating physical and mental health QoL composite scores, and subdomains within each. Characteristics of QoL at follow-up were assessed by linear regression, adjusted for age, sex, socioeconomic status, comorbidity number, MS type, disability, fatigue, prescription antidepressant medication use, and ongoing relapse symptoms. Baseline predictors of change in QoL were additionally adjusted for baseline QoL score.
Results
Mean baseline QoL composite scores were 61.99 for physical (n=1155) and 70.29 for mental (n=1316) QoL composite score, materially unchanged at follow-up. QoL scores were higher among those taking vitamin D supplements (physical: aβ=3.44, 95% CI=1.17-5.71; emotional: aβ=3.14, 95% CI=0.76-5.51); higher supplementation frequency and dose were more strongly associated with both. Baseline vitamin D supplementation was associated with greater increase in physical (aβ=1.06, 95% CI=0.26-1.86), but not mental health (aβ=0.16,95%CI=-0.96,1.28), QoL. Sun exposure was cross-sectionally associated with higher QoL scores but not with change in QoL.
Conclusions
Vitamin D supplementation, particularly average daily doses over 5000IU/d, were associated with higher QoL and with an increase in physical QoL.
P0878 - Lifestyle characteristics of adherence to diet programs in an international cohort of people with MS (ID 289)
Abstract
Background
Multiple sclerosis (MS) is a demyelinating condition of the central nervous system of complex aetiology. One such factor implicated in its onset and progression is diet and because of this a number of diet program have been proposed which their creators assert will improve MS.
Objectives
This study sought to investigate the prevalence and characteristics of adherence to several popular diets proposed for people with MS.
Methods
The international observational cohort study, the HOLISM Study, has measured lifestyle and clinical characteristics over 5 years of follow-up. At the 5-year review, 952 participants were queried as to their adherence to 6 diet programs – the Overcoming MS (OMS), Wahls Elimination, Swank, McDougall, Ashton Embry Best Bet, and Palaeolithic diets – adherence constrained to those doing so for at least 12 months. Adherence was defined by two dichotomisations of the 5-point Likert at 3 and 4 of 5. Lifestyle characteristics of adherence to each diet were assessed by log-binomial regression.
Results
OMS adherence was common, with roughly 30-40% adhering, while Swank (5-6%) and Wahls (2-3%) adherence was less frequent and other diets even less (<2%). Higher BMI and smokers were less likely to follow OMS, while participants who were more active, those consuming alcohol or using vitamin D/omega-3 supplements, and who meditated were more likely to adhere. OMS adherers were less likely to consume meat or dairy. Swank adherence was higher among those who were more active and less so among those of higher BMI, but otherwise did not differ by any lifestyle characteristics. Wahls adherence was more common among those consuming alcohol and those who consumed meat but less common among those consuming dairy.
Conclusions
OMS and to a lesser extent Swank and Wahls diets had material followings in this international cohort. Though it was expected all diet adherence would generally track with healthier lifestyle, there was some variability, suggesting that adherence to these diet programs is more likely in certain subgroups.