Effects of nutrition education given to persons with multiple sclerosis and their families on diet quality and anthropometric and biochemical measurements

UZDİL, Zeynep; TÜRKER, Perim Fatma; TERZİ, Murat

doi:10.1590/1678-9865202235e220153

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ORIGINAL • Rev. Nutr. 35 • 2022 • https://doi.org/10.1590/1678-9865202235e220153 copy

Effects of nutrition education given to persons with multiple sclerosis and their families on diet quality and anthropometric and biochemical measurements

Efeito da educação nutricional dada a pessoas com esclerose múltipla e suas famílias em relação a qualidade da dieta, medidas antropométricas e bioquímicas

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

In this study, it was aimed to investigate the effects of nutrition education given to persons with multiple sclerosis and their families on anthropometric and biochemical measurements and diet quality.

Methods:

Data from 51 persons with multiple sclerosis were analysed in this intervention study. The study was conducted with 3 groups. The education group consisted of only persons with multiple sclerosis, the family education group consisted of persons with multiple sclerosis and a family member living with them, and the control group consisted of persons with multiple sclerosis who had not received an education. Anthropometric and biochemical measurements and dietary quality assessments were made before (T1) and immediately after education (T2) and also 3 months after education (follow-up, T3).

Results:

The distribution of family education group diet quality scores showed a significant increase from “poor” to “needs improvement” at T3 compared to T1. The upper middle arm circumference measurements of the female control group were decreased at T2 and T3 [from 29.0 (23-34) cm to 28.0 (22-31) cm and to 27.5 (22-31) cm]. Women in family education group, levels of serum haemoglobin and haematocrit were higher than in control group at T2 and T3. Also, men in family education group, levels of alanine aminotransferase were lower than those in education group at follow up. Levels of total cholesterol and low-density lipoprotein cholesterol in education group were higher than those control group at T1, T2, and T3.

Conclusion:

This study indicates that nutrition education affects some biochemical and anthropometric measurements in persons with multiple sclerosis. Diet quality improved when receiving education together with families.

Keywords:
Diet quality; Multiple sclerosis; Nutrition education

Variables	Intervention						Total (n=51)			p
	EG (n=19)			FEG (n=15)		CG (n=17)
	n	%		n	%	n	%	n	%
Gender										0.20^*
Men	5	26.3		4	26.7	1	05.9	10	19.6
Women	14	73.7		11	73.3	16	94.1	41	80.4
	M±SD			M±SD		M±SD
Age (year)	39.7±11.1			35.6±13.1		33.5±7.1				0.21^*
Duration of illness (year)	(9.6±6.2)^a			(4.1±5.1)^b		(6.2±5.4)^ab				0.02^*
EDSS score	0.8±1.1			0.3±0.6		1.1±1.3				0.16
	n	%	n		%	n	%
Education level										0.25^*
Primary school	7	36.8		2	13.3	8	47.1
High school	9	47.4		8	53.4	5	29.4
Undergraduate	3	15.8		5	33.3	3	17.6
Postgraduate	-	-		-	-	1	05.9
	n	%		n	%	n	%
Occupation										0.21^*
Student	2	10.5		3	20.0	2	11.8
Self-employment	3	15.8		2	13.3	-	-
Housewife	8	42.2		3	20.0	13	76.4
Worker	2	10.5		4	26.7	-	-
Civil servant	2	10.5		1	06.7	1	05.9
Retired	2	10.5		2	13.3	1	05.9
	n	%		n	%	n	%
Marital status										0.64^*
Married	15	78.9		10	66.7	11	64.7
Single	4	21.1		5	33.3	6	35.3
	Yes	No		Yes	No	Yes	No
Physical activity (%)
T1	35.3	64.7		31.6	68.4	26.7	73.3			0.93^*
T2	11.8	88.2		26.3	73.7	20.0	80.0			0.55^*
T3	5.9	94.1		26.3	73.7	6.7	93.3			0.13

Variables	EG (n=19)		FEG (n=15)		CG (n=17)
Variables	Men (n=5)	Women (n=14)	Men (n=4)	Women (n=11)	Men (n=1)	Women (n=16)
BMI
T1	24.7(20.4-41.6)	26.0(20.7-41.3)	25.2(21.9-31.2)	25.6(18.9-38.2)	24.0	26.2(18.9-32.3)
T2	24.8(20.6-41.3)	26.1(21.7-42.3)	25.3(22.4-31.7)	26.4(19.3-39.6)	24.9	26.0(18.8-32.2)
T3	24.8(20.6-41.3)	26.6 (20.3-42)	25.1(22.2-31.7)	26.1(19.3-39.6)	24.0	26.2(19-32.6)
p	0.29	0.43	0.63	0.12		0.15
WC
T1	89.0(75-125.5)	92.0 (87-97)	90.0(70-113)	83.0 (68-104)	89.0	86.0(66-102)
T2	87.0(75-123)	94.5 (87.5-96)	87.5(75-111)	87.0 (69-107)	91.0	83.5(64-100)
T3	87.0(76-123)	93.0 (85-96)	88.0(72-111)	84.5 (68-107)	89.0	84.0(65.5-100)
p	0.82	0.66	0.37	0.52		0.73
HC
T1	98.0(94-130)	103.0(100- 108)	101.5(91-135)	103.0 (91-122)	103.0	104.0(91-119)
T2	102.0(94-125)	102.5(100- 106)	102.0(90-130)	103.0 (92-118)	106.0	103.5 (88.5-122.5)
T3	106.0(94-125)	104.5(101- 106)	102.5(89-130)	104.0 (88-118)	103.0	104.0(88.5-118)
p	0.78	0.23	0.22	0.57		0.11
UMAC
T1	28.0(24-36.5)	28.0 (23-40)	30.5 (27-33)	28.0(21.5-37)	28.0	29.0(23-34)^a
T2	28.5 (23-36)	27.5 (25-41)	30.0 (26.5-32)	29.0(21-34)	28.5	28.0(22-31)^b
T3	29.0 (24-36)	27.5 (24-41)	30.0 (26-32)	28.0(20.5-34)	28.0	27.5(22-31)^b
p	0.305	0.4	0.06	0.81		<0.001^*
TST
T1	9.8±6.0	17.5±2.8	11.4±2.4	(16.6±2.7)^a	6.0	16.7±3.0
T2	10.3±6.7	16.7±3.9	11.3±2.6	(15.3 ± 2.5)^b	8.0	15.8±3.3
T3	11.0±6.8	16.8±3.5	11.3±2.8	(15.9 ± 2.8)^ab	6.0	16.7±3.6
p	0.13	0.28	0.96	0.03^*		0.17
BFM
T1	(16.9±17.2)^a	27.2±13.6	16.3±6.8	23.6±9.9	8.6	21.2±7.1
T2	(18.0±17.1)^ab	28.2±13.9	17.1±7.4	24.5±9.9	12.7	21.5 ± 7.3
T3	(17.5±17.4)^b	27.9±14.2	16.7±7.7	24.5±9.9	8.6	21.4 ± 7.3
p	0.04^*	0.12	0.28	0.13		0.78
FFM
T1	64.2±14.0	46.8±8.0	62.8±3.3	44.1±4.5	66.7	46.3 ± 4.5
T2	63.7±13.3	46.5±8.3	63.0±3.9	44.2±4.1	69.2	45.8±4.1
T3	64.7±12.8	46.7±8.1	62.9±4.0	44.7±4.6	66.7	46.7±5.0
p	0.19	0.74	0.94	0.26		0.26
Hand strength
Right
T1	34.8(13-37)	18.1(11-37)	35.6(29-59)^a	20.9(8-30)^a	35.6	20.9(7-31)
T2	23.3(9-40)	18.1(9-35)	33.6(23-46)^b	19.7(9-28)^ab	33.6	18.9(6-34)
T3	30.8(9-40)	17.9(8-35)	31.2(25-58)^ab	17.3(9-23)^b	31.2	17.4(5-31)
p	0.21	0.35	0.04^*	0.02^*		0.10
Variables	EG (n=19)		FEG (n=15)		CG (n=17)
Variables	Men (n=5)	Women (n=14)	Men (n=4)	Women (n=11)	Men (n=1)	Women (n=16)
Left
T1	33.4(13-40)	18.9(8-40)	33.9(31-59)	20.4(6-30)^a	20.3	22.7(9-31)^a
T2	25.6(9-43)	18.5(7-33)	33.2(27-44)	17.3(7-27)^ab	24.9	19.6(6-30)^ab
T3	29.1(9-43)	17.1(7-33)	33.8(24-56)	15.9(7-23)^b	20.3	17.1(0-26)^b
p	0.21	0.73	0.21	0.006^*		0.001^*

Variables	T1			T2			T3
Variables	EG	FEG	CG	EG	FEG	CG	EG	FEG	CG
Hb (g/dL)¹
M:13.5-16.9	(14.6±0.3)^a	(15.2±0.5)^b	13.4^ab	(14.6±0.7)^a	(16.3±0.9)^b	13.7^ab	14.9±0.7	15.9±1.3	14.5
W:11.9-14.6	12.6±1.1	12.9±1.3	12.5±1.1	(12.9±1.3)^ab	(13.3±1.2)^a	(11.9±1.1)^b	(12.7±1.2)^ab	(13.3±1.4)^a	(11.8±1.3)^b
Htc (%)¹
M:40-49.4	43.1±1.5	44.1±1.9	41.9	43.6±2.2	46.5±1.5	39.4	43.9±2.5	45.8±2.3	42.1
W:36.6-44	38.3±2.8	38.9±4.7	37.6±2.9	(38.7±3.2)^ab	(39.8±4.1)^a	(36.1±2.9)^b	(38.4±2.7)^ab	(40.2±3.9)^a	(35.7±3.5)^b
TC (mg/dL)
M/W:0-200	185.0 (133.5-304.7)^a	162.6 (127.5-221.5)^b	159.6 (101.5-190.7)^b	186.4 (138.5-341.7)^a	171.8 (117-242.6)^ab	152.0 (108.9-201.7)^b	181.0 (138.6-340.6)^a	175.4 (118-221.7)^ab	165.2 (114.6-217.9)^b
TG (mg/dL)
M/W:0-200	112.3 (47.6-312.8)	122.5 (41.7-296.2)	93.3 (46.7-336.3)	112.5 (50-307.7)	142 (41.7-392.4)	87.0 (50.7-354.1)	109.5 (58.5-278.7)	142.3 (41.8-579.2)	91.3 (45.1-323.2)
LDL-C (mg/dL)
M/W:0-160	109.5 (67.3-241.5)^a	82.0 (50.8-133.5)^b	78.9 (48.6-117.7)^b	100.1 (67.3 -241.8)^a	93.9 (50.8-172.6)^ab	76.2 (51.1-117.8)^b	105.4 (67.3-241.8)^a	99.5 (50.8-140.2)^ab	71.8 (51.1-109.1)^b
HDL-C (mg/dL)
M/W:35-75	53.0±12.7	49.2±14.5	53.4±11.7	54.0±13.5	50.8±14.7	54.7±11.8	52.7±11.8	52.1±15.8	55.5±12.5
AST (U/L)
M/W:8-46	19.4 (12.4-69.1)	19.1 (10.9-41)	13.2 (8-30.4)	18.2 (10.3-29.9)	17 (11-34)	15.9 (10.5-29)	19.3 (11.6-26.8)	17.4 (11.8-45.5)	15 (8-41.6)
ALT (U/L)
M:0-40	21.2 (18.6-24.0)	20.9 (7.2-32.3)	14.8	22.3 (16.1-34.0)	15.6 (8.3-33.2)	14.2	23.8 (20.9-45.9)^a	10.3 (4.3-17.2)^b	13.3^ab
Variables	T1			T2			T3
Variables	EG	FEG	CG	EG	FEG	CG	EG	FEG	CG
W:0-35	15.8 (7-129.7)	12.9 (7.3-80.1)	12.4 (7-71.5)	14.7 (10.1-38.9)	11.2 (7-102.6)	12.1 (6.2-39)	15.0 (10.1-37.5)	11.9 (7.9-143.8)	12.1 (7.4-74.2)
Iron (µg/dL)¹
M:59-158	75.8 (60.0-127.3)	75.5 (43.6-161.8)	55.7	98.4 (75.4-121.4)	76.4 (65.8-83.7)	94.3	79.2 (69.8-121.5)	81.5 (65.9-118.5)	69.6
W:37-145	61.9 (31.6-143.0)	68.4 (32.0-142.8)	55.7 (16.3-173.6)	69.7 (37.1-161.7)	77.1 (51.0-142.8)	72.9 (22.9-110.2)	65.5 (22.5-96.9)	72.5 (39.0-159.2)	66.0 (28.0-124.0)
Ferritin (ng/mL)¹
M:21.8-274.7	66.7±36.3	130.9±92.5	53.0	59.2±27.6	136.8±103.0	67.9	57.6±25.7	137.9±101.7	67.9
W:4.63-204	22.4 (10.7-138.9)	38.8 (5.1-76.9)	21.7 (5.1-101.4)	30.8 (8.8-174.2)	55.5 (5.1-100.7)	17.8 (4.7-81.1)	33.0 (5.2-238.7)	44.4 (4.6-87.0)	16.7 (4.7-81.1)
Vitamin B₁₂ (pg/mL)²
M/W:197-866	313.5 (166.7-429.4)	351.5 (305.9-397.0)	326.6 (249.1-404.1)	317.5 (261.2-392.8)	645.9 (397.0-894.9)	308.5 (258.3-358.6)	338.1 (261.3-1113.0)	411.7 (263.4-560.0)	334.1 (327.2-341.0)
Vitamin B₁₂ (pg/mL)¹
M/W:197-866	322.4 (161.4-730.7)	304.4 (185.4-441.5)	322.1 (213.4-615.9)	302.0 (228.9-572.2)	307.4 (205.4-894.9)	290.3 (171.9-615.1)	303.0 (215.6-504.9)	(195.1-505.7)	306.4 (172.0-938.4)

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[1] Correspondence to: Z UZDİL. E-mail: <zuzdil1010@hotmail.com>.