The effect of nutritional education given to patients with multiple sclerosis and their families on nutritional status and diet quality

The aim of this study was to evaluate the effect of nutrition education given to a group of patients with multiple sclerosis (MS) and families of MS patients with another group of patients on their nutritional status and diet quality. The study was conducted on 10 (19.6%) males and 41 (80.4%) females in total 51 outpatient multiple sclerosis (MS) patients between the ages of 18-59 who were diagnosed as MS according to the McDonald criterion and applied to Samsun Ondokuz Mayıs University Health Application and Research Center Neurology Polyclinic between October 2018 and March 2019. The questionnaire form was used for general descriptive information, anthropometric measurements (such as body weight, height, waist and hip circumference, upper middle arm circumference, triceps skin fold thickness), body composition analysis, food consumption record, nutritional information level (NIL) test, healthy eating index (HEI), depression status, sleep quality index, physical activity and biochemical measurements were evaluated. The patients were divided into three groups: education group (EG); only patients are educated, family education group (FEG); patients and their families were educated and control group (CG); uneducated patients. Nutritional education with the same content was given 3 times once a month in total for 3 months. Anthropometric measurements, body composition analysis, food consumption record, NIL test, HEI, depression status, sleep quality index, physical activity and biochemical findings of individuals were evaluated before, after (all education) and 3 months after the completion of the education (follow-up). It was determined that the mean NIL scores of the individuals in EG and FEG increased after the education and in the follow-up compared to the pre-education (p<0.05). In EG female subjects in the follow-up vitamin K, after education vitamin B2 consumption showed an increase compared to pre-education with the nutritional education (p<0.05). In the follow-up, the amount of vitamin C consumption was found to be higher in who received both nutritional education groups (EG and FEG) compared to the uneducated KG (p<0.05). In both education groups (EG and FEG), consumption of vitamin C is higher than the KG, but meeting of Nutrition Guide For Turkey (NGFT), recommendation is inadequate for them. It was found that the amount of calcium consumption of women in AEG increased after education (p <0.05), and the amount of consumption of other minerals did not change in any group. While potassium, calcium, magnesium and zinc consumption rates increased to meet NGFT recommendations with nutritional education, recommendations have not been fully met. It was found that insoluble fiber consumption amounts of female individuals in EG after education, and total fiber consumption amounts of female individuals in FEG increased after education (p<0.05). There was no statistically significant difference in the mean HEI scores of the patients with nutritional education and control group (p> 0.05). It was found that the individuals in FEG had a moderate HEI score before and after education and also follow (53.3%, 66.7% and 80.0% respectively) and there was a statistically significant increase in the follow-up compared to the pre-education (p<0.05). The Beck Depression Inventory (BDI) score of the individuals in EG decreased after the training and in the follow-up compared to the pre-training levels (p <0.05). After nutritional education, no significant change was found in the sleep quality and physical activity score of individuals (p> 0.05). A negative correlation was determined between BDI score and NIL in pre-education, post-education and follow-up of individuals in EG (p <0.05). A negative correlation was determined between EDSS score and NIL before training (p <0.05). A positive correlation was determined between the activity score and the NIL score of individuals in FEG after training (p <0.05). As a result, it was found that the nutritional education given to MS patients positively affected the nutritional knowledge level and nutritional status of the patients, and participation of family members caring for the patient to the nutritional education had positive effects in terms of improving the quality of diet.