Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep-Oct;24(5):235-241.
doi: 10.7224/1537-2073.2021-051. Epub 2022 May 26.

Facilitators of and Barriers to Adherence to Dietary Interventions Perceived by Women With Multiple Sclerosis and Their Support Persons

Cassidy Dean  1 , Samantha Parks  1 , Tyler J Titcomb  1   2 , Andrea Arthofer  1 , Paul Meirick  1 , Nicole Grogan  1 , Mary A Ehlinger  1 , Babita Bisht  1 , Sara Shuger Fox  3 , Sandra Daack-Hirsch  4 , Linda G Snetselaar  2 , Terry L Wahls  1
Affiliations

Facilitators of and Barriers to Adherence to Dietary Interventions Perceived by Women With Multiple Sclerosis and Their Support Persons

Cassidy Dean et al. Int J MS Care. 2022 Sep-Oct.

Abstract

Background: People with multiple sclerosis (MS) frequently report implementing dietary strategies as part of their personal wellness programs; however, little is known about the perceived themes of healthy behavior change in people with MS.

Methods: Semistructured one-on-one interviews were conducted with 20 women with MS enrolled in 2 different restrictive dietary intervention studies and their 18 self-identified support persons consisting of partners and adult children. Interviews were transcribed, coded, categorized, and then grouped into summative themes. The frequency of issues being mentioned as facilitators of or barriers to diet adherence was evaluated to identify possible differences in perceived experiences between women with MS and their support persons during the studies.

Results: Five qualitative themes were identified: (1) personal motivation, (2) diet components, (3) time, (4) support, and (5) resource access. Major facilitators of dietary adherence were positive support from support persons and study staff, access to resources, symptom improvement, and personal motivation. Major barriers included the novelty of the study diet, lack of cooking skills, no change in or worsening of symptoms, lack of diet knowledge, and food preferences and temptations. Symptom severity was more frequently reported as a barrier to study diet adherence among participants with secondary progressive MS.

Conclusions: Methods to enhance personal motivation and ensure positive support from support persons and study staff may improve study diet adherence. Due to the unique challenges faced by people with MS, future studies should tailor interventions to their unique MS cohort to increase diet adherence.

Keywords: dietary interventions; multiple sclerosis; support person; women with MS.

PubMed Disclaimer

Conflict of interest statement

FINANCIAL DISCLOSURES: Dr Wahls personally follows and promotes the Wahls diet. She has equity interest in the following companies: Terry Wahls, LLC; TZ Press, LLC; The Wahls Institute, PLC; FBB Biomed, Inc; and the website http://www.terrywahls.com. She also owns the copyright to the books Minding My Mitochondria (2nd edition) and The Wahls Protocol, The Wahls Protocol Cooking for Life, and the trademarks The Wahls Protocol, Wahls diet, Wahls Paleo diet, and Wahls Paleo Plus diet (the Wahls elimination diet is not trademarked). She has completed grant funding from the National Multiple Sclerosis Society for the Dietary Approaches to Treating Multiple Sclerosis Related Fatigue Study. She has financial relationships with BioCeuticals; MCG Health, LLC; Genova Diagnostics; and the Institute for Functional Medicine. She receives royalty payments from Penguin Random House. She has conflict of interest management plans in place with the University of Iowa and the Iowa City VA Health Care System. The other authors have disclosed no relevant financial relationships.

References

    1. Thompson AJ, Baranzini SE, Geurts J, Hemmer B, Ciccarelli O. Multiple sclerosis. Lancet . 2018;391(10130):1622–1636. doi: 10.1016/S0140-6736(18)30481-1. - DOI - PubMed
    1. Russell RD, Lucas RM, Brennan V et al. Reported changes in dietary behavior following a first clinical diagnosis of central nervous system demyelination. Front Neurol . 2018;9:161. doi: 10.3389/fneur.2018.00161. - DOI - PMC - PubMed
    1. Fitzgerald KC, Tyry T, Salter A et al. A survey of dietary characteristics in a large population of people with multiple sclerosis. Mult Scler Relat Disord . 2018;22:12–18. doi: 10.1016/j.msard.2018.02.019. - DOI - PubMed
    1. Abdollahpour I, Jakimovski D, Shivappa N et al. Dietary inflammatory index and risk of multiple sclerosis: findings from a large population-based incident case-control study. Clin Nutr . 2020;39(11):3402–3407. doi: 10.1016/j.clnu.2020.02.033. - DOI - PubMed
    1. Fitzgerald KC, Tyry T, Salter A et al. Diet quality is associated with disability and symptom severity in multiple sclerosis. Neurology . 2018;90(1):e1–e11. doi: 10.1212/WNL.0000000000004768. - DOI - PubMed