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
. 2023 Jul;32(7):1883-1896.
doi: 10.1007/s11136-023-03361-w. Epub 2023 Feb 23.

Higher diet quality is associated with short and long-term benefits on SF-6D health state utilities: a 5-year cohort study in an international sample of people with multiple sclerosis

Harry Kirkland  1 , Julie Campbell  2 , Jeanette Reece  1 , Nupur Nag  1 , Yasmine Probst  3 , Sandra Neate  1 , Alysha De Livera  1   4   5 , George Jelinek  1 , Steve Simpson-Yap  6   7
Affiliations

Higher diet quality is associated with short and long-term benefits on SF-6D health state utilities: a 5-year cohort study in an international sample of people with multiple sclerosis

Harry Kirkland et al. Qual Life Res. 2023 Jul.

Abstract

Background/purpose: Health state utilities (HSU) are a subjective measure of an individual's health-related quality of life (HRQoL), adjusted by societal or patient relative preference weights for living in different states of health-related quality of life (HRQoL), derived from patient-reported responses to multi-attribute utility instrument (MAUI), and can be used as inputs for cost-utility analyses and in clinical assessment. This research assessed associations of diet with subsequent HSU in a large international cohort of people living with multiple sclerosis (MS), a progressive autoimmune condition of the central nervous system.

Methods: HSUs were generated from responses to Short-Form Six-Dimension (SF-6D) MAUI, and quality-of-the-diet by Diet Habits Questionnaire (DHQ). Cross-sectional, and short- and long-term prospective associations of DHQ with HSU evaluated by linear regression at 2.5- and 5-years. Pooled prospective associations between DHQ and HSU evaluated using linear and quantile regression. Analyses adjusted for relevant demographic and clinical covariates.

Results: Among 839 participants, baseline DHQ scores showed short- and long-term associations with subsequent HSU, each 10-unit increase in total DHQ score associated with 0.008-0.012 higher HSU (out of 1.00). These associations were dose-dependent, those in the top two quartiles of baseline DHQ scores having 0.01-0.03 higher HSU at follow-up, 0.03 being the threshold for a minimally clinically important difference. Fat, fiber, and fruit/vegetable DHQ subscores were most strongly and consistently associated with better HSU outcomes. However, baseline meat and dairy consumption were associated with 0.01-0.02 lower HSU at subsequent follow-up.

Conclusions: A higher quality-of-the-diet showed robust prospective relationships with higher HSUs 2.5- and 5-years later, substantiating previous cross-sectional relationships in this cohort. Subject to replication, these results suggest interventions to improve the quality-of-the-diet may be effective to improve HRQoL in people living with MS.

Keywords: Diet; Epidemiology; Health state utility; Multiple sclerosis.

PubMed Disclaimer

Conflict of interest statement

GJ receives royalties for his books, Overcoming Multiple Sclerosis and Recovering from Multiple Sclerosis and GJ and SN receive royalties from their book, Overcoming Multiple Sclerosis: Roadmap to Good Health and have previously received remuneration for conducting educational workshops for people with MS.

Figures

Fig. 1
Fig. 1
Prospective relationships of pooled lagged total Diet Habits Questionnaire (DHQ) score quartile with subsequent HSU 2.5 years later
Fig. 2
Fig. 2
Association of baseline total Diet Habits Questionnaire (DHQ) score quartile with Health State Utilities (HSU) at 2.5-years
Fig. 3
Fig. 3
Distribution of baseline total Diet Habits Questionnaire (DHQ) score quartile by Health State Utilities (HSU) at 5-years
See this image and copyright information in PMC

References

    1. Compston A, McDonald I, Noseworthy JH, Lassmann H, Miller D, Smith K, Wekerle H, Confavreux C. McAlpine's Multiple Sclerosis. 4. Churchill Livingston; 2005.
    1. Ford HL, Gerry E, Johnson MH, Tennant A. Health status and quality of life of people with multiple sclerosis. Disability and Rehabilitation. 2001;23(12):516–521. doi: 10.1080/09638280010022090. - DOI - PubMed
    1. McCabe MP, McKern S. Quality of life and multiple sclerosis: Comparison between people with multiple sclerosis and people from the general population. Journal of Clinical Psychology in Medical Settings. 2002;9(4):287–295. doi: 10.1023/A:1020734901150. - DOI
    1. Benedict RH, Wahlig E, Bakshi R, Fishman I, Munschauer F, Zivadinov R, Weinstock-Guttman B. Predicting quality of life in multiple sclerosis: Accounting for physical disability, fatigue, cognition, mood disorder, personality, and behavior change. Journal of the Neurological Sciences. 2005;231(1–2):29–34. doi: 10.1016/j.jns.2004.12.009. - DOI - PubMed
    1. Orme M, Kerrigan J, Tyas D, Russell N, Nixon R. The effect of disease, functional status, and relapses on the utility of people with multiple sclerosis in the UK. Value Health. 2007;10(1):54–60. doi: 10.1111/j.1524-4733.2006.00144.x. - DOI - PubMed