Modifying Diet and Exercise in Multiple Sclerosis: A Pilot Study
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Background: Modest weight loss can have significant health benefits and reduce the risk of developing chronic health comorbidities (Van Gaal et al., 1997). It remains unclear whether weight loss in individuals with multiple sclerosis (MS) can aid in reducing disease burden. Purpose: The three aims of this single arm non-randomized study include, (1) Develop and assess the feasibility and acceptability of a six-month telehealth, behavioral weight loss program for people with MS; (2) Examine the primary outcome variable, percent weight loss, from baseline to six-month follow-up; and (3) Assess minutes of physical activity and servings of fruits and vegetables eaten daily in people with MS. Methods: Participants were provided with a Fitbit device, Fitbit Aria Scale, and a premium subscription to the Lose It! application. Program recommendations included eating 1200 – 1500 calories a day and working up to 150 minutes of moderate intensity physical activity per week over six months. Group members met weekly to discuss topics related to healthy living in MS and attended two individual calls with the group leader. Qualitative and quantitative data were used to examine facilitators and barriers to behavior change, perceived benefits of weight loss and healthy lifestyle practices, and patient satisfaction with the program. Changes in diet and physical activity routines were monitored via questionnaires at baseline and follow-up. Percent weight loss was calculated at follow-up. Results: Eight people were consented and enrolled in the program. On average, participants attended 17 of the 24 weekly sessions (SD = 7.15). Average percent weight loss was 10.57% (SD = 7.20). Nearly all participants strongly agreed the program helped them live a healthier lifestyle (3.87 ± 0.35 on 0 to 4 Likert scale). Activity scores increased from insufficiently active (M = 13.0, SD = 14.98) to active at follow-up (M = 43.50, SD = 21.31; t(7) = -3.33, p = 0.013). Self-reported fruit and vegetable servings increased overall but fruit consumption was the only variable that was significantly increased (M = -0.54, SD = 0.59; t(7) = -2.61, p = 0.035). Discussion: Taken together, results from this pilot trial will be used to inform future study directions. Weight loss interventions tailored to people with MS could potentially improve the health and quality of life for hundreds of thousands of patients.
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Introduction -- Methods -- Appendix
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M.A. (Master of Arts)