Prevalence of diet modification among people with multiple sclerosis: A systematic review and meta-analysis

Abstract

Background: People with multiple sclerosis (MS) report modifying their diet to improve wellbeing; however, the overall prevalence of diet modification in this population is unknown. Objective: To assess the prevalence of diet modification among people with MS. Methods: A systematic literature review was performed July 2024 in four databases (Ovid Medline, Embase, Scopus, and Web of Science Core Collection). Inclusion criteria were: 1) studies including adults with MS and 2) reporting the prevalence of diet modification. Random effects inverse-variance meta-analyses determined the prevalence of current and lifetime diet modification as well as subgroup analyses based on global region, survey date, sample size, and risk of bias (RoB). The protocol was registered August 2024 at PROSPERO (CRD42024573284). Results: Among 39 studies reporting on 43 independent samples with 48,104 participants with MS, 13,808 cases of lifetime diet modification were reported for an overall prevalence (95 % CI) of 0.22 (0.17, 0.27). Additionally, among 23 studies reporting on 27 independent samples with 25,338 participants with MS, 4,893 cases of current diet modification were observed for a prevalence (95 % CI) of 0.17 (0.11, 0.23). High heterogeneity was present and was explained by age, sex, MS duration, global region, survey year, sample size, and RoB, which was moderate/high for 74 % of included samples and drove the very low quality of evidence rating for both outcomes. Conclusion: Diet modification was common among people with MS with the highest prevalences observed in North America, Oceania, and international cohorts, along with an increasing trend over time.