Is malnutrition a problem for multiple sclerosis patients?

Published:April 04, 2014DOI:


      Nutritional problems associated with multiple sclerosis (MS) have been observed in a number of studies and case reports. However, the prevalence of malnutrition in MS patients is currently unknown. The primary aim of this study was to assess the prevalence of malnutrition in MS patients and to compare the frequency of malnutrition in MS to that of other diseases. The second aim of the study was to determine whether malnutrition was associated with MS type, disease duration or disability status in MS patients. One hundred two MS patients were included in the current study. The control group consisted of 50 patients with other chronic neurological diseases. Neurological examination scores, Kurtzke Functional System Scale scores, serum albumin levels, sedimentation rate and C reactive protein (CRP) were recorded for all patients. Chronic malnutrition was defined as serum albumin levels below 3.5 g/dl with normal sedimentation rate and CRP levels. Twelve MS patients and one control patient were diagnosed with chronic malnutrition, but the difference was not statistically significant (p = 0.062). In the MS group, MS type, disease duration, number of attacks, Expanded Disability State Score and Functional System Scale scores were not significantly different regardless of patients’ serum albumin levels. We found malnutrition was more prevalent in MS patients than in other chronic diseases. Malnutrition in MS patients was independent of disease course, disease duration, number of attacks, disability status and functional system involvement. These results should be confirmed with further prospective studies in larger MS populations from several facilities.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Clinical Neuroscience
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Miller J.R.
        Multiple sclerosis.
        in: Rowland L.P. Merritt’s neurology. 10th ed. Lippincott Williams & Wilkins, Philadelphia2000: 773-792
        • Pennington C.R.
        Disease and malnutrition in British hospitals.
        Proc Nutr Soc. 1997; 56: 393-407
        • Baldwin C.
        • Weekes C.E.
        Dietary advice with or without oral nutritional supplements for disease-related malnutrition in adults.
        Cochrane Database Syst Rev. 2011; 7: CD002008
        • Kamalian N.
        • Keesey R.E.
        • ZuRhein G.M.
        Lateral hypothalamic demyelination and cachexia in a case of “malignant” multiple sclerosis.
        Neurology. 1975; 25: 25-30
        • Fantelli F.J.
        • Mitsumoto H.
        • Sebek B.A.
        Multiple sclerosis and malabsorption.
        Lancet. 1978; 13: 1039-1040
        • Cook A.W.
        • Gupta J.K.
        • Pertschuk L.P.
        • et al.
        Multiple sclerosis and malabsorption.
        Lancet. 1978; 24: 1366
        • Williams C.M.
        • Lines C.M.
        • McKay E.C.
        Iron and zinc status in multiple sclerosis patients with pressure scores.
        Eur J Clin Nutr. 1988; 42: 321-328
        • Wozniak-Wowk C.S.
        Nutrition intervention in the management of multiple sclerosis.
        Nutr Today. 1993; 28: 12-20
        • Thomas F.J.
        • Wiles C.M.
        Dysphagia and nutritional status in multiple sclerosis.
        J Neurol. 1999; 246: 677-682
        • Pasquinelli S.
        • Solaro C.
        Nutritional assessment and malnutrition in multiple sclerosis.
        Neurol Sci. 2008; 29: S367-S369
        • Fleck A.
        • Colley C.M.
        • Myres M.A.
        Liver export proteins in trauma.
        Br Med Bull. 1985; 41: 265-273
        • Anderson C.F.
        • Wochers D.N.
        The utility of serum albumin values in the nutritional assessment of hospitalised patients.
        Mayo Clin Proc. 1982; 57: 181