Assessment of Nutritional and Lifestyle Risk Factors Influencing Clinical Remission in Multiple Sclerosis Patients in Nairobi County

Abstract

Multiple sclerosis (MS) is a condition identified by acute inflammation in the cerebrospinal axis, that brings about demyelination and nerve dysfunction. This incapacitating condition presents diverse neurological symptoms, including fatigue, compromised mobility, sensory disturbances, and cognitive impairment. This investigation, conducted in Nairobi, aimed to explore the influence of dietary risk factors on disease activity and clinical remission in MS patients, utilizing a mixed-method approach. Nairobi faces distinctive healthcare challenges and comprehending how dietary factors interact with MS outcomes can lead to tailored interventions that enhance the well-being of patients in this environment. The study employed a cross-sectional study design encompassing qualitative and quantitative data collection methods. A total of 150 participants with multiple sclerosis (MS) were studied, with a mean age of 41 years; 58.67% were male and 41.33% female. Most had Relapsing-Remitting MS (80%) and were primarily managed by neurologists (88.67%). Mediterranean (39.33%), low-carb (27.33%), and vegetarian (26%) diets were the most common dietary patterns, with 84% of participants reporting supplement use and 67.33% consuming whole grains daily. A large proportion (88.67%) achieved clinical remission. Statistically significant associations were found between dietary compliance and remission (χ² = 15.495, p = 0.004), with 92% of those reporting “very close” adherence attaining remission. Dietary patterns such as gluten-free (100%), low-carb (95.12%), and vegetarian (92.31%) were significantly associated with higher remission rates (χ² = 8.3824, p = 0.039). Supplement use (OR = 36.05, p < 0.001), avoidance of sugary foods (OR = 209, p < 0.001), and occasional dairy intake (OR = 16.33, p = 0.006) were strongly linked to remission. Logistic regression showed that disease stage (OR = 0.099, p < 0.01) and disease progression markers (OR = 0.301, p < 0.05) negatively influenced remission. While most demographic factors showed no significant effect, poor dietary adherence significantly reduced the odds of remission. Non-dietary factors such as physical activity (χ² = 105.87, p < 0.001), sleep quality (χ² = 18.85, p = 0.001), psychological health (χ² = 19.69, p < 0.001), and environmental triggers (χ² = 15.04, p = 0.001) were significantly associated with clinical remission. High levels of daily physical activity (61.33%) and satisfactory sleep (88%) were common among participants who attained remission. Qualitative findings confirmed that stress, diet, exercise, sleep, and family support jointly influenced symptom control and compliance. Based on the findings, promoting adherence to anti-inflammatory dietary patterns, regular supplement use, and consistent physical activity is crucial for achieving clinical remission among MS patients. Integrating holistic lifestyle interventions including stress reduction, quality sleep, and psychological support can further enhance disease management and symptom control. The findings revealed that adequate dietary diversity, higher protein intake, and regular physical activity were positively associated with clinical remission, whereas sedentary lifestyle and poor dietary habits were significantly linked to relapse or prolonged symptom activity. Socioeconomic factors such as income level and educational status also influenced dietary compliance and overall disease management. The study concludes that nutritional quality and lifestyle practices play a vital role in modulating remission among MS patients. These findings contribute to understanding the behavioral and dietary determinants of remission and underscore the need for comprehensive dietary counseling and lifestyle interventions in MS care programs.