{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:56:53Z","timestamp":1787849813856,"version":"build-2784847793"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T00:00:00Z","timestamp":1626134400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T00:00:00Z","timestamp":1626134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J. Egypt. Public. Health. Assoc."],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Nutrition was claimed to be a factor in MS causation, course, complications, and management. Several studies were conducted to assess the nutritional status of MS patients; however, few studies were conducted to assess this problem in Egypt. Therefore, the purpose of the current study was to assess the nutritional status of a sample of MS patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The researchers conducted an exploratory cross-sectional study among 76 relapsing-remitting MS (RRMS) patients attending Kasr Alainy Multiple Sclerosis Unit (KAMSU) from October 2018 to January 2019 to assess the nutritional status of a sample of MS patients. Data were collected using a structured interview questionnaire including an inquiry about the socioeconomic status, and nutritional status using anthropometric measurements, patient-generated subjective global assessment (PG-SGA), semi-quantitative food frequency questionnaires (SQFFQ), and hemoglobin level measurement. Assessment of fatigue was done using the Modified Fatigue Impact Scale 5-items version.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The mean age of the study participants was 30 \u00b1 6 years. The disease duration ranged from 2 to 264 months. Malnutrition was prevalent among 67.1% (27.6 % overweight, 36.8% obese, and 2.6% underweight). Half of the investigated patients were anemic. According to the PG-SGA, more than half of the studied patients (53.9%) were classified as moderately or suspected malnourished. The unhealthy dietary habits such as taking only a few meals, junk food intake and skipping breakfast were observed in considerable proportions of the group. The SQFFQ revealed overconsumption of energy and fat, and less than acceptable consumption of dietary fibers by most of the studied patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Overweight, obesity, anemia, and unhealthy dietary habits were prevalent among the RRMS patients attending the KAMSU. Nutrition care service is extremely needed for this group of patients.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s42506-021-00080-3","type":"journal-article","created":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T14:03:14Z","timestamp":1626184994000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Nutritional status of multiple sclerosis (MS) patients attending Kasr Alainy MS unit: an exploratory cross-sectional study"],"prefix":"10.1186","volume":"96","author":[{"given":"Zeinab E.","family":"Afifi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rania I.","family":"Shehata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asmaa F.","family":"El Sayed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"El Sayed M.","family":"Hammad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwa R.","family":"Salem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,7,13]]},"reference":[{"issue":"1","key":"80_CR1","doi-asserted-by":"publisher","first-page":"175909141456818","DOI":"10.1177\/1759091414568185","volume":"7","author":"P Riccio","year":"2015","unstructured":"Riccio P, Rossano R. Nutrition facts in multiple sclerosis. ASN Neuro. 2015;7(1):1759091414568185.","journal-title":"ASN Neuro"},{"issue":"1","key":"80_CR2","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.neurol.2015.10.006","volume":"172","author":"E Leray","year":"2016","unstructured":"Leray E, Moreau T, Fromont A, Edan G. Epidemiology of multiple sclerosis. Rev Neurol. 2016;172(1):3\u201313.","journal-title":"Rev Neurol"},{"issue":"1","key":"80_CR3","first-page":"413","volume":"47","author":"H El-Sawy","year":"2010","unstructured":"El-Sawy H, Abdel Hay M, Badawy A. Gender differences in risks and pattern of drug abuse in Egypt. Egypt J Neurol Psychiat Neurosurg. 2010;47(1):413\u20138.","journal-title":"Egypt J Neurol Psychiat Neurosurg"},{"issue":"5","key":"80_CR4","first-page":"193","volume":"16","author":"E Crabtree-Hartman","year":"2010","unstructured":"Crabtree-Hartman E. Sex differences in multiple sclerosis. CONTINUUM: Lifelong Learning Neurol. 2010;16(5):193\u2013210.","journal-title":"CONTINUUM: Lifelong Learning Neurol"},{"issue":"5","key":"80_CR5","first-page":"19","volume":"16","author":"BA Cree","year":"2010","unstructured":"Cree BA. Diagnosis and differential diagnosis of multiple sclerosis. CONTINUUM: Lifelong Learning Neurol. 2010;16(5):19\u201336.","journal-title":"CONTINUUM: Lifelong Learning Neurol"},{"key":"80_CR6","doi-asserted-by":"crossref","unstructured":"Ascherio A, Munger KL. Environmental risk factors for multiple sclerosis. Part I: the role of infection. Ann Neurol. 2007;61(4):288\u201399.","DOI":"10.1002\/ana.21117"},{"key":"80_CR7","doi-asserted-by":"crossref","unstructured":"Van der Mei IA, Simpson S, Stankovich J, Taylor BV. Individual and joint action of environmental factors and risk of MS. Neurol Clin. 2011;29(2):233\u201355.","DOI":"10.1016\/j.ncl.2010.12.007"},{"key":"80_CR8","doi-asserted-by":"crossref","unstructured":"Khurana SR, Bamer AM, Turner AP, Wadhwani RV, Bowen JD, Leipertz SL, et al. The prevalence of overweight and obesity in veterans with multiple sclerosis. Am J Phys Med Rehabil. 2009;88(2):83\u201391.","DOI":"10.1097\/PHM.0b013e318194f8b5"},{"key":"80_CR9","unstructured":"Burgos R. Nutritional support in neurological diseases.\u00a0 ESPEN guidelines 2016; Topic 25, module 1. [cited 2018, July 20]. Available from:\u00a0 https:\/\/lllnutrition.com\/mod_lll\/TOPIC25\/m251.pdf."},{"key":"80_CR10","doi-asserted-by":"crossref","unstructured":"Schwarz S, Leweling H. Multiple sclerosis and nutrition. Mult Scler J. 2005 Feb;11(1):24\u201332.","DOI":"10.1191\/1352458505ms1119oa"},{"key":"#cr-split#-80_CR11.1","unstructured":"Breton I. Nutritional and Metabolic Consequences of Neurological Diseases. ESPEN guidelines, 2016, Topic 25, Module 4"},{"key":"#cr-split#-80_CR11.2","unstructured":"[cited 2018 July 20]. Available from: https:\/\/lllnutrition.com\/mod_lll\/TOPIC25\/m251.pdf."},{"key":"80_CR12","first-page":"209","volume":"49","author":"AT El-Ghoneimy","year":"2009","unstructured":"El-Ghoneimy AT, Gad AH, Samir H, Shalaby NM, Ramzy GH, Farghaly M, et al. Contribution of vitamin D to the pathogenesis of multiple sclerosis and its effect on bone. Egypt J Neurol Psychiatry Neurosurg. 2009;49:209\u201322.","journal-title":"Egypt J Neurol Psychiatry Neurosurg"},{"key":"80_CR13","first-page":"223","volume":"46","author":"AT El Ghoneimy","year":"2009","unstructured":"El Ghoneimy AT, Gad AH, Samir H, Shalaby NM, Ramzy GM, Farghaly M, et al. Impact of vitamin D deficiency on cognition in patients with multiple sclerosis. Egypt J Neurol Psychiatry Neurosurg. 2009;46:223\u201334.","journal-title":"Egypt J Neurol Psychiatry Neurosurg"},{"issue":"4","key":"80_CR14","first-page":"922","volume":"19","author":"IB Sand","year":"2013","unstructured":"Sand IB, Lublin FD. Diagnosis and differential diagnosis of multiple sclerosis. CONTINUUM: Lifelong Learning Neurol. 2013;19(4):922\u201343.","journal-title":"CONTINUUM: Lifelong Learning Neurol"},{"issue":"1","key":"80_CR15","first-page":"28","volume":"13","author":"S Bitarafan","year":"2014","unstructured":"Bitarafan S, Harirchian MH, Nafissi S, Sahraian MA, Togha M, Siassi F, et al. Dietary intake of nutrients and its correlation with fatigue in multiple sclerosis patients. Iranian J Neurol. 2014;13(1):28\u201332.","journal-title":"Iranian J Neurol"},{"key":"80_CR16","doi-asserted-by":"crossref","unstructured":"El-Gilany A, El-Wehady A, El-Wasify M. Updating and validation of the socioeconomic status scale for health research in Egypt. East Mediterr Health J. 2012;18(9):962\u20138.","DOI":"10.26719\/2012.18.9.962"},{"key":"80_CR17","unstructured":"CDC. Anthropometry procedures manual. 2016. [cited 2020 July 4]. Available from https:\/\/www.cdc.gov\/nchs\/data\/nhanes\/nhanes_15_16\/2016_Anthropometry_Procedures_Manual.pdf"},{"key":"80_CR18","unstructured":"WHO. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. [cited 2018 July 20]. Available from http:\/\/apps.who.int\/iris\/bitstream\/10665\/85839\/3\/WHO_NMH_NHD_MNM_11.1_eng.pdf?ua=1;2011 date af retrival 20\/7\/2018."},{"key":"80_CR19","doi-asserted-by":"crossref","unstructured":"Sheard JM, Ash S, Mellick GD, Silburn PA, Kerr GK. Improved nutritional status is related to improved quality of life in Parkinson\u2019s disease. BMC Neurol. 2014;14(1):212.","DOI":"10.1186\/s12883-014-0212-1"},{"key":"80_CR20","unstructured":"Ottery F, Jager-Wittenaar H. In which health care settings can the PG-SGA\u00a9 be used? 2017; Available from: https:\/\/pt-global.org\/ufaqs\/6-in-which-health-care-settings-can-the-pg-sga-be-used\/.\u00a0\u00a0"},{"key":"80_CR21","unstructured":"Ottery F, Jager-Wittenaar H. What is the difference between the numerical PG-SGA score and the PG-SGA category? 2017. Available from:  https:\/\/pt-global.org\/ufaqs\/10-what-is-the-difference-between-the-numerical-pg-sga-score-and-the-pg-sga-category\/."},{"key":"80_CR22","unstructured":"Ottery F. Jager-Wittenaar H. PG-SGA. 2017. Retrieved from http:\/\/pt-global.org\/?page_id=13."},{"issue":"1","key":"80_CR23","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1136\/jnnp.29.1.60","volume":"29","author":"U Leibowitz","year":"1966","unstructured":"Leibowitz U, Antonovsky A, Medalie JM, Smith HA, Halpern L, Alter M. Epidemiological study of multiple sclerosis in Israel. II. Multiple sclerosis and level of sanitation. J Neurol Neurosurg Psychiatry. 1966;29(1):60.","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"80_CR24","doi-asserted-by":"crossref","unstructured":"Abudayya AH, Stigum H, Shi Z, Abed Y, Holmboe-Ottesen G. Sociodemographic correlates of food habits among school adolescents (12\u201315 year) in North Gaza strip. BMC Public Health. 2009;9(1):185.","DOI":"10.1186\/1471-2458-9-185"},{"key":"80_CR25","unstructured":"FAO, WHO & UNU. Human energy requirements: report of a Joint FAO\/WHO\/UNU Expert Consultation: Food and Agriculture Organization of the United Nations Rome; 2001."},{"key":"80_CR26","unstructured":"National Nutrition Institute (NNI), Egypt. DNPCNCD: diet, nutrition and prevention of chronic non-communicable diseases among Egyptian adolescents; 2008."},{"key":"80_CR27","doi-asserted-by":"crossref","unstructured":"D\u2019Souza E. Modified fatigue impact scale\u20135-item version (MFIS-5). Occup Med. 2016;66(3):256\u20137.","DOI":"10.1093\/occmed\/kqv106"},{"key":"80_CR28","volume-title":"(released 2012). IBM SPSS statistics for windows (version 21.0.)","author":"IBM. Corp","year":"2012","unstructured":"IBM. Corp. (released 2012). IBM SPSS statistics for windows (version 21.0.). Armonk: IBM Corp; 2012."},{"key":"80_CR29","unstructured":"National Nutrition Institute (NNI), Egypt. Food composition tables for Egypt; 2006."},{"key":"80_CR30","first-page":"235","volume-title":"Human vitamin and mineral requirements. Report of a joint FAO\/WHO expert consultation, Bangkok, Thailand","author":"FAO & WHO","year":"2001","unstructured":"FAO & WHO. Human vitamin and mineral requirements. Report of a joint FAO\/WHO expert consultation, Bangkok, Thailand. Rome: Food and Nutrition Division, FAO; 2001. p. 235\u2013247."},{"key":"80_CR31","doi-asserted-by":"crossref","unstructured":"World Medical Association (WMA). World medical association declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;31:2191\u20134.","DOI":"10.1001\/jama.2013.281053"},{"key":"80_CR32","unstructured":"Saka M, Saka M, Koseler E, Metin S, Bilen SA, Aslanyavrusu M. et al. Nutritional status and anthropometric measurements of patients with multiple sclerosis. Saudi Med J. 2012;33(2):160\u20136."},{"key":"80_CR33","unstructured":"Mir-Reza S, Tabatabaeiyan M, Doosti R, Owji M, Moghadasi AN. Is anemia a probable cause of fatigue in patients with multiple sclerosis? Curr J Neurol. 2013:12(1):35\u20136."},{"key":"80_CR34","doi-asserted-by":"crossref","unstructured":"Koudriavtseva T, Renna R, Plantone D, Mandoj C, Piattella MC, Giannarelli D. Association between anemia and multiple sclerosis. Eur Neurol. 2015;73(3-4):233\u20137.","DOI":"10.1159\/000381212"},{"key":"80_CR35","doi-asserted-by":"crossref","unstructured":"Thomas FJ, Wiles CM. Dysphagia and nutritional status in multiple sclerosis. J Neurol. 1999;246(8):677\u201382.","DOI":"10.1007\/s004150050431"},{"key":"80_CR36","doi-asserted-by":"crossref","unstructured":"Sep\u010di\u0107 J, Mesaro\u0161 E, Materljan E, \u0160epi\u0107-Grahovac D. Nutritional factors and multiple sclerosis in Gorski Kotar, Croatia. Neuroepidemiology. 1993;12(4):234\u201340.","DOI":"10.1159\/000110322"},{"key":"80_CR37","doi-asserted-by":"crossref","unstructured":"Kleinewietfeld M, Manzel A, Titze J, Kvakan H, Yosef N, Linker RA, et al. Sodium chloride drives autoimmune disease by the induction of pathogenic TH 17 cells. Nature. 2013;496(7446):518\u201322.","DOI":"10.1038\/nature11868"}],"container-title":["Journal of the Egyptian Public Health Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42506-021-00080-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s42506-021-00080-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42506-021-00080-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T14:13:09Z","timestamp":1626185589000},"score":1,"resource":{"primary":{"URL":"https:\/\/jepha.springeropen.com\/articles\/10.1186\/s42506-021-00080-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,13]]},"references-count":38,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["80"],"URL":"https:\/\/doi.org\/10.1186\/s42506-021-00080-3","relation":{},"ISSN":["2090-262X"],"issn-type":[{"value":"2090-262X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,13]]},"assertion":[{"value":"11 July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 June 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 July 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol was revised and approved by the Ethics Committee in the Public Health Department, Faculty of Medicine, Cairo University. The committee\u2019s reference number was N-10-2017. All subjects were treated in accordance with the Helsinki Declaration of biomedical ethics []. Informed consent was obtained after proper orientation of the participants regarding the objectives of the study, confidentiality of data, and the impact of the research. Since the data were anonymous (identifier codes were used instead) and to ensure freely given responses, verbal consent was obtained from the participants. Approval of the Ethics committee to obtain participants\u2019 verbal consent was ensured.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"20"}}