{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T19:47:02Z","timestamp":1768679222417,"version":"3.49.0"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T00:00:00Z","timestamp":1673913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Multiple sclerosis (MS) is associated with osteoporosis, possibly due to neurological disability and decreased calcium intake. The objective of this study was to evaluate the efficacy of a personalized nutritional advice program by a dietitian compared to the delivery of a standard advice form to optimize dietary calcium intake in outpatients with MS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a randomized, controlled, parallel trial comparing the efficacy of a personalized dietary advice (PDA) program to standard advice form (SAF) to increase daily calcium intake in MS patients. The study population was composed by patients with relapsing-remitting MS aged 18\u201369 years old. PDA program consisted in dietary advice delivered by a dietitian at baseline, 1 month, and 3 months. Calcium and nutrient intake in patients from both groups was evaluated at baseline and 6 months using a dietary survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 194 patients screened for inclusion, 182 patients were included (79% female, median age of 42 years, and median EDSS of 2.0), and randomized to SAF (<jats:italic>n<\/jats:italic> = 92) or PDA (<jats:italic>n<\/jats:italic> = 90). At 6 months, median calcium intake increased by 241 mg\/day in the PDA group and decreased by 120 mg\/day in the SAF group (<jats:italic>p<\/jats:italic> &amp;lt; 0.0001). However, the median calcium intake was 947 mg\/day in the SAF group and 778 mg\/day in the PDA group at baseline (<jats:italic>p<\/jats:italic> = 0.0077), potentially favoring the effect of dietary advice. Complementary analyses focusing on patients with insufficient calcium intakes at baseline revealed comparable values in both groups (<jats:italic>p<\/jats:italic> = 0.69). Of those, patients included in the PDA group obtained significantly higher calcium intakes at 6 months than patients from the SAF group (<jats:italic>p<\/jats:italic> = 0.0086) independently of EDSS, PASAT, HADS and EQ-5D scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This work shows the efficacy of dietary management based on personalized advice program over 3 months to durably increase calcium consumption in MS patients with insufficient calcium intake.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p><jats:ext-link>clinicaltrials.gov<\/jats:ext-link>, identifier NCT02664623.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2022.919336","type":"journal-article","created":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T05:57:40Z","timestamp":1673935060000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Personalized dietary advices provided by a dietitian increase calcium intake in outpatients with multiple sclerosis\u2014Results from a randomized, controlled, single-blind trial"],"prefix":"10.3389","volume":"9","author":[{"given":"Sandrine","family":"Fiorella","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanane","family":"Agherbi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilia","family":"El Houjeiry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Castelnovo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitri","family":"Renard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pauline","family":"Privat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elodie","family":"Santamaria","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginie","family":"Vallayer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandrine","family":"Alonso","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thierry","family":"Chevallier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Candice","family":"Bancal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabine","family":"Laurent-Chabalier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Thouvenot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,1,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"S23","DOI":"10.2215\/CJN.05910809","article-title":"Calcium metabolism in health and disease.","volume":"5","author":"Peacock","year":"2010","journal-title":"Clin J Am Soc Nephrol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1016\/0002-9343(93)90218-E","article-title":"Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis.","volume":"94","year":"1993","journal-title":"Am J Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1016\/j.beem.2008.06.001","article-title":"Epidemiology of osteoporosis.","volume":"22","author":"Holroyd","year":"2008","journal-title":"Best Pract Res Clin Endocrinol Metab."},{"key":"B4","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1016\/S0140-6736(07)61342-7","article-title":"Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis.","volume":"370","author":"Tang","year":"2007","journal-title":"Lancet."},{"key":"B5","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1056\/NEJMoa055218","article-title":"Calcium plus vitamin D supplementation and the risk of fractures.","volume":"354","author":"Jackson","year":"2006","journal-title":"N Engl J Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1502","DOI":"10.1016\/S0140-6736(08)61620-7","article-title":"Multiple sclerosis.","volume":"372","author":"Compston","year":"2008","journal-title":"Lancet."},{"key":"B7","year":"2001","journal-title":"National Agency for Accreditation and Evaluation in Health. 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