Higher diet quality is associated with short and long-term benefits on SF-6D health state utilities: a 5-year cohort study in an international sample of people with multiple sclerosis

• Published in: Quality of life research Vol. 32; no. 7; pp. 1883 - 1896
• Main Authors: Kirkland, Harry, Campbell, Julie, Reece, Jeanette, Nag, Nupur, Probst, Yasmine, Neate, Sandra, De Livera, Alysha, Jelinek, George, Simpson-Yap, Steve
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.07.2023; Springer Nature B.V
• Subjects: Cohort analysis; Diet; Medicine; Medicine & Public Health; Multiple sclerosis; Public Health; Quality of life; Quality of Life Research; Sociology; Multiple sclerosis; Diet; Epidemiology; Health state utility
• ISSN: 0962-9343; 1573-2649; 1573-2649
• DOI: 10.1007/s11136-023-03361-w

Background/Purpose Health state utilities (HSU) are a subjective measure of an individual's health-related quality of life (HRQoL), adjusted by societal or patient relative preference weights for living in different states of health-related quality of life (HRQoL), derived from patient-reported responses to multi-attribute utility instrument (MAUI), and can be used as inputs for cost-utility analyses and in clinical assessment. This research assessed associations of diet with subsequent HSU in a large international cohort of people living with multiple sclerosis (MS), a progressive autoimmune condition of the central nervous system. Methods HSUs were generated from responses to Short-Form Six-Dimension (SF-6D) MAUI, and quality-of-the-diet by Diet Habits Questionnaire (DHQ). Cross-sectional, and short- and long-term prospective associations of DHQ with HSU evaluated by linear regression at 2.5- and 5-years. Pooled prospective associations between DHQ and HSU evaluated using linear and quantile regression. Analyses adjusted for relevant demographic and clinical covariates. Results Among 839 participants, baseline DHQ scores showed short- and long-term associations with subsequent HSU, each 10-unit increase in total DHQ score associated with 0.008–0.012 higher HSU (out of 1.00). These associations were dose-dependent, those in the top two quartiles of baseline DHQ scores having 0.01–0.03 higher HSU at follow-up, 0.03 being the threshold for a minimally clinically important difference. Fat, fiber, and fruit/vegetable DHQ subscores were most strongly and consistently associated with better HSU outcomes. However, baseline meat and dairy consumption were associated with 0.01–0.02 lower HSU at subsequent follow-up. Conclusions A higher quality-of-the-diet showed robust prospective relationships with higher HSUs 2.5- and 5-years later, substantiating previous cross-sectional relationships in this cohort. Subject to replication, these results suggest interventions to improve the quality-of-the-diet may be effective to improve HRQoL in people living with MS.