Individuals with multiple sclerosis (MS) often use complementary and alternative medicine (CAM). However, specific CAM therapies used within this population have not been thoroughly described, particularly the use of supplements, herbal remedies, and dietary modifications. The aim of this pilot study was to determine the prevalence of specific types of CAM used by adults with MS in the United States. Participants included adults who were diagnosed with MS at least 1 year prior to study enrollment. CAM use was measured using the CAM Supplement of the National Health Interview Survey, and nutrient intake was assessed using an Automated Self-Administered 24-h Recall. This study found that a majority (77 %, n = 27) of the sample used CAM within the past 12 months, the most prevalent type being vitamins/minerals (88.9 %, n = 24), nonvitamin, nonmineral, natural products (NP) (44.4 %, n = 12), relaxation techniques (33.3 %, n = 9), and special diets (29.6 %, n = 8). Regarding diet, median percent calories from fat (37 %) and saturated fat (12 %) were higher than current recommendations, while dietary fiber intake met only 87 % of the adequate intake. Participants following the Paleo (7.4 %, n = 2) diet did not meet the Estimated Average Requirement (EAR) for vitamins D and E, while those on the Swank diet (7.4 %, n = 2) were below the EAR for vitamins C, A, E, and folate. The results support previous findings that CAM therapies are commonly used by individuals with MS. Inadequate intakes of certain vitamins and minerals by those following the Swank and Paleo diet suggest these diets may be too restrictive, thus further research is warranted.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
NINDS Multiple Sclerosis Information Page [http://www.ninds.nih.gov/disorders/multiple_sclerosis/multiple_sclerosis.htm].
Multiple Sclerosis: Hope Through Research [http://www.ninds.nih.gov/disorders/multiple_sclerosis/detail_multiple_sclerosis.htm].
Noonan, C. W., Kathman, S. J., & White, M. C. (2002). Prevalence estimates for MS in the United States and evidence of an increasing trend for women. Neurology, 58(1), 136–138.
Alonso, A., & Hernán, M. A. (2008). Temporal trends in the incidence of multiple sclerosis: A systematic review. Neurology, 71(2), 129–135.
Simpson, S., Blizzard, L., Otahal, P., Van der Mei, I., & Taylor, B. (2011). Latitude is significantly associated with the prevalence of multiple sclerosis: A meta-analysis. Journal of Neurology, Neurosurgery and Psychiatry, 82(10), 1132–1141.
Anderson, D. W., Ellenberg, J. H., Leventhal, C. M., Reingold, S. C., Rodriguez, M., & Silberberg, D. H. (1992). Revised estimate of the prevalence of multiple sclerosis in the United States. Annals of Neurology, 31(3), 333–336.
Derwenskus, J. (2011). Current disease-modifying treatment of multiple sclerosis. The Mount Sinai journal of medicine, New York, 78(2), 161–175.
Walther, E. U., & Hohlfeld, R. (1999). Multiple sclerosis: Side effects of interferon beta therapy and their management. Neurology, 53(8), 1622–1627.
Apel, A., Greim, B., & Zettl, U. K. (2005). How frequently do patients with multiple sclerosis use complementary and alternative medicine? Complementary Therapies in Medicine, 13(4), 258–263.
Apel, A., Greim, B., König, N., & Zettl, U. (2006). Frequency of current utilisation of complementary and alternative medicine by patients with multiple sclerosis. Journal of Neurology, 253(10), 1331–1336.
Marrie, R. A., Hadjimichael, O., & Vollmer, T. (2003). Predictors of alternative medicine use by multiple sclerosis patients. Multiple Sclerosis, 9(5), 461–466.
Stoll, S. S., Nieves, C., Tabby, D. S., & Schwartzman, R. (2012). Use of therapies other than disease-modifying agents, including complementary and alternative medicine, by patients with multiple sclerosis: A survey study. Journal of the American Osteopathic Association, 112(1), 22–28.
Berkman, C. S., Pignotti, M. G., Cavallo, P. F., & Holland, N. J. (1999). Use of alternative treatments by people with multiple sclerosis. Neurorehabilitation and Neural Repair, 13(4), 243–254.
Leong, E. M., Semple, S. J., Angley, M., Siebert, W., Petkov, J., & McKinnon, R. A. (2009). Complementary and alternative medicines and dietary interventions in multiple sclerosis: What is being used in South Australia and why? Complementary Therapies in Medicine, 17(4), 216–223.
O’Connor, K., Weinstock-Guttman, B., Carl, E., Kilanowski, C., Zivadinov, R., & Ramanathan, M. (2012). Patterns of dietary and herbal supplement use by multiple sclerosis patients. Journal of Neurology, 259(4), 637–644.
Page, S. A., Verhoef, M. J., Stebbins, R. A., Metz, L. M., & Levy, J. C. (2003). The use of complementary and alternative therapies by people with multiple sclerosis. Chronic Diseases in Canada, 24, 2–3.
Nayak, S., Matheis, R. J., Schoenberger, N. E., & Shiflett, S. C. (2003). Use of unconventional therapies by individuals with multiple sclerosis. Clinical Rehabilitation, 17(2), 181–191.
Schwartz, C. E., Laitin, E., Brotman, S., & LaRocca, N. (1999). Utilization of unconventional treatments by persons with MS: Is it alternative or complementary? Neurology, 52(3), 626–629.
Stuifbergen, A. K., & Harrison, T. C. (2003). Complementary and alternative therapy use in persons with multiple sclerosis. Rehabilitation Nursing, 28, 141–147.
Sastre-Garriga, J., Munteis, E., Río, J., Pericot, I., Tintoré, M., & Montalban, X. (2003). Unconventional therapy in multiple sclerosis. Multiple Sclerosis, 9(3), 320–322.
Shinto, L., Yadav, V., Morris, C., Lapidus, J. A., Senders, A., & Bourdette, D. (2005). The perceived benefit and satisfaction from conventional and complementary and alternative medicine (CAM) in people with multiple sclerosis. Complementary Therapies in Medicine, 13(4), 264–272.
Barnes, P. M., Bloom, B., & Nahin, R. L. (2007). Complementary and alternative medicine use among adults and children: United States. Hyattsville, MD: National Center for Health Statistics.
Institute of Medicine. (2001). Multiple sclerosis: Current status and strategies for the future. Washington, DC: The National Academies Press.
Riccio P, Rossano R, Liuzzi G. (2010). May diet and dietary supplements improve the wellness of multiple sclerosis patients? A molecular approach. In: Autoimmune Dis. vol. 2010.
About the Swank Low-Fat Diet for the Treatment of MS [http://www.swankmsdiet.org/About%20The%20Diet].
Anderson, J. W., Trivieri, L., & Goldberg, B. (2002). Alternative medicine: The definitive guide (2nd ed.). New York: Celestial Arts.
McDougall, J. A. (1991). The McDougall program: 12 days to dynamic health. New York: Penguin Books.
Willett, W. C. (2013). Nutritional epidemiology (11th ed., Vol. 3). New York, New York: Oxford University Press.
Shinto, L., Yadav, V., Morris, C., Lapidus, J. A., Senders, A., & Bourdette, D. (2006). Demographic and health-related factors associated with complementary and alternative medicine (CAM) use in multiple sclerosis. Multiple Sclerosis, 12(1), 94–100.
Schwarz, S., & Leweling, H. (2005). Multiple sclerosis and nutrition. Multiple Sclerosis, 11(1), 24–32.
Paleo Diet FAQ [http://thepaleodiet.com/paleo-diet-faq/].
This research was funded in part by Arlette I. Rasmussen Graduate Research Award in Nutrition and Dietetics. The authors thank Dr. Dick Sacher for his time and Qualtrics expertise.
Laura Masullo and Lauren Mahoney were students in the Department of Behavioral Health and Nutrition, University of Delaware at the time of the study.
About this article
Cite this article
Masullo, L., Papas, M.A., Cotugna, N. et al. Complementary and Alternative Medicine Use and Nutrient Intake Among Individuals with Multiple Sclerosis in the United States. J Community Health 40, 153–160 (2015). https://doi.org/10.1007/s10900-014-9913-z
- Multiple sclerosis
- Complementary and alternative medicine
- Nutrient intake