The Effects of Gain-Versus-Loss Messages Following the Dietary Approaches to Stop Hypertension (DASH) Diet and Low-Glycemic-Index Diet on Stress, Anxiety, Depression, and Fatigue in People with Multiple Sclerosis: A Protocol Study

Abstract

Background: The global prevalence of multiple sclerosis (MS) is rising, and there is currently no cure. The dietary approaches to stop hypertension (DASH) and low glycemic load diets have demonstrated benefits in improving mood and physical function among adults with MS. Objectives: This study aimed to evaluate the effects of gain- versus loss-framed messages on stress, anxiety, depression, and fatigue in patients with relapsing-remitting MS who follow DASH and Low-Glycemic-Index diets. Methods and Results: This open-label, 12-week randomized controlled trial was conducted at the MS Association of Ahvaz. The study included men and women aged 18 - 55 with an Extended Disability Status Scale (EDSS) score below 4.5. A total of 96 participants were randomly assigned to receive either gain-framed or loss-framed messages. Educational messages, presented in graphical or textual formats, were tailored to participants based on their responses. Outcomes were assessed using the Modified Fatigue Impact Scale (MFIS), the Depression Anxiety Stress Scale-21 (DASS-21), and measures of pain intensity, physical activity, dietary intake, and adherence to the recommended interventions. Data were analyzed using both per-protocol and intention-to-treat methods. SPSS version 26.0 was used for statistical analysis, with significance set at P < 0.05. Conclusions: If this study demonstrates the effectiveness of gain- and loss-framed messages, these approaches can be utilized to enhance knowledge and awareness among individuals with MS. Furthermore, they can promote adherence to DASH and low Glycemic Index diets, potentially improving stress, anxiety, fatigue, and pain intensity in this population.