Dietary intervention in Multiple Sclerosis / El estudio Loxo sobre multimorbilidad en Atención Primaria: una investigación con métodos mixtos

Multiple Sclerosis (MS) is a chronic, inflammatory, neurodegenerative and immune-mediated disease that primarily affects young adults, leading to disability and imposing a significant socioeconomic burden. Although its exact cause remains unclear, both genetic and environmental factors are involved. Among the environmental factors, the microbiome has gained attention for its association with the development and symptomatology of the disease. Diet is one of the most influentian factors with potential to modulate the microbiota. In this project, we have designed and implemented a dietary intervention aimed at modulating the intestinal microbiota and reducing inflammation in patients. Our goal is to observe how these changes impact the primary MS symptoms, as well as less frequently studied symptoms that significantly affect quality of life, such as fatigue, anxiety and depression.

This intervention focuses on providing nutritional education to participants, quiding them in following a modified Mediterranean diet that has been adjusted to enhance its anti-inflammatory properties. Preliminary results from the implementation of these evidence-based guidelines, show promising improvements, including higher levels of vitamin D and improved cholesterol profiles, as well as reductions in body weight and fat (without loss of muscle mass). Participants have also reported reduced physical and psychological fatigue, along with lower levels of anxiety and depression.

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Los métodos mixtos de investigación combinan la perspectiva cuantitativa y cualitativa. Cada vez son más utilizados en ciencias de la salud para acercarnos al conocimiento de problemas complejos como es el de la atención a los pacientes mayores con multimorbilidad

El estudio Loxo éstá basado en esta población, en el quese realiza un abordaje cuantitativo que incluye la realización de revisiones de la literatura; un análisis de trayectorias de cluster de enfermedades crónicas, mediante un diseño retrospectivo de 10 años de datos de la historia clínica electrónica; y un abordaje cualitativo mediante técnicas de photovoice y la realización de grupos focales con pacientes y profesionales de atención primaria.

Este estudio se realiza en 7 comunidades autónomas españolas. En el seminario presentaremos el diseño mixto del estudio y los avances realizados en los primeros 18 meses del mismo.