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Body Composition and Its Outcomes and Management in Multiple Sclerosis: Narrative Review.

Ariel Kidwell-Chandler1, Justin Jackson1, Brenda Jeng1

  • 1Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL 60612, USA.

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|April 28, 2025
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Summary

Body composition, measured by DEXA, offers a more comprehensive view of obesity in multiple sclerosis (MS) than BMI. Future research should focus on body composition interventions to improve MS management.

Keywords:
adipose tissuebody compositionbone mineral densitydual-energy X-ray absorptiometrylean soft tissue massmultiple sclerosisobesity

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Area of Science:

  • Neurology
  • Metabolic Science
  • Biomedical Imaging

Background:

  • Obesity is increasingly recognized as a factor influencing multiple sclerosis (MS) prevalence, outcomes, and management.
  • Traditional obesity markers like Body Mass Index (BMI) in MS populations overlook crucial body composition details.
  • Body composition, encompassing fat, bone, and muscle mass, is a relevant but often neglected aspect in MS research.

Purpose of the Study:

  • To highlight the utility of dual-energy X-ray absorptiometry (DEXA) for accurate body composition assessment in MS.
  • To synthesize existing evidence on body composition in MS using DEXA.
  • To identify research gaps concerning body composition in multiple sclerosis.

Main Methods:

  • A narrative review adhering to the Scale for the Assessment of Narrative Review Articles (SANRA) criteria.
  • Literature search on PubMed using keywords 'body composition' and 'multiple sclerosis'.
  • Thematic analysis and synthesis of identified research based on theme saturation.

Main Results:

  • Three key themes emerged: body composition comparisons between MS patients and controls (2 meta-analyses), associations between body composition and various outcomes (14 cross-sectional studies), and interventions targeting body composition in MS (11 clinical trials).

Conclusions:

  • Body composition represents a novel and informative concept for understanding and managing multiple sclerosis.
  • Randomized controlled trials focusing on body composition as a modifiable outcome are crucial for advancing MS care.
  • Further research can enhance the understanding of obesity and poor body composition in MS, leading to improved clinical recommendations.