Originally posted on the National Multiple Sclerosis Society‘
Diet and MS – the big picture
Maintenance of general good health is important for people with MS or any chronic disorder. A well-balanced and carefully planned diet will help to achieve this goal. While many different diets have been proposed as a treatment, or even a cure, for the signs and symptoms of MS, evidence of effectiveness is very limited. Most of these proposed diets have not been subjected to rigorous, controlled studies, and the few that have been evaluated have produced mixed results.Researchers are making significant connections, however, in the story of diet and MS that may eventually impact the lives of people living with MS. Here are some key findings and some areas where the results are mixed.
Vitamin D – Research is increasingly pointing to a reduced level of vitamin D in the blood as a risk factor for developing MS, and studies are underway to determine if vitamin D levels influence MS disease activity. The National MS Society has led the way in this research, funding early preclinical studies, convening a summit on this topic, and now funding a clinical trial of vitamin D supplementation. Read more here.
Salt – Several reports suggest that dietary salt can speed the development of an MS-like disease in mice, and provide new insights on immune system activity involved in MS. Read more about these reports here. While more research needs to be done to confirm a role for salt in triggering MS, or to determine whether reducing salt can inhibit MS immune attacks, these studies pinpoint new avenues for strategies that can decrease MS attacks. These studies were funded in part by the National MS Society, and the Society is now funding further research that explores how salt affects the immune system in humans.
Antioxidants – these natural or manmade substances are found in many foods. In MS, the immune system damages and destroys myelin, the material that surrounds and protects nerve fibers in the brain and spinal cord. Nerve fibers themselves are damaged as well, which appears to drive long-term disability. “Free radicals” are normal by-products of bodily processes, and may cause tissue injury and turn on immune attacks in MS. Antioxidants block the action of free radicals. Controlled trials are underway to test the potential of several antioxidants for treating MS:
- Scientists at Oregon Health Science University are testing whether oral lipoic acid can reduce optic nerve damage (often the first symptom indicating MS) in people at high risk for MS.
- Researchers at the National Institutes of Health are testing whether idebenone (a man-made drug that is similar to coenzyme Q10, a common dietary supplement) can decrease loss of brain tissue volume in people with primary progressive MS.
- Several groups are investigating antioxidants isolated from green tea in people with MS, based on studies in MS-like disease which showed that these substances can reduce the effects of the immune attack.
- Plant-based diet – A one-year study tested a low-fat, plant-based diet on measures of disease activity, mobility, fatigue, cholesterol, body weight, and compliance in 61 people with relapsing-remitting MS. Half of the participants received 10 days of diet and cooking training, while the control group was wait-listed. Results show no significant changes in MRI scans, EDSS, or mobility. Fatigue scores improved significantly. Participants showed good compliance, and were able to lose weight and reduce cholesterol levels. Although larger studies are needed, these results (presented at a medical meeting, and yet to be published in full) help to fine-tune our understanding of how managing diet may help people with MS.
- Red wine – Previous research has suggested that resveratrol, a component of red wine, enhances the activity of a molecule (SIRT1) that might help to preserve nerve fibers, and it has been shown in several studies to decrease the severity of MS-like disease in mice. At least one more recent report, however, suggests that resveratrol actually may worsen disease in mice, so additional research is needed.
- Ginkgo – Extract from the Ginkgo biloba tree has been used for a variety of medicinal purposes, and small pilot studies hinted that it might be beneficial for cognitive impairment in MS. But results of a placebo-controlled, 12-week clinical trial showed that Ginkgo biloba failed to improve cognitive function in 121 people with MS.
- Omega-3 – Polyunsaturated fats — and the omega-3 fatty acids they contain — have been the focus of MS studies with some evidence pointing to benefits for relapsing-remitting MS. But a recent Norwegian study showed that omega-3 fatty acid supplements were safe in 92 people with relapsing-remitting MS, but failed to show benefit in any clinical or quality of life measures.