Multiple sclerosis (MS) is one of the most baffling of all diseases – we do not know enough about what causes it and what factors influence its progression and outcome. MS begins with localized inflammatory damage of the myelin sheaths surrounding nerve fibers due to attack by the immune system. The resulting damage interferes with nerve impulses, leading to such symptoms as muscle weakness, loss of vision, and other impairments.
Your question about dietary changes to influence multiple sclerosis is timely. A discussion at a November 2018 European conference on MS reviewed investigations on the effects of diet for helping slow the progression of the disease. Results of a Johns Hopkins observational study with 280 MS patients showed that those consuming high-quality foods had a higher processing speed (the speed at which you can understand and react to information), a slightly faster walking speed and slightly better manual dexterity compared to patients whose diets were not as good. High quality diets were defined as those that included plenty of fruits, vegetables, legumes, seafood/plant proteins, whole grains and monounsaturated fats.
A study from New York’s Mount Sinai Hospital looked at young patients with early MS to see how their consumption of monounsaturated fats, polyunsaturated fats and saturated fats affected brain matter atrophy, a change closely linked with disability. The researchers didn’t see associations between polyunsaturated or saturated fats and atrophy, but they did see less brain atrophy in patients whose intake of monounsaturated fats was high, suggesting that these fats may be protective.
A modified ketogenic diet for MS has been under investigation at the University of Virginia. This diet is very low in carbohydrates and high in fat. It has long been used to treat drug-resistant epilepsy in children. Although it is a very hard diet to follow, the Virginia researchers were able to recruit 20 patients to join the study and stick with it for six months. The team reported lessening of the patients’ fatigue and depression.
A pilot study at Mount Sinai looked at the effects of a modified Mediterranean diet that included fish, nuts, avocados, fruits and vegetables and whole grains but eliminated meat, dairy products and most processed foods. Researcher Ilana Katz Sand, M.D., reported a statistically significant reduction in fatigue among the patients who joined the study and followed the diet for six months, as well as improvements in the impact of the disease on quality of life. She also said that many of the patients “really felt like their lives were better and they were healthier.” Dr. Sand added that some of the improvement may be related to weight loss; the patients participating in the diet group lost an average of six pounds over the course of the study.
These new findings are promising, but more research with larger study populations is needed to determine what kind of dietary changes would best benefit people with MS.
Andrew Weil, M.D.
Stephen Krieger, Ilana Katz Sand, “Can Diet Alter Brain Function in MS?“ Medscape, November 5, 2018, medscape.com/viewarticle/904116#vp_3