Multiple sclerosis and nutrition guidelines
Multiple sclerosis is an autoimmune disease of the central nervous
system. The “European Journal of neurology” defines it as the commonest
non‐traumatic disabling disease that affects young adults.
According to the “National Multiple Sclerosis Society”,
it is estimated that 2.3 million people live with MS globally and nearly 1
million in the United States are living with MS. Every week about 200 new
cases are diagnosed each week in the United States. African and Asian countries
are at a lower risk.
Classification:
“Journal of the American Academy of Physician Assistants”
classify it in four subtypes
·
Relapsing-remitting
multiple sclerosis:
It occurs in
85% to 90% of patients and is characterized by relapses that last from months
to years without giving new symptoms. About 65% of these patients progress to
secondary progressive MS.
·
Secondary
progressive multiple sclerosis:
It is, in fact,
the second stage of RRMS. Men and older patients mostly experience faster
progression. The disease course includes distinct exacerbations. Patient
experiences neurocognitive decline.
·
Primary
progressive multiple sclerosis:
It is
responsible for about 10% to 15% of cases. No remissions occur in this subtype.
·
Progressive
relapsing multiple sclerosis:
This subtype is
the least common. Patients can experience a constant decline that includes
exacerbations without any symptom-free remissions.
Symptoms:
Symptoms vary greatly from person to person. They include:
·
Numbness or
weakness in limbs, mostly occur on one side of the body or legs and trunk, gait
is unsteady. Electric shock sensations may occur with some neck movements.
·
Some common
vision problems may occur, such as blurry vision, prolonged double vision, loss
of vision, and pain during eye movements.
·
Bladder/ bowel dysfunction
·
Slurred speech
·
Fatigue and
pain in body parts
Risk factors:
The disease is more common in the Western European population. Affect people
between the ages of 16 and 55 and is more common in women. Exposure to sunlight
and vitamin-D deficiency may reduce the risk. Smokers and the patients of
thyroid disease and type 1 diabetes are at higher risk.
Diagnosis:
MRI: It is the
test of choice. It may show multiple white lesions. Doctors look for the
changes caused by multiple sclerosis to your brain, like signs of inflammation
in the brain and spinal cord. Along with these, the symptoms are also
considered.
Lumbar puncture: This test
is commonly known as, a spinal tap. The fluid that runs through the spinal
column is checked in it. The results may
show myelin basic protein, in 80%-85% of patients with active MS but these
findings are not specific for MS
Evoked potentials: These are
electrical nerve tests and are conducted to find out if Multiple sclerosis has
affected your sight, vision, and hearing. The doctor place wires on your scalp
to test your brain response and get the electric pulses on your arm and leg.
Nutrition:
Many different diets have been proposed for multiple sclerosis or
the symptoms of MS, but these diets have not been subjected to rigorous studies.
A balanced diet consists of the major food groups, proteins, which help in
growth and tissue repair in the body; carbohydrates are needed for energy;
fats, act as a source of essential fatty acids and help in the absorption of
vitamins; vitamins and minerals are needed to carry out complex cellular
functions; and fluids are required for transport of nutrients.
A diet for Multiple Sclerosis patients should include:
·
Fish, such as
salmon, herring, mackerel, tuna, sardines, and lake trout because they have a high amount of omega-3 fatty acids
·
Use skinless
chicken or turkey or lean meats with no visible fat
·
Beans, soy,
lentils and nuts are good to use
·
At least five
fruit and vegetables a day
·
Three to four
servings of whole-grain products a day
·
Try to use oils
from vegetables, seeds, and fish instead of butter
Fats:
Foods high in saturated fats, such as butter cheese, red meat, and
full-fat dairy products should be avoided. Such foods reduce oxygen availability
to the CNS, causing the activation of lysing enzymes in cells which as a result
make the blood-brain barrier more permeable to toxins. A study of people with
relapsing-remitting MS indicated that a low-fat, plant-based diet, led to
reductions in cholesterol levels, BMI, and fasting insulin levels. A reduction
in fatigue was also observed.
In the 1950s, “The Swank diet” appeared to treat multiple
sclerosis. It was given by Dr. Roy Swank who claimed that it can reduce
the frequency of flares, the severity of symptoms, and mortality.
The central future of this diet is that it limits fats, especially
saturated fats, and focuses on non-fat products, fruits, and vegetables. However, it is important to note that this study had several weaknesses,
it had no control group for comparison and the drop-out rate among participants
was high.
Vitamin-D:
Due to the positive effects of vitamin D on the immune system, research
suggests a connection between vitamin D and MS.
Exposure to sunlight reduces the risk of MS. Some studies suggest
that vitamin D beneficially lessens the frequency and severity of symptoms in
people who already have MS. But more research is still needed to support this.
“The Institute of Medicine” recommends a
dose of 600 international units of vitamin D a day for pregnant women and people
up to age 70. Research suggests taking 400 IUs or more of vitamin D per day
decreases the risk of MS in women.
Although there is no known cure for MS, some
changes in lifestyle, such as regular physical activity, a balanced diet, and meditation
may prove beneficial. Exercise helps to reduce fatigue, depression, anger, and
to improve the overall quality of life
.
