Multiple sclerosis and nutrition guidelines

   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.

The process involves white matter inflammation in areas of CNS. In this disease, our immune system attacks the protective myelin sheath that covers our nerve fibers and results in communication problems between your brain and the body. This leads to demyelination of neurons, loss of oligodendrocytes, glial scarring, and axonal destruction. The etiology of multiple sclerosis is unclear. Some studies suggest a viral etiology while others include environmental factors acting in conjunction with immunodeficiency.

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

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