Diet and Multiple Sclerosis, What's the Story?

Food and diet are the foundation of everyone’s health, and individuals with MS are no exception. Dietary choices that benefit one person, however, may not work for another, even if their symptoms and disease history are similar. Therefore, it is up to the individual and his or her healthcare provider to come up with a dietary plan that works best for them.

When it comes to diet and multiple sclerosis, there are two main issues: does a certain type of diet affect the risk of developing MS, and which type of diet is best for people who already have the disease. Let’s look at the first scenario first.

Diet and risk of multiple sclerosis
The results of a new study presented at MS Boston 2014 focused on whether dietary habits had an impact on the risk of developing MS. Based on research gathered from 185,000 women, the authors concluded there is no relationship between consuming healthful, high-quality foods and a lower risk of MS.

At the same time, however, one of the study’s authors, Dalia Rotstein, MD, of Brigham and Women’s Hospital, pointed out that the research did not include adolescent females. It’s possible a person’s diet earlier in life may have more of an impact on risk.

In fact, research has already indicated that obesity during adolescence is associated with a greater risk of developing the disease. For now, however, the relationship between diet during childhood and adolescence and the risk of MS deserves more investigation.

Diet for people with multiple sclerosis
At the same MS Boston 2014 gathering, experts from Oregon Health & Science University reported on their findings regarding diet and MS. Here are the highlights of the study, which was presented by Vijayshree Yadav, MD.

A total of 61 participants were randomly assigned to follow either a very low saturated fat, plant-based diet (the McDougall diet) or to a regular diet. Those in the low-fat diet group received training and then completed food questionnaires for one year.

This approach was associated with less fatigue, a reduction in total cholesterol, and an average weight loss of 20 pounds, and better mental health scores. However, no clear impact was observed on the process of the disease.

One bit of advice Rotstein offers her patients regarding diet is to take vitamin D supplements. Vitamin D deficiency is common among the general population as well as among people with MS, and supplementation may be especially beneficial for individuals with multiple sclerosis.

In fact, previous research done by Harvard Public Health experts reported that people with multiple sclerosis who took vitamin D supplements experienced a reduced risk of disease relapse, reduced risk of new active brain lesions, and a reduced annual increase in lesion volume.

Another dietary suggestion for people with multiple sclerosis is to hold off on the salt shaker. Several studies have examined the role of salt in MS, and thus far they indicate that higher salt intake is associated with greater disease progression and accelerated nerve damage.

A few experts have looked at a relationship between gluten/celiac and multiple sclerosis. At least one study found an increased prevalence of celiac among people with MS (11.1%) when compared with the general population (1-2%).

The story of diet and multiple sclerosis is still being written. Among the few individuals I have spoken with, each had their own ideas of what seemed to help them: plant-based diet, low-fat diet, gluten-free, and Mediterranean. What has been your experience?

References
Ascherio A et al. Vitamin D as an early predictor of multiple sclerosis activity and progression. JAMA Neurology 2014 Jan 20 Online
MS Boston 2014/WebMD
Rodrigo L et al. Prevalence of celiac disease in multiple sclerosis. BMC Neurology 2011 Mar 7; 11:31