Salt and Other Foods MS Patients Should Consume or Avoid
Food choices may have a significant impact on quality of life among people who have multiple sclerosis (MS). One of those food items is salt, as noted in a new study from researchers at Yale and Harvard, and there are also other items MS patients may want to either consume or avoid. Here’s what the research and experience have revealed so far.
Is salt bad for MS patients?
You are probably familiar with the recommendations to limit your intake of salty foods and salt in general because of an increased risk of high blood pressure and other health problems. Now a new study suggests that one of those “other” health problems associated with salt (sodium chloride) may be accelerated nerve damage, which is especially a hallmark of the autoimmune disease multiple sclerosis.
Multiple sclerosis is characterized by the destruction of myelin sheaths, which are the protective covering on nerves. Once the nerves are damaged they begin to deteriorate, and this process cannot be reversed. The exact symptoms associated with multiple sclerosis and their severity depend on the degree of damage and which nerves are affected.
To come to this conclusion, researchers from Yale and Harvard conducted experiments in the laboratory, exposing immune system cells called helper T cells to high levels of sodium chloride. They discovered that exposure to salt caused the cells to become Th-17 cytokines, proinflammatory cells that have been associated with multiple sclerosis.
When they exposed mouse models of multiple sclerosis to high levels of salt, they observed accelerated nerve damage. Their findings suggest—but do not confirm—that high salt exposure has a significant role in multiple sclerosis.
Foods and supplements MS patients should avoid or use
No specific diet has been established for people who have multiple sclerosis, but a number of studies have shed some light on possible benefits or risks of certain foods and supplements.
Vitamin D. For example, a review published in the Journal of Pharmacy Practice noted there is evidence of an increased incidence of MS associated with low levels of vitamin D and that vitamin D supplementation may protect against development and/or relapse of the disease. An appropriate serum vitamin D concentration is between 75 and 100 nanomoles per liter, and individuals may need to take up to 3,000 International Units (UI) as a supplement to achieve that goal.
Supplementation may be the route to take for vitamin D, since few foods are rich sources of this vitamin. However, people with MS should still include vitamin D rich foods whenever they can, including sun-dried shiitake mushrooms, salmon, mackerel, herring, and sardines, as well as vitamin D fortified foods (but check the labels).
Caffeine and alcohol. A recent study appearing in Multiple Sclerosis and conducted by Harvard researchers found no association between intake of alcohol (wine, beer, liquor), caffeine, and decaffeinated coffee and the risk of multiple sclerosis. The authors reviewed dietary data on nearly 190,000 women to arrive at their conclusion. Note that this study does not advocate consuming either of these products, but only did not see an increased risk from their intake.
Gluten and celiac. Some experts have suggested that a gluten-free diet may benefit some individuals who have multiple sclerosis. In fact, studies have shown an increased incidence of celiac disease (gluten intolerance) among people who have MS.
For example, while the worldwide prevalence of celiac disease is estimated to be between 1 to 2 percent of the population, a recent study found celiac disease to be present in 11.1 percent of people with multiple sclerosis and in 32 percent of their first-degree relatives. These findings indicate a strong relationship between gluten intolerance and MS.
Gluten is a protein found in all forms of wheat (e.g., durum, kamut, semolina, spelt) and related grains (e.g., barley, rye, triticale). Many processed foods contain wheat product or gluten, which makes it difficult for many people to find gluten-free foods.
However, with growing awareness of celiac and gluten intolerance, more and more choices are available, making it somewhat easier to live gluten-free. Because following a gluten-free diet is a challenge, individuals with MS may want to be tested to see if they do indeed have an intolerance for gluten, and for such individuals a gluten-free diet may be helpful.
Saturated fat. Another dietary consideration is saturated fat, which has been the focus of some research, especially by Dr. Roy Swank, former head of the University of Oregon’s Department of Neurology and currently a practicing physician at the Health Science Center at the University of Oregon. Swank researched the effect of a low-fat diet on multiple sclerosis for more than 34 years.
Swank found that if multiple sclerosis is identified early, individuals have had few attacks, and they then adopt a low-fat diet, they have a 95 percent chance of not getting worse. Among people who have more severe disease, switching to a low-fat diet can slow progression of the disease.
Swank advocated a diet containing about 7 percent fat (about 15-18 grams daily), with the dietary fat coming mainly from low-fat vegetable foods. That means a diet rich in fruits, vegetables, whole grains, legumes, and nuts. Small amounts of no-fat and low-fat dairy and fish (e.g., 3 ounces of sockeye salmon contains only 2 grams of saturated fat) makes it possible to stay in the low-fat range.
Swank’s approach to a diet for multiple sclerosis is supported by experts, including John McDougall, MD, author, lecturer, and founder/medical director of the McDougall Program, which involves a plant-based diet that contains only 5 to 10 percent total fats. McDougall has noted that “Obviously, this is the ideal diet for patients suffering from multiple sclerosis. And it is a practicable diet, as well as a palatable one.”
People with multiple sclerosis may find some symptom relief and even an effect on disease progression if they change their dietary ways. It appears there are certain foods and dietary factors, such as salt, saturated fat, gluten, and vitamin D, that can have an impact on the quality of life of MS patients.
Massa J et al. Caffeine and alcohol intakes have no association with risk of multiple sclerosis. Multiple Sclerosis 2013 Jan; 19(1): 53-58
McDougall, John MD.
Rodrigo L et al. Prevalence of celiac disease in multiple sclerosis. BMC Neurology 2011 Mar 7; 11:31
Summerday NM et al. Vitamin D and multiple sclerosis: review of a possible association. Journal of Pharmacy Practice 2012 Feb; 25(1): 75-84
Swank R. Multiple sclerosis: twenty years on low fat diet. Archives of Neurology 1970; 23:460
Swank R. Multiple sclerosis: the lipid relationship. American Journal of Clinical Nutrition 1988; 48:1387