Treating multiple schlerosis by diet: fact or fraud?

Somaye Sadeghi,1,* Parastoo ehsani,2

1. pasteur institute of iran

Abstract

Introduction

Multiple sclerosis (ms) is a multifactorial, inflammatory, and neurodegenerative disease of the central nervous system. in addition to the genetic, epigenetic and immunological components, various other factors e.g. unhealthy dietary habits play a role in the ms pathogenesis. diet could affect ms in one of two ways: dietary components that prevent or control the progression of the disease and those that help to manage and reduce symptoms. since nutritional status and dietary habits in ms patients have not been extensively reported, the aim of this review is to elucidate the role of an accurate nutritional counseling in ms to move toward a multidisciplinary management of the disease. this review evaluates published studies examining diets and nutritional supplements for the impact on prevention and treatment of multiple sclerosis (ms).

Methods

In this simple overview to collect information, articles that contain one of the terms: diet, multiple sclerosis, neurodegenerative disease and treatment from 2010 to 2018 at science direct, scopus, pubmed and google scholar were searched and reviewed. so, through an extensive search of relevant literature, this review reports the most significant evidence regarding nutrition as a possible co-factor influencing the inflammatory cascade by acting on both its molecular pathways and gut microbiota.

Results

This review summarizes current knowledge about the effect of different dietary approaches (diets low in saturated fat and dietary supplements such as fish oil, lipoic acid, omega-3 polyunsaturated fatty acids, seeds oils, high fiber diet, vitamin d, etc.) on neurological signs, patient’s well-being, physical and inflammatory status. besides arresting ms, a low-fat vegetarian diet promotes weight loss in the obese, relieves constipation, and cuts the food bill by 40 percent. in fact, this type of diet is in line with recommendations made by other health organizations (including the american cancer society, the american heart association, and the surgeon general’s office) that urge americans to eat less fat and meat, while adding more whole grains, vegetables, and fruits. what increases inflammation are hypercaloric diets, characterized by high salt, animal fat, red meat, sugar-sweetened drinks, fried food, low fiber, and lack of physical exercise. exercise and low-calorie diets based on the assumption of vegetables, fruit, legumes, fish, prebiotics, and probiotics act on nuclear receptors and enzymes that upregulate oxidative metabolism, downregulate the synthesis of proinflammatory molecules, and restore or maintain a healthy symbiotic gut microbiota. recommendations to achieve optimal health include: • eat plenty of vegetables, legumes and fruits • eat plenty of cereals, preferably wholegrain • include lean meat, fish, poultry and/or alternatives • include milk, yoghurt, cheeses and/ or alternatives. reduced fat versions should be chosen where possible. • drink plenty of water and take care to:  limit saturated fat and moderate total fat intake  choose foods low in salt  consume only moderate amounts of sugars and foods containing added sugars.

Conclusion

This work collects recent findings on nutrients of great interest among ms patients and physicians. in fact, all the existing scientific evidence points to diet as the most helpful approach. future research should explore the importance of diet for those who have had ms for a longer period of time. we can expect that a nutritional intervention with anti-inflammatory food and dietary supplements can alleviate possible side effects of immune-modulatory drugs and the symptoms of this disease, thus favor patient wellness.

Keywords

Diet, multiple sclerosis, neurodegenerative disease, treatment.