Can what we eat affect the course of MS? Researchers explore an area where advancements might change the daily lives of people with MS.
Diet and MS – the big picture
Maintenance of general good health is important for people with MS or any chronic disorder. A well-balanced and carefully planned diet will help to achieve this goal. While many different diets have been proposed as a treatment, or even a cure, for the signs and symptoms of MS, evidence of effectiveness is very limited. Most of these proposed diets have not been subjected to rigorous, controlled studies, and the few that have been evaluated have produced mixed results.
Researchers are making significant connections, however, in the story of diet and MS that may eventually impact the lives of people living with MS. Here are some key findings and some areas where the results are mixed.
Vitamin D - Research is increasingly pointing to a reduced level of vitamin D in the blood as a risk factor for developing MS, and studies are underway to determine if vitamin D levels influence MS disease activity. The National MS Society has led the way in this research, funding early preclinical studies, convening a summit on this topic, and now funding a clinical trial of vitamin D supplementation. Read more here.
Salt – Several reports suggest that dietary salt can speed the development of an MS-like disease in mice, and provide new insights on immune system activity involved in MS. Read more about these reports here. While more research needs to be done to confirm a role for salt in triggering MS, or to determine whether reducing salt can inhibit MS immune attacks, these studies pinpoint new avenues for strategies that can decrease MS attacks. These studies were funded in part by the National MS Society, and the Society is now funding further research that explores how salt affects the immune system in humans.
Antioxidants – these natural or manmade substances are found in many foods. In MS, the immune system damages and destroys myelin, the material that surrounds and protects nerve fibers in the brain and spinal cord. Nerve fibers themselves are damaged as well, which appears to drive long-term disability. “Free radicals” are normal by-products of bodily processes, and may cause tissue injury and turn on immune attacks in MS. Antioxidants block the action of free radicals. The Society is funding scientists at Oregon Health & Science University to test whether an antioxidant can reduce progression in 118 participants with primary progressive or secondary progressive MS.
Diet Research Funded by the National MS Society
Is there an ideal “MS Diet” that can reduce symptoms or change the course of MS? While emerging evidence suggests that wellness behaviors and lifestyle factors can influence the risk for developing MS, disease course, severity of symptoms and quality of life, most of the diets promoted for MS have not been subjected to rigorous, controlled studies. That’s one reason why studies looking at the impacts of diets, supplements and complementary approaches on the course of disease and quality of life are among the key topics identified as Society Research Priorities
. Research projects funded by the Society include:
- Clinical Trials of Diets-
- Investigators at Washington University in St. Louis and at Johns Hopkins University in Baltimore are testing the safety and tolerability of a diet that intermittently restricts calorie intake as a treatment for disease activity in people with MS.
- Researchers at the Icahn School of Medicine at Mount Sinai in New York are exploring the potential of a dietary approach in people with MS designed to include dietary components that have been suggested to be of benefit in MS through previous studies, and to exclude those that have been suggested to be detrimental.
- A team at the University of Iowa is conducting a trial comparing the effects on fatigue of a low saturated fat diet (a diet developed by Roy Swank, MD) or a modified paleolithic diet (a diet developed by Terry Wahls, MD).
- Clinical Trials of Dietary Supplements –
- Johns Hopkins University investigators are comparing the effectiveness of the current recommended amount of vitamin D supplementation versus high-dose vitamin D supplementation at reducing MS disease activity, when added to standard therapy with glatiramer acetate (Copaxone®, Teva Pharmaceutical Industries).
- Investigators at Oregon Health & Science University are conducting a clinical trial to determine if the oral supplement, lipoic acid, is an effective treatment for progressive forms of multiple sclerosis.
- Johns Hopkins researchers are investigating whether a bile acid supplement can be beneficial for the immune system, gut bacteria and MS disease activity in people with progressive MS.
- Studying Dietary Risk Factors -
- Johns Hopkins University researchers are conducting studies characterizing how vitamin D may protect individuals from getting MS and looking at genetic predictors of changes and progression in MS using measures of the eye.
- Investigators at University of California, San Francisco are leading the Network of Pediatric MS Centers in a study of how kids’ diets impact MS relapses and progression.
- Researchers at The Ohio State University are seeking to determine if low vitamin D in early life increases the risk of developing MS.
- Yale researchers are using immune cells from the blood of people newly diagnosed with MS and people without MS MS to investigate how a high salt may switch a helpful type of immune cell (called Tregs) to a harmful type (called Th1-like Tregs) and if the helpful function can be restored to turn off inflammation.
- Harvard researchers are investigating how an enzyme called SGK1 works to increase salt intake and disrupt the balance between helpful and harmful immune cells in a mouse model for clues to the possible role of salt in MS.
- Each of us has millions of “commensal” bacteria living within our guts. Most of these bacteria are harmless as long as they remain in the inner wall of the intestine. They play a critical role in our normal physiology, and accumulating research suggests that they play a role that intestinal bacteria in the brain inflammation that underlies MS. The National MS Society continues to fund research in this area, most recently The MS Microbiome Consortium, a comprehensive analysis of gut bacteria in people with MS to determine factors that may drive progression and develop probiotic strategies for stopping progression.