Diets of MS Patients in Spain Seen to Favor Fats, Proteins and Inflammation

A study from Spain found the diet of multiple sclerosis (MS) patients to contain more fat and protein, and fewer carbohydrates, than recommended, which was linked to abdominal weight gain and higher levels of inflammation.

As “an excessive intake of lipids” is known to be “related to oxidative stress and inflammation,” one of the “practical outcomes” of this study could be new dietary guidelines that stress lesser fat consumption, its researchers said.

The study, “The Relation between Eating Habits and Abdominal Fat, Anthropometry, PON1 and IL-6 Levels in Patients with Multiple Sclerosis,” was published in the journal Nutrients.

MS, a neurodegenerative disease, is marked by immune system attacks on the protective myelin coating of nerve fibers, affecting the communication between neurons. These attacks also result in inflammation that can accelerate disease progression.

People with MS show disabilities associated with muscle mass loss, and excessive weight around the abdomen. While diet is known to play an important role in disease, the “nutritional status and eating habits in MS patients have not been studied in depth, as of yet,” the researchers wrote.

A team led by scientists at Catholic University of Valencia San Vicente Mártir sought to characterize how caloric and nutritional intake related to body measurements and inflammatory signals in patients.

In total, 57 adults with MS were selected to participate (average age, 47.04; 66.7% women and 33.3% men). All were diagnosed at least six months prior to study enrollment, and were being treated with glatiramer acetate (sold as Copaxone, Glatopa, and generic forms) or interferon beta (sold under several brand names).

Each was asked to fill out a form called the Food Frequency Questionnaire, which provides information on how often major food groups (tailored to a given culture) are eaten. Patients also registered every food they ate, measured down to ingredients, for seven days, providing a more detailed look into their diets.

Results showed that the average MS patient ate less than the recommended quantities of carbohydrates (which include fruits, vegetables, nuts and grains), and higher amounts of proteins (like meats and fish), and lipids (fats like butter, oils and cheese). This was true in both male and female participants, with men consuming higher-than-recommended amounts of cholesterol.

Caloric intake was seen to be in the normal range for women (mean calorie intake of 1917.11 kcal; normal range 1875–2300 kcal for females), and slightly lower than recommended for men (mean calorie intake of 2312.04 kcal; normal range 2400–2850 kcal for males).

Body measurements were taken, and patients were classified as having abdominal obesity if they had a ratio of waist circumference to height greater than 0.5 (their mean waist circumference was 97.53 cm). In total, 50 of the 57 participants (87.7%) had abdominal obesity.

Those with abdominal obesity also had a higher body fat percentage, and higher body mass index (mean of 28.54 found; normal range is 18.5–24.9).

Researchers then measured inflammatory signals in non-obese and obese participants, specifically looking at the proteins IL-6 and PON1.

Levels of IL-6 were significantly higher in obese patients compared to non-obese ones, the researchers found. No significant difference was seen in PON1 levels.

IL-6 is generally correlated with obesity, and it is involved with inflammation, which is part of the pathology of MS.

PON1 is an enzyme that is activated during the breakdown of LDL cholesterol, also known as “bad” cholesterol. While low PON1 activity has been associated with certain types of disease, these findings and others from related studies indicate it is not a relevant biomarker for MS.

From these results, the researchers suggested a link between the accumulation of abdominal fat in MS patients and a rise in IL-6 levels, but not PON1.

Overall, these data showed a nutritional imbalance in MS patients, and one that can contribute to abdominal weight gain and higher levels of inflammation, as measured by IL-6 levels.

“MS patients’ nutrient intake shows an imbalance between macronutrients,” the researchers wrote. “This seems to favour abdominal obesity associated to high values of proinflammatory interleukin 6, which, however, is not correlated with a lower activity of the oxidation marker PON1.”

They noted their study was limited by a small patient size and a possible regional bias, as all participants were from Spain.

Nevertheless, the team suggested it had practical implications for MS patients. Namely, “establishing new dietary guidelines based on decreasing high lipid intakes could be a therapeutic strategy to reduce the inflammatory state,” and to limit weight gain.