Diet and nutrition

Multiple sclerosis (MS) patients eat a more limited diet, with a lower average of 31 nutrients, including zinc, thiamin, and iron, when compared with healthy controls, a study shows. Blood tests also showed that MS patients had significantly lower iron levels, a different fatty acid composition in their red blood…

Vitamins B12 and B9 (folic acid) supplements can lower levels of homocysteine (a common amino acid), improve anemia status, and boost self-reported physical health in patients with multiple sclerosis, according to new research. The study suggests a potential role for these two vitamins in improving the quality of life of MS patients. Despite treatment, MS patients often experience symptoms that interfere with their daily lives. Many patients have turned to dietary supplements with the hope they would reduce the severity of their symptoms. There is substantial literature suggesting the benefits of various supplements for MS, including vitamin B12 and folic acid. Homocysteine, of which high levels are associated with heart disease and detrimental effects in the nervous system, can be more prevalent in MS patients compared to healthy individuals. That suggests homocysteine is "one of the causative factors in the pathogenesis [development] of MS," researchers wrote. Lack of vitamin B12 — naturally found in meat, fish, poultry, eggs, and dairy products — can lead to a disruption in myelination, the process of forming a protective myelin coat around nerve cells. The loss of myelin is a hallmark of MS. A lack of folic acid, together with too little vitamin B12, has been linked to neurological symptom onset in MS patients. Meanwhile, vitamin B12 and folic acid supplements have shown promising results among these patients. In addition, MS patients are known to have an increased risk for the development of megaloblastic anemia — a condition in which the bone marrow produces unusually large, immature red blood cells referred to as megaloblasts. The most common causes of megaloblastic anemia are a deficiency of either vitamin B12 or folic acid. Based on these observations, researchers from Urmia University of Medical Sciences and Kermanshah University of Medical Sciences, in Iran, studied the effects of vitamin B12 and folic acid supplements in  relapsing-remitting multiple sclerosis (RRMS) patients. The team looked specifically at serum homocysteine levels, anemia status, and quality of life. This double-blinded clinical trial (IRCT2015100313678N7) enrolled 50 RRMS patients (age 20-40 years), who were divided into two groups: the vitamin group, which received three doses of 1 mg vitamin B12 injection (spaced a month apart) plus 5 mg folic acid tablets daily; and the placebo group, which received neutral saline injections. All participants completed two quality-of-life questionnaires, one geared toward physical health and the other toward mental health, at the start and end of the study. Blood samples were collected from all participants, and blood pressure readings were taken. Results showed a drop in average homocysteine blood serum levels in the vitamin group, which may be indicative of an improvement in nervous system health. Researchers also observed a decrease in mean corpuscular volume (MCV) in the vitamin group, which is indicative of improved anemia status. At the end of the study the vitamin group showed improvements in both physical and mental fields in the quality-of-life questionnaires. However, RRMS patients in the control group (without vitamin supplements) also had an increase in the quality-of-life questionnaire for mental health, obscuring any conclusions on the effect of vitamin supplements in MS patients’ mental health. “Results of the present study have shown that homocysteine levels, anemia status, and eventually the quality of life of patients with MS can be significantly improved by administration of 1 mg of vitamin B12 monthly and adding rich-food sources of folic acid on their diet,” the researchers wrote. The team nonetheless emphasizes that "further studies in the field of MS dietary patterns must be conducted."

Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum. This week’s question was inspired by the forum topic “Do you know any natural remedies that help fight inflammation?“, from May…

When I first met Stephanie in March, she was like any healthy 28-year-old coming in to see me for a nutrition consult. Her positive attitude and bright smile filled the room as she told me about her job as a grade school teacher and the new apartment she…

Changeable lifestyle factors influence the risk and severity of depression associated with multiple sclerosis (MS), a study based on a large group of patients shows. According to the study, alcohol consumption in particular was linked negatively with depression incidence and severity. In addition, a healthy diet and vitamin D and omega-3 supplementation…

Researchers at Yale uncovered a way that high-salt diets may trigger inflammation and possibly contribute to the development of autoimmune diseases such as multiple sclerosis (MS). Their study, “Activated β-catenin in Foxp3+ regulatory T cells links inflammatory environments to autoimmunity,” was recently published in the journal Nature…

Thousands of scientists, doctors, pharmaceutical company executives and others — representing about 100 countries — will meet for three days to discuss and debate the latest developments in multiple sclerosis (MS) at the 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis, best known as…

Lemtrada Can Lower Number of B-cells Infiltrating Nervous System and Forming Clumps, Animal Study Shows I usually stay away from recommending articles about mice studies, but this article does a nice job of explaining how Lemtrada works and the role of B-cells in multiple sclerosis (MS). As…

People who eat a healthy diet that includes foods such as vegetables, fish, eggs, poultry, and legumes may have a reduced risk of multiple sclerosis (MS), a study suggests. The study, “A healthy dietary pattern associates with a lower risk of a first clinical diagnosis of central nervous system…

Brain Iron Levels Correlate with MS Progression, Disability Risk, Study Shows Currently, doctors measure shrinkage in the brain as a way to predict physical and cognitive decline in people with multiple sclerosis (MS). But it takes a long time to see this brain atrophy on a standard…

A diet that incorporates non-fermentable fiber — a common component of a vegetarian diet — during early life can help prevent the onset of autoimmune diseases such as multiple sclerosis (MS), a new study shows. The study, “Dietary non-fermentable fiber prevents autoimmune neurological disease by changing gut metabolic and…

Missouri Trial to Examine if Fasting Alters Gut Microbiome and Immune System of RRMS Patients in Helpful Ways The impact of various diets on multiple sclerosis (MS) has been studied, but this new study will look into whether fasting has an impact. The researchers at Washington University…

Health professionals are often not discussing the importance of following national dietary guidelines with their multiple sclerosis (MS) patients, causing them to turn to other sources like the internet that may advise potentially harmful diets with serious consequences, according to an Australian study. The study, “Dietary responses to…

A 12-week clinical study is recruiting people with relapsing-remitting multiple sclerosis (RRMS) to evaluate if intermittent fasting can improve their immune response, metabolism, and gut microbiome — the bacterial community that inhabits the gastrointestinal tract. Its findings may also hint at whether such a diet might ease MS symptoms or alter discourse course and, if used in conjunction with other treatments, boost their efficacy. Conducted by researchers at Washington University in St. Louis, Missouri, the trial is supported by their findings in an earlier mouse study.  Results showed that fasting worked to ease MS-like symptoms in a mouse model of the disease, the research team reported. Specifically, EAE mice fed every other day were less prone to symptoms that included difficulty in walking, limb weakness, and paralysis than mice allowed to eat freely.  A fasting diet also enriched bacterial diversity in the mice guts, and shifted immune cell populations there toward a lower inflammatory response. When gut bacteria were transferred from fasting mice to nonfasting mice, the later also were seen to be better protected against MS-like movement problems, supporting the influence of the gut microbiome on MS symptoms. Several diets have been proposed to help ease disease progression in MS patients, but solid scientific evidence is lacking to support any one diet over another, leaving the issue much to an individual’s choice. “The fact is that diet may indeed help with MS symptoms, but the studies haven’t been done,” Laura Piccio, MD, an associate professor of neurology at WUSTL and the study's lead author, said in a WUSTL news release written by Tamara Bhandari. Taking place at the Missouri university, the trial is expected to enroll 60 RRMS patients. Half will be randomly assigned to eat a standard Western-style diet seven days a week, and the other half to Western-style diet five days a week, with two days set aside for fasting (consuming a maximum of 500 calories each day). On fasting days, patients can only drink water or calorie-free beverages and eat fresh, steamed or roasted non-starchy vegetables All will undergo a neurological assessment, and provide blood and stool samples in the study's beginning, at mid-point or week six, and at its end (week 12). Those using MS medications will continue on their prescribed treatment regimens throughout the study. More information, including enrollment information, is available here. Piccio noted that a pilot study on diet in 16 MS patients showed that limiting calories every other day for two weeks led to immune and gut microbiome changes that resembled those observed in the mice study she helped to lead. Its researchers concluded that intermittent fasting had the potential to positively manipulate the immune response in MS patients by changing their gut microbiome. The gut microbiome plays a central role in digestion, and in producing vitamins and amino acids (the building blocks of proteins). But a growing body of evidence indicates that it also determines how our immune systems develops and matures. Indeed, an increasing number of studies link irregularities in the gut microbiome with MS. “There are several possible ways fasting can affect inflammation and the immune response,” Piccio said. “One is by changing hormone levels. We found that levels of the anti-inflammatory hormone corticosterone were nearly twice as high in the fasting mice. But it also could act through the gut microbiome.” The new trial will allow the team to analyze more deeply the effects of a fasting diet — and perhaps gather evidence for a larger study investigating if skipping meals can ease MS symptoms. Its goal is to find out "whether people on limited fasts undergo changes to their metabolism, immune response and microbiome similar to what we see in the mouse,” Piccio said. “I don’t think any physician working with this disease thinks you can cure MS with diet alone,” she added, “but we may be able to use it as an add-on to current treatments to help people feel better.”

Getting plenty of sun, eating fresh fruits regularly and drinking coffee daily are associated with a lower risk for multiple sclerosis (MS) among adults in Saudi Arabia — while eating a lot of fast-food raises that risk, researchers report. Their study, “Environmental exposures and the risk of…

Last month, I challenged myself to conquer Whole30: 30 days of no gluten, grain, dairy, sugar, or sulfites. Forty days later, I am proud to say I not only survived, I thrived. I am still thriving. Friends have long been touting the merits of adopting a synonymous eating plan.

In general, multiple sclerosis (MS) patients are able to make and sustain healthy lifestyle changes associated with a better quality of life, a study shows. The study, “Health outcomes and adherence to a healthy lifestyle after a multimodal intervention in people with multiple sclerosis: Three year follow-up,”…

Awareness is, at times, barely imperceptible, a quiet conviction that lies within. As with most truths, they are self-evident long before we decide to own them. And when we do, it is as if we have opened our eyes for the first time. My eyes are open. Living with progressive…

Metabolites produced by microbes in the gut can ease inflammation in the central nervous system by limiting the damage done by microglia, an immune cell of the brain, an early study reports. Its scientists suggest this gut-brain axis may open new avenues to treatment. “These findings provide a clear understanding of how…

A diet rich in fish consumption and supplemented with omega-3 polyunsaturated fatty acids (PUFAs) is linked to a reduction of 45 percent in the risk of developing multiple sclerosis, a study shows. The results confirming previous research will be shared April 26 at the 2018 Annual Meeting of the American Academy of…

While Reese’s Peanut Butter Cups are the true “two great things that go great together,” calcium and magnesium take first place for those with MS. Many proponents of special diets for MS encourage the consumption of foods high in this mineral dynamic duo (along with other vitamins needed for…

I’m not a fish eater. I never have been. Unless the seafood is lobster, shrimp, clams, or crab cakes (pickin’ the crabs is too much work), I’m not interested. Is the fact that I eat very little fish one of the reasons why MS attacked me about 40 years…

Can Do MS has launched an MS Path 2 Care initiative that aims to help people affected by MS  be more active partners in their healthcare experience. A national non-profit organization based in Avon, Colorado, Can Do MS delivers health and wellness education programs focused on exercise, nutrition, symptom…

Eating fish once a week, or one to three times per month along with taking daily fish oil supplements, may help lower the risk of developing multiple sclerosis (MS), a preliminary study shows. These findings suggest that the omega-3 fatty acids in fish like salmon, tuna and shrimp may…

Pilot Study Is Testing Whether Mediterranean Diet Can Help MS Patients There’s been a good deal of news recently about the possibility that bacteria in our stomachs have an impact on our MS. There’s also been talk, for a long time, about whether certain diets can improve…

New York researchers are doing a pilot study of whether a Mediterranean diet can reduce multiple sclerosis symptoms and improve patients’ quality of life.  Dr. Ilana B. Katz Sand, an assistant professor of neurology at the Icahn School of Medicine at Mount Sinai, is leading…

It started with vitamin D. Little did I know I was starting a habit. I had my first sclerosis attack in 2006 and learned about it by having an appalling fall on a tennis court. That’s another story. I haven’t written about that yet, but I’m sure I will.

Get plenty of rest. Drink lots of warm fluids. Use a humidifier. Gargle and flush your sinuses with warm salt water. Blow your nose early and often. Take over-the-counter medications. Eat some chicken soup. No doubt, you know what I’m talking about when you read this list of…

New research shows how a high-salt diet leads to excessive levels of interleukin-17 (IL-17) in multiple sclerosis (MS) patients, causing changes in endothelial cells that result in dementia. These findings suggest that therapeutics targeting IL-17 may help halt the neurovascular damages of MS and other autoimmune diseases linked to high…

My life has been in limbo for several months and it’s been a dark and scary place to be. One quickly learns that life can be unpredictable when living with multiple sclerosis. Each day can bring different challenges and life will never be…