Can what you eat help MS?

Crispy fries, gooey cream cake, crunchy chocolate biscuits…why is it that the most irresistible foods are also the ones that often do so little for our bodies? With temptation around every corner, making the right food choices can be a challenge…I mean, those biscuits are actually begging to be eaten, right?! It’s worth being mindful about what you munch, though. Eating healthily is important for everybody, but even more so when you have a chronic disease like Multiple Sclerosis (MS)¹. Here’s why.

Carbohydrates

While low-carb diets are all the rage right now, carbohydrates are an important source of fuel for the body – as long as you eat the right kind. Opting for a variety of complex carbohydrates, such as wholegrains, whole meal bread and brown rice will help maintain your energy levels (as well as provide important vitamins and minerals). These are also a great source of fiber, which encourages regular bowel movements and reduces constipation, a common symptom of MS².

Salt

Although sodium (which we usually consume in the form of salt) is essential for our bodies to function properly, a high-salt diet can be detrimental to our health, leading to conditions such as high blood pressure. For people with MS, high-salt consumption might have further consequences: a recent study in two separate groups of people with relapsing-remitting MS (70 and 52 participants) found a relationship between relapse rate and sodium intake – in fact, relapse rate was around 3 times higher for people with a medium to high sodium intake (above 2 g per day) than those with a sodium intake of less than 2 g per day. Furthermore, the chance of developing a new MRI lesion more than tripled in individuals with high sodium intake. Clinical trials are needed to test whether sodium intake reduction is a beneficial intervention for people with MS.

Omega-3 Oils

Ah, the age old “good fats” versus “bad fats” conversation. Today we are going to focus on one of the good ones: polyunsaturated fats. Preclinical evidence suggests that these fats may have a protective role in the central nervous system, particularly omega-3 oils found in oily fish and some plants, such as flaxseeds. Studies show that countries with the highest rates of fish consumption tend to have lower rates of MS, which some experts believe could be due to the anti-inflammatory effects of omega-3 oils. Evidence published from a web-based survey of people living with Relapsing–Remitting MS (RRMS) with various dietary habits found that those who ate the most fish fared better in terms of quality of life, relapse rate and disease progression. Furthermore, it was found that those patients who reported to add flaxseed supplements to their diet (129 out of 1377) saw a 60% reduction in relapse rate over 12 months³.

Another possible benefit of a diet rich in omega-3 oils is the impact on brain chemistry. Omega-3 oils appear to play an important role in brain function and several studies show a link between deficiency in this fatty acid and depression. More research is needed to determine whether omega-3 supplements can help ease depression, but in the meantime, it wouldn’t hurt to include oily fish such as salmon and mackerel in your diet, or to add flaxseed to your cereal in the mornings⁴.

Vitamin D

Vitamin D is commonly associated with sunshine, but it is also present in fatty fish –just another reason to add it to your diet! There are studies investigating the effect of vitamin D supplements in relapsing-remitting MS on the way, but in the meantime, try incorporating salmon, mackerel, cod liver oil, and, the occasional egg yolk to your diet. The recommended daily intake of vitamin D varies from country to country, but some experts advise that people with MS take 4000–5000 International Units (IU) of vitamin D per day. If you’re concerned about your vitamin D levels, speak to your doctor about taking vitamin D supplements⁵.

Fad = Bad!

What you eat is a vital tool in the management of MS. Remember it’s important to avoid fad diets – particularly those that exclude whole food groups, as these may lead to a vitamin or mineral deficiency and make some symptoms worse. The key is to eat a varied, balanced diet that comprises all food groups: fruits and vegetables, carbohydrates, fat, protein and dairy products⁶.

And What About That Battle of the Bulge?

As well as ensuring your body receives all the nutrients it needs, eating well will help you maintain a healthy weight. One recent study has reported a potential link between obesity in adolescence and early adulthood and risk of developing MS, which, according to the authors, might be due to the inflammatory effects of a hormone called leptin (levels of which increase with body mass index, or BMI). Overall, being overweight will make it harder to remain active and contributes to fatigue, so strive to maintain a healthy BMI (between 18.5 and 24.9). Keeping your weight in check while nourishing your body will help you feel your best today, tomorrow, and in the long-term⁷.

References:

1. Website “Multiple Sclerosis News Today” Healthy Eating and MS: Foods to Eat and Avoid. Available at: https://multiplesclerosisnewstoday.com/living-with-ms/ms-diet-nutrition/healthy-eating-ms/
2. Website “National MS Society” The Lowdown on Low Carb. Available at: https://www.nationalmssociety.org/Living-Well-With-MS/Diet-Exercise-Healthy-Behaviors/Diet-Nutrition/Low-Carb
3. George A. Jelinek, Emily J. Hadgkiss, Tracey J. Weiland, et al. Association of fish consumption and omega 3 supplementation with quality of life, disability and disease activity in an international cohort of people with multiple sclerosis.  2013 Nov; 123(11): 792–801. doi: 10.3109/00207454.2013.803104. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821380/
4. Website “National MS Society” The Omega-3 Factor. Available at: https://www.nationalmssociety.org/Living-Well-With-MS/Diet-Exercise-Healthy-Behaviors/Diet-Nutrition/Omega-3
5. Website “MS Trust” Vitamin D. Available at: https://www.mstrust.org.uk/life-ms/diet/vitamin-d
6. Website “MS Society” Special Diets and MS. Available at: https://www.mssociety.org.uk/care-and-support/everyday-living/eating-and-drinking/special-diets-and-ms
7. Website “Multiple Sclerosis News Today” Excess Body Fat Spurs Disease Progression by Impact on Immune Cells, Study Suggests. Available at: https://multiplesclerosisnewstoday.com/news-posts/2019/04/11/body-mass-index-may-play-a-significant-role-in-the-progression-of-multiple-sclerosis/