Multiple Sclerosis - A nutritional approach

By: 

ION Archives

Issue: 
Spring
Year of publication: 
2002

According to Judy Graham, Director of the Multiple Sclerosis Resource Centre (MSRC) nutrition is the single most important factor in treating MS. Here, she provides first-hand experience on the dietary guidelines, of how to keep this progressive, degenerative disorder in check

Multiple sclerosis (MS) is classified as a neurological disease as it mainly affects the central nervous system (CNS) - the brain and spinal cord. During MS “attacks”, the CNS becomes inflamed. Part of the process of MS is demyelination. The fatty tissue which insulates nerves in the CNS, myelin, gets attacked by an auto-immune reaction.

Symptoms can be both sensory and motor, depending on where the damage in the CNS is. Sensory symptoms - often the first to show - include numbness, tingling, pins and needles, and distorted sensations. Motor symptoms include weakness and heaviness in the legs and/or arms, making walking difficult. Other common symptoms are eye problems, fatigue, bladder urgency and frequency, slurred speech and tremors.

Typically, untreated MS gets worse over time. In most cases, it starts with a relapsing/remitting course. Later, it becomes chronic progressive. A small percentage of sufferers start with the chronic progressive type of MS, never having any remissions.

MS mostly affects young adults aged 20 - 40, although cases can be younger and older.


CAUSES OF MS


Latitude. MS is much more prevalent in temperate climates, but unknown in the tropics. If you emigrate from a high risk to a low risk country before age 15, you inherit the low risk. After age 15, you carry the risk with you.
Environmental agent in childhood. The above suggests that there is some environmental element at work during the first 15 years of a child’s life.
Dairy/Western Diet. Dairy produce and a Western diet are eaten in countries where MS is most prevalent.
Viral Infection. Many people with MS had a viral infection in childhood such as glandular fever. Throat infections are common too.
Trauma. Many people with MS had a physical or psychological trauma prior to getting MS.
Genetic Predisposition. People with MS have a particular genetic type. MS is also higher in families where MS already exists. The strongest link is mother to daughter.


THE NUTRITION CONNECTION

Nutrition is the single most important factor in treating MS. Say this to a typical neurologist and you will be treated with derision. But look at the thousands with MS world-wide who are doing well on a regime of diet and supplements, and it is hard not to be convinced that it makes a difference. Deterioration can be slowed, halted or even reversed; people with MS can get better, rather than worse.

I have been banging on about this for the last 30 years, ever since I was diagnosed with MS. But thank goodness I am no longer a lone voice in the wilderness. The number of voices around the globe proclaiming that nutrition is the key to MS has now reached a veritable clamour. Luckily - whether it’s me and many others in England, Ashton Embry in Canada, or Betty Iams, John Pageler and Debi Greco and many doctors in the USA - we are all saying virtually the same thing. So what are we all saying?


A COMPLEX TAPESTRY

You have to do many things at the same time to treat MS nutritionally. Some approaches have been around for decades; others are newer. The most effective way of dealing with MS encompasses all of the following:


The Swank Low Saturated Fat Diet (1)

Professor Roy Swank started his low saturated fat diet for MS as long ago as the 1940s in North America. Swank looked at the epidemiology of MS and noticed that MS was high in countries -or areas of countries - where a large amount of animal fat was eaten. By contrast, it was low in countries where the consumption of animal fat - especially dairy produce - was low. The Swank Diet started out with just reducing saturated fat, but later also advocated a high polyunsaturated fat/low saturated fat diet.


The Omega Factor - Essential Fatty Acids (EFAs) (2,3,4,5,6)

A flurry of interest in sunflower seed oil and linoleic acid started in the early 1970s following an article in The Lancet. Soon after, evening primrose oil (Omega-6 EFAs) became the favoured supplement as it contained GLA (gamma linolenic acid) which was more easily metabolised than linoleic acid on its own. The key players in this were Professor E.J. Field and Dr David Horrobin. Around this time, Professor Michael Crawford was also alerting people to the importance of fish and Omega-3 EFAs in the treatment of MS. MS is lowest in areas where a lot of fish is eaten.


Gluten-Free Diet (7,8)

Pioneered by the late Roger MacDougall, it started out with just cutting out the gluten grains -wheat, barley, oats and rye. It went on to cut out sugar and saturated fat, and to include specific supplements. With all its various modifications, the Roger MacDougall diet is still going strong today, though many are now on the more rigorous Stone Age Diet.


The Stone Age Diet (Paleolithic Diet) - The “Best Bet Diet” (9)

The latest diet for the treatment of MS is advocated by scientist Ashton Embry in Calgary, Canada, whose son has MS but is doing well on “The Paleolithic Diet”. This diet goes back to what our ancestors ate in Stone Age times. The thinking behind this is that modern man is not adapted to eating certain foods, and some people (e.g. with MS) are especially sensitive to them. So the Stone Age Diet excludes all “new” foods, or foods which may have been around during Stone Age times, but have changed significantly since then. An example of this is red meat, which used to be lean game, but now comes from reared cattle and contains much more saturated fat. Excluded foods include dairy products, gluten grains, beans and legumes, eggs, margarine, refined oils, yeast, refined sugar, and saturated fat. Ashton Embry has succeeded in getting proper scientific trials going in Canada on diet and MS. He has an excellent website and a world-wide following, who are on what is known as the “Best Bet Diet”.


THE BIGGER PICTURE

In recent years, the nutritional picture for MS has become more complex and taken on board the importance of:

 

Candidiasis, Leaky Gut Syndrome and Malabsorption.
Food Sensitivities.
Probiotics.
Free radicals and the role of Antioxidants.
Breach of the blood-brain barrier. (The blood-brain barrier is a membrane which protects the brain from the general circulation and prevents toxic substances from getting through. It is generally agreed that in MS, the blood-brain barrier is breached. This allows components of blood which are toxic to myelin to get into the cerebro-spinal fluid.)
The role of weak blood vessels in MS.
The importance of certain nutrients vital in MS e.g. vitamin B12.
The need for therapeutic doses of nutrients.

Taking account of all these inter-connected factors, the current nutritional treatment for anyone with MS needs to include dietary changes as above together with:

Nutrient Status Test and Supplementation

MS sufferers tend to be low in many nutrients, especially Omega-3 and Omega-6 essential fatty acids, vitamin B12, other B vitamins, magnesium, zinc and selenium. These deficiencies may be due to problems with absorbing nutrients properly from the gut (see Malabsorption below), together with an inadequate diet. Once deficiencies are found, the missing nutrients need to be taken to make up the shortfall. But this will only work if the gut is healed so the nutrients can be absorbed properly.


Anti-Candida Treatment

Candidiasis, the proliferation of a fungus in the gut, is widespread in MS and related to all the following points. This has to be treated, as everything else seems to stem from it. Like the Japanese say: “Illness starts in the gut”. The treatment for candidiasis includes:

A very strict diet with the avoidance of yeast, bread, pastries, sugar and other sweeteners, fermented foods, alcohol, white flour in all forms, malted products, citrus fruit, milk and dairy products, processed and smoked meat and fish, melons, ripe bananas and grapes, mushrooms, peanuts and pistachios and any products containing these nuts (as they can contain mould), processed foods, steroid drugs, coffee and tea. The anti-candida diet is hard to follow, but is worth persevering with as the benefits can be great.

Probiotics. As people with MS are advised to avoid milk yoghurt, it is better to use probiotics from other sources.
Anti-fungal remedies. These include garlic, propolis, grapefruit seed extract, caprylic acid, pau d’arco tea, Pseudowintera colorata, aniseed and barberry.
Avoiding mildew, mould and damp in the environment.

 

Leaky Gut (10)

Leaky gut syndrome is very widespread in MS sufferers and possibly affects everyone with the condition. Semi-digested protein particles get through the leaky lining of the gut wall. These toxic substances circulate in the blood, clog tiny capillaries throughout the body, and cross the blood brain barrier to the brain and spinal cord.
They trigger an immune response, inflammation and all manner of unpleasant symptoms. These include poor absorption of nutrients and therefore nutritional deficiencies and their consequences, food sensitivities, abnormal red blood cells, free radical formation, liver stress, and feeling generally fatigued and ill. Many people with MS have all these symptoms but don’t know why.

The causes of leaky gut need to be found and dealt with. These usually include candidiasis (where the fungi have punctured the gut wall), an imbalance of gut flora, bacteria, alcohol intake, frequent use of non-steroidal anti-inflammatory drugs, gluten (found in wheat, barley, oats and rye), and parasites.


Malabsorption (11)

Up to 70% of people with MS have problems in absorbing nutrients properly. So digestive nutrients (see SUPPLEMENTS below) are needed to get the full benefit from food and supplements.

 

Food Sensitivities (12)

Food sensitivity is another common problem in MS and appears to be linked to leaky gut. You can become sensitive to virtually any food, no matter how “healthy” it may seem. So bell peppers, for example, can be culprits alongside the more usual suspects of wheat, caffeine, tannin, sugar, alcohol, etc. Once food sensitivities have been identified, it works best to give the offending foods up completely.


Antioxidants

Dr Ray Strand in the US thinks that free radicals are involved in demyelination of the myelin sheath.13 Dr Strand, who sees many MS patients at his American clinic, says: ”Several studies demonstrate strong evidence that the underlying cause of MS is oxidative stress. In MS, the immune system attacks the myelin sheath around the nerve. This causes an inflammatory response. It is actually the oxidative stress caused by this reaction that is causing the damage in the myelin sheath. A tremendous number of harmful free radicals are being produced. Since oxidative stress is the cause of multiple sclerosis, it makes sense to put patients on the most potent antioxidant combination possible straight after diagnosis.”
 

SUPPLEMENTS

In addition to doing all of the above, it is wise for someone with MS to also take specific supplements at therapeutic doses. Although there are some slight variations, there is a high degree of consensus on what supplements to take, shared between people with MS in the UK, USA and Canada.

 


Supplement Function Dosage
Evening Primrose Oil or Borage Oil (Starflower Oil) Anti-inflammatory, helps regulate
immune system, anti-viral. 4 – 6 gms a day
Fish Oils (EPA and DHA)
Additional EPA and DHA can be
obtained from flaxseed oil. Needed for normal functioning of
brain and nervous system and
production of myelin. 2 – 5 gms a day
Multivitamins and minerals For general health. Once or twice a day (depending on brand)
Vitamin B12 Needed for a healthy myelin sheath,
nervous system and bone marrow.
Deficiency can impair processes of
the immune system. 100 – 480µg in spray form under tongue
or weekly injections of 1000µg or more.
B12 injections are usually given
at a GP's surgery, often by a nurse
Vitamin B Complex Needed for a healthy nervous system
and as co-factors for EFAs. 50 – 100mg a day
Vitamin B6 Needed as a co-factor for EFAs. 50 – 100mg a day
Vitamin B3 Relaxes the blood vessels, improves
circulation, regulates blood sugar. 500mg a day
Folic Acid Needed for healthy nerve function. 800µg a day
Vitamin D Low vitamin D and lack of exposure
to sunlight is believed to be a cause
of MS.
14 400 i.u a day
Vitamin A (in the form of halibut
or cod liver oil) Beta-carotene
(pro-vitamin A) can be taken as a
vegetarian form of vitamin A. Benefits the lining of the digestive
tract, helps fight infection. 1 capsule a day, not exceeding 7,500i.u
Vitamin A or 25,000i.u beta-carotene
Vitamin C Needed for a healthy immune system,
tissue repair and is an antioxidant. 3 gms a day. The buffered form is
recommended
Vitamin E Antioxidant. Up to 1000i.u a day
Calcium Needed for the healthy functioning of
nerves and muscles. Works in synergy
with magnesium. 800 – 1200mg a day
Magnesium Metabolism is dependent on magnesium,
helps produce cellular energy, needed for
nerve impulse transmission. 600 – 800mg a day
Zinc Needed for EFA metabolism. 15 – 50mg a day
Copper Needed for the maintenance of the
myelin sheath, and to make the
antioxidant enzyme SOD. 0.75 – 2µg a day
Selenium Antioxidant. Also needed by the immune
system and for prostaglandin production. 100 – 200µg a day
Manganese Involved in many enzymes in energy
metabolism and is essential for fatty acid
synthesis. 20mg a day
Oligoproanthocyanidins (OPCs):
pycnogenol, grape seed extract Antioxidant 50mg 3 or 4 times a day
Alpha-Lipoic Acid Antioxidant 300-500mg a day
Betaine Hydrochloric Acid
with pepsin As many as 70% of people with MS have
abnormally low hydrochloric acid secretion,
which is needed to digest protein. 6 – 8 capsules a day, with meals
Pancreatic Enzymes Aids digestion. Take with the above
Acidophilus Keeps gut flora healthy. 1 – 8 capsules a day (depending on brand)
Full Spectrum Amino
Acid Complex Amino acid blood levels have been found
to be low in MS patients. 8 capsules a day away from food
L-Glutamine Helps protect against and heal leaky gut.
Most important nutrient for mucosal lining
of small intestine and colon. Also a brain
fuel. 500mg a day away from food
L-Phenylalanine Precursor of some neurotransmitters. 500mg a day away from food
NADH (dinucleotideadenosine) Relieves fatigue and boosts energy,
improves alertness, concentration and
mental clarity. 5mg twice a day
Ginkgo Biloba Increases blood flow to the brain
and extremities. 600mg a day
Co-Enzyme Q 10 Helps with energy release from cells. 120mg a day


Other supplements taken to treat MS include: Bee pollen, lecithin, octaconosol, ginseng and MSM.

Note: It is strongly advised to consult a nutritionist or other health professional before embarking on a MS nutritional management programme.

 

REFERENCES


Swank, R.L., Dugan B.B. Effect of Low Saturated Fat Diet in Early and Late Cases of Multiple Sclerosis. Lancet 1990;336:37-39.
H. Mertin, C.J. Meade. Relevance of Fatty Acids in MS. British Medical Bulletin 1977;33:67-71.
S.C. Cunnane et al. Essential Fatty Acid and Lipid Profilesi in Patients with MS. American Journal of Clinical Nutrition 1989;50:801-6.
R.H. Dworkin. Linoleic Acid and Multiple Sclerosis. Lancet 1981;1:1153-4.
E.J. Field and G. Joyce. Multiple Sclerosis: Effect of Gamma-Linolenic Administration upon Membranes and the Need for Extended Clinical Trials of Unsaturated Fatty Acids. European Neurology 1983;22:78.
W. Cendrowski. Multiple Sclerosis and MaxEPA. British Journal of Clinical Practice 1986;40:365- 67.
D.C. Hewson. Is There a Role for Gluten-Free Diets in Multiple Sclerosis? Human Nutr Applied Nutr 1984;38A:417-20.
L.S. Lange and M. Shiner. Small Bowel Abnormalities in Multiple Sclerosis. Lancet 1976;2:1319- 22.
Ashton Embry PhD. Essays on Paleolithic Diet: www.directms.org or www, ms-diet.org.
Galland, Leo. Leaky Gut Syndromes: Breaking the Vicious Cycle. Health World Online: www.healthy.net/library/articles/galland/leakygut.
J.K. Gupta, A.P. Ingegno, A.W. Cook, L.P. Pertschuk. Multiple Sclerosis and Malabsorption. Am. J. Gastroenterol 1977;68:560-6.
B. Agranoff, D. Goldberg. Diet and the Geographical Distribution of Multiple Sclerosis. Lancet 1974;2:1061-66.
Dr Ray Strand’s website: www.raystrand.com/case_studies


Judy Graham edits the magazine New Pathways, published by the Multiple Sclerosis Resource Centre (MSRC). She is author of Multiple Sclerosis - The Self Help Guide, (Thorsons), Evening Primrose Oil (Thorsons), and MS and Having A Baby (Healing Arts Press). Her new book, A-Z of Complementary Therapies for MS, is published by the MSRC.

 

 

 

 

 


 

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