Is diet a factor in developing MS?

Multiple sclerosis, Dieting, Vitamins, Minerals

Comparison with general population

A diagnosis of MS does not mean that someone has nutritional difficulties. One research study showed that the majority of people who are newly diagnosed or who have only mild MS symptoms had a comparable level of overall nutritional health with the general population.[
However, some people with MS may be more susceptible to complications arising from poor diets. Weight gain and obesity may become unwanted side effects of limited mobility or of some medications. Similar problems can be caused by excessive dependence on convenience foods if fatigue is a major problem. By contrast, some people with MS may experience significant weight loss, perhaps through problems in preparing food or from the side effects of some medications that act as appetite suppressants.
Poor diet and nutrition can also worsen existing symptoms such as fatigue and weakness. Fatigue can be a particular problem as a few heavy meals can make this much worse; frequent, small meals may be more manageable.
If you are overweight, underweight or have unwanted weight loss/gain, ask your GP for an appointment with a dietitian. It is important that any dietary changes you make will not be detrimental to health. Avoid ‘crash dieting’ or excluding food groups to lose weight.

Is diet a factor in developing MS?

Studies of where MS occurs (epidemiology) have shown that the risk of MS is higher in countries where there is a high consumption of animal fat. However, studies of the population as a whole in these countries have not shown that eating a diet high in saturated fat causes someone to develop MS. Conversely, no study has found that eating more fruit and vegetables protects against developing MS. Consequently, the link between animal fat intake and developing MS has not been proven.[2]
Recent research has suggested a link between inadequate levels of vitamin D and the risk of developing multiple sclerosis. Lack of exposure to sunlight and/or inadequate dietary intake of vitamin D in childhood increase the likelihood that someone may develop MS in later life. There does not appear to be any evidence that increasing vitamin D intake once MS has developed makes a difference to the course of the condition.[3,4].

What is a good diet for MS?

Research into diet and MS has been limited. Diet is notoriously difficult to research, for a number of reasons:

it is usually impossible for researchers to control exactly what someone else eats over a period of time
it is often very difficult to contrast an ‘active’ element with a ‘dummy’ placebo
what someone eats is known and obvious, so there cannot be any ‘blinding’, as there would be in a drug trial
most research is expensive and costs need to be recouped. Many foods are cheap, so there is little financial benefit in proving them beneficial

However, there has been research into a healthy diet for other conditions, notably cardiovascular disease, which is much more common than MS in the general population. This research found that a diet that was low in fat, with lots of fruit and vegetables reduced someone’s risk of developing heart disease, strokes and certain cancers. Consequently it forms the Government’s advice for a normal balanced diet.

Elements of a balanced diet

A balanced diet is essential to provide all the nutrients needed to be as active and healthy as possible. A balanced diet needs to include foods from the major food groups of fruit and vegetables, carbohydrates, fats, protein and dairy products. Each of these is considered in turn.

Fruit and vegetables: Fruit and vegetables provide a range of vitamins and minerals. The current recommended daily intake is five portions a day, a portion being, for example, an apple, a small glass of fruit juice, two plums or three tablespoons of cooked vegetables. Fruit and vegetables are a vital source of antioxidant vitamins, which are important in helping to maintain and protect myelin. Fruit and vegetables are also an important source of soluble fibre, which can help proper bowel function.
Vitamin supplements that contain antioxidants may be popular with people with MS. However, research into levels of antioxidants in people with MS has found conflicting results. One study reported normal levels in people with and without MS, whereas other studies have reported significantly lower levels of antioxidants in people with MS.[2] Consequently, while some people with MS choose to take supplements such as selenium to increase their antioxidant levels, the evidence for this is unclear. Antioxidants work to stimulate the immune system, which is generally thought to be overactive in MS, so increasing intake of antioxidants may not always be helpful. It is not believed that supplements have all the benefits of fruit and vegetables.
Carbohydrates: Carbohydrate is vital for producing slow-release sugars, which provide energy, and is found in starchy foods such as bread, cereals, potatoes, pasta and rice. It is recommended that carbohydrates should make up around a third of the daily diet. High fibre carbohydrates such as whole grain cereals, wholemeal or fibre fortified white bread etc, can help prevent and treat constipation.
Fats: Fat is a vital element in any diet because it contains concentrated calories or energy. Some types of fat provide essential fatty acids, which are required for the human body to function properly. These cannot be made by the body and therefore have to be consumed in the diet. There are two kinds of fats: saturated fats, found in meat and animal fats (e.g. lard) and dairy products such as butter and cheese; and unsaturated fats, which are divided into monounsaturated fats, such as olive oil, and polyunsaturated fats such as sunflower oil. Research has shown a link between a high saturated fat intake and an increased risk of heart disease and certain cancers, suggesting that a diet that reduces saturated fat intake is desirable. Monounsaturated fats are better for the heart than saturated fats, but do not have any proven benefits for MS Some polyunsaturated fats have been found beneficial for people with multiple sclerosis. Polyunsaturated fats are made of two kinds of essential fatty acids, omega 3 essential fatty acids and omega 6 essential fatty acids. It is important to achieve a balance between these two groups, so it is recommended for health that foods from each are included in the diet. Omega 3 essential fatty acids are present in oily fish such as salmon and mackerel, which are also good sources of protein and vitamin D. Other sources include green leafy vegetables and linseed oil. Omega 3 essential fatty acids are important as part of a balanced diet, but the main benefit for MS has been found with omega 6 essential fatty acids. The main omega 6 essential fatty acid is linoleic acid. This is found in the oils of seeds and nuts, such as sunflower, safflower, soya, corn seeds or walnut oils. A combined analysis of three small controlled trials into linoleic acid indicated that taking 17-23g linoleic acid a day could benefit some people with relapsing/remitting MS. There was a reduction in rate and severity of relapse, particularly for those who were newly diagnosed or more mildly affected. In terms of increase in disability, less or no benefit was shown in people who had more symptoms read more