The National Multiple Sclerosis Society defines multiple sclerosis (MS) as an immune-mediated process in which the body's immune system responds to the central nervous system (CNS).
The central nervous system consists of the brain, spinal cord and optic nerves. The exact antigen—the target that immune cells are sensitized to attack—remains unknown. This is why many experts consider multiple sclerosis to be “immune-mediated” rather than “autoimmune.”
What is multiple sclerosis?
Multiple sclerosis (MS) is an autoimmune disease in which the protective sheaths of nerve fibers are gradually destroyed.
These coverings are called myelin sheaths. Over time, this disease can permanently damage your nerves, disrupting communication between your brain and body ().
Here are the symptoms of multiple sclerosis ():
- fatigue
- tingling and numbness
- bladder and bowel dysfunction
- difficulty moving and spasticity
- visual impairment
- problems with learning and memory
MS is very complex, and the disease's progression varies from person to person. Scientists are still not sure what causes multiple sclerosis and how to cure it ().
Although diet cannot cure multiple sclerosis, some research suggests that dietary changes may help people with multiple sclerosis better control their symptoms. This, in turn, can improve their quality of life (, ).
Conclusion:
Multiple sclerosis (MS) is a neurological disease that gradually destroys the protective sheaths called myelin sheaths that surround nerve fibers. Scientists do not fully understand the disease, and there is no cure.
Literature
- Hoare S. et al. Higher intake of omega-3 polyunsaturated fatty acids is associated with a decreased risk of a first clinical diagnosis of central nervous system demyelination: Results from the Ausimmune Study //Multiple Sclerosis Journal. – 2021. – T. 22. – No. 7. – pp. 884-892.
- Lee JE et al. A Multimodal, Nonpharmacologic Intervention Improves Mood and Cognitive Function in People with Multiple Sclerosis // Journal of the American College of Nutrition. – 2021. – T. 36. – No. 3. – pp. 150-168.
- Masullo L. et al. Complementary and alternative medicine use and nutrient intake among individuals with multiple sclerosis in the United States //Journal of community health. – 2015. – T. 40. – No. 1. – pp. 153-160.
- Richard-Miceli C., Criswell LA Emerging patterns of genetic overlap across autoimmune disorders //Genome medicine. – 2012. – T. 4. – No. 1. – P. 6.
- Rolf L. et al. Exploring the effect of vitamin D3 supplementation on the anti-EBV antibody response in relapsing-remitting multiple sclerosis //Multiple Sclerosis Journal. – 2021. – P. 1352458517722646.
- Shor DBA et al. Gluten Sensitivity in Multiple Sclerosis //Annals of the New York Academy of Sciences. – 2009. – T. 1173. – No. 1. – pp. 343-349.
- Swank RL, Dugan BB Effect of low saturated fat diet in early and late cases of multiple sclerosis //The Lancet. – 1990. – T. 336. – No. 8706. – pp. 37-39.
- Yadav V. et al. Low-fat, plant-based diet in multiple sclerosis: A randomized controlled trial //Multiple sclerosis and related disorders. – 2021. – T. 9. – P. 80-90.
- Zhu X. et al. Microbiota-gut-brain axis and the central nervous system //Oncotarget. – 2021. – T. 8. – No. 32. – pp. 53829-53838.
How does diet affect multiple sclerosis?
There are currently no official dietary recommendations for people with MS.
No two people with MS experience the disease the same way ().
However, scientists believe that a combination of genetic and environmental factors may cause the disease, and that diet may have an effect. The fact that multiple sclerosis is more common in Western countries than in developing countries is one clue that diet may play a key role ().
This is why dietary recommendations for people with multiple sclerosis should be aimed at helping manage symptoms and improve overall quality of life.
Diet can help with multiple sclerosis in several ways, including by preventing or controlling its progression, relieving its symptoms, and reducing flare-ups.
Ideally, an MS-friendly diet should be high in antioxidants to fight inflammation, high in fiber to help with bowel movements, sufficient calcium and vitamin D to fight osteoporosis, and contain plenty of vitamins and minerals to help with bowel movements. fight fatigue and improve health.
You should also limit your intake of foods that have been linked to chronic inflammation and other poor health effects, or those that simply make daily activities difficult for a person with MS.
Some evidence suggests that other diets, including ketogenic diets, may help relieve symptoms in people with MS. However, this research is ongoing and scientists need to continue studying the role of diet in MS.
A study of 60 people with multiple sclerosis found that fasting-mimicking and ketogenic diets have potential in treating relapsing-remitting multiple sclerosis (RRMS). However, the researchers suggested that more high-quality studies of the effects of fasting-mimicking diets in humans are needed ().
Another study in which people with MS followed a ketogenic diet found they experienced relief from symptoms including fatigue, inflammation and depression ().
A separate study found that certain nutrients may benefit people with mild to moderate multiple sclerosis, potentially leading to improved overall functioning as well as improved quality of life and mobility ().
Nutrients that have been linked to these positive changes are healthy fats, cholesterol, folate, iron, and magnesium. On the other hand, reducing carbohydrate intake has proven beneficial ().
Clinical studies examining the effects of ketogenic diets and intermittent fasting on MS are currently ongoing ().
Current evidence suggests that a modified Paleolithic diet and supplementation may help reduce perceived fatigue in people with MS ().
There is also evidence that people with MS are more likely to be deficient in certain nutrients, including vitamins A, B12 and D3 ().
Preliminary evidence suggests that taking certain vitamins, minerals, fatty acids, antioxidants, plant compounds, and melatonin may help relieve some symptoms ().
Scientists need to do more research before making official recommendations for many of the diets described above. However, preliminary research is promising.
Conclusion:
There are no official dietary recommendations for multiple sclerosis. However, research shows that certain dietary changes can help slow the progression of the disease and help manage symptoms of multiple sclerosis and improve quality of life.
Recommended Supplements
Essential Supplements – Essential Supplements
- Vitamin D3: 6000-8000 IU. It is advisable to receive it in tablets that do not contain vitamin A.
- Omega-3 fatty acids: 5 g EPA + DHA (docosahexaenoic (DHA) and eicosapentaenoic (EPA) acids). The source of omega-3 fatty acids is fish oil, but care must be taken to ensure that the vitamin A content in fish oil capsules does not exceed 5000 IU. Adding 1 tablespoon of flaxseed oil can also be of practical value because it contains alpha-linolenic acid, a precursor to EPA and DHA.
- Calcium: 1000-1200 mg
- Magnesium: 500-600 mg
Basic supplements - vitamins
- Vitamin A: 5000 IU
- B vitamins: 100 mg
- Niacin (B3): 2 g
- Folic acid: 400 mcg
- Vitamin B12: 1-2 mg
- Vitamin C: 1 g
- Vitamin E (natural): 400 IU
Key Supplements - Minerals
- Zinc: 25-50 mg
- Copper: 1-2 mg
- Selenium: 200 mcg
- Manganese: 20 mg
- Iodine: 200 mcg
Key Supplements - Antioxidants
- Grape seed extract: 2-4 capsules
- Ginkgo biloba: 120 mg
- Alpha lipoic acid: 1200 mg
- Coenzyme Q10: 60-90 mg
- EGCG Max (epigallocatechin-3-gallate): 2 capsules (700 mg)
- Quercetin: 400 mg
- Bromelain: 400 mg
Key Supplements – Probiotics
- Acidophilus - 6 to 9 capsules (2 to 3 times daily, with each meal)
Additives recommended for use
- N Acetyl Cysteine (NAC): 500 mg This supplement supplement may increase glutathione levels which increases the level of antioxidant activity.
- Inosine: 2g. This supplement increases uric acid levels, which neutralizes peroxynitrite (a strong oxidizing agent that can cause serious damage to cell molecules). Please note that if uric acid levels are too high, gout may occur. The trick is to keep your uric acid levels as high as possible without causing gout.
Before presenting Embry's recommended list of supplements, I mentioned that it is controversial. The first question is the cost of additives. Even the most conservative estimate of the cost of a monthly course is quite impressive.
Given the costs of preventive and symptomatic treatments for multiple sclerosis (and in most cases, these are unavoidable costs), the decision to invest additional funds in such supplements is questionable. The second question that arose was the dosage of certain supplements. It's no secret that both vitamins and minerals can bring both benefits and harm. The dosage recommendations given by Embry raised some doubts in me.
For example, excess vitamin D accumulates in the body, sometimes in toxic amounts. The daily requirement of a healthy person for this vitamin is 400-800 IU, the recommended dosage by Embry is 6000-8000 IU.
What foods should you eat if you have multiple sclerosis?
An MS-friendly diet should help people with MS control their symptoms.
In particular, it should help control the progression of the disease and minimize the impact of common symptoms of multiple sclerosis on overall quality of life.
Here is a list of foods to include in a multiple sclerosis-friendly diet:
- Fruits and Vegetables : All fresh fruits and vegetables.
- Grains : All grains such as oats, rice, buckwheat and quinoa.
- Nuts and Seeds : All nuts and seeds.
- Fish : All fish, especially fresh and oily fish such as mackerel, herring and salmon, as they are rich in omega-3 fatty acids and vitamin D.
- Meat and Eggs : Eggs and all fresh meats such as beef, chicken, lamb, etc.
- Dairy products : milk, cheese, yogurt and butter.
- Fats : Healthy fats such as olive oil, flaxseed oil, coconut oil, and avocado oil.
- Foods rich in probiotics : yogurt, kefir, sauerkraut and kimchi.
- Drinks : water, herbal teas.
- Herbs and Spices : All fresh herbs and spices.
In short, recommendations for an MS-friendly diet are similar to eating a generally healthy, well-balanced diet. However, she emphasizes eating more plant-based foods and grains.
This is because plant foods and grains contain more fiber, vitamins, minerals and fluids, which can help with symptoms of multiple sclerosis such as constipation, fatigue and bladder dysfunction.
They also contain more plant-based compounds that act as antioxidants, molecules that help protect your cells from free radical damage and inflammation. These compounds may help fight inflammation and potentially slow the progression of multiple sclerosis (, ).
Fish, especially fatty fish such as mackerel and salmon, appears to be beneficial for MS, possibly because they are high in anti-inflammatory omega-3 fatty acids. It's also rich in vitamin D, which, when combined with calcium, can help keep your bones strong (, ,).
Current research on the effects of red meat and saturated fat consumption on MS symptoms shows mixed results. However, moderate consumption of red meat, with an emphasis on eating more fruits, vegetables and grains, is likely to be beneficial for people with MS (, ).
Dairy products also show mixed results. However, they are a good source of calcium, vitamin D, vitamin A and potassium, so you can include them in moderation in an MS-friendly diet (,).
Additionally, some research suggests that people with multiple sclerosis may have a higher risk of developing celiac disease, an autoimmune disease that causes damage to the small intestine when gluten is consumed ().
Gluten is a group of proteins found in wheat, barley and rye.
If you have multiple sclerosis and experience severe discomfort when eating gluten-based foods such as bread, pasta, cookies, and other baked goods, it is important to notify your doctor to find out if you have celiac disease.
People with multiple sclerosis who do not have celiac disease can still benefit from healthy grains in their diet.
Conclusion:
Eating plenty of fruits, vegetables, grains and fish can help manage the symptoms of multiple sclerosis. A person with multiple sclerosis may want to eat red meat and dairy products in moderation, as current research on their effects is mixed.
Ashton Embry Diet
The Ashton Embry diet is most popular among neurologists. Diet changes are based on a large amount of scientific research. It is known that a number of products have a structure similar to myelin, which can cause the development of an autoimmune reaction to this nerve fiber protein. In this regard, the diet is based on limiting the consumption of legumes, dairy products, gluten-containing foods and sweets.
Myelin primarily consists of fatty acids, therefore, the amount of saturated and unsaturated fats in the diet is reduced. For example, lean beef, olive and other types of oil are allowed only once a week. Ashton Embry believed that a person needs to adhere to the principles of a gluten-free diet - eliminate all grains that contain gluten, which is responsible for a number of autoimmune pathologies.
Chicken, turkey and rabbit are not limited to. It is important to remove the skin before cooking. The amount of fish (salmon, mackerel) in the diet is increased. The restrictions do not apply to vegetables and fruits.
Due to the restriction of a number of foods in the diet, nutritionists recommend additional use of vitamin and mineral supplements. The deficiency of vitamin E, C, A, B12, as well as calcium, copper, magnesium, and selenium should be compensated. In addition, in the first weeks after switching to the Ashton Embry diet, you can take dietary supplements - adaptogens, which can improve performance and well-being.
Alcoholic drinks are definitely excluded. Ethyl alcohol not only leads to changes in proteins, but also contributes to the development and maintenance of inflammatory processes. The restriction also applies to alcohol with low ethanol content.
Foods to Avoid
Although an MS-friendly diet allows you to eat a variety of healthy and delicious foods, there are still some food groups that you should limit to help manage your MS symptoms.
Most of these foods are associated with chronic inflammation. These include processed meats, refined carbohydrates, trans fats, and sugar-sweetened drinks, to name a few (, ,).
Here is a list of foods to avoid if you have MS:
- Processed meats : such as sausages, bacon, canned meats, and salted, smoked or cured meats.
- Refined carbohydrates : such as white bread, pasta, cookies and flour tortillas.
- Fried foods : such as french fries, fried chicken, mozzarella sticks and donuts.
- Junk food : such as fast food, potato chips, processed foods and frozen meals.
- Trans fats : such as margarine, shortening and partially hydrogenated vegetable oils.
- Sugar-sweetened drinks : energy drinks, sports drinks, sodas, and sweet tea.
- Alcohol : Limit all alcoholic beverages if possible.
As mentioned above, some people with multiple sclerosis may have celiac disease. If you have celiac disease, try to avoid all gluten-based foods, such as those containing wheat, barley and rye.
Conclusion:
An MS-friendly diet is similar to a general healthy diet. She limits her intake of unhealthy foods such as processed meats, refined carbohydrates, soda and trans fats. These foods do not help manage the symptoms of multiple sclerosis and may make inflammation worse.
My experience
On forums you often come across a lively discussion of the Embry diet: some see it as a panacea, others remain indifferent. I tried to follow his advice. Having spent a significant amount on purchasing most of the recommended supplements, changing my usual diet, I tried to track the impact of the “Embry nutrition strategy” on my own health. Here's what happened:
- I noticeably lost weight, and all previous attempts to lose extra pounds were usually not crowned with success, but here somehow everything happened unnoticed (the goal was different);
- I realized that eating healthy and not eating sweets at night is not as scary and disgusting as it seems. In this regard, I recall a children’s saying: “Mom, why is it always that what is harmful is colorful and sweet, and what is healthy is always green and tasteless?”;
- I did not notice any change in the state of my MS: the symptoms did not worsen, but did not improve either. I didn’t have any new exacerbations, but I still give credit to Rebif’s action in this matter;
Now I do not adhere to the proposed nutrition strategy: I do not take supplements, but I try to adhere to the diet recommended by Embry, with the exception of periodic indulgences (completely eliminating sweets is a major task). I will be grateful to site visitors for comments in which they will talk about their experience with the Embry Diet.
Source: Ashton Embry Website: https://www.direct-ms.org
Other Diet Recommendations to Help with MS
In addition to the dietary recommendations above, people with multiple sclerosis may want to consider the following tips to help manage their symptoms.
- Make sure you eat enough food . Not eating enough calories can cause fatigue.
- Prepare food in advance . If you have time, preparing meals ahead of time will help you save energy later. If you are often tired, this may be especially helpful.
- Remodel your kitchen . Place food, dishes and other equipment in areas that are easy for you to clean. This will help you save energy.
- Try "ready-to-eat" foods . Buying pre-cut fruits and vegetables can shave a few minutes off your prep time and make the preparation process easier.
- Make thicker drinks . If you have difficulty swallowing, making thicker drinks, such as a healthy smoothie, will make it easier for you to swallow.
- Soft foods may help . If a lot of chewing makes you tired, try choosing softer foods, such as baked fish, bananas, avocados and cooked vegetables.
- Limit your consumption of crumbly foods . If you have difficulty swallowing or often choke on food, consider limiting crumbly foods such as toast and crackers.
- Ask for help . Even if you don't like asking for help, helping other family members with small tasks like cooking, cleaning, or just setting the table can help reduce your fatigue.
- Stay physically active . Although exercise can make a person with MS feel tired, it is especially important for managing weight and staying healthy. Physical activity is also important to prevent osteoporosis, which is more common in people with MS.
If you have other problems related to multiple sclerosis not discussed above, it is important to notify your doctor. He or she can make personalized recommendations to help you better manage your symptoms.
Conclusion:
The tips listed above can help improve your quality of life with MS by helping you maintain a healthy weight and manage symptoms such as fatigue and problems swallowing.
Diet modification by Terry Waltz
Terry Waltz is a physician and nutritionist who focuses on the treatment of multiple sclerosis using non-traditional methods, including nutrition. She came to such treatment approaches after she herself was diagnosed with the disease, and medications did not lead to a positive effect. While studying the effect of food on the course of the disease, she noted that when following the paleo diet, her condition improved. In addition, the Paleolithic diet made it possible to abandon the consumption of large amounts of dietary supplements with vitamins and microelements, since they are all contained in natural products.
The main differences between the Terry Waltz diet and the standard Paleo diet are as follows:
- The amount of vegetables and fruits consumed is precisely measured and should be equal to 9 cups per day. One cup – 200-250 ml. With less consumption, there is a deficiency of vitamins in the body, which develops gradually and worsens the prognosis for the patient.
- Gluten, eggs and dairy products are prohibited. All of them, according to Waltz, lead to activation of the immune system, which is unacceptable in multiple sclerosis.
- The use of synthetic sweeteners is prohibited. It is acceptable to use 1 tsp. a day of natural honey, stevia or raw cane sugar. Simple sugars reduce insulin sensitivity, creating the preconditions for the development of metabolic syndrome, characterized by systemic inflammation.
- The diet has 3 levels, each with a different list of restrictions. All patients are recommended to start with the basic stage, which has a small list of prohibited foods, thereby ensuring an easy transition to this diet. Gradually the diet becomes stricter.
The effectiveness of the Terry Waltz diet has not been clinically proven, however, there are a large number of people's reviews, including written books, about its benefits for multiple sclerosis.
