Multiple Sclerosis - Possible Medical Nutrition Therapy?

Multiple Sclerosis (MS) is an autoimmune disease in which the body 'eats' up the myelin protective sheath that covers and protects the nerves. This leaves the body in numbness and may lead to paralysis, blindness, inability to speak, tremored and fatigue.

Multiple sclerosis is increasing in Lebanon, such that the first MS center was founded end of 2011 within the American University of Beirut's Medical Center.

The causes of this disease remain unknown but the risk factors can be general! Risks can increase if you're: white, with family history of MS, a female, between the age of 20 and 40, with an autoimmune disease such as diabetes type 1 and carrying viruses such as mononucleosis. 


A cohort study published year 2008, concluded that the characteristics of MS in Lebanon were of:

• The peak age of onset of MS in 62.4% of patients developing their first symptoms between 20 and 39 years
• The female/male ratio was 1.8/1.0
• A positive family history for MS was present in 5% of patients
• With the most frequent presenting symptoms were brainstem-cerebellar (46.2%) followed by sensory (42.5%), motor (33.9%) and visual (29.6%)

Medical Nutrition Therapy in MS 

Foods to Avoid

Crappy processed fatty salty unhealthy junk food
MUST be avoided,
whether you have MS or not!

1. Foods high in salt and sugar
   It is important to watch your intake of salt and sugar containing foods. This is a general important recommendation but it is highly crucial especially when taking corticosteroid medications (such as solumedrol, cortancyl, solucortef, etc.). Decreasing amounts of salt and sugar depends on the dosage of the medication, of course and this should be done by consulting both your health care provider and your dietitian.
   If not watched out for, high salt intake can increase the risk of hypertension, injuring your blood vessels as well as adding more work on your heart, and it will increase water retention (edema) leading to unbalanced electrolyte levels in your body. High sugar intake on the other hand can increase blood sugar (glycemia) fluctuations, increase the risk of insulin resistance (aka diabetic-like-state) and increase fat deposition in the blood and body!
   Food high in sugar are cookies, granulated sugar, canned foods, soda, cornflakes (even the plain non-sugary ones), iced tea and the list goes on! So read your food label well and your sugar lingo! While foods high in salt include pickles, olives, table salt, processed foods especially canned meats, cold cuts and deli, canned foods.
2. Caffeine containing foods and beverages as well as alcohol
   Caffeine and alcohol are stimulants which excite and irritate the nervous system, burden its nerve conduction, increase anxiety and increase sleepiness.
   It is best to watch out alcoholic beverages and foods that contain alcohol (such as some desserts, candies and cooked meals) and keep your intake of caffeine (coffee, tea, chocolate and carbonated beverages) low.
3. Foods with allergens
   Recent studies are showing an association between allergens and an increased risk in MS. Gluten from wheat, rye, barley and possibly oats as well as allergens from soy, milk, dairy products and butter are best watched out for.
4. Saturated fats
   Foods from animal origins (red meat, chicken), milk and products, junk food (chips, chocolate, etc.) show an increased risk of MS development and worsening.

So what can are the foods recommended?

Dark green leafy vegetables
provide you with antioxidants!

1. Diet rich in fibers
   Increasing your intake of fibers is highly important especially that most fibers you get are from plant origins! Fruits and vegetables provide you with ample amount of antioxidants, phytochemicals, compounds that science has not figured out yet - and lots of fibers! Of course increase your fruits and vegetables intake gradually and accompany them with enough fluids (water). Our cuisine can be very helpful in increasing a variety of green leafy vegetables such mloukhiye (mallow's jew), sele2 (chard), spinach, rocca, coriander, parsley and dark lettuce leaves. Always go for the darkest leaves, these contain the most chlorophyll!
   On the other hand, go for dark rainbow colors when choosing your fruits! Each color provides you with different types of antioxidants so have fruits and vary them too!
   
2. Polyunsaturated fats especially omega-3 fatty acids
   Omega-3 is no joke when it comes to the health of your nervous system!
   Having regular amounts of fatty fish (such as salmon, halibut, marlin and sardines) as well as walnuts, sea weed and flax seeds are habits to be adopted.
   
3. Unprocessed organic food
   It is important to decrease allergen and pesticide intake. Therefore eat whole and unprocessed foods because these still contain nutritious components such as fibers, minerals, vitamins and phytochemicals that could be destroyed/extracted during processing. Processed 'plastic' and canned food, fruits and vegetable are best decreases and replaced with whole fresh foods!
4. Keep a healthy weight and eat small frequent meals
   Keeping your weight within the healthiest range decrease any burden weight and inflammation exert on your nervous system. It is also important to have 6 small meals instead of 3 large ones to aid your intestines (and their nerves) in digestion. Avoiding fatty/sugary meals that require a longer process of digestion can also help.

According to the literature, no cure has been found for Multiple Sclerosis especially Medical Nutrition Therapy. However, new research conducted by Dr. Terry Wahls is suggesting that maybe, nutrition can cure (?) multiple sclerosis. Nothing is conclusive yet! More research is to be conducted and approved as a grade A evidence before any conclusion can be made. Below you can find Dr. Wahls's talk in TEDx about how fixing her diet cured her from MS. This sure got me intrigued to research the topic; however, literature still denies any treatment/cure for MS. This only proves that science is, as it has always been, fluid and ever changing. I will be waiting for further randomized controlled trials on this topic!