Curing MS with Diet: Could Fat Have Something To Do With It?
The public has been fed a great deal of misinformation about the relative virtues of various fad diets as well as dietary supplements touting claims from anti- aging, increased sex drive, improved athletic performance, weight loss, and everything in between including multiple sclerosis. Unfortunately, such claims are often unproven and are usually made to sell a product or service. If you have multiple sclerosis, there are many things you should know before you change your diet or start taking dietary/herbal supplements. For one thing, some diets and dietary supplements may actually be dangerous and some have the potential to cause an exacerbation or have other harmful side effects. Furthermore, extremely low fat diets could be life threatening. For these reasons, it is very important to seek professional advice from a qualified healthcare provider before starting a new diet plan.
On a positive note, diet remedies that include certain foods and nutrients have been used successfully from time immemorial to fight disease and restore health. Hippocrates said it best, “Let your food be your medicine and your medicine be your food”. As a registered dietitian, I believe that good nutrition is the key component to maintaining lifelong health. Unfortunately, there is no medically proven diet that cures multiple sclerosis. Part of the reason for this may be because researchers are not provided with funding to conduct scientific studies that would correlate diet and MS. Diets lack the revenue generating possibilities of patent- protected pharmaceutical drugs and so research is limited on them.
So, diet alone will not cure MS. But, the routinely prescribed drugs for MS are not a cure either. Current medications are used as part of a treatment plan for MS designed to slow the progression of the disease or treat MS symptoms. For the most part, these drugs are not well tolerated and have the potential for very serious side effects. This leaves people who have MS feeling frustrated and many turn to alternative or complementary strategies to help combat their illness. Diet is one of the first things people think about changing when they have been diagnosed with a serious disease.
If you have been diagnosed with MS, you should consider what foods you have been eating and for how long. One nutrient that has been given a lot of attention as a potential catalyst for disease onset and progression is dietary fat of animal origin. Yet, more recent research tells us that another class of fats, the Omega 3 fatty acids, may have a positive effect on certain types of MS because they have the ability to decrease inflammation.
Not only is the type of fat confusing but MS itself is an unpredictable disease that has perplexed medical researchers for years. The truth is they really don’t know what triggers the immune attack on the brain and spinal cord or how to prevent attacks. Another mystery is why people experience MS so differently and also why some people respond well to treatment and others do not. Recent research indicates that there may be several types of MS. The MS Lesion Project revealed that there are at least four types of lesions that are distinct with MRI. According to Dr. Claudia Lucchinetti, assistant professor of Neurology at the Mayo Clinic and lead investigator for the project, “… the course of the disease, response to medications, and even brain MRI findings vary greatly among people with MS.” In addition she states, “that there may be several types of MS, and that these types may have different immune related causes. MS, in fact, may prove to be a ‘syndrome’ of several diseases.”
We now know that MS is not a “one size fits all” disease so it makes sense that there is not one specific diet therapy that halts the disease or reverses its’ damage. Does that mean diet does not play a role in treating MS? Absolutely not! It just means that the medical community has not been provided with enough scientific evidence to support a dietary prescription specific for MS. Truth be told, it is difficult to name diseases that are cured with diet alone. But it is easy to name the diseases that are better managed with diet therapy such as diabetes, heart disease, and hypertension to name a few. And multiple sclerosis is no exception. Diet therapy should definitely be part of a treatment plan to better manage multiple sclerosis simply because choosing the right foods can make you healthier and help with your MS symptoms. Furthermore, there is clear evidence that particular nutrients have an impact on multiple sclerosis symptoms and the progression of the disease.
Fat and MS
Fats have become highly publicized over the last few years and are generally recognized as the “bad guys”. But, fats are essential nutrients for the body and they perform specific functions necessary for life. No question, your body needs some fat to stay healthy. Yet, the main contributor to many diet-related diseases is the overconsumption of fat. Distinctly, the type and quantity of fat are risk factors for coronary heart disease and some types of cancers. But, is there a linkage between dietary fat intake and multiple sclerosis? And, if so, which type of fat is good and which is bad? To understand this better we must first examine the different types of fats.
Saturated fats are the most notorious for their negative impact on health and implication in obesity-related diseases. They are usually solid at room temperature and are usually from animal sources. The exceptions are palm and coconut oils which are plant derived and liquid at room temperature. Unsaturated fats are classified as mono or polyunsaturated (PUFAs) and are generally from plant and fish sources. When substituted for saturated fat, they have been shown to lower LDL cholesterol levels. The two categories of PUFA’s are the omega-3 and the omega-6 fatty acids. These are both essential fatty acids because they are not made by the body and so they must be obtained in the diet. There are three types of omega-3 fatty acids that are relevant: a-linolenic acid (ALA) and eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). ALA is an essential nutrient that must be obtained in diet. As long as there is enough ALA present in the body, EPA and DHA can be synthesized and so they are not really considered essential. Food sources of omega-3 fatty acids include fatty fish such as salmon, mackerel, herring and sardines as well as flaxseed and walnuts. Omega-6 fatty acids are another class of PUFA’s that are found abundantly in vegetable oils, meats and eggs. Typically, the western diet is lacking in omega-3 and provides too much omega-6 as most Americans consume large amounts of meats and dairy products and not enough plant foods. Of course, a healthy diet should be balanced in both omega- 6 and omega-3 fatty acids. Researchers have taken a closer look at omega-3 fatty acids and their potential to benefit multiple sclerosis.
The Potential of Omega-3
Studies have shown Omega-3 fatty acids to be beneficial in some types of MS. They are known to be anti inflammatory and could possibly be an effective adjunctive treatment for MS. A recent study showed that fish oil may have the potential to have a beneficial effect on the immune response in MS patients Participants in this study followed a low fat diet and these dietary interventions were well tolerated and related to a reduction in the number of relapses. This study is promising and warrants further investigation to evaluate the benefit of fish oil supplementation in MS patients.
Probably the most significant nutrient that plays a role in multiple sclerosis is saturated fat. This was determined many years ago by Dr. Roy Laver Swank, a truly remarkable neurologist that developed a low-fat diet for the treatment of multiple sclerosis.
In 1948, Dr. Swank arrived in Montreal and began intensely studying multiple sclerosis at the Montreal Neurological Institute. After a review of literature Dr. Swank determined there was a strong correlation between a high fat diet from animal sources and a high number of MS cases. He started to put MS patients on a low-fat diet and he conducted a comprehensive and well documented study on diet and multiple sclerosis. He studied the relationship between dietary fat intake and the disease, following his patients for thirty four years. The results of the entire 36 year study have been detailed in several publications, the first was published in 1970. Years later, in 1990, his results were published in the highly esteemed medical journal, The Lancet. Swank’s findings showed that individuals who consumed 20 grams or less of dietary fat per day displayed significantly less deterioration and lower death rates than those who ate more fat. His groundbreaking research showed that the Swank low-fat diet could very well be an effective treatment for multiple sclerosis, reducing the number and severity of exacerbations in MS patients.
Swank’s Dietary Guidelines
The focal point of the diet is to restrict animal fat as much as possible. Here are the guidelines in a nutshell:
- No red meat for the first year including dark meat of chicken and turkey.-3oz red meat per week allowed thereafter.
- No dairy products containing 1% or more butterfat:
Dairy containing 1% butterfat never exceeding 1 gram of fat per serving are allowed 1 serving per day. Permissible in any amount are nonfat and fat free dairy products
Allowed: 3 eggs per week-not exceeding 1 per day-unlimited egg whites - Saturated fat must never exceed 15 grams (3tsp) per day
- Unsaturated fat intake should be maintained at a minimum of 20 grams per day and a maximum of 50 grams per day
1 tsp. cod liver oil and 1 multivitamin/mineral supplement is rec’d daily
Measurement of all fats and oils is expressed in teaspoons. 1 tsp =5grams of fat or oil - Forbidden foods:
Hydrogenated oils, whole milk, cream butter hydrogenated margarine sour cream ice cream with more than 1% butterfat imitation dairy containing palm or coconut oils
Shortening, lard, cocoa butter, palm and coconut oils - Limit sugar: including sugar, jam marmalade, honey molasses corn syrup, maple syrup
- Limit coffee 4 cups or combined cola tea coffee to 3 cups per day
Some critics of the diet argue that the results of his study have not been duplicated and that it was not a double blind controlled study. These are valid points since double blinding helps to avoid bias and certainly there is a need for additional dietary research studies that follow up on Swank’s original work. Until such time, it is hopeful that other researchers have become interested in studying what role, if any, fat plays in an MS attack.
Why Focus On Fat?
Current medical research zeroing in on lipids (fats) may have been initiated by recent clinical trials involving statin drugs in multiple sclerosis patients. Statins are normally prescribed by doctors to lower cholesterol (a fat like compound) and reduce the risk of heart attack and stroke. In addition to their cholesterol lowering effects, statins have shown to be immune modulating and also to decrease inflammation. Knowing that inflammation plays a significant contributory role in the disease process of multiple sclerosis, researchers became interested in using statin drugs in MS patients. But, studies involving statin drugs in MS patients have shown both benefits as well as some harmful effects. Possible explanations for the negative impact on MS could be that statins have the ability to cross the blood-brain barrier and they may decrease the number of cells that are considered protective during an MS attack. These findings leave some doubt whether or not statins should be used as a treatment option in MS.
Nonetheless, lipids are at the forefront of some important medical research under current investigation today and researchers studying MS are increasingly intrigued with these fat molecules. Lipids are a major component of myelin, a fatty protein that is wrapped around the nerve axons creating the myelin sheath. The myelin sheath acts as a protective shield to guard against nerve damage and is the primary target of an MS attack. Dr. Jennifer Kanter, a Research Fellow at Harvard Medical School has been studying lipid molecules from the myelin sheath as possible immune attack targets. Her team was able to show a reaction to particular brain lipids from spinal fluid samples taken from individuals having MS. This was a major medical breakthrough.
This work underscores the necessity to further investigate lipids and their relationship with MS symptoms and disease progression as they may provide researchers with a better understanding of the disease process.
Perhaps this will lead the way for other researchers to re examine dietary fat and the link with MS. It is certainly believable that a low fat diet may be considered a promising treatment option for those with MS. Until more research is conducted and there are more answers on the quantity and the quality of dietary fat that may be beneficial for MS patients, it is important to note, extremely low fat diets can be dangerous and are not advisable. However, most of the medical community agrees that a low fat well-balanced diet is beneficial for everyone and a good choice for those with MS.
Despite limited research on diet and MS, neurologists should listen respectfully to their patients’ questions and concerns regarding diet therapy and specific nutritional supplementation as part of an effective treatment plan for MS.
References
Silberman, S. The MS lesion project: taking the mystery out of MS Inside MS. FindArticles.com. 25 Sep, 2009. http://findarticles.com/p/articles/mi_m0850/is_1_19/ai_70363088/
Swank, R. L. (1977). The Multiple Sclerosis Diet Book. New York, New York: Doubleday.
Weinstock- Guttman, B., et al. Low fat dietary intervention with n-3 fatty acid supplementation in multiple sclerosis patients. Prostaglandins, Leukotrienes and Essential Fatty Acids. 73: 397-404. 2005