This Is MS Multiple Sclerosis Community: Knowledge & Support

Okay, so I've been reading a little about the potential role of diet in the pathophysiological processes of MS. It does sound interesting particularly since there seem to be so many testimonies to the positive affects of adopting a new diet which is low in fat and cuts out potential allergic foods. I understand that ideally one would have Elisa tests to check for his or her own food allergies thereby determining which foods to eliminate from the diet. But barring that what to do? There seem to be some conflicts between the various diets.

I understand that the best diet would be low in saturated fats and would include mainly fish, white meat poultry, fruit and veggies .
I further understand that the items to be eliminated should include: red meat, all dairy products, gluten/grains, sugar, legumes/beans , etc.
But for some items there seems to no real agreement.
I'm specifically concerned about the following foods- breakfast cereals, eggs, rice, honey, millet or quinoa, and corn. Some diets seem to say these foods are fine and others say no way.

So I know that every individual is different, but does anyone have any thoughts on which dietary regimen is best. Specifically, if I am considering a diet , should I follow the Swank diet or Dr. Embry's Best Bet Diet?

If I am considering supplements which ones are a must? I'm guessing grapeseed extract, omega 3 fat, and vitamin D3. Any thoughts on these and by the way does anyone know the chemical name of vitamin D3?


Tracy

Hi Tracy,
You may want to read one of my earlier posts where I discuss my supplement regimen and also share some thoughts on grape seed extract which may be counter indicated for MS. Overall, it seems that not all antioxidants work in identical ways, e.g., some help to reduce inflammation and others may actually increase it. There has also been some discussion on this board where some folks have had good results with curcumin which is an extract of turmeric. Do a search to find the relevant posts if you're interested.

As far as dietary changes are concerned, the major changes that I've made are to eliminate partially hydrogenated fats (aka trans fats). The book I mentioned in the earlier thread, The Perricone Prescription, discusses that these fats are proinflammatory. I also try to eat more fruits and vegtables in general.

NHE

NHE

Thanks for your input. Fortunately I had not started taking the grapeseed extract yet. I am taking the omega 3 fish oil and 800 mg of vitamin D, but am a little hesitant to take large doses such as the frequently mentioned 4000 iu vitamin D until I can get some reassurance that there is no risk of toxicity.
Tracy

MrT,

I am posting a link to a really good meta-study on vitamin D done by the European Union in 2002 to determine their recommended tolerable upper intake level. I hope it helps.

http://europa.eu.int/comm/food/fs/sc/scf/out157_en.pdf

Dignan,

Thanks for the article . The bottom line is that the upper limit for vitamin D is 50 micrograms for adults. Perhaps I didn't read closely enough, but what is the international unit equivalent of 50 micrograms?
Tracy

Tracy,

There are different forms of Vitamin D. Vitamin D2 is also called ergocalciferol. That is the one that is usually added to food like milk to fortify it. Vitamin D3 is also called cholecalciferol. That is the one often seen in vitamin supplements, and is the form that is naturally found in animal tissues.

There are other chemical names if you need them, but they are long and bulky ones because they are bulky chemicals. This website has pictures of the chemical structures:

http://www.chm.bris.ac.uk/webprojects20 ... amind.html

On page 10 of Dignan's EU report, there is mention that 200 IU is 5 micrograms. If they are recommending a change to 50 micrograms for an adult upper-bound dose, that would be 2000 IU. They should have also put the IU units in their recommendation!

Lisa

Lisa,

I guess I just completely missed the iu/microgram equivalent. Thanks for pointing that out to me.
Tracy

Tracy,

Well, the EU report should have given both micrograms and IUs for the new recommendations section, in my opinion. Sometimes these reports remind me of Easter Egg hunts!

Have you been following the research being done by R. Veith on Vitamin D?

Lisa

Lisa,

I am not familiar with the vitamin D research by R Veith but would be interested.
Thanks,
Tracy

Direct-MS has two of Vieth's papers at their site in pdf format. They are Vitamin D Nutrition and its Potential Health Benefits for Bone, Cancer and Other Conditions and Vitamin D supplementation, 25-hydroxyvitamin D concentrations and safety

Cheers
Nick

VP Direct-MS

Thanks, Nick!

I was looking for the links to those papers for Tracy and couldn't find them again! I must have been spelling his name wrong Veith vs Vieth

Tracy, you can see in the papers that Dr. Vieth is a proponent for increasing the recommended intake of Vitamin D.

Below is also a link to a recent reference in Neurology, 2004 which is a response to an earlier 2004 paper about the study in nurses (in which Vitamin D supplementation was associated with a significantly reduced risk of developing MS).

The link to the comment reference is:
http://www.ncbi.nlm.nih.gov/entrez/quer ... s=15365162

One of the authors is R. "Veith" which might be a typo (and threw me off track) or there are two of these Vitamin D researchers with almost identical names. Unfortunately the comment does not have an abstract, and I don't have a subscription access to Neurology to find out what the comments were. If someone out there does have access to this recent comment, can they provide a summary of what Ebers, Sadovnick, and "Veith" said? Thanks!

Lisa

Lisa B. Goode

Here it is:

Vitamin D intake and incidence of multiple sclerosis

To the Editor: We read with interest the article by Munger et al.1
A protective effect of sunlight on multiple sclerosis (MS) risk was
first suggested by Acheson et al.2 Vitamin D is a potential mediator
of this relationship. We are sympathetic to the hypothesis
being tested3 by Munger et al. but have the following concerns.

1) NHS studied women age _30, but more than half of female
patients with MS have onset below this age. Of those accrued,
some 50,000 were excluded from analysis.1 Was this done before
testing the vitamin D hypothesis? What were the characteristics,
when known, of exclusions for calculated vitamin D estimates
compared to those retained? Perhaps MS risk can be altered after
age 30, but earlier ages are implicated from migration studies.

2) 61 and then 130 questions were asked in the NHS and NHS
II questionnaires. Was correction made for multiple analyses?
Could the authors explain the assumptions and approach used to
calculate the “p trend” statistic that forms the basis of this report?

3) The apparent association of low MS risk with intake of _400
units of vitamin D from supplements per day seems at odds with
the recent report that those intakes of supplements have minimal
effects on 25(OH)D levels. Furthermore, young women who took
multivitamins were more likely to exercise outdoors. Multivitamin
use correlated better with summer 25(OH)D levels than winter.5
Vitamin D production in the skin requires UVB that is not intense
enough at latitudes >30 for at least 1 month each winter.

4) The association of MS with latitude seems unambiguous
from Kurtzke’s US Veterans’ studies and from Australia.6 The
lack of interaction with latitude in this study4 is surprising if
vitamin D intake in adulthood is causally related to MS risk, since
D levels and putative functional effects are dependent on latitude
related UVB.

5) We note that the NHSII cohort had more MS “cases/
person–y” (97/7.5 _ 105) compared to the NHS cohort (76/1.5 _
106). These data are difficult to compare. As age specific incidences
seem less in NHSII, is there evidence for a decreasing
incidence or prevalence in the areas surveyed?

6) How does the nurses’ D intake relate to that in the general
population? Vitamin intake could vary by ethnicity. Did the definition
of “white” include ethnic groups known to be resistant to
MS? Recall bias has been reported within weeks of illness associated
events. Has the accuracy of four yearly reports been
validated for the measures in this article?

George C. Ebers, MD, FRCPC, A.D. Sadovnick, PhD, Reinhold
Veith, PhD, Oxford, UK

Reply from the Authors: We thank Ebers et al. for their interest
in our study. We excluded women with an incomplete baseline
food frequency questionnaire. This exclusion was made a priori
following the same rules used in all previous dietary analyses in
these cohorts. Adjustment for multiple analyses in our study was
not necessary as only two measures of vitamin D intake were
considered: the combined amount of vitamin D intake from food
and from supplements. The p for trend was calculated using a
proportional hazards regression model using the median intake
values for each category of vitamin D from food or supplements as
a continuous variable. This method tests the overall null hypothesis
that vitamin D intake is unrelated to risk of MS without any
specific assumptions.

In contrast with the results of Vieth et al.5 quoted by Ebers et
al., in a substudy among 323 healthy women from the NHS cohort,
we found that vitamin D intake at levels below 400 IU does
increase 25(OH)D levels. Average winter plasma levels of
25(OH)D were positively correlated with levels of vitamin D intake:
40 nmol/L in the lowest quintile of intake (median _ 108
IU), 55 nmol/L in the third quintile (median _ 301 IU), and 70
nmol/L in the highest quintile (median _ 703 IU). Further, in our
cohorts, the association between vitamin D intake from supplements
and risk of MS was not materially altered by adjustment
for physical activity (unpublished data).

The women in the NHS cohort are older than those in the
NHSII cohort and because of modest overlap between the two
cohorts, age-specific incidence rates are difficult to compare. However,
age-specific incidence rates are slightly higher, not lower, in
NHS II (unpublished data). Further, the increasing use of MRI
may reduce the time between onset of MS and diagnosis, possibly
causing spurious changes in incidence rates.
The nurses’ intake of vitamin D is similar to that of women in
other US cohort studies.7 Race was self-reported and “White” did
not include ethnic groups with low risk of MS.

The lack of significant interaction between latitude and vitamin
D in our study may be explained by the insufficient power to
detect such an interaction.

As this was a prospective study, recall bias was not of concern
as none of the women had MS or MS symptoms when completing
the food frequency questionnaires.

Kassandra L. Munger, MSc, Eilis O’Reilly, MSc, Alberto
Ascherio, MD, DrPH, Boston, MA
Copyright © 2004 by AAN Enterprises, Inc.

References
1. Munger KL, Zhang SM, O’Reilly E, et al. Vitamin D intake and incidence
of multiple sclerosis. Neurology 2004;62:60–65.
2. Acheson ED, Bachrach CA, Wright FM. Some comments on the relationship
of the distribution of multiple sclerosis to latitude, solar radiation
and other variables. Acta Psychiatr (Scand) 1960;35 Suppl 147:132.
3. Steckley J, Dyment D, Sadovnick D, et al., and the Canadian Collaborative
Study Group. Genetic analysis of vitamin D related genes in multiple
sclerosis patients. Neurology 2000;54:729–732.
4. Hernan MA, Olek MJ, Ascherio A. Geographic variation of MS incidence
in two prospective studies of US women. Neurology 1999;53:1711–1718.
5. Vieth R, Cole DE, Hawker GA, Trang HM, Rubin LA. Wintertime vitamin
D insufficiency is common in young Canadian women, and their
vitamin D intake does not prevent it. Eur J Clin Nutr 2001;55:1901–
1097.
6. Hammond SR, English DR, McLeod JG. The age-range of risk of developing
multiple sclerosis: evidence from a migrant population in Australia.
Brain 2000;123:968–974.
7. Merlino LA, Curtis J, Mikuls TR, et al. Vitamin D intake is inversely
associated with rheumatoid arthritis: results from the Iowa Women’s
Health Study. Arthritis Rheum 2004;50:72–77.

Thanks, Nick! I'm trying to figure out what it all means....

Lisa

Lisa,

My thanks to you and to Nick as well for the link to Direct-MS and the vitamin D articles which I have now read in full. Many interesting articles at Direct-MS.
Tracy

Has anybody read the Gold Coast Cure?