2017 review: The role of diet in multiple sclerosis

A board to discuss various diet-centered approaches to treating or controlling Multiple Sclerosis, e.g., the Swank Diet

2017 review: The role of diet in multiple sclerosis

Postby jimmylegs » Fri Apr 14, 2017 10:13 am

The role of diet in multiple sclerosis: A review
http://www.tandfonline.com/doi/abs/10.1 ... 17.1303016
Multiple sclerosis (MS) is a multifactorial, inflammatory, and neurodegenerative disease of the central nervous system, where environmental factors interact with genetic susceptibility. The role of diet on MS has not been comprehensively elucidated; therefore, through an extensive search of relevant literature, this review reports the most significant evidence regarding nutrition as a possible co-factor influencing the inflammatory cascade by acting on both its molecular pathways and gut microbiota. Since nutritional status and dietary habits in MS patients have not been extensively reported, the lack of a scientific-based consensus on dietary recommendation in MS could encourage many patients to experiment alternative dietetic regimens, increasing the risk of malnutrition. This work investigates the health implications of an unbalanced diet in MS, and collects recent findings on nutrients of great interest among MS patients and physicians. The aim of this review is to elucidate the role of an accurate nutritional counseling in MS to move toward a multidisciplinary management of the disease and to encourage future studies demonstrating the role of a healthy diet on the onset and course of MS.

TRUTH. once again, no thanks, blanket dietary recommendations. there's a reason they don't work for everyone. keep moving, and work hard to achieve optimal intakes of essential macro and micro nutrients from healthful sources. increase healthy intakes in lockstep with increased physical activity and/or antinutrient influences.

can't get into full text by the looks of things. not yet at least. bummer.
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!
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Re: 2017 review: The role of diet in multiple sclerosis

Postby jimmylegs » Wed Dec 20, 2017 5:44 pm

got in this time. excerpts:

"Health implications of unbalanced diet
Nutritional imbalances might justify widespread vitamin deficiencies,101 reduced control of body weight,102,103 prevalence of atherosclerosis,104 hypertension,
hyperlipidemia, diabetes, and an increased risk of vascular comorbidities, observed in MS patients as compared to the general population.105 Emerging evidence of an increased risk of disease progression in MS patients with vascular and metabolic comorbidities makes it reasonable to assume the existence of a dangerous vicious circle.

Malnutrition
Malnutrition can be defined as a pathological state resulting from inadequate nutrition, including undernutrition, over-nutrition (overweight and obesity), and deficiency of one or more specific nutrients (such as vitamins or minerals). To date, its exact prevalence in MS patients is unknown, but some studies have demonstrated that malnutrition may occur more frequently in MS than in other chronic diseases, being more relevant in severely disabled patients. The detrimental consequences on functional abilities, mental activity, immune system, and muscle strength may contribute to worsen pre-existing MS symptoms,impacting negatively on patients’ quality of life.
...
Pressure ulcers and malnutrition
Pressure ulcers – which represent a major cause of hospitalization – occur more often in MS than in the general population, especially in the presence of mobility
decline (in advanced stages of the disease), older age, male sex, lower socio-economic status. Decreased albumin and hemoglobin levels, but also a low mid-arm circumference, seem to be related with pressure sores. An inadequate nutritional status characterized by a low intake of calories, iron, folate, vitamin D, zinc, arginine, and anti-oxidants,120 in combination with the use of medications, such as glucocorticoids, may contribute to delaying the healing process of pressure ulcers in MS patients, increasing costs for medical care and hospitalization.
...
Evaluation of nutritional status in MS The evaluation of nutritional status in MS is a stepwise, time-consuming procedure, often neglected in clinical practice ...

*cough* YA DON'T SAY!! *cough*

... although the early identification of patients at risk of developing malnutrition or nutritional imbalances has important health implications. Many nutritional screening questionnaires are available: ... As suggested by Pasquinelli et al., the following steps should be observed:
• Evaluation of nutritional status through some key points. Nutrition ‘history’ (through diet diaries etc) assessing lifestyle and types/quantities of consumed food; ...
• Calculation of nutritional needs; ...
• Evaluation of dysphagia and potential interfering conditions with nutrition (through a multidisciplinary approach).
• Schedule of nutritional intake.
• Plan for the eventual occurrence of complications.
...
Dietary recommendation and specific nutrients in MS Until now, a specific dietary model has not been established for MS patients; therefore, balanced and healthy nutrition – as advised to the general population – is recommended.
...
In MS subjects, respecting the proportions between macro- (lipids, proteins, and carbohydrates) and micronutrients (vitamins and minerals), the diet
should increase plasma levels of essential fatty acids, unrefined carbohydrates (to alleviate symptoms such as fatigue and weakness), anti-oxidants, vitamin D and B12; it would also be appropriate to ensure an adequate supply of proteins, zinc (for tissue trophism), fibers, and fluids (to maintain regular gut function).
...
Vitamin D
... in case of demonstrated deficiency – a very common occurrence in MS population – oral supplements of vitamin D are strongly and unanimously recommended. ... a cumulative dose of 300 000–1 000 000 IU, over 1–4 weeks, is recommended, followed by a maintenance dose of 800–2000 IU/day (or weekly equivalent).

Minerals
Some authors have speculated about the relationship between the dysregulation of certain minerals and MS.176–178 It has been reported that selenium deficiency (contained in cereals, beef, white bread, pork, chicken, fish, and eggs), and that of zinc (in oysters, sardines, meat turkey, beef, lamb, poultry, pumpkin seeds, eggs, cereals, nuts, legumes, dark chocolate), magnesium (in green leafy vegetables, dried fruit, legumes, cereals, and bananas), and iron (in beef, pig, horse, poultry, and fish), probably associated with malnutrition and/or to an increased demand, may worsen some aspects of the disease (especially pressure sores and fatigue).109,179 Given their multiple biological roles and the lack of association between serum concentrations and homeostasis at tissue level, in the nutritional assessment of MS patients, it seems appropriate to evaluate the individual risk factors of mineral dysregulation and deficiencies, in order to promptly correct them according to the RDA.

Conclusions and future perspectives
...Furthermore, because diet-related comorbidities, such as malnutrition, metabolic syndrome, and cardiovascular disease, seem to be related to a decline in physical condition and quality of life in MS patients, an accurate nutritional counseling should be encouraged in clinical practice. Future studies, exploring the role of a healthy and specific diet on MS onset and/or evolution, should be strongly encouraged in order to move toward a holistic management of MS."

common sense FTW :D
Image
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!
User avatar
jimmylegs
Volunteer Moderator
 
Posts: 11234
Joined: Sat Mar 11, 2006 4:00 pm


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