Diet Reviews and Resources for PWMS

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

Diet Reviews and Resources for PWMS

Postby jimmylegs » Sun Sep 09, 2018 2:04 pm

This topic provides an overview of, and excerpts from, an array of diet resources for people with MS, presented in alphabetical order:

Mayo Clinic
Is there a multiple sclerosis diet?

https://www.mayoclinic.org/diseases-con ... q-20057953
I was recently diagnosed with MS. Is there a special diet I should follow?
There is no evidence that a specific diet can prevent, treat or cure multiple sclerosis (MS). Some special diets can actually be harmful because they contain too much of certain vitamins or not enough of others.

Make sure you talk to your doctor before making significant changes to your diet.

Overall, people with MS need a balanced, low-fat and high-fiber diet. Unprocessed or naturally processed foods are preferred to processed foods. This is similar to the Mediterranean diet, and the same healthy diet that's recommended for the general population. Also consider limiting alcohol as much as possible.

Some research suggests that a diet low in saturated fats and supplemented with omega-3 fatty acids may benefit people with MS. But these results haven't been confirmed by large-scale studies. However, it's recommended that people with MS limit animal-based fats. Instead, opt for fish and nut-based fat sources such as olive oil, avocado oil and almond butter, which are rich in omega-3s.

Researchers are also investigating a link between vitamin D and biotin — a form of vitamin B also known as vitamin H — on multiple sclerosis disease activity. These studies are in the very early stages. Still, it's recommended that people with MS keep vitamin D levels in the upper range of normal.

It's important for people with MS to make healthy food choices:

Not getting enough vitamins and minerals can worsen MS symptoms. Skipping meals may contribute to low energy levels. Some MS symptoms such as depression and MS treatments such as steroids can cause weight gain. Weight gain can lead to more health concerns, such as joint stress and cardiac and respiratory problems. Alcohol can intensify common MS symptoms, such as imbalance and lack of coordination.

MS Trust (UK)
Healthy eating

https://www.mstrust.org.uk/life-ms/diet/healthy-eating
On this page:
What is a healthy diet?
Why is diet important in MS?
Did my diet cause my MS?
Can diet affect the progression of my MS?
Dietary supplements
Where can I get help with my diet?
...
There is no specific diet or dietary supplement that is proven to help everyone with MS. However, many people with MS have found benefit in switching to a healthy diet, from small changes to radical overhauls. Currently, more than half of people with MS are following a diet or taking a dietary supplement.
...
Do stay safe with dietary changes, especially if you intend to cut out whole food groups or change your diet radically. Discuss your plans with a dietician, doctor or MS Nurse, and be careful not to leave out essential nutrients.
...
A US study of nearly 7,000 people with MS recently reported that the people with the healthiest diets and lifestyles reported the least disability and lower burden of symptoms. This study wasn’t looking at particular ‘MS’ diets, but at general eating patterns. The researchers rated high intakes of fruit, vegetables and whole grains as healthy, and rated high intakes of sugars, red meat and processed meats as unhealthy. They also looked at age, sex, body weight, smoking and physical activity.
...
Unless you have a diagnosed deficiency in some essential nutrient, supplements should not be necessary with a balanced, healthy diet. An exception is Vitamin D. This is made in the skin when exposed to sunlight, as well as being found in food. During winter in the UK, the sunlight is not strong enough to make Vitamin D, and a supplement may be reasonable.

(caveat - we're still pretty bad at picking up on suboptimal nutrient status, as opposed to the severity of deficit currently required to result in a "diagnosed deficiency")

Multiple Sclerosis Society of Canada
Healthy Eating: A guide for people with MS

https://mssociety.ca/en/pdf/eating.pdf
© 2008 Multiple Sclerosis Society (Great Britain and Northern Ireland).
Like everyone else, people with MS can benefit from a healthy diet. This booklet explains what is meant by a ‘well-balanced diet’, why we should all be aiming for one and how to get one. You might find that symptoms of MS affect what you can eat or how you prepare meals. Learning new ways of cooking, or using energy-saving tips can help you carry on eating what you enjoy. Adjusting to MS will not always mean changing your diet, but sometimes it can help. Many special diets have been proposed as treatments, but none have been proven to prevent MS or affect the way it may develop. Special diets are best approached with caution as some may be expensive or even harmful. Most people do not need to use expensive supplements either. You can usually obtain the nutrients you need through your daily meals. With careful planning, perhaps with the help of a dietitian, you can make sure you meet your dietary needs – even if they change over time. Many people with MS report that they feel better when they eat well.

Multiple Sclerosis Society of Canada
Diet

https://mssociety.ca/hot-topics/diet
Diet
The effects of diet on MS treatment and progression are uncertain. Although a topic of interest for the MS community, conclusive evidence supporting dietary claims is scarce. Research investigating the effect of dietary manipulation on MS is challenging, as these types of studies are difficult to design and control for. Below is a summary of various talked-about diet regimes for MS. ...
(click through for details on special diets [Paleo, Swank, Jelinek and Best Bet], sodium and cholesterol)

National Multiple Sclerosis Society (U.S.)
Diet & Nutrition

https://www.nationalmssociety.org/Livin ... -Nutrition
Overview
Maintenance of general good health is very important for people with any chronic disorder: a well-balanced and planned diet will help achieve this goal. Although there's no special “MS diet,” what and how you eat can make a difference in your energy level, bladder and bowel function, and overall health. MS specialists recommend that people with MS adhere to the same low-fat, high-fiber diet recommendations of the American Heart Association and the American Cancer Society for the general population. ...

Challenges with special diets
Different diets have been proposed as treatments, or even cures, for the signs and symptoms of MS. Most of the diets touted as helping people with MS have not been subjected to rigorous, controlled studies, and the few that have been evaluated have produced mixed results.

Most claims made for dietary treatments are based on personal accounts, and reported benefits may be changes that could have happened without any treatment. ...

Some special diets may be harmful because they include potentially toxic amounts of certain vitamins, or exclude important nutrients. That's why it's important to consult with your healthcare professional before starting any diet that includes nutritional supplements or vitamins.

Vitamin D
It is well known that vitamin D works to promote calcium absorption for strong bones. However, recent research also suggests that vitamin D may have important effects on the immune system and may help regulate cell growth and differentiation. A clinical trial is underway to determine what role vitamin D supplementation might play in reducing MS disease activity. Read more about vitamin D in Vitamin D Deficiency and Possible Role in Multiple Sclerosis. Treatment of Multiple Sclerosis – Relationship between Vitamin D and Interferon β-1b presents data demonstrating how vitamin D might enhance the effect of interferon beta on MS disease activity. The National MS Society also provides guidelines for healthcare professionals on managing vitamin D issues in clinical practice.

Biotin /MD1003
Biotin is considered a form of vitamin B, and is a component of enzymes in the body that help break down certain substances in the body. Biotin, also known as vitamin H, is usually obtained from food.

In spring of 2015, an abstract was published of preliminary results from a clinical trial in France involving 154 people with primary-progressive MS or secondary-progressive MS. They were given high-dose biotin (MD1003) or inactive placebo for 48 weeks. The results suggested that 12.6% of those given MD1003 showed improvement in disability (using either the EDSS scale that measures disability progression, or improvement in a timed walk), versus none of those on placebo, and there were no serious safety issues reported.

More research is needed to determine who might benefit from this approach. MedDay Pharma, which sponsored the trial, stated that another trial is underway.

NOTE: In November, 2017, the FDA issued a Safety Alert to let the public and healthcare providers know that biotin can significantly interfere with certain lab tests, causing falsely high or falsely low test results that may go undetected. Talk to your doctor if you are currently taking biotin or are considering adding biotin, or a supplement containing biotin, to your diet. Biotin is found in multivitamins, including prenatal vitamins, biotin supplements and dietary supplements for hair, skin, and nail growth. Withholding biotin is often necessary before certain blood tests are done to avoid falsely abnormal results. It is important to speak with the healthcare provider who is ordering the blood tests for specific withholding instructions. The FDA is requesting information about any adverse events or side effects you may experience related to the use of biotin or products containing biotin.

National Multiple Sclerosis Society (U.S.)
DIET AND MULTIPLE SCLEROSIS

http://www.nationalmssociety.org/Nation ... -26-15.pdf
Introduction...
Possible mechanisms by which diet may have an effect on MS -
1. Direct effects on the immune system ...
2. Indirect effects through modulation of the gut flora ...
3. Effects on components of the central nervous system ...

(click through for details re special diets including Paleo, Mediterranean, McDougall, Gluten-Free and Swank Diets)

Cautions:

The Paleo diet can result in deficiencies in folic acid, thiamine and vitamin B6 (due to reduced intake of cereals), calcium and vitamin D (due to lack of dairy intake) and insufficient caloric intake without appropriate nutritional advice.

No specific nutritional deficiencies would be expected from following the Mediterranean Diet.

The McDougall diet could result in deficiencies in iron, vitamin B12, vitamin D, calcium and ω3-fatty acids.

No definite nutritional deficiencies expected if gluten-free breads and cereals are substituted on a gluten-free diet

Though no definite deficiencies would be expected to develop from this [Swank] diet, a recent study showed that those following this diet were consuming less than the recommended levels of vitamin A, C, E and folate.

Conclusions

While many different dietary strategies are being promoted for people with MS, currently there is insufficient evidence to recommend any of these strategies. Interestingly despite the differences between these diets there are several common themes. Almost all the diets advocate avoiding highly processed food, foods with high glycemic index and food that is high in saturated fat. Most diets also recommend reducing consumption of fatty red meat and increasing consumption of fruits and vegetables.
Other approaches to diet are also being considered and include caloric restriction, which appears to be effective in animal models of MS. Trials of caloric restriction in people with MS are now underway. More systematic evaluation of dietary strategies in MS is required. However, while we wait for such research to be done, following a diet that incorporates some of the themes that are common to these various diets and also has beneficial effects for overall health may be the most pragmatic option at this time.
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: Diet Reviews and Resources for PWMS

Postby ElliotB » Sun Sep 09, 2018 4:16 pm

"Overall, people with MS need a balanced, low-fat and high-fiber diet.


Really?


Dr. Wahls, who's protocol is conveniently omitted as it often is from diet discussions, would not agree. And there are many others who would not agree either. And, as someone who has followed an extremely high good fat and low fiber diet for about 4 1/2 years, I would not agree either.

But the above statement is the commonly accepted thought on diet for those with MS and accepted by most as being factual. But there is ample evidence to the contrary.
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Re: Diet Reviews and Resources for PWMS

Postby jimmylegs » Sun Sep 09, 2018 4:40 pm

i'm afraid your personal story does not weigh equally in the balance with the statistically powerful existing and growing research evidence base.

neither does dr w's personal story, self-promotion and self-interested protocol (which anyone interested in reading, vs knee jerk criticism, will discern given decent attention to linked resources above)
don't need to dig very deep elsewhere online, to find the thousands of dollars being charged for private protocol certifications - i won't be contributing to that particular giblet gravy train.
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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jimmylegs
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Posts: 11555
Joined: Sat Mar 11, 2006 4:00 pm

Re: Diet Reviews and Resources for PWMS

Postby NHE » Mon Sep 10, 2018 9:28 pm

jimmylegs wrote:National Multiple Sclerosis Society (U.S.)
Diet & Nutrition

https://www.nationalmssociety.org/Livin ... -Nutrition
Overview
Maintenance of general good health is very important for people with any chronic disorder: a well-balanced and planned diet will help achieve this goal. Although there's no special “MS diet,” what and how you eat can make a difference in your energy level, bladder and bowel function, and overall health. MS specialists recommend that people with MS adhere to the same low-fat, high-fiber diet recommendations of the American Heart Association and the American Cancer Society for the general population. ...

Challenges with special diets
Different diets have been proposed as treatments, or even cures, for the signs and symptoms of MS. Most of the diets touted as helping people with MS have not been subjected to rigorous, controlled studies, and the few that have been evaluated have produced mixed results.

Most claims made for dietary treatments are based on personal accounts, and reported benefits may be changes that could have happened without any treatment. ...

Some special diets may be harmful because they include potentially toxic amounts of certain vitamins, or exclude important nutrients. That's why it's important to consult with your healthcare professional before starting any diet that includes nutritional supplements or vitamins.

Vitamin D
It is well known that vitamin D works to promote calcium absorption for strong bones. However, recent research also suggests that vitamin D may have important effects on the immune system and may help regulate cell growth and differentiation. A clinical trial is underway to determine what role vitamin D supplementation might play in reducing MS disease activity. Read more about vitamin D in Vitamin D Deficiency and Possible Role in Multiple Sclerosis. Treatment of Multiple Sclerosis – Relationship between Vitamin D and Interferon β-1b presents data demonstrating how vitamin D might enhance the effect of interferon beta on MS disease activity. The National MS Society also provides guidelines for healthcare professionals on managing vitamin D issues in clinical practice.

So the NMSS article references a 2015 Holick paper which states that 20,000 IU of vitamin D3 per day is safe and without deleterious side effects.

http://www.touchneurology.com/articles/ ... -sclerosis

Vitamin D toxicity is very rare, with none seen at doses up to 20,000 IU/day.


:confused:
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Re: Diet Reviews and Resources for PWMS

Postby jimmylegs » Tue Sep 11, 2018 12:49 am

pretty early in the curve on that issue for sure. recalling old arguments on here with mark insisting my xp was a one off. far from it, but widespread megadosing is a new thing never before inflicted on people or the environment.
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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jimmylegs
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Posts: 11555
Joined: Sat Mar 11, 2006 4:00 pm

Re: Diet Reviews and Resources for PWMS

Postby NHE » Wed Sep 12, 2018 4:11 pm

NHE wrote:So the NMSS article references a 2015 Holick paper which states that 20,000 IU of vitamin D3 per day is safe and without deleterious side effects.

http://www.touchneurology.com/articles/ ... -sclerosis

Vitamin D toxicity is very rare, with none seen at doses up to 20,000 IU/day.


:confused:

In addition to magnesium depletion, here's another risk. Kidney stones.


Vitamin D, Hypercalciuria and Kidney Stones.
Nutrients. 2018 Mar 17;10(3).

    The estimated lifetime risk of nephrolithiasis is growing nowadays, and the formation of kidney stones is frequently promoted by hypercalciuria. Vitamin D, and especially its active metabolite calcitriol, increase digestive calcium absorption-as urinary calcium excretion is directly correlated with digestive calcium absorption, vitamin D metabolites could theoretically increase calciuria and promote urinary stone formation. Nevertheless, there was, until recently, low evidence that 25-hydroxyvitamin D serum levels would be correlated with kidney stone formation, even if high calcitriol concentrations are frequently observed in hypercalciuric stone formers. Low 25-hydroxyvitamin D serum levels have been associated with a broad spectrum of diseases, leading to a huge increase in vitamin D prescription in the general population. In parallel, an increased frequency of kidney stone episodes has been observed in prospective studies evaluating vitamin D alone or in association with calcium supplements, and epidemiological studies have identified an association between high 25-hydroxyvitamin D serum levels and kidney stone formation in some groups of patients. Moreover, urinary calcium excretion has been shown to increase in response to vitamin D supplements, at least in some groups of kidney stone formers. It seems likely that predisposed individuals may develop hypercalciuria and kidney stones in response to vitamin D supplements.

Free full text.
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NHE
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Re: Diet Reviews and Resources for PWMS

Postby jimmylegs » Wed Sep 12, 2018 6:45 pm

indeed - super fun stuff. my kidneys have always given me an immediate warning any time i even take a solo calcium pill. glad i listen to them!
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
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Posts: 11555
Joined: Sat Mar 11, 2006 4:00 pm


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