Multiple sclerosis (MS) is a disease that damages the myelin sheaths of neurons located in the central nervous system. The name "sclerosis" refers to the associated scars visible in the brain and spinal cord.
Multiple sclerosis impairs correct nerve transmission, with the appearance of physical, mental and psychiatric symptoms and clinical signs. The most frequent are: double vision, blindness of one eye, muscle weakness, sensory difficulty and coordination problems.
It occurs most frequently between the ages of 20 and 50 and is twice as common in women than in men.
Multiple sclerosis can occur in isolation (relapsing) or worsen over time (progressive).
Symptoms may disappear completely between attacks, but the neurological lesions are definitive.
The causes of multiple sclerosis are not certain and it is likely that it is an autoimmune disease (evident from activation of T cells) or caused by malfunctioning of myelin-producing cells.
The predisposing factors for MS are genetic and environmental (for example a viral infection).
Diagnosis is made on the basis of clinical signs, symptoms and laboratory tests.
There is no definitive cure. Available treatments improve recovery after attacks and facilitate prevention.
Drugs can have very important side effects, while motor therapy tends to preserve functional capacity.
Life expectancy in multiple sclerosis patients is 5-10 years lower than in the healthy population.
In 2013, around 2,3 million people were affected by MS and 20.000 died compared to 12.000 in 1990 (statistics suggest a significant increase in diagnosed cases).
Diet appears to be partially involved in the onset of multiple sclerosis.
Evidence on the relationship between MS and nutrition varies according to the nutrient under consideration; sometimes they are scarce and unconvincing, while in others they seem more evident and objective.
Since the evidence to support nutritional treatments continues to be weak, the diet can be considered an alternative or at best complementary therapy system.
Today, more than 50% of people with multiple sclerosis also rely on alternative medicine (although the percentage varies depending on the method of classification of the protocols).
Of the many solutions, dietary supplementation, certain dietary regimens, hyperbaric oxygen therapy, self-infection with hookworms, reflexology, yoga and acupuncture are the most accredited.
As regards the dietary field, they are most used:
- Supplement with vitamin D (calciferol).
- Supplement with antioxidants.
- Supplement with essential polyunsaturated fatty acids (PUFA).
Vitamin D and Multiple Sclerosis Supplements
Vitamin D is a fat-soluble molecule with various metabolic functions (bone metabolism, immune system, etc.).
It can be taken with food or synthesized in the skin from cholesterol and in the presence of UV rays.
High levels of vitamin D3 (cholecalciferol) are statistically associated with:
- Lower risk of contracting multiple sclerosis.
- Lower number of relapses.
- Smaller and sparse central nervous tissue scars.
- Greater conservation of motor function.
Conversely, a modest plasma concentration of vitamin D3:
- The overall danger of the disease increases.
- Increases the severity of damage done.
This could be due to the vitamin's immuno-modulating effect on perennially active T cells.
The Hayes CE study. "Vitamin D: a natural inhibitor of multiple sclerosis" has shown that by supplementing with 10ng / ml of vitamin D3 per day, a 15% reduction in the risk of injury and 32% of relapses can be achieved.
The foods richest in cholecalciferol are: egg yolk, fishery products, cod liver and related oil etc.
Supplement of Antioxidants and Multiple Sclerosis
Myelinated degeneration of nervous tissue has an inflammatory and oxidative etiology.
It is scientifically proven that lipid oxidation and peroxidation in myelin tissue play a fundamental role in the etiology of multiple sclerosis.
On the other hand, it has not yet been possible to correlate the reduction in general oxidative stress with an improvement in the pathological condition of MS.
The elements used in the antioxidant experimentation are of nutritional origin, although it could be useful to carry out measurements concerning the concentration and effectiveness of the antioxidants produced in the organism itself.
The effect of food supplementation on multiple sclerosis was evaluated with:
- Selenium: it is mainly contained in: meat, fish products, egg yolk, milk and derivatives, enriched foods (potatoes, etc.).
- Vitamin A or equivalent retinol: they are contained in vegetables and red or orange fruits (apricots, peppers, melon, peaches, carrots, squash, tomatoes, etc.); they are also present in crustaceans and milk.
- Vitamin C or ascorbic acid: it is mainly contained in sour fruit and raw vegetables. In particular: peppers, lemon, orange, grapefruit, tangerine, parsley, kiwi, lettuce, apple, chicory, cabbage, broccoli etc.
- Vitamin E or tocopherols (or tocotrienols): it can be found in the lipid portion of many seeds and related oils (wheat germ, corn germ, sesame, etc.).
The results were controversial.
While protecting against oxidation, these nutritional principles appear to activate T cells and macrophages implicated in the etiology of multiple sclerosis.
The safety of their use is yet to be defined.
Importance of PUFAs and Swank Diet
Essential polyunsaturated fatty acids (PUFAs) are lipid molecules that the body is unable to synthesize on its own. At the right doses and in the correct proportions they all have a beneficial effect on cholesterolemia, glycemia, arterial hypertension and cardiovascular risk in general.
PUFAs can be classified into two types:
- Omega 3 (especially alpha-linolenic acid, eicosapentaenoic and docosahexaenoic acid): precursors of the anti-inflammatory molecules par excellence.
- Omega 6 (linoleic acid, gamma linoleic acid, dihomogamma linolenic acid and arachidonic acid): also involved in the synthesis of PROinflammatory molecules.
In particular, arachidonic acid is the polyunsaturated omega 6 which plays the most inflammatory role.
GOOD FATS AND BAD FATS
As anticipated, essential polyunsaturated fatty acids perform many beneficial functions for the body
Most of these are in opposition to the role of the so-called "bad fats", that is: cholesterol, saturated fatty acids and hydrogenated fatty acids, the latter especially in trans conformation.
We specify that the "bad fats" are defined as such because an EXCESS in the diet can cause some discomfort of a metabolic nature. Moreover, it has been shown that a diet too rich in these molecules can negatively affect the maintenance of cognitive abilities during old age.
This does not mean that they are useless or completely harmful. They too play an important role in maintaining nervous health as they structure much of the myelin.
Myelin is a very fatty substance (70% lipids in the dry matter) and mainly contains:
The proportion is 4: 3: 2.
Phospholipids and galactolipids are composed of:
- 75% from SATURATED fatty acids (50% stearic or octadecanoic and 25% lignoceric or tetracosanoic).
- 25% da monoinsaturi (24: 1 acido nevroico o cis-15-tetracosenoico).
It can be deduced that saturated fats and cholesterol are not to be considered totally harmful nutrients, since they structure a large part of the myelin guanine.
However, we must not forget that:
- The organism is able to produce them autonomously.
- Any excess can prove harmful to:
- Cholesterolemia and atherosclerotic risk.
- Nervous efficiency, especially during aging.
Their intake with food should be only complementary or even marginal to endogenous synthesis.
With the advent of the Second World War, even in the USA there was a significant decline in the consumption of food of animal origin.
During this time, chief neurologist Roy Swank noted a 200-250% reduction in multiple sclerosis cases.
Sensing a nutritional correlation, he subsequently experimented with a nutritional regime almost devoid of meat, fish, eggs and dairy products.
Food therapy (Swank Diet) provided for keeping fats at 20% of total energy, which is about 5-10% less than the norm.
Roy Swank saw a significant improvement in symptoms and a reduction in relapses in 95% of multiple sclerosis cases.
A potential therapeutic role of a cyclically low animal protein (and calorie) diet has also been highlighted by preliminary studies on the fasting mimicking diet.
The most biologically active omega 3s (DHA and EPA) are contained above all in fishery products, in particular in blue fish and in extracted oils (sardine, mackerel, bonito, alaccia, herring, alletterato, tuna belly, garfish, seaweed, cod liver oil, seaweed oil, krill oil etc).
The less active omega 3 (ALA) are contained in some seeds and related extraction oils: soy, linseed, kiwi seed, grape seed etc.
Omega 6 are mainly contained in certain seeds, part of them or extracted oils. In particular: sunflower, wheat germ, sesame, almost all dried fruit, corn germ, etc.
NORMAL RECOMMENDED DOSES
To maintain a metabolic balance, the research bodies recommend taking essential polyunsaturated fatty acids in the omega 3 / omega 6 ratio = 1: 4 and in a total quantity of about 2,5g / day (0,5g omega 3 and 2,0g omega 6).
The intake of saturated or hydrogenated fats should be equal to that of PUFA and dietary cholesterol should remain below 200-300mg / day.
Ultimately, reducing the amount of total fat may be helpful in multiple sclerosis.
Furthermore, it is advisable to prefer the omega 3 fraction for the production of anti-inflammatory eicosanoids, to the disadvantage of the omega 6 precursors of inflammatory eicosanoids and bad fats (but without eliminating them completely).
Gout and Multiple Sclerosis
There is a statistical correlation between uricaemia, gout and multiple sclerosis.
It seems that gout is rarer in people with multiple sclerosis than in the general population.
The detection of uric acid in the blood seems to confirm this hypothesis; levels of this metabolite are lower in people with multiple sclerosis than in healthy people.
It is conceivable that uric acid plays a protective role against multiple sclerosis, even if the real importance and the mechanism of action are still being studied.