Update on diets and MS
Comparatively few studies have looked at the potential benefits of different diets in multiple sclerosis. For example, only one diet study was presented at the recent European Academy of Neurology annual meeting. That study found that people who adhered to the Mediterranean diet – which emphasizes fresh fruits and vegetables, unsaturated fats, oily fish, and lower amounts of meats and dairy – showed some benefits with respect to MS symptoms and disability levels (Miele and colleagues. EAN 2020; abstract EPR2145). A separate study looking at environmental factors found that a mixed diet and lower body weight were associated with a lower risk of worsening MS (Pozzato and colleagues. EAN 2020; abstract EPO2287).
Two recent published studies looked at different diets and their possible effects on MS. An Australian study looked at dietary patterns over a five-year period in people who had experienced a relapse but were not yet diagnosed with MS (Simpson-Yap and colleagues. Mult Scler 2020;1352458520943087). People with a ‘prudent’ diet – fruits, vegetables, fish, wholegrains and nuts – had a significantly lower risk of having a relapse compared to people on a High-Vegetable diet or people with a Mixed diet (which included meats and alcohol).
The second study compared a ketogenic diet with the paleo diet (Lee and colleagues. J Am Coll Nutr 2020;1-13). The keto group showed improvements in their fasting blood sugar level but no specific improvements in MS symptoms. The paleo group reported less fatigue and better cognitive function.
As a general rule, it’s difficult to demonstrate that a specific diet has a specific benefit: studies are often small, people often don’t stick with the diet, and food is only one of countless factors that can affect the progression of MS. It’s difficult to tease out dietary habits from other factors: healthy eaters may be more into exercise, and less likely to smoke and to be obese, all of which may be more important than eating specific foods. So rather than adopting a fad diet, it may be a better strategy to practice sensible eating habits, maintain a healthy body weight and get some exercise on a regular basis.
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