Multiple Sclerosis and Food: Dietary Foes and Friends

The healthy fats featured in the Mediterranean diet have been found to reduce the risk of chronic disease, including neurodegenerative diseases such as MS.

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New research adds to earlier investigations that indicate certain dietary choices play an important role in how multiple sclerosis (MS) progresses. A mouse study published in the journal GLIA found that diets rich in palm oil, a common ingredient in processed foods, have been linked to a more serious course of MS. However, it’s worth noting that human studies do not always get the same results as animal studies.

While palm oil might be an MS foe, research suggests that fatty fish may be an MS friend.

Patrizia Casaccia, lead author of the GLIA study, told The Epoch Times in an email, “Take home message: Not all fats are bad,” adding that fatty fish and olive oil are associated with better health.

While fats are important, research suggests other foods can be helpful or harmful for MS patients as well.

Dietary Foes

Dietary foes for general health are also foes for specific conditions, such as MS. Such foes include ultra-processed or junk food. Although these foods have an array of nutritional drawbacks, the GLIA study highlights palm oil as a prominent one.

Palm Oil

MS is an inflammatory autoimmune condition that involves damage to myelin, a sheath that insulates nerve cells. According to the GLIA study statement, earlier research has reported that a high-fat diet has toxic effects that increase the severity of MS symptoms. For this reason, the researchers set out to explore possible mechanisms that would cause palm oil to harm nerve cell health.

First, the researchers noted that a diet rich in palm oil was associated with more severe MS in mice. Next, they observed that certain enzymes in the body convert palm oil into a toxic substance that deprives nerve cells of the energy needed to oppose inflammation in the brain. The team then examined whether inactivation of the enzymes could provide neuroprotection.

When the researchers genetically removed the enzymes involved, neurodegeneration in the mice with MS was prevented. The protection held even when the mice were fed a diet rich in palm oil.

“The work reinforces that lifestyle choices, such as diet, can have a profound impact on the course of the disease,” researchers said in the statement. “The study’s results build on previous concepts about careful dietary choices in managing the symptoms of MS.”

Many processed and packaged foods contain palm oil, Sazan Sylejmani, pharmacist and owner of Westmont Pharmacy in Illinois, told The Epoch Times in an email. These include baked goods, such as cookies and crackers; instant noodles; snacks such as potato chips; nut butters; and candy bars.

“I’ve found that labels on products marketed as ‘healthier’ or ‘natural’ still sometimes include palm oil,” Sylejmani said. “This is notably true for some brands of plant-based margarine and spreads which use it as a substitute for trans fats. It’s always insightful to check ingredient lists if you’re trying to avoid or monitor palm oil consumption.”

Ultra-Processed Food

While ultra-processed foods often contain palm oil, this is not the only ingredient and characteristic that makes them foes of MS. Such foods have high amounts of free sugars, saturated fat, and salt and lower levels of protein, fiber, antioxidants, and potassium.

An observational study published in Frontiers in Neurology investigated the association between eating ultra-processed foods and the severity of MS among people in Italy. After analyzing food frequency questionnaires and neurology assessments, it was found that higher intake of ultra-processed foods was linked to moderate-to-high MS severity compared with lower intake. These results are preliminary and need further research for validation.

The researchers noted that processed foods tend to have large amounts of additives, which, when processed, can produce harmful substances that lead to oxidative stress and chronic disease. Additionally, ultra-processed foods are associated with low-grade inflammation. Both oxidative stress and inflammation can negatively affect the immune system, which is involved in MS.

Dietary Friends

A wealth of research indicates that the Mediterranean diet is an especially healthy eating plan and is linked to a reduced risk of chronic disease, including neurodegenerative diseases such as MS, according to a study published in Nutrients. The Mediterranean diet is rich in nutrient-dense foods that promote health.

According to some studies, fatty fish is one of its most beneficial components.

Fatty Fish

Fatty fish is a good source of a healthy fat known as omega-3 polyunsaturated fatty acids.

A cohort study published in Nutrients, involving 502,507 individuals aged 40 to 69 years, used dietary intake information from the UK Biobank to explore possible links between food and MS. Cohort studies are observational investigations that follow participants over time.

After comparing dietary records with MS diagnoses, the researchers determined that moderate intake of fatty fish was linked to a reduced risk of MS compared with no intake. The protective effect was associated with eating the fish once, twice, or more per week. Intriguingly, eating fatty fish once per week was marginally more protective than eating it two times or more per week.

Aside from having a protective effect against MS, fatty fish may also be associated with less severe cases. A study published in Multiple Sclerosis and Related Disorders evaluated dietary records from 180 people diagnosed with early MS.

The investigators found that higher intake of omega-3 fatty acids was linked to more normal-appearing white matter in the brain. Part of the pathophysiology in MS stems from abnormal structural changes in white matter, reported research published in the American Journal of Neuroradiology.

When asked whether the benefit for white matter would translate to less symptoms or a less severe progression of MS, Casaccia replied, “I would say yes, as integrity of white matter tracts would indicate less damage.”

Casaccia added that marine sources of omega-3 fat include the fatty fish varieties of salmon, mackerel, sardines, anchovies, and herring, as well as algae. Nonmarine sources of omega-3 fatty acids include chia seeds and walnuts.

Mediterranean Diet

In addition to fatty fish, the Mediterranean diet is rich in fruits, vegetables, beans, seeds, nuts, olive oil, and minimally processed grains. It also includes a moderate amount of dairy foods and is low in red meat.

The study above, published in Nutrients, evaluated people with MS in Italy to see whether adherence to the Mediterranean diet could affect the severity of the condition. Using data from dietary diaries and MS clinical scores, the researchers found that higher adherence to the Mediterranean diet and higher fiber intake were linked to lower MS severity.

The researchers noted that foods in the Mediterranean diet contain nutrients that can reduce neuroinflammation and improve the composition of the gut microbiome. Fruits, vegetables, and beans contain fiber and antioxidants, such as vitamins and polyphenols. Olive oil contains polyphenol antioxidants, and as aforementioned, fish is plentiful in omega-3 fatty acids.

Fiber fermentation produces substances with immune-enhancing effects that regulate inflammation, and researchers hypothesize that they also may have a positive effect on the gut microbiome. Polyphenols have neuroprotective and antioxidant properties and omega-3 fatty acids counter neuroinflammation.

Vitamin D Foods

The Mediterranean diet contains several foods that are good sources of vitamin D, a nutrient that plays a role in MS. A review published in Neurology and Therapy looked at research on the connection between vitamin D and MS and concluded that low levels of vitamin D are linked to increased risk and severity of MS. Vitamin D has several properties that enhance immunity.

In an email to The Epoch Times, Dr. Rabih Kashouty, neurologist and medical director of Premier Neurology & Wellness Center, said, “Foods like egg yolks, fatty fish, fortified dairy products, and beef liver have significant Vitamin D content and are highly recommended for MS patients.”

The Dietary Difference

Taking steps to improve one’s diet can take considerable effort. Is it worth it? How much of a difference can diet make in the debilitating symptoms of MS?

“Many studies have identified crucial links between dietary choices and the progression of MS,” Kashouty said. “They reinforce that lifestyle choices, such as diet, can have a profound impact on the course of many neurological diseases, including MS.”

Thus, efforts of those with MS, such as avoiding or limiting processed foods and focusing on the nutrient-dense foods of the Mediterranean diet as defined above, are well worthwhile.

If people find it challenging to switch from a diet that is largely processed to a healthy eating plan such as the Mediterranean diet, they may wish to make one change at a time. For instance, they could start eating more fruits and vegetables. Those who experience difficulty could benefit from getting personalized guidance from a dietitian.