Current Evidence about Diet and MS

Stuart SchlossmanNational MS Society Related, Nutrition


                                                                  

DIET AND MULTIPLE SCLEROSIS
     By:Pavan Bhargava, MD

Introduction
Multiple Sclerosis is a chronic immune-mediated demyelinating disorder that affects the
central nervous system (CNS). In MS, inflammatory cells of the immune system
(including T cells, B cells and others) are believed to target cells and tissues within the
CNS, causing inflammation and damage to myelin, nerve fibers and the cells that make
myelin. Several genetic and environmental factors that influence the risk for developing
MS have now been identified. Perhaps the most significant dietary factor that has been
linked with the occurrence of MS and its disease course is vitamin D.
1,2
Another recent dietary factor associated with autoimmunity is high salt intake.
3 Ongoing
research is also demonstrating a link between the gut microbiota (bacteria in our gut)
and MS.
4 Diet plays an important role in shaping our gut microbiota and is also
implicated in multiple other chronic diseases (type 2 diabetes, obesity, hypertension).
There is increasing interest in the possible role of diet in autoimmunity and in the role of
dietary interventions in diseases such as MS.

Possible mechanisms by which diet may have an effect on MS –

1. Direct effects on the immune system: 
Recent immunological research has shown
that metabolism plays an important role in the function of several types of
immune cells. Additionally several immune cells have receptors (surface
structures that allow cells to connect and communicate with other cells) for
various types of dietary metabolites (vitamin D, fatty acids). Thus intake of
certain types of fats has been linked to greater inflammation while intake of
polyunsaturated fatty acids (PUFAs) has the opposite effect.

Indirect effects through modulation of the gut flora:
The gut bacteria metabolize
certain components of the diet into short chain fatty acids that, besides helping
in colonic health, can also act on immune cells and make T cells more
regulatory.
 Additionally diet can lead to alterations in the gut bacterial
composition that can shift the immune system towards a pro- or antiinflammatory
state.

 Effects on components of the central nervous system: 
As mentioned above,
since altered metabolism may play a role in the adaptation of the nervous
system to damage, various experimental foods and diets are being studied for




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