Diet and Nutrition Steer MS Disease Course

Maintaining general good health is important for patients who have multiple sclerosis (MS) or any chronic disorder, according to the National Multiple Sclerosis Society, which notes that a well-balanced diet plays a key role.

Accordingly, the finer points of how patients with MS are affected by diet and nutrition-as well as alcohol intake-were featured in studies reported at the American Academy of Neurology’s Annual Meeting held in late April in Washington, DC.

Turn the pages for a brief overview of the AAN 2015 diet, nutrition, and alcohol study highlights.

Diet Could Decrease Inflammation, Fatigue in RRMS

• Italian researchers looked at whether the disabling fatigue often experienced in relapsing-remitting multiple sclerosis (RRMS) could be associated with diet and related changes in body composition.

• The study included 17 patients (mean age, 37.4 ± 2.3 years) with RRMS (mean duration, 9.7 ± 1.7 years; mean Expanded Disability Status Scale [EDSS] score, 1.3 ± 0.2).

• Intervention: 6-week diet modification consisting of foods low in saturated fat from animal sources and high in antioxidants; calorie content matched to energy expenditure of each patient.

• Measurements: Patients underwent body composition evaluation that used impedance analysis, and evaluation of fatigue that used modified fatigue impact scale (MFIS), both before and after diet intervention.

Diet Low in Saturated Fat, High in Antioxidants Fights RMMS Fatigue

• Following the diet led to significant (p <0.01) decreases in:

• Percent body fat (%: 30.8 ± 1.8 vs 32.5 ± 2.0).
• Body fat mass (kg: 22.7 ± 2.3 vs 20.7 ± 1.9).
• Visceral fat mass (cm²: 88.9 ± 8.7 vs 96.02 ± 10.4).

• Following the diet also was associated with significant (p <0.001) improvement in:

•  MFIS score (25.0 ± 4.9 vs 43.3 ± 5.6).
•  Physical, cognitive, and psychosocial functioning.

• Conclusion: Even short-term compliance with a diet low in saturated fat from animal origins and high in antioxidants can result in significant improvement in fat tissue found in body areas linked to inflammation, as well as reduce fatigue in patients with RMMS.

Alcohol Intake Linked to Lower MS Disability and Severity

• Evidence about the effect of alcohol on MS risk is conflicting. Alcohol’s effect on MS disease course has not been studied.

• A Harvard study looked at 908 patients (73% female; mean age, 47 ± 11 years; mean disease duration, 13 ± 9 years) involved in the Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women’s Hospital (CLIMB) study.

• Servings per week of alcohol and red wine were assessed with self-administered questionnaires.

• Researchers evaluated influence of alcohol and red wine on MS clinical outcomes, controlling for age, gender, disease duration, time to first treatment, and cumulative proportion of time on disease-modifying therapies.

Alcohol Intake and MS Relapse: No Significant Relationships

• Women with higher alcohol intake had significantly lower EDSS scores (p=0.015) and multiple sclerosis severity scores (MSSS; p=0.003).

• Drinking red wine was linked to lower EDSS scores (p=0.57) and MSSS (p=0.64), although results were not significant.

• No significant relationships were found between alcohol or red wine intake and relapse rate in the past year, change in EDSS score or MSSS over 1 year, or current or change in Symbol Digit Modalities Test score, which screens for cerebral dysfunction.

• Conclusion: Higher alcohol intake is linked to lower MS disability and severity. The study could not evaluate cause-effect relationships and underlying mechanisms, which require further study.

Take-Home Points:

• Disabling fatigue often experienced in RRMS could be associated with diet and related changes in body composition.

• Even short-term compliance with a diet low in saturated fat from animal sources and high in antioxidants can result in significant improvement in fat tissue found in body areas linked to inflammation and reduce fatigue in patients with RRMS.

• Women with MS who had higher alcohol intakes had significantly lower disability and severity scores.

• There were no significant relationships between alcohol or red wine intake and relapse rate and tests of cerebral dysfunction.