MULTIPLE SCLEROSIS

C A L LY B Y R N E
PRECEPTOR: LISA PLUNGAS, MS RD
S C I R O TAT I O N

BACKGROUND
Immune-mediated disease
2.3 million people worldwide
Inflammatory cells attack CNS
Myelin
Oligodendrocytes
Underlying nerve fibers

Four disease courses

Relapsing-remitting MS (RRMS)
Secondary-progressive MS (SPMS)
Primary-progressive MS (PPMS)
Progressive-relapsing MS (PRMS)

SYMPTOMS & COMPLICATIONS

Fatigue
Difficulty Walking
Numbness
Spasticity
Weakness
Vertigo
Bladder problems
Sexual problems
Pain
Cognitive Changes
Emotional Changes
Depression
Paralysis
Epilepsy

RISK FACTORS

Age
Sex
Family Hx
Certain Infections
Race
Climate
Autoimmune diseases
Smoking

POSSIBLE CAUSES OF MS
Genetic factors
Environmental factors
Geography
Distance from equator

Demographics
Migration patterns
Infectious causes
Smoking
Vitamin D

TREATMENT OF MS
No cure
Focus:

Slow progression
Treat relapses
Manage symptoms
Improve function and safety
Address emotional health

IDT approach

NUTRITION

SPECIALTY DIETS
Mediterranean Diet

Emphasis: WG, veg, fruits, legumes, olive oil and fish

Limits: sat fats, red meat, poultry, dairy products
No data for role of MD in MS
Meta-analysis of 17 RCTs benefit of MD on inflammation

McDougall Diet
Low-fat, High carb, Moderate sodium, Vegan
No data for role in MS

Gluten Free Diet

No data for role in MS
Same prevalence of anti-gliadin and anti-TTG antibodies as
healthy controls

PALEO DIET
Components
Game meats, plant based foods
(besides cereals)
Limits gluten containing grains
Animal protein: 30-35% of daily
caloric intake

Evidence
Small (n=10) uncontrolled trial
Effect of modified Paleo diet on
people w/ SPMS
Significant improvement in fatigue
Study involved other healthy
lifestyle practices

Wahls Protocol

SWANK DIET
Components
Low fat
Saturated fat <15 g/day
Unsaturated fat/oils 20-50 g/day

Whole grain cereals and pastas

Two cups (ea.) fruits and vegetables

Evidence
1970 observational report
20 yr period

Diet reduced occurrence of relapses,

accumulation of disability and mortality
Limitations
No control
No standardized scoring system

VITAMIN D

CONCLUSIONS
Well-balanced, planned diet
No MS diet
More systematic evaluation needed

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QUESTIONS?