Nutrition and Multiple Sclerosis - Part 2
Multiple Sclerosis and Individual Nutrients
Various research has been done on the relationship between specific supplements and foods and multiple sclerosis.
Vitamin B3 is a water soluble vitamin which is also known as niacin. It is a member of the B vitamin groups of vitamins. It comes in two forms, nicotinic acid and nicotinamide. B3 is found in whole grains, nuts, meat, poultry, oily fish, eggs, dairy produce, dried fruit and yeast extract. It is important for normal growth and development as well as enzyme function, energy production, depression and fatty acid processing. In a comparative study on mice with EAE (experimental allergic encephalomyelitis, the animal version of multiple sclerosis) in the Children's Hospital in Boston showed that the degeneration of nerve fibres was much less in those who were treated (He, 2006). However, I have found no research as yet on people.
Vitamin B12 is another member of the B vitamin group, it is a water soluble vitamin also known as cobalamin. It occurs naturally in offal, oily fish, red meat, white fish and dairy products. It is important in myelin production because of its vital role in the metabolism of fatty acids which are essential for the maintenance of myelin, it is required for the methylation reaction that lead to its production. Symptoms of B12 deficiency are numbness and tingling in the arms and legs, loss of balance and fatigue. A more severe deficiency will lead to a breakdown of the myelin sheath. Therefore there is a very strong similarity between multiple sclerosis and a B12 deficiency.
Research (Ransohoff, 1990; Reynolds, 1992; Sandyk, 1993) shows that nearly all multiple sclerosis patients are deficient in B12 but they showed no sign of pernicious anemia, which is usually linked with this and more recent studies have shown that low levels of B12 are linked with the early start of multiple sclerosis. Other research has also showncome up with similar results
Folic Acid and sugar
Folic Acid is another B vitamin which seems to help multiple sclerosis. It is found naturally in fruit, green leafy vegetables, nuts, pulses and yeast extract. It is also added to many foods. It is important for many metabolic reactions and protein and sugar metabolism. Deficiency in folic acid can lead to a red sore tongue, anaemia, diarrhoea, tiredness, insomnia and muscle cramps and weaknesses. Swiss doctors believe that folic acid stops damage from toxic compounds called aldehydes caused by an incomplete breakdown of dietary sugar which can lead to myelin damage (Henzi and Schwyzer, 1992). Obviously in this case sugar should be kept to a minimum.
Vitamin D is a water soluble vitamin and it also known as cholcalciferol. It is important for absorption of calcium and the formation of bones. It also helps with skin and a deficiency can lead to constipation, muscle weakness, lowered immunity, increase susceptibility to infection, poor growth, irritability, bone pain, bone deformities and deafness.
There has been plenty of research in recent years into the correlation between multiple sclerosis and vitamin D (Goldberg, 1974a; Goldberg, 1974b; Nieves et al, 1994; Hayes, 2000; van der Mei et al, 2003; Munger et al, 2004; VanAmerongen et al, 2004). Vitamin D primarily comes from the effect of sunshine on the skin, about 90% of it is received this way. Food sources of vitamin D are fish oils and some vegetables and it is added to some milk, cereals and breads. Unfortunately because of the use of sunscreens and less time spent outdoors our intake of this vitamin has substantially reduced. This is particularly a problem with children since there is a link between high exposure to sun between the ages of 6 and 15 and a third decreased risk of multiple sclerosis (van der Mei et al, 2003). As well as multiple sclerosis, vitamin D deficiency has been linked to heart and lung disease, cancer, diabetes and schizophrenia. The correlation with sunlight is considered to be the reason why there is a seasonal fluctuation with the condition, it is also noticeable that those people who live where there is more sunlight, are less like to develop multiple sclerosis. In a prospective study by Dr Munger (2004) at Harvard University on 190,000 women showed that women who take vitamin D supplements are 40% less likely to develop multiple sclerosis. A random, double blind study at Pennsylvania State University indicates that a daily dose of vitamin D of 1000IU has a positive effect on multiple sclerosis (Cantorna, 2000).
Vitamin D normalises immune function and enhances immune cell production which then reduces abnormal inflammatory responses. Activated vitamin D (1,25(OH)2D) is one of the most potent inhibitors of cellular proliferation and inducers of cellular maturation and has important immunomodulatory activities on B and T lymphocytes. Vitamin D receptors are found in many parts of the body. It also helps to maintain normal blood levels of calcium and phosphorus. (Long and Santos, 1999; Deluca and Cantorna, 2001; Ghezzi and Zaffaroni, 2001).
There is some support to the theory that myelin breakdown is caused by free radicals, which occur when the body is exposed to some toxic chemicals (Syburra and Passi, 1999). These free radicals can be removed from the body by taking antioxidants, a range of nutrients of which the most common are vitamins A, C and E and selenium. Antioxidants are found in fruit and vegetables. Research by Pradip (1991) in Chicago showed that those who had attacks of multiple sclerosis had higher levels of by-products of this action by free radicals than those who were in remission. Research shows that antioxidants and fatty acids together help reduce the symptoms of multiple sclerosis (Mai, 1990; van Meeteren, 2005).
Vitamin E is a potent antioxidant and helps counteract the effect of oxidation that can increase the symptoms of multiple sclerosis (van der Goes, 1998)
Coenzyme Q10 is another antioxidant that is indicated with multiple sclerosis (de Bustos, 2002; Kidd, 2005). It is also known as ubiquinone and it improves energy production and oxygen utilisation. It is an antioxidant that helps with protection of body fats and healing the blood brain barrier.
Grape seed extract is high in oligomeric proanthocyanidins which make it a particularly potent antioxidant (Bagchi, 2000; Ray, 2000).
Pycnogenol is the extract from the maritime pine tree and it contains a large number of proanthocyanidins and bioflavonoids which means it is an excellent antioxidant.
Probiotics are the good bacteria in the intestine. They help to keep out the bad bacteria and to digest your food. They include acidophilus and are very important to ensure that the digestive system is working efficiently as this is beneficial to general health. If this is not the case then the food and supplements taken will not be properly absorbed and so the body will still be deficient (Uhlenhuth, 2001). Natural sources of probiotics are live yoghurts and fermented milk drinks.
Glucosamine is a naturally occurring substance in the body. It is important for healthy joints, nails, tendons, skin, eyes, bones, ligaments and mucous membranes. It has been found to reduce the progression of EAE (experimental allergic encephalomyelitis, the animal form of multiple sclerosis) in rats, but as yet there is not enough information on its effects on multiple sclerosis (Zhang et al, 2005; The MS Society, 2006). However, it seems to be perfectly safe and is used for many other conditions, primarily arthritis.
We have, for a long time, been told that fats are bad for us. Whilst many fats are, some are not, and these good fats are essential to the effective functioning of the brain. This is due to the fact that about two thirds of the brain is composed of fats and the membranes of the neurons are composed of a thin double layer of fatty acid molecules (de Vries, 2002). Unfortunately, because these fats are often easily destroyed by light and heat, they are removed from food in order to increase its shelf life. There are three groups of essential fatty acids, the omega-3s, the omega-6s and the omega-9s. So far, not much research has been done on the omega-9s. There are a range of fats in each of these groups, many of which can be made from other fats in the same group by most people. However, to ensure adequate intake, supplements should contain the whole range. There are four types of fats that our bodies process from food, these are cholesterol, saturated fat, monounsaturated fats and polyunsaturated fats. The polyunsaturated fats include the essential fatty acids. The omega-3 fatty acids cannot be made by the body from the other fats it absorbs, therefore they are termed essential fatty acids because it is essential that they are provided in the diet. The balance between the omega-3s and the omega-6s is very important and in the modern day diet the proportions are out of balance. Therefore it is important to have more omega-3s in order to stabilise the ratios. Essential fatty acids (EFAs) are essential for immunity, production of hormones, good digestion and absorption, nerve cell function and learning. Myelin contains high levels of polyunsaturated fatty acids, including omega-3 and omega-6 and these are essential for brain and nerve development and function.
The leading omega-6 essential fatty acid is linoleic acid. Levels of linoleic acid can be increased by supplementing with evening primrose oil or borage oil, which supply the biologically active linoleic derivative, gamma linoleic acid (GLA). Proper essential fatty acid supplementation may also improve dryness of the skin and hair and brittle nails (Brewer, 2002). The best natural sources of fatty acids are linseed oil, fish oils, walnuts, beans, whole grains, chestnuts, soya beans and pumpkin seeds.
Flax seed oil supplies alpha linoleic acid which is deficient in many diets because of food processing and dietary choices. Fish oils also supply decosahexanoic acid (DHA) and are an excellent source of vitamin D and fatty acids (Matthews, 2005). DHA is the omega-3 essential fatty acid with the highest concentration in the brain. Inadequate DHA levels result in memory loss and other neurological problems . Decosahexaenoic acid is a polyunsaturated fatty acid found in oily fish, it has been proved to help mental agility, memory and multiple sclerosis. Arachidonic acid is an omega-6 fatty acid which is abundant in the brain. Like DHA, arachidonic acid is an important structural component of cell membranes in the eye and brain where it helps facilitate healthy communication between nerve cells. DHA plays an important role in repairing the myelin sheath due to it being found in high concentrations in the myelin sheath (Lin, 2000).
Fish oil supplements consist of oil from cold water fish like mackerel salmon, tuna, sardine and herring and these are important because of their omega-3 fatty acid content. Other sources of omega-3s are flaxseed oil and walnut oil. Omega-3 fish oils are known to reduce inflammation in allergic conditions (Hoff et al, 2005).
There has been much research on the relationship of fatty acids and multiple sclerosis (Field and Shenton, 1975; Pradip et al, 1991; Shumin et al, 2000; Weinstock-Guttman et al; 2003 Nordvik et al, 2005; van Meeteren, 2005). The research by Dr Weinstock-Guttman on 29 patients found that those patients put on low fat diet with a polyunsaturated fatty acid supplement had fewer attacks and less worsening of disability. Research by Klaus Lauer (1997) in Germany showed that 20-25g a day of omega-6 fatty acids reduced the severity of multiple sclerosis in new cases, but didn't seem to have any effect on those who had had the condition for some time.
Ginkgo biloba is an antioxidant which comes from the leaves of the tree of the same name and is popular for help with memory and mental functioning and is known to help Alzheimer's Disease (Stadtarztlicher Dienst, 2000). It is also taken for dizziness, depression and peripheral circulation. A recent study suggests that it helps attention in those with multiple sclerosis who have cognitive impairment (Modie, 2005).
DHEA has been shown to affect moods, the immune system, skin and stress as well as a range of neurological factors (Mindell, 1995; Anderson, 2000). It is used to treat many autoimmune disorders. Research by Calabrese et al (1990) found that DHEA helped to improve the fatigue that comes with multiple sclerosis. Natural precursors to DHEA are found in wild yam.
Digestive enzymes occur naturally but can be depleted as we age. Supplementing the diet with these enzymes helps food to be properly absorbed and this can help resistance to many conditions. Systemic enzymes help to reduce waste material in the body and then increase the action of the body's self healing mechanisms, including the removal of scar tissue, which is important in multiple sclerosis (Serafini, 2006).
Calcium and Magnesium
Calcium and magnesium work together to ensure healthy nerves and muscles. They have many other functions, including controlling the stress levels in the body. In an experimental study patients were given dolomite (calcium and magnesium) and this resulted in halving of the number of exacerbations expected (Goldberg, 1986). Insufficient calcium at times of rapid myelination and growth can lead to a deficiency of enzymes required for myelin synthesis. Stress can lead to exacerbations in multiple sclerosis. (Buljevac et al, 2003).
Zinc is a trace element and is required for the function of over 200 enzymes. A zinc deficiency is very common in those with autoimmune diseases and those with depression (Williams, 1988).
- Nutrition and Multiple Sclerosis Part 3
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