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MS research update - Can a change in diet help MS? - 19 December 2012

There has been a lot of debate about whether a particular type of diet or dietary supplement can help MS. There is plenty of information available in books, magazines and on the web, much of it contradictory. Opinions range from saying that there is no benefit at all to suggesting that MS can effectively be cured by particular diets.

People with MS are often keen to self manage their condition so that they can be as well as possible. Having the right diet might be one way to do this and there is always a high level of interest in what the best diet might be. Consequently, any research that sheds light on this is very welcome.

How this study was carried out

There had already been some research into diet and dietary supplements in MS but the results were often not clear cut. This Cochrane Database Systematic Review pooled the results of previous high quality research to see if any clear evidence existed overall.

The researchers had a number of aims:

  • To review how effective and safe the diets were
  • To see whether changes in diet helped MS
  • To look at any side effects of changes in diet
  • To examine any interactions between changes in diet and treatments for MS symptoms

They searched a number of databases of medical publications, including Medline and the Cochrane Multiple Sclerosis and Rare Diseases of the Central Nervous System Group Specialised Register. They selected controlled trials of a specific dietary intervention, diet plan or dietary supplementation (except for vitamin D supplementation). All of those selected had a control group who had either no change in diet or a placebo.

Two reviewers worked independently to select the eligible trials, assess their quality and extract the data. The results were then statistically analysed.

What was found

The key findings were:

  • Polyunsaturated fatty acids (PUFAs): Six trials, involving 794 people, showed no significant difference in disease progression after 24 months.
  • Omega-6 fatty acids (11 to 23 g/day linoleic acid): No benefit was seen in 144 people with MS
  • Linoleic acid (2.9 to 3.4 g/day): No benefit in 65 people with progressive MS
  • Omega-3 fatty acids: No benefit in 292 people with relapsing remitting MS
  • Omega 6 fatty acids: possibly a small benefit on relapses but only in some studies

It was not possible to draw any conclusions about how safe the dietary changes were. Overall, the quality of the trials was poor. None of the trials of vitamin supplementation or allergen free diets met the criteria for inclusion in the analysis.

What does it mean?

Despite the careful analysis in this study, there is no strong evidence that changes in diet can make a difference in MS.

Farinotti M, Vacchi L, Simi S, et al.
Dietary interventions for multiple sclerosis.
Cochrane Database Syst Rev. 2012 Dec 12;12:CD004192.
abstract

More about diet and MS

You can read more about diet in the A to Z of MS which looks at the components of a healthy diet. 

In an article from the February 2012 issue of Open Door, the MS Trust's quarterly newsletter, a dietitian looks at the influence of nutrition on both the risk and progression of MS.

More about Cochrane reviews

This research was a Cochrane Review which is a systematic review of the best available evidence about a particular healthcare intervention. These reviews explore the evidence for and against the effectiveness and appropriateness of treatments in specific circumstances.

Cochrane reviews are produced by the Cochrane Collaboration, an international, not for profit, independent organisation, and are highly regarded. You can read more about Cochrane reviews in the A to Z of MS.

Research by topic areas...

Diagnosis

Sombekke MH, Wattjes MP, Balk LJ, et al.
Spinal cord lesions in patients with clinically isolated syndrome: a powerful tool in diagnosis and prognosis.
Neurology. 2012 Dec 12. [Epub ahead of print]
abstract

MS relapses

Burton JM, O'Connor PW, Hohol M, et al.
Oral versus intravenous steroids for treatment of relapses in multiple sclerosis.
Cochrane Database Syst Rev. 2012 Dec 12;12:CD006921.
abstract

Disease modifying treatments

He D, Xu Z, Dong S, et al.
Teriflunomide for multiple sclerosis.
Cochrane Database Syst Rev. 2012 Dec 12;12:CD009882.
abstract

Comi G, Martinelli V, Rodegher M, et al.
Effects of early treatment with glatiramer acetate in patients with clinically isolated syndrome.
Mult Scler. 2012 Dec 12. [Epub ahead of print]
abstract

Nolan R, Gelfand JM, Green AJ.
Fingolimod treatment in multiple sclerosis leads to increased macular volume.
Neurology. 2012 Dec 5. [Epub ahead of print]
abstract

Dinkin M, Paul F.
Higher macular volume in patients with MS receiving fingolimod: positive outcome or side effect?
Neurology. 2012 Dec 5. [Epub ahead of print]
abstract

Singer B, Bandari D, Cascione M, et al.
Comparative injection-site pain and tolerability of subcutaneous serum-free formulation of interferonbeta-1a versus subcutaneous interferon beta-1b: results of the randomized, multicenter, Phase IIIb REFORMS study.
BMC Neurol. 2012 Dec 6;12(1):154. [Epub ahead of print]
abstract

Other treatments

[No authors listed]
What place for cannabis extract in MS?
Drug Ther Bull. 2012 Dec;50(12):141-4.
abstract

Bolinger R, Engberg S.
Barriers, complications, adherence, and self-reported quality of life for people using clean intermittent catheterization.
J Wound Ostomy Continence Nurs. 2012 Dec 5. [Epub ahead of print]
abstract

Epidemiology

Giordano A, Ferrari G, Radice D, et al.
Self-assessed health status changes in a community cohort of people with multiple sclerosis: 11 years of follow-up.
Eur J Neurol. 2012 Dec 6. doi:10.1111/ene.12028. [Epub ahead of print]
abstract

Quality of life

Baumstarck K, Reuter F, Boucekine M, et al.
Relevance of quality of life assessment for multiple sclerosis patients with memory impairment.
PLoS One. 2012;7(12):e50056.
abstract

Schiavolin S, Leonardi M, Giovannetti AM, et al.
Factors related to difficulties with employment in patients with multiple sclerosis: a review of 2002-2011 literature.
Int J Rehabil Res. 2012 Dec 12. [Epub ahead of print]
abstract

Kuspinar A, Rodriguez AM, Mayo NE.
The effects of clinical interventions on health-related quality of life in multiple sclerosis: a meta-analysis.
Mult Scler. 2012 Dec;18(12):1686-704.
abstract

Paediatric MS

Holland AA, Graves D, Greenberg BM, et al.
Fatigue, emotional functioning, and executive dysfunction in pediatric multiple sclerosis.
Child Neuropsychol. 2012 Dec 7. [Epub ahead of print]
abstract

Psychological aspects

Senders A, Wahbeh H, Spain R, et al.
Mind-body medicine for multiple sclerosis: a systematic review.
Autoimmune Dis. 2012;2012:567324.
abstract

Simioni S, Schluep M, Bault N, et al.
Multiple sclerosis decreases explicit counterfactual processing and risk taking in decision making.
PLoS One. 2012;7(12):e50718.
abstract

Physical activity

Motl RW, Pilutti L, Sandroff BM, et al.
Accelerometry as a measure of walking behavior in multiple sclerosis.
Acta Neurol Scand. 2012 Dec 13. doi: 10.1111/ane.12036. [Epub ahead of print]
abstract

Prognosis

Ferreira Vasconcelos CC, Cruz Dos Santos GA, Thuler LC, et al.
African ancestry is a predictor factor to secondary progression in clinical course of multiple sclerosis.
ISRN Neurol. 2012;2012:410629.
abstract

Giorgio A, Battaglini M, Rocca MA, et al.
Location of brain lesions predicts conversion of clinically isolated syndromes to multiple sclerosis.
Neurology. 2012 Dec 5. [Epub ahead of print]
abstract

Pathophysiology

Kooi EJ, Strijbis EM, van der Valk P, et al.
Heterogeneity of cortical lesions in multiple sclerosis: clinical and pathologic implications.
Neurology.2012 Sep 25;79(13):1369-76.
abstract

CCSVI

van Zuuren EJ, Fedorowicz Z, Pucci E, et al.
Percutaneous transluminal angioplasty for treatment of chronic cerebrospinal venous insufficiency (CCSVI) in multiple sclerosis patients.
Cochrane Database Syst Rev. 2012 Dec 12;12:CD009903.
abstract

Falls

Gunn HJ, Newell P, Haas B, et al.
Identification of risk factors for falls in multiple sclerosis: a systematic review and meta-analysis.
Phys Ther. 2012 Dec 13. [Epub ahead of print]
abstract

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