Health And Wellness

Introduction

The Health and Wellness column features news and information about diet, exercise, and various alternative therapies that some people may be considering as an adjunct treatment for their MS. These articles will often include theories and personal experiences that have yet to be proven in a clinical setting. When reviewing this information, please remember that more studies may be needed before any given assumptions can be validated. Additionally, MSAA does not endorse any specific product or treatment. All changes to one's diet, exercise, treatment, or lifestyle, should only be done under the guidance of a medical professional.

This issue's Health and Wellness column features the third of three articles on nutritional factors and MS. These have been written by Ashton Embry, PhD, a research scientist whose son was diagnosed with MS nine years ago. Since that time, Dr. Embry has been doing his own research on scientific evidence pointing to various nutritional factors that could potentially play major roles in the onset and progression of MS. Readers should note that more studies are needed to prove whether or not nutritional factors are actually involved with MS.

Food Proteins and Multiple Sclerosis

The basic disease process of MS is thought to involve the activation of myelin-sensitive immune cells that subsequently lead an autoimmune attack on myelin in the central nervous system (CNS). In other words, the body's own disease-fighting cells become activated and attack its own myelin (the protective covering to nerves in the CNS) along with the nerves themselves. This leads to myelin and nerve destruction and the occurrence of the many symptoms and sometimes disabilities that characterize MS. Two obvious strategies for slowing the MS disease process are therapies that (a) decrease the activation of the autoaggressive immune cells ("autoaggressive" is a term that refers to an attack on self by the immune system) and (b) those which suppress the actions of the autoimmune cells that become activated.

Vitamin D, which was the subject of the last column in this series on nutrition and MS, may have the ability to suppress autoaggressive immune cells and hence its potential value as a therapy for MS. This article summarizes the scientific evidence that suggests how various food proteins may be playing a role in the activation of the autoaggressive immune cells. If this is indeed happening, then avoidance of those food proteins might well help to decrease the activation of myelin-sensitive immune cells and thus be of benefit for controlling MS.

Scientific evidence points to proteins derived from dairy products as possibly being involved in the MS disease process. An epidemiological study showed a correlation between the prevalence of MS in a country and the amount of milk consumed in that country (1). Subsequent immunological studies demonstrated that protein fragments from milk closely resemble parts of proteins associated with myelin. Researchers then demonstrated that these "mimicking" milk proteins can activate immune cells that are sensitive to myelin (2).

As a final part of this study, the researchers showed that injection of the milk protein into laboratory animals caused EAE, a disease which closely resembles MS. Thus it appears that milk proteins have the potential to activate autoaggressive immune cells that attack myelin. In another, yet to be published study, a researcher demonstrated that mice fed a diet with no proteins did not develop EAE despite being primed to do so. When milk was added to the diet of the mice they developed EAE* (please see editor's notes). This study was conducted by the University of Alberta. It is also worth noting that diverse research, including small clinical trials, has implicated milk in closely related autoimmune diseases such as type 1diabetes, rheumatoid arthritis, and Crohn's Disease.

Another source of potentially problematic proteins relates to wheat, rye, and barley grains, all of which contain gluten, a complex mix of proteins. Gluten has been identified as the cause of two autoimmune diseases, celiac disease and dermatitis herpetiformis. This establishes that food proteins can play a substantial role in the onset and progression of certain autoimmune diseases.

The evidence linking gluten to MS is not strong. Researchers have noted that areas of high rates of MS coincide with areas of major gluten grain cultivation and consumption (3). No studies have been done on determining if proteins in gluten grains are "molecular mimics" of myelin proteins. However, it has been established that protein fragments from gluten grains closely resemble parts of self-proteins in the joints and pancreas (4). These grain-derived proteins can activate autoaggressive immune cells that are part of the disease process in rheumatoid arthritis or type 1 diabetes. Avoidance of gluten has been found to reduce symptoms in rheumatoid arthritis and Crohn's Disease. Another relevant study demonstrated that adding gluten to the diet of genetically susceptible mice (5).

The last food type that is suspected of contributing to autoimmune diseases such as MS, rheumatoid arthritis, and type 1 diabetes is legumes (beans). Like gluten, legumes have been found to yield protein fragments that closely resemble self-proteins in the pancreas and in joints. Soy, a commonly consumed legume, can cause genetically susceptible mice to develop type 1 diabetes (6). No epidemiological or immunological studies have been done for legumes and MS.

In summary, dairy products, gluten grains, and legumes have all been suspect in autoimmune diseases, including MS. Notably, these food types are some of the most allergenic foods and this further demonstrates a potential lack of compatibility between these food types and the human immune system.

Such a potential lack of compatibility may be explained by the fact that these foods have been added to the human diet relatively recently, during the agriculture revolution over the last 10,000 years. This may seem like a long time but it is extremely short when compared with four million years of human evolution. It is postulated that humans have not had sufficient time to adapt to such foods and that part of the population still carries genes that result in immune problems caused by these food types (7). Autoimmune reactions may well be one of the associated immune problems.

Some people with MS are choosing to avoid eating dairy products, gluten grains, and legumes because they do not want to take the chance that such foods might be activating myelin-sensitive immune cells. Such a substantial change in dietary habits can be accommodated with a few strategies. Dairy products are the main source of calcium for many people and thus, if dairy products are not eaten, a calcium supplement of 1000 mg is essential. Rice products such as rice breads and pastas can readily be substituted for gluten grain products. Legumes tend to be a minor component of most people's diet and increased vegetable intake readily compensates for any nutritional losses associated with avoiding legumes.

At this stage, researchers do not know if milk products, gluten grains, and legumes are contributing to the MS disease process by activating autoaggressive immune cells. All that may be said is that such foods could potentially play a role. Each person with MS may consider the information available and decide whether to avoid certain foods or wait until the scientific evidence is conclusive. -- Ashton Embry, PhD

*Editor's notes: While EAE in animals is similar to MS in humans, it is not the same. Treatments that have been effective in treating EAE in rodents do not necessarily help in the treatment of MS. For this reason, findings with EAE cannot be directly correlated with MS. Additionally, any role that milk plays in MS may only be considered as theory at this time; no conclusive evidence has been found to definitively link milk with the onset or worsening of MS.

As stated in the introduction, MSAA does not endorse any specific product or treatment. All changes to one's diet, exercise, treatment, or lifestyle, should only be done under the guidance of a medical professional. Readers should note that more studies are needed to prove whether or not nutritional factors are actually involved with MS.

References:

1. Freedman DM, Dosemeci M, Alavanja MC: Mortality from multiple sclerosis and exposure to residential and occupational solar radiation: a case-control study based on death certificates. Occup Environ Med, 2000; 57: 418-421.
2. Van der Mei IAF, Ponsonby A, Dwyer T, et al: Past exposure to sun, skin phenotype, and risk of multiple sclerosis: case-control study. BMJ, 2003; 327: 316-321.
3. Munger KL, Zhang SM, O'Reilly E, Hernan MA, Olek MJ, Willett WC, Ascherio A: Vitamin D intake and incidence of multiple sclerosis. Neurology, 2004 Jan 13;62(1):60-5.
4. Goldberg P, Fleming M, Picard E: Multiple Sclerosis: Decreased relapse rate through dietary supplementation with calcium, magnesium and vitamin D. Medical Hypotheses, 1986; 21: 193-200.
5. Nordvik I, Myhr KM, Nyland H, et al: Effect of dietary advice and n-3 supplementation in newly diagnosed MS patients. Acta Neurol Scand, 2000; 102: 143-149.
6. Embry AF, Snowdon LR, Vieth R: Vitamin D and seasonal fluctuations of gadolinium-enhancing magnetic resonance imaging lesions in multiple sclerosis. Ann Neurol, 2000; 48: 271-272.
7. Eaton SB, Eaton SB 3rd, Paleolithic vs. modern diets--selected pathophysiological implications. Eur J Nutr. 2000 Apr;39(2):67-70.

Back